Myelography (Myelogram)
Reviewed
Also called: Cervical myelography, Lumbar myelography
Myelography is an imaging test that uses contrast dye injected into the spinal canal to check for problems in the spinal canal, such as herniated disks, spinal stenosis, tumors, or nerve injury. It is performed using fluoroscopy or CT scan.
Specimen: not applicable
Why this test may be ordered
- To look for conditions affecting the nerves, blood vessels, and structures in the spinal canal, such as herniated disk, spinal stenosis, tumors, infections, or arachnoiditis.
- If you have new pain or weakness in your back after a recent surgery.
- If you have symptoms of a spinal disorder, including back, neck, or leg pain, tingling, weakness, trouble walking, or trouble with small muscle tasks.
Preparation and collection
Your provider will give you specific instructions. You may be asked to drink extra fluids the day before. On the test day, you may be asked not to eat or drink anything except clear fluids (water, clear broth, tea, black coffee). Tell your provider about all medicines you take; aspirin and blood thinners may need to be stopped up to 72 hours before. Do not stop any medicine unless your provider tells you to.
You will lie on your side or stomach on a padded x-ray table. Your back is cleaned with antiseptic, and numbing medicine is injected. A thin needle is used to inject contrast dye into your spinal canal. You may feel pressure, warmth, flushing, nausea, or a metallic taste. The table may be tilted to move the dye. Images are taken using fluoroscopy or CT scan. The procedure takes about an hour.
You should not have this test if you are pregnant or think you may be pregnant, as radiation can harm a developing baby. For others, the radiation dose is very low and not considered harmful for most people, but talk to your provider about all x-rays you've had. There is a small risk of allergic reaction to the contrast dye; tell your provider if you have allergies, especially to shellfish or iodine. Other risks include headache (may last up to 24 hours), nausea, and vomiting. Serious reactions are rare but may include seizures, infection, or a blockage in the spinal canal. Contact your provider right away if you have a headache that doesn't go away in 24 hours, fever, stiff neck, tingling or numbness in your legs, or trouble going to the bathroom.
Understanding results
Your provider will consider your symptoms, medical history, and other test results to understand your myelography results.
- Normal: Your spinal canal and structures were normal in size, position, and shape. Limitation: Your provider may want to do more tests to find out what is causing your symptoms. Next step: Talk to your provider about your results and any further testing needed.
- Not normal: May indicate a condition such as herniated disk, spinal stenosis, tumor, nerve injury, bone spurs, or arachnoiditis (inflammation of the membrane surrounding the spinal cord). Limitation: This test does not diagnose the specific condition on its own; your provider will correlate with your symptoms and other tests. Next step: Your provider may recommend additional tests to confirm the cause of your symptoms.
- Myelography is an imaging test, not a laboratory test or diagnostic screening.
- Results must be interpreted by your healthcare provider in the context of your symptoms, medical history, and other tests.
- There is a small risk of allergic reaction to contrast dye; serious reactions are rare.
- Radiation exposure is low but should be discussed with your provider if you have had many x-rays.
What to do next
After the test, you may be monitored for one to two hours and need someone to take you home. Your provider may ask you to rest at home with your head elevated for a few hours, avoid strenuous activity for one to two days, drink plenty of fluids, avoid alcohol, and use over-the-counter pain reliever if you have a headache. Contact your provider right away if you have a headache that doesn't go away in 24 hours, fever, stiff neck, tingling or numbness in your legs, or trouble going to the bathroom.
- What specific symptoms or conditions led to recommending this test?
- What are the possible results and what would they mean for my health?
- Are there any alternatives to this test, such as an MRI?
- How should I prepare, especially regarding my current medicines?
- What should I do after the test and when will I get the results?