Myelogram

What is a myelogram?

A myelogram uses X-rays and a special dye to make pictures of the spinal canal and roots of the nerves in your spine.

The special dye is injected into the space between the bones in your spine. After the dye is injected, pictures are taken using an X-ray machine or a CT scanner.

Benefits of a myelogram

• Used for diagnosis to show detail of your spine and the nerves in your spine.
• Can be used for patients who are unable to have an MRI due to metal implants.

Risks of a myelogram

Your doctor knows the risks of having a myelogram. Your doctor will consider the risks before recommending you to have a myelogram.

Myelograms are not recommended for pregnant women.

Possible risks include:

• Headache – this is common and usually mild, however, sometimes it can be more severe and last for a few days after the procedure. If you have a headache, you may need to lie down and drink extra fluids. If this does not help, you should contact your doctor.
• Injury to the nerves or spine (this is very rare).
• Some medications cannot be taken for 48 hours (2 days) before a myelogram. These include anti-depressants, anti-psychotic and blood thinning medications.
• Small amount of radiation. The amount of radiation you are exposed to depends on the number of pictures taken and the part of the body being examined.
• Extremely small chance you could develop cancer in the long term from the radiation.
• An allergic reaction from the dye. You may have nausea, sneezing, vomiting, itching, hives or dizziness.
• Infection at the site of an injection.

If you have any allergies, tell the staff or radiology doctor.

If you are concerned about the risks, talk to your doctor before the examination.

Preparation

• Bring your referral letter or request form and all X-rays taken in the last 2 years with you.
• Leave the X-rays with the radiology staff as the doctor may need to look at them. The radiology staff will tell you when these are ready to be picked up.
• Wear comfortable, loose clothing.
• Leave all jewellery and valuables at home.
• You may be asked not to eat or drink for a few hours before the myelogram.

Tell your doctor before the myelogram

• If you are or may be pregnant.
• If you have any allergies and medical conditions, including asthma, diabetes, heart disease, kidney disease or thyroid problems.
• Any medications you are taking.

Just before the myelogram

• You will be given a gown to wear.
• You may be asked to remove any metal objects.

What happens during a myelogram

Staff will ask you to lie on your stomach on the X-ray bed. The staff will clean the skin on your back with an antiseptic liquid and then inject a local anaesthetic into the skin. This may sting for a little while.

A radiology doctor will use a special type of X-ray machine, called a fluoroscope, to help them put a needle into your spinal canal. You may feel a bit of pressure from the needle. Once the needle is in the right place they will inject the dye into the spinal canal. The radiology doctor will watch the dye on the television screen and once the dye is in the correct location, he/she will remove the needle. The X-ray table you are on may be tilted to help the dye flow through your spine.

Once the dye has flowed into your spine the radiology doctor and X-ray staff will start taking X-rays. If you are having a CT myelogram (sometimes done instead of plain X-rays), you will be taken to the CT scan area where you will have CT scans taken. You will need to lie still while the staff are taking pictures. This may be done straight away, however depending on the section of your spine being X-rayed you may need to wait 2 or 3 hours before your CT scan.

If you are having a CT scan, the staff will leave the room and control the movement of the bed from behind a screen. They will see, hear and speak to you at all times. You will be able to speak to them at all times. They will tell you what is happening, when to hold still and if you need to take a deep breath and hold it. If you get stiff, need to move or are feeling closed in (claustrophobic), tell the staff.

When the scanning is finished you will be asked to wait while the staff check the pictures.

The myelogram takes between 30 to 60 minutes, including getting you ready on the table. A CT myelogram will take an extra 30 to 60 minutes.

Consent

You have the right to refuse an examination and may do so if you wish. You may be asked to complete a consent form.

When will I get the results?

The amount of time it takes for you to get your results will differ depending on where you get your scans done. The radiology doctor will look at the pictures and write a report. The pictures may be on films or on a CD.

Ask whether you should wait to take the pictures and report with you, or whether they will be sent to your doctor.

Your doctor will need to discuss the report with you. You will need to make an appointment to do this.

After a myelogram

You will usually need to stay for a few hours after the myelogram. Your head will usually be raised and you will start drinking fluids to help flush the dye out of your body.

You should not over-exercise or bend over for 1 to 2 days after the myelogram.

Also:

• Staff will give you any special instructions.
• The dye will pass out of your body in your urine. You will not notice it as it is colourless.
• Drink plenty of fluid to help get rid of the dye.

You should not drive a car for 24 hours after a myelogram.

Costs of a myelogram

For an Australian patient in a public hospital in Western Australia:

• public patient – no cost to you unless advised otherwise
• private patient – costs can be claimed through Medicare and your health insurance provider

For a patient in a private hospital or private imaging site in Western Australia – ask your doctor or the staff where you are having your test done.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.