Myelogram and CT Scan
PLEASE NOTE: Gold Coast Spine does not perform these investigations, we are supplying information for your reference only.
What is a Myelogram?
Myelography is an imaging technique that allows for the examination of the spinal canal and the nerve roots in your spine. A spinal needle is introduced into the spinal canal followed by injection of a contrast material into the space around the spinal cord and nerve roots (subarachnoid space) and then fluroscopy or x-rays are performed. The contrast material helps allow the radiologist to evaluate the integrity of the spinal cord, the nerve root, and the meninges (membranes surrounding the spinal cord and nerve roots). It also allows for assessment of any abnormalities affecting these structures. Myelography is often followed by a CT scan while the contrast is still in the spinal canal.
A myelogram is used to help with diagnosis by providing detailed images of the spine and nerve roots. It can also be used for patients who are not suitable to have an MRI scan due to metal implants or other reasons.
How do I prepare for my Myelogram?
Prior to arriving for your myelogram, you will be asked to complete a series of safety questions to find out if you are able to have a myelogram performed. If you should answer YES to any of these questions, it is important that you notify the radiology company as soon as possible as certain medications may need to be ceased before the procedure or alternate diagnostic tests may need to be considered. These questions may include:
- Do you take any blood thinning medications? e.g. Aspirin, Clopidogrel (Plavix and Iscover), Warfarin or Dipyridamole (Asasantin and Persantin)
- Do you take any medications for:
- Mental health conditions?
- Are you allergic to seafood?
- Are you allergic to Iodine?
- Do you suffer from asthma?
- Are you pregnant, or could you be pregnant?
Prior to your scan, patients are generally advised to increase their fluid intake and ensure adequate hydration. However, in most cases, you will be required to fast (not eat or drink) for 4 hours prior to your appointment.
It is also important that you bring your referral letter or request form and all x-rays, CT scans or ultrasounds taken in the last 2 years that may be relevant to why you are having the scan. The radiologist may like to compare the information or see if your condition has changed since your last scan.
How is a myelogram performed?
The myelogram requires that patients lie on their stomach on an x-ray bed. Your back will be thoroughly cleaned and draped with sterile sheets. A local anaesthetic will be injected to numb the area of your back, followed by a fine needle into the fluid filled space surrounding the nerves in your lower back. The location of the needle is confirmed using the x-ray. A small amount of fluid may then be taken as a sample for analysis. Then the x-ray contrast is injected and the table may then be tilted to help the contrast material spread throughout the spinal canal. X-ray pictures are then taken of sections of your spine.
It is important that you try to remain relaxed and still during the procedure. The procedure is generally not painful but some patients may feel an exacerbation of their symptoms.
The myelogram takes between 30 to 60 minutes, including getting you ready on the table. A CT scan after the myelogram will take an extra 30 to 60 minutes.
What can I expect after the Myelogram?
Following the myelogram, patients are generally required to stay for a few hours. Your head is generally raised and you will begin drinking fluids. Be careful when you first stand as a temporary weakness of your legs can occur. It is important not to over exercise or bend for several days following your myelogram. It is also advised not to drive a car for 24 hours after a myelogram.
What are the risks of Myelograms?
Common side effects of this procedure are:
- Headache which is usually mild; however, it may be severe and last several days. This typically occurs after myelography when the patient begins to sit upright or stand. Patients may find that lying down and ensuring adequate hydration often helps relieve this type of headache. If you get a severe headache that lasts for several days please call Gold Coast Spine’s Practice Nurse.
- Bruising at the site of puncture; especially if blood-thinning medications were not ceased.
- Minor pain at the puncture site.
Rare risks/complications of this procedure include local infection, meningitis, nerve damage (usually temporary), seizures, allergic reaction to the contrast material, and damage to surrounding structures.
The use of a CT scan and fluoroscope during the procedure also raises the risk of exposure to a small amount of radiation.
Delivery of Results
Following your myelogram, the images will be reviewed for clarity and accuracy and a specialist radiologist will interpret the images; however, this takes some time. A copy of the images obtained from your myelogram and the radiologist report will be delivered to your surgeon. This delivery generally takes several days.