Myelography: Lumbar/CT
What is a myelogram?
A myelogram is an x-ray test of the spine in which a
contrast agent is injected into the spinal canal to outline the
fluid space around the spinal cord and nerve roots. After the
contrast is injected, images of the spine and spinal canal contents
are obtained with conventional x-ray for a lumbar myelogram or
by a CT scanner for a CT myelogram. Often both imaging modalities
are used on the same day.
Why do a myelogram?
This exam is often used as a problem solving tool, or
to help confirm a finding that may be amenable to surgery. Because
the contrast agent used during a myelogram outlines the spinal
cord and nerve roots it helps your doctor determine if there
are any unusual indentations or abnormal shapes in the spinal
cord/ nerve roots. The myelogram can be very useful for patients
for whom traditional MRI/CT scanning might be limited.
How is a myelogram performed?
The contrast material is injected into the spinal canal
at a puncture site selected by the radiologist who performs the
procedure. Usually you are placed on your abdomen on the x-ray
table. The area is cleaned, and a local anesthetic is applied
to the skin. A small spinal needle is advanced, with x-ray assistance,
into the fluid filled space within the spinal canal, which contains
the nerve roots. Contrast is then instilled into this space,
with x-ray guidance. This outlines the lower spinal cord and
nerve roots. X-rays are then taken for the Myelogram and/or a
CT scan is performed through the lumbar spine.
How do I prepare for a myelogram?
Eat a light breakfast, but do not eat 2 hours prior
to your scheduled exam time. Take all your usual prescription
medication (there are some exceptions, and our registered nurse
will review these with you during a confirmation call before
your appointment). Bring your medications with you. Wear comfortable
clothing. If you take pain medication, you may take it for this
exam, but please let our nurse know. You will need a ride home
and we prefer someone be with you the first 24 hours following
the procedure. The exam will take about 4 hours from start to
finish. (Special instructions may be given by our nurse to diabetic
patients and those with known contrast allergies)
Other important information:
A nurse from Borg imaging will be calling you 2-3 days prior to your scheduled appointment in order to complete a health history and review the procedure with you. At that time she will instruct diabetic patients on the timing of insulin administration and determine if pre-medication will be necessary for those with contrast allergy. She will also review your medications, since certain medications need to be discontinued prior to the exam.
We would also request that you have a person drive you home following the procedure.
Although myelography is a very safe procedure, there may be certain complications, and these will be reviewed with you by the radiologist. By far, the most common complaint after the exam is that of a headache. Coming to the exam well hydrated and continuing hydration for 24 hours after the procedure will drastically reduce your risk for a headache.
How do I receive my results?
After our radiologist has reviewed the images, a written
report of your exam will be sent promptly to your referring physician,
who will review the findings with you.