Resurgens Orthopaedics

Greater Atlanta's Premier Spine Center

Myelography

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WHAT IS A MYELOGRAM?
A myelogram is the injection of a special dye into the spinal canal.  This special dye makes the spinal nerves more visible on a CT scan or x-ray and helps your physician view the spinal canal in more detail.  Myelograms are used to diagnose areas of stenosis (narrowing) of the spinal canal caused by bulging discs, bone spurs and arthritis.


HOW DO I PREPARE FOR A MYELOGRAM?
  • Medications that “thin the blood”, such as aspirin, antiinflammatories, coumadin, plavix, or ticlid must be stopped prior to the myelogram.  Your physician will tell you how far in advance to stop these medications.  Check with the physician who originally prescribed the medication before stopping them.
  • Do not eat any solid foods after midnight the night before your myelogram.  You can have a clear liquid breakfast (clear broth, juices, jello or tea) the day of the myelogram.
  • Come dressed comfortably in a warm-up suit, sweats, or shorts.  Please leave all jewelry and valuables at home.  You might bring a book, magazine, or something to pass the time.
  • Try to relax.  Newer techniques allow myelograms to be perfomed with minimal discomfort.

 

PRIOR TO THE PROCEDURE, TELL THE PHYSICIAN IF…
  • You have had a previous allergic reaction to x-ray dye, xylocaine, or other medications.
  • You are currently or might be pregnant.
  • You have a history of seizures or epilepsy.
  • You are diabetic.

WHAT HAPPENS DURING A MYELOGRAM?
  • You may be given medication to make you drowsy and relaxed.
  • You will lie on your abdomen and side during the procedure.  A physician and a technician will be in the room.
  • After cleaning your lower back with a cooling antiseptic, the physician will inject a local anesthetic. 
  • When the area is numb, the physician will inject the dye by placing a needle into the spinal canal.   You will feel some discomfort which gradually disappears following the procedure.
  • Afterwards the needle is removed and x-rays are taken.  You will be asked to move into different positions or tilt your head downward.  You might also be tilted downward by the table.
Most individuals also have CT scans performed afterwards.

 


WHAT HAPPENS AFTER A MYELOGRAM?
  • After the procedure you will be taken to the recovery area for an observation period of 2 to 4 hours. 
  • You must make arrangements for someone to drive you home.  YOU WILL NOT BE ALLOWED TO DRIVE YOURSELF HOME.
  • You may feel tired or drowsy from the medicine you received.  The needle site may be tender for a few days and you might have a minor headache.
  • You may eat and drink when fully awake.  Drink at least 8 large glasses of fluids over the next 24 hours.  Avoid alcohol.
  • You should plan to rest the remainder of the day.  You can resume regular activities the morning after your procedure.
  • Keep your head elevated for 24 hours by sitting up in a chair or propping yourself up in bed with 2 or 3 pillows.
  • Do not take blood thinners such as Coumadin, Plavix, Ticlid, aspirin, Vitamin E, Advil , Motrin, ibuprofen, Compazine, Phenergan, or Phenothiazine drugs for 24 hours.  You may take all your other medications after the myelogram.

 

WHAT IF I HAVE A SEVERE HEADACHE, NAUSEA, OR VOMITING?
  • One in five patients get these symptoms hours to days following the myelogram.  If nausea or vomiting occurs, do not take Compazine, Phenergan, or other Phenothiazine drugs. 
  • The main risk with a myelogram is the potential for a spinal headache. The spinal headache usually resolves in one to two days with rest and fluids, and seems to be more common for patients with a history of migraine headaches.
  • If symptoms become severe, call your physician.  Caffeinated beverages often relieve mild headache discomfort.
  • If the headache continues, some blood can be withdrawn from the patient's arm (antecubital vein) and then injected into the epidural space in the back (blood patch). This procedure places pressure over the site that is leaking spinal fluid to stop the leak and in turn resolve the headache.



CALL YOUR PHYSICIAN IF YOU DEVELOP ANY OF THE FOLLOWING:
  • Loss of feeling or movement in either leg
  • Redness, swelling, increased warmth, uncontrollable bleeding, or drainage from the needle site
  • Fever greater than 101º or chills
  • Chest, arm, or neck discomfort or new or increased shortness of breath