What is myelography?

In order to perform myelogram, doctors inject a radio-opaque dye into your spinal canal after using a local anesthetic and then take X-ray pictures of the dye. The whole procedure lasts around half an hour. This procedure is to visualize spinal cord abnormalities.

Indications

Visualize spinal cord abnormalities; evaluate signs and/or symptoms of compression of the spinal nerve roots or spinal cord by a herniated disc, degenerative spur, traumatic injury, neoplasm, or other mass when the CT ( computer tomography ) and MRI ( magnetic resonance image ) are not prevalent.

Now, it is usually performed in the patients who had previous spinal surgery with internal metallic fixation but still have compression syndrome.

Contraindications

1. Evidence of raised intracranial pressure
2. Bleeding abnormalities
3. Poor cooperative patients
4. Infection in the puncture site or sepsis
5. Severe allergy to contrast medium

Patient Preparation

1. Sign a consent form
2. Fast 4 hours before the procedure.
3. Any bleeding abnormally is corrected beforehand.

How to perform the procedure?

1. Please empty your bladder and you will be sent to the myelography suite on a stretcher with your chart.
2. The doctor may keep you in prone position or knee to chest position.
3. For local anesthetic, the doctors will make a small hole directly into your spine so that they can inject the dye into the tiny space around the spinal cord and the nerves.
4. The operation will be done on a tilted table  so that the doctors can move you up and down to make the dye run up and down your spine and around various different nerve junctions. The whole procedure lasts around half an hour.
5. A number of patients having this test may get headache, nausea and vomiting sensation with a mild degree.
6. CT, as an assist examination , will be performed following the myelography.

Aftercare

1. The patient is placed on bed for rest with the head of the bed elevated at least 15° to 30° for 6 hours.
2. Oral fluids are encouraged and the diet is as tolerated.
3. Any nausea or vomiting should not be treated with phenothiazine antinauseants.
4. Follow the physician's post-op orders.