Myelography Background: A myelogram is a special spinal X-ray examination used to help determine the cause of pain, numbness and/or

weakness in the back, arms or legs. During the test, a contrast medium (also referred to as contrast material) is injected into the spinal canal under X-ray guidance to provide an outline of the spinal cord and nerve roots. A series of X-ray films are taken.

Prep of the patient:

Patients should be well-hydrated at the time they are undergoing a myelogram. Increasing fluids the day before the study is usually recommended. All food and fluid intake should be stopped approximately four hours before the procedure.

Certain medications may need to be stopped for one to two days before myelography is performed. These include some antipsychotics, antidepressants, blood thinners, and diabetic

medications. Patients should discuss this with their physician or the staff at the facility where the study is to be done.

Patients who smoke may be asked to stop the day before the test. This helps decrease the chance of nausea or headaches after the myelogram. Immediately before the examination, patients should empty their bowels and bladder.

During the test:

You will wear a hospital gown during the examination. You will be asked to lie on your abdomen or side during the procedure. After cleaning your back with an antiseptic, a local anesthetic will be administered. When the area is numb, a contrast material is injected into the spinal canal. This sometimes causes pressure. During the X-rays, you may be asked to assume different positions, or tilt your head downward. You may also be tilted downward by the table, which may be uncomfortable. You may feel some discomfort or have a minor headache. The needle is removed once the contrast material has been injected.

Nursing care after procedure:

After the examination is complete, the patient usually rests for several hours, with the head elevated. Extra fluids are encouraged, to help eliminate the contrast material and prevent headaches. A regular diet and routine medications may be resumed. Strenuous physical activities, especially those that involve bending over, may be discouraged for one or two days. The physician should be notified if the patient develops a fever, excessive nausea and vomiting, severe headache, or a stiff neck.

A normal myelogram shows nerves that appear normal, and a spinal canal of normal width, with no areas of constriction or obstruction.

Abnormal results

A myelogram may reveal a herniated disk, tumor, bone spurs, or narrowing of the spinal canal (spinal stenosis).