Myelograms detect problems with the spinal
cord and spinal nerves including spinal cord stenosis
and nerve impingement, cysts and tumors. The procedure
involves injection of contrast medium into the lumbar
spinal canal, followed by several X-ray projections, and
then a CT scan. A CT myelogram is most useful for
patients who cannot undergo MRI (for example, those with
pacemakers or cochlear implants) or for those in whom
MRI provides limited information (including those with
extensive metal in the spine).
To prepare, you must not eat or drink anything four
hours before the exam. The physician referring you for
this exam will review your chart and may restrict
particular medications from 48 hours before your exam
until after the exam is complete.
Please bring a list of the medications you’re taking,
and, if you like, something to read or do while waiting
the prescribed time after the CT scan. You will also
need to bring someone who can drive you home after the
A radiology nurse will check your vital signs, review your
medication list, and explain the procedure to you before the exam. You will
remove your clothes and be given a gown to wear.
For the exam, you will lie down on the x-ray table on your stomach, and a
preliminary x-ray will be taken. A radiologist will clean your spinal area
with Betadine and use a local anesthetic to numb the injection site. After
the anesthetic takes effect, he will insert a needle into the spinal column
and inject the contrast solution. Then a variety of x-rays will be taken,
with you shifting into different positions for different views.
After the x-rays, you will be taken to a different room for a CT scan.
After the CT scan, you will need to remain
in the facility on bed rest, with your head elevated at
least 30%. A nurse will check your vital signs every
thirty minutes, for three hours. If you need to use the
restroom, use the call button so someone may assist you.
Assuming you do not have complications, you’ll be
released three hours after the exam. Be sure you’ve
brought someone to drive you home, as you won’t be able
to drive yourself.
Afterwards, you are encouraged to follow your regular
diet and drink plenty of water or juice. Avoid drinking
alcoholic beverages for at least 24 hours after the
exam. You may resume your previous medications EXCEPT
for those medications that were held 48 hours before the
exam. Follow your primary care physician’s instructions
about when to resume those medications. Unless your
physician tells you not to, you may take Tylenol,
aspirin, or ibuprofen (Advil) if you get a headache.
Do not lie flat for the next 12 hours: keep your head
elevated at least 30% during this period of time. You
may resume light activity on the day of the exam, and
regular activity the following day.
If you develop a fever, severe headache or seizures,
call your primary care physician or go to the emergency
department of the hospital. If you become nauseated or
if you vomit, do not use Phenothiazine anti-nauseants
(for example, Compazine, Phenargan).
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