MYELOGRAM FOLLOWED BY COMPUTERIZED TOMOGRAPHY (CT) SCAN
A myelogram is a special x-ray study of the spinal cord, spine , discs and nerve roots. Contrast material (x-ray dye) is used to help show structures that cannot be seen with regular x-rays. The myelogram will give your physician information he needs to diagnose your source of pain. It will also help him decide your treatment options.
If you are allergic to contrast material, (IVP dye, x-ray dye), or taking Glucophage or Metformin Hydrochloride, you need to inform your physician before anything is done. Omitting this information can be life threatening.
The spinal cord is nerve tissue beginning at the base of the brain and extending halfway down the back. Spinal fluid surrounds the spinal cord. The spine is a bony structure, composed of several vertebrae. It surrounds and protects the spinal cord. Soft discs separate and cushion each vertebra.
The procedure will be performed by a physician from the Radiology Department.
After your myelogram you will be transported to the Computerized Tomography (CT) Scanner for special x-rays. The dye from the myelogram will enhance the CT scan. CT scans do not produce any more radiation than normal x-rays. The information they provide can be of ten times more value than a regular x-ray.
If you have any reason to believe that you are pregnant, please notify your physician before the procedure.
You may eat and drink as normal prior to this procedure but a light meal is suggested as you will have to lie on your stomach. Before you leave your room, put on a hospital gown. Please empty your bladder, the procedure can last up to 2 hours. Take your routine pain medicine for your comfort during the procedure.
You will need to discontinue any medications for nausea, seizure or depression 2 days prior to the procedure. Discontinue anti-inflammatories, including aspirin and blood thinners 5 days prior to the procedure. If you are taking GLUCOPHAGE for diabetes you must discontinue it 2 days prior to the procedure and do not restart it until your physician checks your blood work and instructs you to do so. If you have questions about stopping any of your medications call the Radiology Department and ask to speak to a nurse about your myelogram.
If you think you may be pregnant do not have this procedure as x-rays may be harmful to the child. If you are allergic to iodine, shellfish or novocaine please tell the Radiologist.
You will lie on your stomach on a special table, which moves into many positions. There will be handles for you to hold and boots for your feet so you will not slide as the table moves. Pads will be placed under your chin and stomach to cushion them. The Radiologist will clean your back with a cool solution. This will kill any germs on your skin. Local anesthetic (numbing medicine) will be used to numb the clean area. A special needle will be inserted between your vertebra until it reaches your spinal fluid. You should not feel pain after the skin has been numbed, only a sensation of pressure. The Radiologist uses a TV-like screen and x-rays to position the needle in the appropriate place. Once the needle is in place the contrast material is slowly injected and allowed to mix with the spinal fluid. It will flow around your spinal cord. The table may be positioned with your head lower than your feet. When the contrast material has spread to show the structures the Radiologist wants to see you will be transferred to the CT scanner for your special x-rays.
If you are going to the CT scanner you will lie on a stretcher with your head elevated. This keeps the contrast material pooled along your spine until your CT scan pictures can be taken. If the target of your myelogram is the cervical region (neck), the opposite may be true.
After all your x-rays and CT sans are complete you should sit up or keep your head elevated for 8 hours. You should not bend over for 8 hours. You may walk to the restroom with assistance. Your body will absorb the contrast material. It will leave your body through your urine. It will be clear and will not change the color of your urine. Drink extra fluids to help your body flush out the contrast material. If you have a headache notify your nurse and she will give you pain medicine.
As soon as you recover, you will be discharged home. You will be given an appointment to follow-up at the pain clinic. The results of your myelogram will be discussed at this visit. Occationally, patients may develop a persistent headache, which worsens with standing or straining. This is known as a ́Post-Dural-Puncture Headacheî, or spinal headache.