In order to perform a
myelogram doctors inject a radio-opaque dye into your spinal canal
and then take X-ray pictures of the dye. Using a local anaesthetic
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 which come from it. The operation will be done on a
table which tilts 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.
This is an unpleasant, tricky and potentially hazardous procedure,
and you will usually need to spend a day in hospital if you are
having this test.
The side affects - which seem to affect quite a number of patients
having this test - include headache, nausea and vomiting. In the
past some patients are believed to have suffered long -term problems
as a result of damage - arachnoiditis - done by an oil-based dye,
and so today most doctors use a water-soluble contrasts material.
Because of the dangers associated with this procedure it is usually
only performed when a surgeon intends to operate and wants an accurate
idea of the sort of damage that may exist in the spine.
Synonyms: Cervical Myelogram; Lumbar Myelogram; Thoracic Myelogram
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
Contraindications: Evidence of raised intracranial pressure, such
as papilledema; bleeding abnormalities, such as elevated prothrombin
and partial thromboplastin times, decreased platelet count, or patients
Patient Preparation: Informed consent is obtained from the patient.
Patient is made NPO 4 hours before the procedure. Any bleeding abnormally
is corrected beforehand. The patient with chart is sent on a stretcher
to the myelography suite.
Aftercare: The patient is placed on bedrest with the head of the
bed elevated at least 30° to 45° for 4 hours. Oral fluids are encouraged
and the diet is as tolerated. Any nausea or vomiting which occurs
should not be treated with phenothiazine antinauseants. Follow physician's
Special Instructions: Any previous spine x-rays or any prior CT
or MR studies of the spine should be made available to the radiologist.
The patient should not be on phenothiazines at the time of the procedure.