Note: The following preps are for outpatient care only. For questions about any of these preps, please contact the Radiology Reception Desk, at (734) 936-4500 for more information.
What is a Myelogram? Who Performs the Exam?
A myelogram is a radiologic examination of the spinal cord and the space surrounding it. A contrast medium (commonly called "dye") will be injected into your spinal canal. The contrast medium highlights the area of interest. A radiologist performs the examination. A radiologist is a medical doctor who specializes in the use of x-rays for diagnosis of medical conditions. The radiologist is assisted by a radiologic technologist, who is trained in the use of x-ray equipment and by a registered nurse.
Where is the Exam Performed? How Long Does the Exam Take?
Myelograms are performed in the Radiology Department of the B1 level of University Hospital. Your exam probably will be completed in approximately 2 hours, but may take longer. The recovery period is about 2 hours. Plan to be in the Department of Radiology for 4-6 hours. Arrange to have someone stay with you for 24 hours following the procedure. Inpatients will return to their rooms to recover.
What Happens During the Exam?
There are various techniques used for administering the contrast medium. Usually, you lie on your stomach on the x-ray table. The radiologist will view your spine on a TV monitor to identify the best location to insert the needle. First, the area will be cleaned with antiseptic solution, which may feel a little cold. Second, you will feel a pin prick in the skin, and a brief burning sensation as a local anesthetic is injected. The radiologist will insert a needle and inject the contrast medium. The x-ray table will be tilted slowly to allow the contrast medium to travel to different levels of the spinal column. The radiologist will watch the flow of the contrast medium on a TV monitor. Then the technologist will take a series of x-rays while the table is tilted in various positions. The nurse will monitor your vital signs and assess your need for analgesics. You will then be taken to another room where a CT scan of the spine will be performed.
Before Your Exam:
- If you are a smoker, your doctor may ask you to stop smoking the day before your test and on the day of your test. Smoking before the procedure may contribute to headaches or nausea after the procedure.
- It is important to stay well hydrated until the time of your exam. For this reason, we recommend that you drink 4-8 ounces of fluids every 2 hours while you are awake. This regimen may start at noon the day before your test and continue until 6 hours before your exam. You may drink clear liquids up to 2 hours prior to the procedure. Examples of clear liquids include water, tea, apple juice, carbonated beverages (soda pop), black coffee, sugar water, Hawaiian Punch. These liquids should not include alcohol. Orange juice is NOT a clear liquid
- If you are taking any of the following drugs, you should stop taking them 2 days before your myelogram and resume taking them 2 days after your myelogram. 1) Certain antipsychotic medications, especially Phenothiazines. For example Thorazine,Compazine and Torecan. 2) Certain antidepressants, such as Amitriptylines - for example, Elavil, Endep 3) MAO Inhibitors, such as Parnate, Nardil, Marplan 4) Ultram derivatives
- Blood thinners, like Coumadin, need to be stopped prior to your procedure. You must ask your physician for instructions regarding the length of time.
- Allergies: If you are allergic to contrast (X-ray dye) or iodine, let your doctor know as soon as possible. Let the interventional radiologist know about your allergy a few days before your scheduled myelogram.
- If you have any questions regarding medication, contact the Radiology nurses at (734) 936-6883.
When I Arrive in the Radiology Department:
- You will change into a hospital gown.
- Intravenous (IV) line will be placed in one of your veins. This will be used to give you fluids and medicines during the procedure. The IV will stay in place until your recovery is completed.
- Before your procedure begins, a member of the interventional radiology team (doctor, nurse, or technologist) will talk with you about the procedure in detail and answer any questions you have.
After The Procedure
- If you are already a patient in the hospital or if you have been scheduled to be admitted to the hospital immediately after your procedure: you will stay in the hospital after your study is completed. You will return from the radiology department to your hospital room, and the nursing staff will observe you to make sure you are all right.
- If you are having your myelogram done as an outpatient: you will stay in the hospital for two hours after the procedure is completed. Hospital staff will watch over you to make sure that you are all right. You will go home after the observation period.
- Please make arrangements for someone to drive you home. You may not drive yourself home. The radiologist will send a report to your doctor after he has studied your x-rays. It is best to ask your doctor for the exam results.
When you go home:
- After the exam, there is usually no need to remove the contrast material from your spinal canal. Myelographic contrast material is absorbed by your body and eliminated naturally through your kidneys by urination within 1-2 days.
- Drink extra fluid - 1 cup every other hour until bedtime - unless otherwise instructed by your doctor.
- Fluids will help eliminate the contrast medium from your body and help prevent headaches.
- Avoid strenuous physical activity that involves bending down.
- To the extent possible, avoid coughing, sneezing, straining and quick movements for 24 - 48 hours.
- You may immediately resume medication and diet as before the examination.
- You will remain in the Radiology Recovery Room for about 2 hours.
- Before you are discharged, the nurse will give you instructions to take home with you.
- Please have someone accompany you who is able to drive you home. You can not drive yourself home.
You should call your doctor if any of the following conditions should develop
- excessive nausea and/or vomiting
- severe headache
- fever greater than 101°
- stiff neck
After The Procedure
The radiologist will send a report to your doctor after the images have been studied. It is best to ask your doctor for the exam results.
Scheduling
If you have any questions regarding Myelography scheduling, please call (734) 936-4500.
Reviewed and Approved:
Sophia Jan
Bill Weber
Suresh Mukherji
11/2011