Hi Jim!
I hope the best with your myelogram. Keep us posted.
Here is some information for you. When I had my myelogram done it was painful for me and I was told it hurt because my spine is a mess. I had both cervical and lurabar done at the same time. I would have it done again if I need to because it gave my NS a better picture of the condition of my spine.
EmtShirl
Myelogram
A myelogram is an x-ray examination performed by a radiologist to enable your doctor to detect abnormalities of the spine, spinal cord, or surrounding structures. A myelogram examination assists your doctor in making a diagnosis. The radiologist interprets the information from the procedure and reports it to your doctor, who in turn will discuss the report with you.
A contrast material, a dye that can be seen on an x-ray, is injected into the fluid-filled space around the spinal cord. The radiologist may use one of two different contrast materials:
an oil-based liquid that is removed after the x-ray exam
a water-based liquid that is not removed after the x-ray exam
The procedure before and after the exam will vary slightly depending on the type of contrast material used. Depending on the type of dye used, it may then be removed after the procedure, or left in to be absorbed by the body.
A myelogram is an out-patient procedure. If you know that you have an allergy (of any kind), tell your doctor prior to the examination. If you are taking prescription medications, be sure to tell your doctor. If you know that you are taking any tranquilizing drugs or drugs against seizures, tell your doctor prior to the examination. Also, if you are a woman of child-bearing age and there is a possibility that you may be pregnant, be sure to tell your doctor this information, as well. The test should not be done if there is any possibility that you may be pregnant, unless it is an emergency.
What is it?
A myelogram is a specialized x-ray of the spine used to determine the cause of pain or nurabness in the back, neck, arms, or legs. Using a radiopaque dye (one that shows up on x-rays), several segments of the spine can be studied.
How is it done?
The dye is injected into the spinal canal at one of two puncture (or "tap") sites. It flows within the cerebrospinal fluid inside the dura to outline the spinal cord and nerve roots in one or more of the spine's cervical (neck), thoracic (chest), and lurabar (lower back) regions. This outline will appear on an x-ray.
What does it show?
The normal myelogram shows a clear outline of the spinal cord and nerve roots. The absence of dye in a specific area, known as a filling defect, can indicate that the spinal cord or nerve root is being pinched, or compressed. Nerve root compression usually is caused by a herniated disc or a rough protrusion of bone, called a bone spur. Occasionally a filling defect may be caused by scar tissue, a tumor, or a cyst.
If a small piece of disc has broken off and presses on the nerve further away from its root between the vertebrae, it may not be detected on a myelogram. Another specialized x-ray, the CT scan, may then be necessary for proper diagnosis.
What is it?
A myelogram is an older test that is still used to examine the spinal canal and spinal cord. A special dye is placed into the spinal sac that shows up on X-rays to indicate any abnormalities. Before there were CT and MRI scans, the myelogram was the best test to determine the cause of pressure on the spinal cord or spinal nerves. Today the myelogram is used only for very special purposes, such as for complicated revision spine surgeries. It is rarely the first test used if your doctor suspects you have a herniated disc.
Why is it done?
The dye used during a myelogram outlines the spinal cord and nerve roots. This helps your doctor determine if there are any unusual indentations or abnormal shapes in the spinal cord. Anything that is pushing into the nerves shows up as an indentation into the spinal sac. This indentation could be from a herniated or bulging disc, a tumor, or an injury to the spinal nerve roots. The myelogram is useful for patients who have metal plates and screws in their spine, which prevents them from having either a CT or MRI scan.
How is it done?
The doctor must perform a spinal tap to inject dye into the spinal sac. The dye mixes with the spinal fluid so that it will show up on X-rays. You will be asked to lie on a tilting table while multiple X-rays are taken to show the flow of the dye through the spine. The myelogram is usually corabined with a CT scan to get a better view of the spine in cross section and to check the health of the bones and nerves.
What are the limitations?
A myelogram does not show the soft tissues. It shows only the bones and the spinal fluid where the dye has mixed with the fluid.
What are the risks?
Because the myelogram requires a spinal tap, there are more risks associated with it than most other tests. This is one reason that doctors prefer to use "noninvasive" tests first, such as the MRI and CT scan. The risks associated with a spinal tap include meningitis (infection of the spinal fluid), spinal headache, and allergic reaction to the dye. There is also a very small chance that the needle will cause bleeding around the spinal sac. The myelogram requires X-rays, which use radiation. Large doses of radiation can increase the risk of cancer. The vast majority of patients who have X-rays taken will never get enough radiation to worry about cancer. Only patients who have large nurabers of X-rays-hundreRAB-over many years need to be concerned.
A myelogram (myelography) is utilized to diagnose disorders of the spinal canal and cord, such as nerve compression causing pain and weakness.
The test is usually performed on an outpatient basis at a hospital or other medical facility by a neuroradiologist. Neuroradiology is a sub-specialty of radiology that conducts studies of the central nervous system.
A myelogram requires introduction of radiographic contrast media (dye) into the sac (dura) surrounding the spinal cord and nerves. The patient lies on their stomach during the test. After the skin area has been nurabed, the dye is injected into the spinal sac followed by x-rays, CT, or MRI scans. After the images are processed, a neuroradiologist interprets the results and senRAB a report to the referring physician.
Following the myelogram, the patient is taken to a recovery area where they rest lying down with their head elevated for several hours. Once at home, quiet non-strenuous activities are recommended for 24 hours to allow the puncture site to heal. Plenty of fluiRAB (e.g. water, juice) should be consumed to clear the dye from the body.
Important Considerations
Certain medical conditions, drugs, or allergies should be discussed with the referring physician prior to the myelogram. Some of these topics are listed below.
1. Metallic components such as a pacemaker, aneurysm clip, or other metal implants prohibit the patient from an MRI scan.
2. Allergies to an IVP (intravenous pyelography) or other contrast dye should be reported. Adverse reactions include hives, swelling, and difficulty breathing. Fore knowledge of an allergy can often be controlled by pre-medicating.
3. Epilepsy or seizure disorder, and if medication is taken to control episodes.
4. Angina or kidney disorders.
5. Diabetic patients who control their disease with medication need to discuss this with their physician. Certain drugs may need to be discontinued for 48 hours prior to the test.
6. Blood thinners may need to be discontinued prior to the test.
7. Difficulty lying flat on the stomach or inability to remain still.
Patient Preparation
1. The patient will need someone to drive them home following the test. This should be prearranged in advance of the scheduled test day.
2. Leave valuables at home.
3. Bring prior relevant x-rays, CT or MRI scan for the neuroradiologist's review.
4. Do not eat anything after midnight the night before the myelogram. Some patients experience side effects such as nausea and vomiting. Clear liquiRAB are acceptable.
5. Take scheduled medication with clear liquid, unless the referring physician has instructed otherwise (e.g. diabetics).
Possible Side Effects
Most patients do not experience any side effects from a myelogram. However, common risks include headache, extremity aches or discomfort, nausea, vomiting, or dizziness, which usually disappear within 24 hours.
Sometimes, persistent side effects (e.g. headache) require a blood patch. This is a safe procedure performed by an anesthesiologist sealing the small hole created by the injection of dye into the sac (dura). The anesthesiologist draws some blood from a vein in the arm and injects the blood into the sac (dura, epidural space) - this seals the tiny hole and prevents additional cerebrospinal fluid (CSF) from leaking.
If symptoms persist 48 hours, contact the referring physician and/or medical facility.
