Myelography (Myelogram)

Imaging Study of the Spinal Cord and Spine's Nerve Structures

Written by Stewart G. Eidelson, MD

Myelography is a test that can help diagnose the cause of spinal myelopathy, which may develop when the spinal cord is pinched or compressed. Myelography is also performed to diagnose other disorders that affect the spinal canal, spinal cord, meninges (protective membrane covering the spinal cord), or nerve roots.

Myelography is often performed by a neuroradiologist; a radiologist who specializes in imaging the nervous system and spine. The test is usually performed on an outpatient basis at a hospital or a radiology clinic. After the images are processed, the neuroradiologist interprets the results and sends a report to your physician.

The test involves injecting a contrast medium into the dural sac; a protective membrane covering the spinal cord and nerve roots. The contrast improves the detail of the imaging studies, such as x-ray, CT scans or MRIs.

What to Tell Your Physician
It is important that the physician who orders the myelogram knows ahead of time if you have any of conditions listed below. Depending on your personal medical history, your physician may need to provide you with special pre-test instructions and/or relay particular information to the neuroradiologist.

Myelography involves two essential  steps:

  1. Injection of a contrast medium into the space surrounding the spinal cord and nerve roots.
  2. Utilization of x-ray, CT scan or MRI to obtain still images of the spine.

Step 1: The injection is performed using sterile procedures. After changing into a gown, you are positioned either on your stomach or side for the injection.

Step 2: The neuroradiologist uses fluoroscopy—real time video x-ray—to make sure the contrast flows into the targeted area of the spine. Then the required x-rays, CT scans or MRIs are obtained.

View Myelography Animation

Preparing for Myelography
Always follow the instructions your ordering physician and/or neuroradiologist provides. In general, most instructions may include the following:

After the Procedure
After myelography, you are taken to the recovery area. There you rest lying down for a period of time up to 4 hours. Some patients are positioned to lay with their head elevated. Radiology staff monitors you during this time.

When you are discharged home, your instructions will include:

Potential Side Effects
Common side effects include headache, aches or discomfort in the arms or legs, nausea, vomiting, and dizziness. Most patients do not experience any side effects, and when side effects do occur, they usually disappear within 24 hours.

If side effects persist longer than 24 hours, or you develop a fever over 100.4F degrees, contact your physician, the hospital or radiology clinic where the test was done.

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