Back Pain Diagnostic Test
Myelography is a test your physician may order to help diagnose a problem affecting your spine’s nerves or the spinal cord. Myelogram is another term for myelography. The procedure combines injection of a contrast dye and imaging the spine using x-ray, CT scans or MRI. The contrast dye, when combined with imaging, illuminates spaces surrounding the nerves and spinal cord, and helps detect nerve and/or cord compression, injury, or damage. The radiologist performs the test, interprets the results and prepares a report for your physician. Of course, the images are made available to your physician to view, too.
Why Your Physician May Order Myelography
During your physical and neurological examination, your physician evaluates your symptoms and signs (eg, are you having difficulty walking?). A myelogram may be recommended to reveal a problem not detected by other tests. It may also be used to confirm a diagnosis of a spinal condition, such as:
- Central canal spinal stenosis (narrowing of the spinal canal)
- Foraminal spinal stenosis (narrowing of the spinal nerve pathways)
- Disc herniation
- Degenerative disc disease
- Spinal cord injury
Before Myelography: Give Accurate Information to the Radiologist
In advance of your test, the radiologist or a member of his medical staff asks you about your allergies, existing conditions, and medications. The same questions may be included in paperwork you complete before the test, including a consent form.
Be sure to tell the radiologist about:
- shellfish allergy
- iodine allergy
- existing kidney problem
- being pregnant (or perhaps pregnant)
- all medications, especially
- blood thinners (eg, Coumadin, heparin, aspirin)
- metformin, or other diabetic medicines
- antidepressant medication
Potential Risks in Myelography
Like other medical procedures, there are potential risks associated with myelography. To make sure you have all the facts about your specific risks, talk with your physician or a member of the radiologist’s staff. Potential risks include:
- spinal infection
- allergic reactions
Your physician and/or the radiological facility provides specific instructions. Instructions often include when you can eat, drink, and take medications. It is very important to follow the instructions your physician and/or radiologist provides.
What to Expect During the Myelogram
At the radiology facility, you are asked to change into a gown. You are positioned on the x-ray, CT scan, or MRI bed laying on your stomach or side. General anesthesia is not necessary. You are awake throughout the test.
A local anesthetic (numbing medicine) is injected into the skin area. Next, the contrast dye is injected into the spine. The needle is removed, and a small bandage covers the skin. Then the x-rays, CT scans, or MR images are taken.
After the myelography procedure, you are moved into a recovery area where you continue to lie down. The medical staff monitors your vital signs—breathing, blood pressure, pulse, and temperature. The radiologist discharges you from the facility when he/she determines you are ready.
Instructions for your care at home may include:
- laying down for the remainder of the day
- specifics on what you may eat and drink
- when to resume routine medications
- potential post-test symptoms, and who to contact
Myelography Results: What Do They Tell You About Your Pain?
The radiologist ensures your physician receives the test results in a timely manner. Your physician discusses the results of the myelogram with you, and he or she is available to answer all your questions and concerns about the test and what it tells you about your spinal condition.