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What is a myelogram?

A myelogram is an invasive diagnostic procedure that helps the physician determine whether your symptoms are because of spinal-cord tumors, bone spurs or spinal cord compressions from a herniated disk. A myelogram is a spinal tap with minimal pain followed by an injection of special dye into the spinal canal. A real-time X-ray records the images formed by the dye. The dye used in the procedure shows up white on X-rays whereas regular X-rays only provide images of bones. This helps the physician and radiologist view the spinal cord and canal in detail.

How is a myelogram performed?

The myelogram is done in the Diagnostic Imaging Department. You will be asked to arrive one to two hours before the test to complete some paperwork. Any potential complications or side effects will be explained, and you will be asked to sign a permission form. You will change into a gown, and you will usually be given oral sedation to help you relax. Please be sure to inform the nurse of any medicines taken that day, specifically any pain medicines.

The first part of the test is myelogram procedure. A technician will help you get into position on a table, usually on your stomach. Your back will be cleansed and a local anesthetic will be injected into the lower back where the spinal needle will be inserted. When the area is numb, the radiologist will place a needle into the spinal canal and inject a colorless contrast material. X-rays then will be taken of your spine from various directions. A myelogram of the neck differs slightly in that the head of the table will be tilted down to help the contrast travel to the neck.

The second part of the test involves computed tomography scanning to get the additional pictures from perspectives that cannot be obtained with routine X-rays. Computed tomography is painless, and it usually takes about one hour. You will return to a recovery area and remain on bedrest for four to six hours after the test.

How do I prepare for the myelogram test?

  • Arrange for someone to drive you home after the procedure.
  • Bring a book or magazines.
  • Bring your routine and pain medicines with you. Do not take any other medicines after you arrive without permission from the nurse.
  • Do not drink or eat anything after midnight the night before the test. If you take daily medicine, take it with a sip of water and be sure to tell the nurse or technician what you have taken and when.
  • Drink extra fluids the day before the test to help increase fluid in your body and decrease your risk of developing a headache.
  • Leave valuables at home.
  • Wear comfortable clothing. Plan to spend up to 10 hours at the hospital.

Are there any special instructions for after the myelogram?

  • Drink extra fluids the day after the test.
  • For 48 hours after the test, do nothing but bedrest with your head as flat as possible to help prevent a headache. Only get up if necessary. If a headache should develop, please notify your physician’s nurse. Although the risk of a headache is low, these preventive tips before and after the procedure can decrease the chances further.
  • If you experience discomfort at the injection site, you may apply an ice pack for 30 minutes, and off for at least an hour.

Please call the nurse if you have other concerns after the test.

Are there any special concerns my physician should know before my myelogram?

Notify your physician if you:

  • Are allergic to any medicine
  • Are diabetic or taking the medicine Glucophage, or if you require insulin injections. You may want to check with your family physician on how you should handle the timing of the injections because your meals will be delayed the day of the test.
  • Are or could possibly be pregnant
  • Are taking any blood thinner medicines, specifically Coumadin or heparin
  • Have epilepsy or seizures
  • Have had an allergic reaction to X-ray dye or Xylocaine