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Myelography by Krisha McCoy, MS

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

This is an imaging test that uses a special contrast material to view the spinal cord. Along with an x-ray , the contrast material can help your doctor clearly outline the space containing the spinal cord and nerves. An x-ray is a test that uses radiation to take a picture of structures inside the body.

Reasons for Procedure

This is used to detect problems in and around the spinal cord, such as:

Spinal tumors
Herniated disks
Narrowing of the spinal canal

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have myelography, your doctor will review a list of possible complications, which may include:

Headache
Allergic reaction to the contrast
Bleeding
Inflamed or infected spinal cord

What to Expect

Prior to Procedure

Your doctor may do the following:

Physical exam and medical history
Ask if you are pregnant—this test is not usually done on women who are pregnant
Discuss your medicines with you, as you may need to stop or change the dosing
Determine if you have any allergies
Possibly prescribe a mild sedative to help you relax

Leading up to your procedure:

The night before, do not eat solid foods after midnight. You should continue to drink liquids.
If your doctor prescribes a sedative:
- Arrange to have someone drive you home. Also, arrange for someone to help you at home.
- Take the sedative before the exam as directed by your doctor.

Anesthesia

There is usually no anesthesia with this procedure. Your doctor may give you a mild sedative. You may have local anesthetic to reduce the pain of the needle.

Description of the Procedure

You will lie on your side or face down. Or, you may sit on the edge of a table, leaning forward. You may be given a local anesthetic injection in your back.

Your doctor will insert a needle into the space between your vertebrae. A small amount of fluid will be removed from the spinal canal. Next, the contrast will be injected through the needle. Your doctor will use an imaging procedure called fluoroscopy. This combines an x-ray unit with a camera and a screen.

To take the images, you will be positioned stomach-down on the table. A brace will be against your shoulders. The table will be tipped forward. Next, the doctor will take images of your back. You will hold your breath while the images are taken. You may be asked to turn slightly to one side and then the other.

Often, your doctor will perform a CT scan after myelography. This is to see the spread of the contrast dye.

Lumbar Myelogram Injection

Immediately After Procedure

You may be asked to stay in the exam room while the doctor looks at the images. You will be able to go home after about an hour.

How Long Will It Take?

About 30-60 minutes (CT scan will take 30-60 minutes longer)

How Much Will It Hurt?

You will have some pressure or pain when the needle is inserted.

Post-procedure Care

If you took a sedative, do not drive, operate machinery, or make important decisions until the sedative wears off.
Avoid strenuous exercise (including bending over) for 1-2 days.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Headache lasting more than 24 hours
Excessive nausea or vomiting
Neck stiffness
Numbness in your legs
Trouble urinating or moving your bowels
Symptoms of allergic reaction (eg, hives , itching, nausea, swollen or itchy eyes, tight throat, difficulty breathing)
Worsening of your symptoms

In case of an emergency, call for medical help right away.

RESOURCES:

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
North American Spine Society http://www.spine.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Canadian Orthopaedic Foundation http://www.canorth.org/

References:

Herniated disc. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated August 2009. Accessed September 22, 2009.
Myelography. American Society of Radiologic Technologists website. Available at: http://www.asrt.org/content/ThePublic/AboutRadiologicProcedures/Myelography.aspx . Accessed September 22, 2009.
Myelography. Radiological Society of North America website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=myelography&bhcp=1 . Accessed September 22, 2009.

Last reviewed December 2011 by John C. Keel, MD

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