What is a myelogram?

A myelogram is an imaging exam that involves the introduction of a spinal needle into the spinal canal (a tunnel-like structure in your spine that holds your spinal cord) in the low back and the injection of contrast dye in the space around the spinal cord. When the contrast material is injected into the spinal canal, the radiologist is able to view and evaluate the status of the spinal cord and its nerves. The radiologist views the passage of contrast dye in real-time within the spinal canal as it is flowing using x-rays in order to document abnormalities involving or affecting these structures. In many of these cases, the myelogram may be followed by a computed tomography (CT) scan to better define any abnormalities.

Before The Myelogram

  • No food or liquids for 2 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
  • It is required that you arrange for a relative or friend to drive you home after the procedure. You should be prepared to lie flat during the drive home.
  • Report any medications you are taking to the radiology nurse, including “blood thinners”, such as aspirin, Plavix, Lovenox, Coumadin, Pradaxa, Xarelto, or Eliquis. Your physician may advise you to stop taking a “blood thinner” for a specific period of time before your procedure.
  • Prior to your procedure, your blood will be tested to determine if your blood clots normally.
  • Report any allergies to the radiology nurse, especially those to iodine contrast (x-ray dye) or local anesthetic medications.
  • Women should always inform the x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.

During The Myelogram Procedure

  • You will be positioned lying face down on your stomach on the x-ray table and images will be taken to find the best location for the procedure.
  • The skin of your lower back is cleaned with an antiseptic solution and the area is covered with a large sterile sheet.
  • You will feel a slight pin prick when the local anesthetic (numbing medicine) is injected in your low back.
  • Guided by real-time x-ray images, the doctor will insert the needle through the skin between two vertebrae and into the sac that contains the spinal fluid. Despite the use of the anesthetic, you may feel some pain or pressure when this happens. Try to remain still.
  • Contrast dye will be injected into your spinal canal.
  • The needle is then removed and a small bandage is placed over the puncture site.
  • Additional x-rays will be taken and if you also need a CT test, it will follow the x-rays.
  • You will be asked to lie on your back for 30 minutes following the procedure in the radiology department.

Potential Risks and Complications

  • Bleeding at the procedure site
  • Infection at the procedure site
  • Severe headache
  • Nerve injury
  • Problems due to iodine contrast, including allergic reaction or kidney damage

After The Myelogram

  • Drink plenty of fluids. Avoid alcohol for 24 hours.
  • Rest for the remainder of the day lying on your back with the head of your bed no more than 30 degrees up. Avoid sitting up or standing. This can cause a severe headache.
  • You may return to normal activities the day after the test, provided you are not experiencing any problems.
  • Avoid heavy lifting or strenuous labor for 3 days after your procedure.
  • Mild pain, discomfort, or bruising at the procedure site is expected. You may take over-the-counter Tylenol for any pain you may experience.
  • You will have a small bandage over the site. You may remove the bandage in 3 days and leave the site dry and exposed. You may shower, but do not have a tub bath for 3 days.

Call your doctor if you have any of the following:

  • Signs of infection at the procedure site, such as redness, swelling, or a fever.
  • Bleeding from the procedure site.
  • Worsening, severe pain near the procedure site.
  • A severe headache that last 2 or more days.
  • Tingling in your groin or legs.

If any further questions or complications arise and you do not know what to do, please call the radiology department at Summit Healthcare at 928-537-4375, ext. 6332.

Getting your test results may take a few days. When the results are ready, your doctor will discuss them with you.

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