A myelogram is a specific application of fluoroscopy, an X-ray technique that displays continuous images as a sort of “movie.” During a myelogram, a tiny amount of contrast dye is injected into the space surrounding the spinal cord. By observing the movement of that dye, doctors can spot abnormalities in discs, nerves and other parts of the spine and nervous system – details they might not be able to see with traditional X-rays.
What to Expect During Your Myelogram
Like other x-ray imaging techniques, myelograms are safe, painless and minimally invasive. While they do require the injection of a contrast dye, your technologist will use local anesthesia and a tiny needle to eliminate pain and reduce soreness.
You’ll lie on your stomach on a cushioned table during the injection and exam, which typically lasts for a total of 30 to 60 minutes. Throughout the exam, your table will tilt slightly at various angles to allow the radiologist to view the areas where you’re experiencing the most pain or discomfort. Your technologist will also stay by your side during the entire exam, ready to answer questions and alleviate concerns.
Frequently Asked Questions
A myelogram is a special type of X-ray or computed tomography (CT) exam that uses contrast dye to clearly image the spinal cord, nerve roots, and other tissues found in the spinal canal. When that dye is injected into the subarachnoid space – the area around the spinal cord – radiologists are able to obtain a clearer view of these tissues than they would with other imaging techniques. Like traditional X-rays and CT scans, myelograms are non-invasive, minimally painful, and extremely helpful in forming accurate diagnoses and treatment plans.
In general, myelograms are excellent for imaging the spinal cord, nerve roots, and meninges – the membranes that cover the nerves. Typically, doctors use these images to assess spinal injuries and abnormalities, including herniated discs, bone spurs, arthritis, and stenosis. In combination with magnetic resonance imaging (MRI), myelograms can also be used to find tumors, infections, and inflammation.
MRI is often doctors’ first choice for evaluating the spine, but there are a few situations in which other methods are necessary. If you have a non-removable medical device, you may not be able to undergo an MRI, and a myelogram may be the next best choice. The same can be true for patients with metal screws, plates, and rods, which can interfere with the MRI machine’s magnets.
Myelograms are also cheaper than MRI, and in some cases, they actually present information that can’t be obtained with any other imaging technique. For these reasons, myelogram is often the top choice for assessing injuries and deciding between surgical and non-surgical treatment.
At the beginning of your myelogram, you’ll be asked to lie face-down on a cushioned table, where you’ll remain for the duration of your exam. To prevent pain during the contrast dye injection, you’ll first be given a local anesthetic in your lower back. Depending upon the specific site being imaged, you may also be asked to turn onto your side.
Once you’re in position, a needle will be inserted into the subarachnoid space underneath your numbed skin. You may feel pressure and a slight warming sensation during the injection of dye, but the anesthetic will prevent pain.
With the contrast dye in place, the radiologist will tilt the exam table at a variety of angles to allow the dye to flow within the subarachnoid space. They will then use a fluoroscope, a real-time X-ray imaging device, to observe and capture the areas where you’re experiencing symptoms. Once all necessary images have been collected, the table will be returned to its normal position, and you’ll be able to move into a more comfortable position. Your technologist will be standing by throughout the procedure, ready to address any questions or concerns.
A myelogram exam typically lasts between 30 and 60 minutes, depending upon the specific area and number of images collected.
However, many doctors order a CT scan to be performed immediately following a myelogram, while the contrast dye is still in place. If you need to undergo CT as well, your appointment will take an additional 15 to 30 minutes.
In most cases, your doctor’s office will notify our staff and schedule your myelogram for you. We will then verify your health insurance coverage and obtain any necessary pre-certifications. If you don’t have health insurance, or if you’re facing a high deductible, we also offer excellent self-pay rates.
If you want to schedule your appointment on your own, or if you need to change an appointment, you can also call one of our four convenient locations. We offer same-day, evening and weekend appointments to ensure your exam fits within your normal schedule.
Our radiologists review and interpret exams as soon as the images are available. Within 24 hours, your physician will have a thorough written report, as well as copies of the myelogram images for their own inspection.
Food in the GI tract may interfere with the imaging process, and it’s important that you avoid solid foods after midnight the night before your exam. However, you may still have water, spritzer, and other clear liquids until three hours before your exam.
There are also several medications that may interfere with the contrast dye. These medications include:
- Plavix: discontinue seven days prior
- Aspirin: discontinue seven days prior
- Lovenox: discontinue 24 hours prior
There are additional considerations for patients taking Coumadin or Heparin. Coumadin must be discontinued seven days prior to your exam.Heparin must be discontinued 4 hours prior to your exam.
Finally, tell your doctor if you have a history of bleeding disorders, or if you are taking aspirin, ibuprofen, or any other blood-thinning medications.
If this seems like too much information to consider, don’t be alarmed. Our staff will contact you at least one week prior to your appointment to ensure you have the specific information you need to prepare for your myelogram. As long as you inform your doctor about your medical history and medications, our staff will be able to advise you on which precautions are truly necessary.
After your images have been collected, you’ll be escorted to another area of the AHI clinic to rest and recover for at least one hour. While the myelogram procedure isn’t painful, the contrast dye injection is deep enough to be stressful to your body, and the withdrawal of spinal fluid will require rehydration. You’ll be asked to drink additional fluids to avoid headaches, and a member of our clinical team will monitor your blood pressure, temperature, pulse, and respiratory rate.
Once you’re discharged, it’s important to keep an eye out for abnormalities such as numbness and tingling, bleeding at the injection site, trouble urinating, headaches, and achy joints. These symptoms are rare, but if they persist for more than a few hours after your exam, you’ll need to notify your physician.
Finally, you may be instructed to limit physical activity for 24 hours following your exam. Generally, if no complications occur during that time, you’ll be free to return to your normal activities.
No, it is not safe to drive immediately following your myelogram exam. Once you are discharged, you must travel with a companion. We also suggest that you limit your activity once you arrive home, and that if you have small children, you get someone to help take care of them for the rest of the day.