What Is a Myelogram Procedure?

A myelogram procedure is an imaging test that is used to find issues present in the spinal canal, including the spinal cord, nerves and other spinal tissue. Also referred to as myelography, the test is generally performed by a radiologist who injects contrast dye into the space around the spinal cord.

Fluoroscopy, or a real-time form of X-ray, provides detailed images of the spinal cord and spinal column, and the radiologist views the passage of the contrast dye as it flows through these spaces. The images allow the radiologist to discover, examine and document abnormalities, which could include infection, tumors or inflammation.

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Reasons You May Require a Myelogram
How to Prepare for a Myelogram Procedure
What You Can Expect During and After the Myelogram Procedure

In general, a CAT scan will be performed on the spinal canal after a myelogram to define potential issues better. Myelogram technology combined with a CAT scan provides more detail than general X-rays.

Reasons You May Require a Myelogram

If your doctor needs to assess your subarachnoid space, spinal cord and other structures in this area, a myelogram allows them to check for any abnormalities or changes. It’s especially useful if a regular X-ray does not provide clear answers as to the cause of any spine or back issues you may be experiencing.

Myelograms are also useful in the evaluation of a number of different conditions, including:

Tumors in the brain or spinal cord
Herniated discs
Inflammation or infection occurring in the tissue around the brain or spinal cord
Ankylosing spondylitis
Spinal stenosis
Arthritis
Bone spurs
Arachnoiditis
Cysts
Tearing or injury to the spinal nerve roots
And more

How to Prepare for a Myelogram Procedure

Before you undergo a myelogram, your physician will fully explain how it works and ask if you have any questions. You may need to fast for a short time before the test or to stop taking some prescription drugs two days prior to the procedure as they could interfere with the results otherwise. Be sure to talk to the radiation technician beforehand if you are taking any medications. You may also need to drink some extra fluids prior to the test.

Tell your doctor or the radiologist if any of the following apply to you:

Allergies to iodine or the contrast dye
You are pregnant or think you could be
History of seizures
History of bleeding disorders or you’re taking blood thinners, aspirin or medications that affect your blood’s ability to clot

What You Can Expect During and After the Procedure

Usually, a myelogram is done as an outpatient procedure and is about an hour long. Before the test begins, you will be given a hospital gown to wear and will need to remove all jewelry or metallic objects. Ensure your bladder is empty before the procedure starts.

During the test, you will lie on a padded table on your stomach. Your back will be sterilized at the site of the injection and draped. The radiologist will then numb the area above your lower spin with a local anesthetic. It may sting, but it will allow you to be more comfortable during the test.

A needle is then inserted between two vertebrae into the subarachnoid space. Even if you feel pressure as the needle is inserted, it’s important to remain still. Some of the spinal fluid will be removed and a small amount of contrast dye is injected through the needle. This may cause a warm sensation as it enters your spinal canal.

To help the contrast dye move throughout your spinal cord, the table you’re lying on may be tilted in various directions. However, you will be kept secure by a brace or special harness.

You may be injected with additional contrast dye as the test progresses, but once the procedure is complete, the needle will be removed. If needed, X-rays or CAT scan images will be taken afterward. Although the procedure may cause some discomfort, your radiologist will strive to minimize any pain.

After the procedure, you will need to stay at the imaging center to ensure no complications arise. You will need to sit or lay down, and your vital signs will be monitored frequently. Once your recovery is complete, you will be discharged to go home.

Limit your activity for 24 hours after the test. And report any adverse side effects such as: