A myelogram is a type of X-ray that uses a dye or contrast material and a special machine called a fluoroscope that takes moving X-rays and displays them on a monitor.

Myelograms have many uses, including:

• Herniated discs (spinal discs that stick out beyond their normal area) that press on nerves
• Spinal stenosis (a narrowing of the bones of the spine that is often caused by osteoarthritis)
• Spinal tumors and lesions
• Infection
• Inflammation

What happens during a myelogram?

A myelogram is usually done as an outpatient procedure, and you can go home with someone who can care for you after the procedure is finished.

Before the myelogram begins, you will be injected with the contrast material, which is a substance that improves X-ray images. This material is injected into the area around the spine, usually in the lower lumbar part of the spine which is down near your hips. Sometimes your doctor may need to look more closely at the spine near your neck, so the contrast is injected into the cervical spine.

Your doctor will thoroughly clean and prepare the area for the injection. First, a local numbing medicine will be injected. Once that starts to work, the doctor will carefully insert a needle into the area around the spine. The contrast material will be injected through this needle. In some cases, a small amount of spinal fluid may be taken for study in the laboratory. To make it easier to get the needle placed correctly, you may need to either:
• lie on your side with your knees pulled up to your chest,
• lie face-down with pillows under your stomach, or
• sit on the edge of the table and lean forward.

The exam begins when the contrast material starts moving through the spine. The fluoroscope will take pictures of the contrast material as it makes its way through the spine. Some still X-rays also will be taken. The exam table will be moved so that the contrast material moves up or down your spine. Velcro straps will help support you as the table is tilted.

You also may need to have a computed tomography (CT) scan after the myelogram. The CT will be done while the contrast material is still in your system to help give the best images possible.

The myelogram itself takes around an hour to complete. If you have a CT myelogram as well, that would add another 30 to 60 minutes to the exam time.


Special Instructions

Your doctor will give you specific instructions that you need to follow before your myelogram. Please tell us if you have an allergy to the contrast material, iodine or shellfish. Please tell us if you have a history asthma. Also, let your doctor know if you are or might be pregnant.

There are certain medications that you should not take before a myelogram. Your doctor will tell you when you should stop taking these medications and when you can start taking them again after the procedure. These medications include blood thinners (anti-coagulants) and anti-seizure drugs. Other medications that your doctor may want you to stop taking may include tranquilizers, antidepressants, MAO inhibitors and central nervous stimulants. Please make sure and give your doctor a complete list of any medications including over-the-counter medicines, vitamins and herbal preparations that you are taking.

Generally, you should not eat solid food at least three to four hours before the exam. You should drink plenty of fluids especially the day before and the day of the exam.

After the Myelogram

You’ll need to rest and have your progress monitored by our staff immediately after the exam. Your head will be elevated while you rest. You will need to drink plenty of fluids after the exam to help your body flush the contrast material from your system. This will help prevent a headache.

A friend or family member should drive you home. You may want to lie down in the car with your head supported by a pillow on the drive home. You will need to rest in bed with your head elevated for about eight hours after returning home. We recommend that you have someone stay with you during this time.

One of the main side effects from a myelogram is a headache caused by the contrast material. Occasionally, these headaches can be quite severe. You can help prevent this by drinking lots of fluids and by resting quietly with your head elevated. The more you can rest, the less likely you will be to have a headache. If you do develop a headache, and it lasts for more than 24 hours please call your doctor’s office.

Other side effects may include reactions to the contrast material such as itching, rash, sneezing, nausea or anxiety. If you develop hives or start to wheeze, please call your doctor’s office. In a few rare instances, patients may have injury to the nerves around the injection site or experience seizures.