Myelography

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Myelography (myelogram) is a diagnostic test that uses a radiographic contrast medium (dye) injected into the fluid of the spinal canal (cerebrospinal fluid, CSF).  The dye enhances visualization of the spinal canal, spinal cord, and nerve roots using x-ray or CT (computered tomography) scan.

A myelogram may be performed to help find the cause of symptoms, including:

• Arm or leg pain
• Numbness
• Arm or leg weakness
• Coordination problems
• Problems walking

A myelogram may be able to diagnose spinal problems, including:

• Herniated disc
• Spinal stenosis
• Spinal tumor
• Spinal infection
• Inflammation of the spinal cord membrane
• Spinal vascular problems

Some doctors combine myelogram with CT to diagnose different spinal conditions, such as disc herniation, spinal stenosis, tumor, or vertebral fracture.  Myelography performed using CT scan imaging provides the physician with more useful detail of the spinal anatomy than standard x-ray.

Preparation

Myelography is performed in a medical center or hospital x-ray department. Prospective patients are given instructions before the myelogram, such as:
 

• Do not eat or drink anything after midnight the night before the test
• Bring prior imaging studies with you (x-ray, CT, MRI), if requested by the physician
• Arrange for someone to drive you home after the procedure
• Do not wear jewelry, or bring valuables

Special Considerations

Patients will be counseled about medications prior to the test. Certain drugs, such as blood thinners, must be stopped 24- to 48-hours before the test. Patients should bring a complete and updated list of their medications with them to the facility.

Not all patients are appropriate candidates for myelography.  Myelography may not be recommended if you have any of the conditions listed below (list is not all-inclusive):

• Allergy to intravenous contrast dye
• Angina
• Kidney disorders
• Epilepsy
• Seizures

Myelography Procedure

Myelography involves two main steps: (1) injecting contrast medium (dye) into the spine and (2) imaging the results.  Injection of the contrast dye is sometimes called a cervical (neck area) or lumbar (low back area) puncture.

Cervical Puncture

The patient is positioned lying on their side or face down.

Lumbar Puncture

The patient is positioned on his side with the knees tucked up toward the chin. This positioning can help separate veretbrae.