WHAT IS MYELOGRAPHY?
A myelogram is an x-ray examination of the spine. During myelography, a dye-like contrast material is injected to show the spinal canal and nerves in detail. The contrast is injected into the fluid surrounding the nerves to help determine the cause of pain or numbness in back, neck, arms or legs. This procedure is commonly performed to evaluate back pain, radiculopathy, spinal stenosis and herniated discs.
How to prepare for a myelogram
Because a myelogram is a specialized procedure, some preparation is needed before the procedure. Please follow these guidelines before your myelogram:
- Drink plenty of clear liquids but no solid food for 4 hours before the procedure.
- Tell the technologist if you are or may be pregnant. Myelography is generally not performed during pregnancy because of the potential risk of embryo/fetal injury.
- Stop taking Coumadin (Warfarin), Plavix (Clopidogrel), Ticlid (Ticlopidine) and Pletal (Cilostazol) with permission from the prescribing physicians for 5 days before your myelogram. If you take Coumadin (Warfarin), a Prothrombin Time (PT) and INR will be obtained here at the clinic before the procedure.
- Stop low-molecular weight heparin therapy with Lovenox (Enoxaparin), Fragmin (Dalteparin), Normiflo (Ardeparin) or Orgaran (Danaparoid) with permission from the prescribing physician for 24 hours before the myelogram.
- Arrange for someone to drive you home after the procedure.
- Bring a copy of the order for the procedure from your referring physician.
What to expect during a myelogram
Myelography typically takes about 20-30 minutes. Before the procedure begins, your skin is cleansed with antiseptic soap and numbed with local anesthetic. Then, an interventional radiologist places a needle in the spinal canal. A small amount of fluid may also be removed for further study. The radiologist will then inject the contrast into the spinal canal. You may be tilted on the table to ensure the contrast reaches your upper spine, depending on the affected area. Following the injection, several x-ray images will be made.
After your procedure, please follow these instructions:
- Drink plenty of clear liquids – at least 8 ounces every hour on the day of the procedure.
- Resume a regular diet and any medications you routinely take (including pain medications).
- Avoid consumption of alcohol for 24 hours.
- Lie flat with your head slightly elevated for 8 hours.
- Do not drive the day of your procedure.
- Do not engage in strenuous work, exercise, physical therapy or lifting for 48 hours.
You may experience a headache or temporary increase in pain following your myelogram. These usually resolve within 2-3 days. Please call your doctor if your headache lasts longer than 2-3 days. You may resume your normal medication, including pain medication, after your procedure. Bed rest and cold compresses are sometimes helpful to reduce pain. One of our board-certified interventional radiologists will review the images and send a report to your physician.