The human spine is a complex structure which is made up of different types of bones and also houses the spinal cord which is a major component of the central nervous system. A lot of imaging techniques are used to image the spinal cord and its adjacent structures such a CT scan, an MRI scan, but during certain instances the images obtained are not very helpful in studying the structures and making a diagnosis.
Myelography also known as myelogram is a specialized diagnostic procedure which utilizes ionizing radiation (X-rays) and a contrast medium which is injected into the spine before the imaging is carried out. The technique used during imaging in Myelography is that of a CT (computerized tomography) or fluoroscopy.
When is a myelogram advised ?
A myelogram is advised in case of the below mentioned indications.
- Numbness in hands and feet
- Continuous pain in the limbs
- Herniation of spinal discs causing impingement of nerves and pain
- Bone growths or bone spurs
- Cyst in the spine region
- Arthritis of the spine
- Degenerative disc of the spine
- Injury of the spine or the vertebrae
- Injury to the spinal nerve roots
- Infections of the spine
- Tumors of the spine
Above mentioned are the important indications of a myelogram, but your neurologist, spine specialist or a neurosurgeon after your detailed clinical examination and analysis of signs and symptoms. This procedure is advised in individuals where an MRI cannot be performed and a CT scan is unable to reveal the details of the spinal cord and its nerve roots.
When is a myelogram not advised ?
A myelogram is not advised in women who are pregnant or are breast feeding as it may interfere with the development of the fetus. Since the procedure involves radiation exposure, individuals who are at slightest risk of developing cancer due to radiation exposure are asked to abstain from the procedure.
How do you prepare for a myelogram ?
A Myelogram is advised by your treating specialist after a complete physical and clinical examination, analysis of your signs and symptoms, medical history and medication history. Your medication chart will be reviewed in detail as some medications will be stopped before the procedure. Also, if you have any medically implanted devices you should inform your doctor in advance.
You will be asked to get admitted before the test and will be asked to drink plenty of fluids a day before the test. You will be asked to avoid certain solid foods a few hours before the procedure.
The radiologist will explain the details of the contrast media used during the procedure to you. It is important to inform your doctor if you are allergic or could be allergic to contrast media before the procedure.
Once you have understood the details of the test you will be asked to sign a consent form and will be asked to change into a hospital gown before the test.
What happens during a myelogram ?
You will be asked to change into hospital gown and will be made to lie on your stomach and your lower back will be cleaned with a sterile solution before the lumbar puncture is done with a needle to inject the contrast media into the spinal canal. This is done under the fluoroscopy guidance. Once the needle is advanced deeper into the right position in the spinal canal, a small amount of cerebrospinal fluid is observed and the contrast media is injected. After the injection of the contrast media, the needle is withdrawn and the examination table is tilted to help in flow of the contrast media up the spinal cord. Once the contrast media reaches the nerve roots and the spinal cord, images are taken by X-ray exposure. You will be asked to remain still during the test to avoid blurry images. The Myelogram procedure takes about an hour to complete.
Occasionally a CT scan is performed after a myelogram and the procedure is called as CT Myelogram.
Once the test is complete you might feel slight discomfort at the area of the needle insertion. You also might experience headache after the procedure which will fade in a few hours. You will be moved to the recovery room after the procedure and will be monitored for a few hours before you can go home.
Who reports a myelogram ?
A Radiologist reports a myelogram, individually or along with your Neurosurgeon/Neurologist/Spine surgeon depending upon the reporting policy of the healthcare facility.
What are the risks and complications of myelogram ?
Myelogram is safe procedure as only a needle is used to inject contrast media and no incision is made. But, one can have allergy to the contrast media, have infection, swelling, blood clotting at the site of injection. There is always a slight risk of radiation exposure during the test. Once can experience headache after the test or even after two three days because of the lumbar puncture. Rarely nerve injury can occur during the Myelogram. Though the benefits outweigh the risks of the Myelogram test, it is always advised that one should discuss the risks, benefits, outcome, and suitability of the test before going ahead with it.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
