Patient education: Myelogram (The Basics)

What is a myelogram? — 

This is a special kind of X-ray that looks at the spine. X-rays are imaging tests that create pictures of the inside of the body. The doctor might order a myelogram to look for problems affecting the spinal cord, discs, and nerves.

For a myelogram, dye is injected into the spinal canal. This makes the bones, discs, and tissues around the spinal cord show more clearly on an imaging test.

How do I prepare for a myelogram? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all your medicines with you.

●Any allergies you have, including allergies to contrast dye

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase your risk of bleeding. Some health conditions also increase this risk. If you are on a medicine that increases the risk of bleeding, the doctor might have you stop taking it temporarily a few days before the test. Do not stop any medicines without talking to your doctor.

●If you are or think you might be pregnant – Radiation from X-rays can harm a developing baby.

You will also get information about:

●Eating and drinking before your procedure – You might need to "fast" before surgery. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a myelogram? — 

The doctors first do a lumbar puncture to inject dye into the fluid around your spinal cord. This fluid is called cerebrospinal fluid, or "CSF." For the lumbar puncture, the doctor inserts a needle between 2 of the bones of your spine, so the tip is in the CSF (figure 1).

When it is time for the myelogram:

●The doctor might ask you to lie on your side and hug your legs, so your back is curved in a "C" shape. Or they might have you lie on your stomach.

●Once you are in the right position, the doctor will feel your spine and choose where to do the lumbar puncture. It will be in the lower part of your back, below where your spinal cord ends (figure 2). Or the doctor might place the needle in another part of your spine. They might also do an ultrasound or use fluoroscopy to see where to place the needle. An ultrasound uses sound waves to create pictures of the inside of your body. Fluoroscopy is an imaging test that uses X-rays.

●It is very important to stay very still during the lumbar puncture. Tell your doctor if you are uncomfortable or think you cannot stay still. Tell them if you feel any numbness, tingling, or other symptoms during the procedure.

●The doctor will clean the area around your lower back with a special liquid. They will drape sterile towels around the area. They might also give you a shot to numb the area.

●The doctor will insert a needle into your back, between 2 of the bones (called "vertebrae") that make up your spine. The needle will go straight through your skin and the tissues around the spinal cord into the space filled with fluid.

●Once the needle is in place, the doctor might collect a small sample of fluid. Then, they will inject a special dye called "contrast" through the needle.

●They will remove the needle and place a bandage over the area.

After the dye is injected, the doctor will use X-rays to take pictures of your spine:

●You might need to lie on your stomach as they take the X-rays. You might need to hold your breath for a short time and stay very still. The table might be tilted, or you might have to change positions to get the best pictures.

●You might get a CT scan for more images of your spine. This is another type of imaging test.

●A myelogram usually takes between 30 and 60 minutes. If you need a CT scan, this will take a bit longer.

What happens after a myelogram? — 

The staff will watch you closely for a little while. Most people can go home after a few hours.

As you recover:

●You might need to avoid strenuous physical activity and bending for the next 1 to 2 days.

●Drink plenty of water or other fluids, unless your doctor told you to limit fluids.

What are the risks of a myelogram? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Most people do not have any problems after a myelogram. But possible risks include:

●Allergic reaction to the contrast dye

●Headache

●Nausea and vomiting

●Nerve damage

●Seizure

●Infection

●Bleeding into the spinal canal

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You have a seizure.

Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have a stiff neck.

●There is clear fluid or blood coming from where the needle went in.

●You have a very bad headache.

●Your legs feel numb, weak, tingly, or painful.

●You have trouble urinating.

More on this topic

Patient education: Lumbar puncture (spinal tap) (The Basics)
Patient education: Lumbar spinal stenosis (The Basics)
Patient education: Cervical spinal stenosis (The Basics)
Patient education: Spinal headache (The Basics)