Please be at ________________________
Your doctor has ordered a myelogram for you. This handout explains the procedure and helps you prepare for the test. If you have any questions about the test, please ask your doctor or nurse. Our staff is here to help you.
If you are allergic to iodine, x-ray contrast dye, or shellfish, please tell your doctor or nurse before you prepare for the myelogram.
What Is a Myelogram?
A myelogram is an x-ray that shows the spinal cord and nerves, the tissue around it, the bone structure, and non-bone material in the back and the neck. An x-ray dye (contrast solution) is used to make these structures appear more clearly on the x-rays. In most cases, a CT scan will be done after the myelogram to give more information to your doctors.
If you have been feeling pain, numbness, tingling, or weakness in your arms, legs, back, or neck, a myelogram might help find the cause. The myelogram is performed on the specific area of your symptoms.
In most cases you will have a myelogram done as an outpatient. Your doctor will let you know if this is not an option for you.
Before the Procedure
1. Please arrange to have someone drive you home.
2. Bring any x-rays, CT scans, or MRI exam of your spine that have been taken elsewhere.
3. If your exam is scheduled for 8:00 am., do not eat anything after midnight, you may have only clear liquids. Clear liquids are liquids you can see through (bouillon, soda, apple juice, tea, etc.). If the test is scheduled for after 1:00 p.m., you may eat a regular breakfast before 8:00 am. Then have only clear liquids until after the exam. You may drink clear liquids up until the time you have the exam and will be asked to drink after the procedure. This will help remove the x-ray dye from your body through your urine. You may also take your regular medicines before the myelogram.
4. Bring along any medicines you will need to take during the day including acetaminophen (Tylenol®).
5. If you have diabetes and are taking insulin, please contact your diabetes health care team for possible insulin adjustment. If you do not take insulin, take your usual medicine.
6. We suggest that you try to have a bowel movement before the exam.
7. Before the exam, your doctor will order blood tests to check your kidney function and your body’s ability to control bleeding. This will make sure that the doctors in Radiology know you can clear the x-ray dye from your body, as well as make sure that your bleeding time is good enough to handle an injection and your blood clots easily.
During the Procedure
Myelograms are done in Radiology here at UWHC. You will be asked to lie on your stomach or side on an x-ray table. Your back will be washed and a local anesthetic, lidocaine, will be injected into the skin at the base of your spine or neck. A needle will be placed in your spinal canal in order to inject the contrast into the spinal canal where your symptoms occur. The contrast is water soluble (mixes with water) and will be absorbed by your body and removed through your urine. You will feel pressure when the needle is inserted, but should not feel any pain. If you feel pain, tell the doctor. Your doctor may decide to send some spinal fluid for tests. This can be easily done. The needle is then removed. A bandage will be placed over the needle site.
The x-ray table will be tilted to move the solution along your spinal canal. The progress will be viewed by a fluoroscope, a type of TV screen. When the contrast flows to the affected area, an x-ray will be taken.
The myelogram lasts about 30-45 minutes. When it is over, you will be taken by cart to the CT room. Here, a CT scan will be taken. You may have to wait another 30-60 minutes. This depends on the demand for the CT scanner at the time.
After the Procedure
Inpatients: When you are back in your bed, keep your head up on an average size pillow for 4 hours. Drink about 1 glass of fluid per hour. Spend this time in bed and limit walking, lifting, or strenuous activity.
Outpatients: Most patients are able to go home within 1-2 hours after the procedure. You must have someone drive you home. Once you are home, lie flat with your head on a small pillow for at least 4 hours. Limit your activity for the rest of the day. Drink about 1 glass of fluid per hour. You may resume your regular diet.
Your Care after the Exam
1. Drink plenty of fluids (one 8 oz. glass of liquid each hour). This helps your body rid itself of the contrast. You may wish to bring your own water bottle along. Feel free to ask for water and juice while you wait in the x-ray area. You may eat solid food unless you are told to do otherwise.
2. Limit your activity for the rest of the day. Stay in bed except for meals and toilet needs.
3. 36 hours after the exam, you may resume your normal routine. The bandage may be removed from the needle site.
4. If you get a headache after the test, lie down for 12-24 hours. The headache will not go away even with pain medicine while you are upright. After 12 hours, you may try to resume light activities.
5. In some cases, the headache may last for up to 36 hours after the exam. If this happens, start drinking more liquids and return to lying flat . You will know the headache is from the myelogram if it goes away when you lie down and returns right away with sitting up. If it does not go away within 36 hours, call the Neuro Radiologist. You may take acetaminophen or other pain medicine that you normally use. The headache usually stops in 48 hours.
If you are concerned or have questions, please let your doctor know. If you have questions once you are home, call the hospital paging operator at (608) 262-0486 and ask for the “Neuro Radiologist on call”. Give your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call: 1-800-323-8942.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/23/2012
Copyright © 02/23/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4371
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