Definition

Myelography is an imaging test that uses a special dye to view the spinal cord. Along with an x-ray , the dye can help your doctor clearly outline the space containing the spinal cord, nerves, to show any disk herniation .

Parts of the Body Involved

Spinal column

Reasons for Procedure

Myelography is used to detect problems in and around the spinal cord. The problems that may be causing ongoing pain that has not been relieved by medication, physical therapy, and activity modification. Myelography can detect issues such as:

• Spinal tumors
• Spinal cord swelling
• Herniated disks
• Narrowing of the spinal canal due to spinal stenosis

Risk Factors for Complications During the Procedure

• Allergies, especially to x-ray dye or xylocaine
• History of seizures or epilepsy
• Diabetes
• Pregnancy

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam and medical history
• Pregnancy test
• Determine if you have any allergies or history of hay fever or asthma
• Possibly prescribe a mild sedative to help you relax

Anesthesia

This is typically no anesthesia. You may receive a mild sedative to help you relax or an anesthetic to reduce the pain of the needles.

Description of the Procedure

You will either lie on your side or face down, or sit on the edge of a table, leaning forward. You may be given antibiotics through an intravenous line. You may receive an injection of local anesthetic into your skin to reduce the pain of the needles.

Your doctor will begin by placing a needle into the space between your vertebrae and remove a small amount of fluid from your spinal canal for laboratory examination. He or she will then inject a contrast die through the needle. An imaging procedure called fluoroscopy, which combines an x-ray unit with a television screen, will be used to take pictures of your spine so that a radiologist can observe any problems in your spinal column.

Once the dye is injected, the needle will be removed and you will be positioned stomach-down on the table with a brace against your shoulders. The table will be tipped forward and the radiologist will take images of your back. You will hold your breath while the images are being taken, and may be asked to turn slightly to one side and then the other.

Often, your doctor will perform a CT scan after myelography to see the spread of the contrast liquid.

	Lumbar Myelogram Injection
	© 2008 Nucleus Medical Art, Inc.

After Procedure

You may be asked to stay in the examination room while a radiographer examines your images and determines whether additional ones are needed. You will be observed for about an hour to make sure you recover fully.

How Long Will It Take?

The procedure takes about 30-60 minutes. A CT scan will add an additional 30-60 minutes.

Will It Hurt?

You may feel stinging when the anesthetic is injected, and some pressure or pain as the spinal needle is inserted.

Possible Complications

• Headache
• Flushing
• Nausea
• Seizures
• Allergic reaction to the contrast agent
• Bleeding around the nerve root
• Inflamed or infected spinal cord
• A blocked spinal canal, requiring surgery
• Risks of radiation to your fetus if you are pregnant

Average Hospital Stay

You will be able to go home about an hour after your exam.

Postoperative Care

• If you took a sedative, do not drive, operate machinery, or make important decisions until the sedative wears off completely.
• If breastfeeding, your doctor may advise you to wait at least 24 hours after the exam before breastfeeding again, due to the contrast agent.
• Refrain from strenuous physical activity and from bending over for 1-2 days.

Outcome

The results of your myelography will be given to you and/or your primary physician.

Call Your Doctor If Any of the Following Occurs

• Fever
• Excessive nausea or vomiting
• Severe headache lasting more than 24 hours
• Neck stiffness
• Numbness in your legs
• Trouble urinating or moving your bowels
• Symptoms of allergic reaction (eg, hives, itching, nausea, swollen or itchy eyes, tight throat, difficulty breathing)
• Worsening of your symptoms

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

North American Spine Society
http://www.spine.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Herniated disk. Health Library website. Accessed May 30, 2007.

Myelography. American Society of Radiologic Technologists website. Available at: http://www.asrt.org/content/ThePublic/AboutRadiologicProcedures/Myelography.aspx . Accessed May 30, 2007.

Myelography. Radiological Society of North America website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=myelography&bhcp=1 . Accessed May 30, 2007.

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