Using a Myelogram to Diagnose Back or Neck Pain
A myelogram is an imaging test that uses a contrast dye injection and X-rays to develop images of the spinal canal. The dye allows physicians to see the fluid-filled spinal nerve rootlet cuffs. The bones themselves are seen on the X-ray portion of the myelogram
Myelograms are good alternative tests for people who cannot undergo MRIs due to metal implants that would be affected by the MRI’s powerful magnetic field. The contrast material used in myelograms makes them a good tool for detecting problems such as a narrowing of the spinal canal (spinal stenosis), herniated discs, sciatica, pinched nerves and other causes of neck or back pain.
How is a myelogram performed?
Myelograms are usually performed in outpatient radiology centers or hospital radiology departments. Radiologists, who specialize in imaging tests, perform the procedure with their teams. A lumbar (lower back) puncture to inject the contrast material into the fluid surrounding the spinal cord is part of the procedure.
After you have removed all of your jewelry and clothes that might interfere with the test, you will be asked to change into a gown and lie on your stomach or side on the X-ray table. The radiologist will numb the skin above your lumbar spine with a local anesthetic and then inject the contrast dye. During this process, X-rays are used to help the radiologist position the needle and make sure the dye is injected in the right spot. Once the dye is absorbed, X-ray pictures are taken. You may be asked to lie still or to move to different positions. A CT scan and MRI scan may also be taken while the dye is in your system.
Here are some considerations that you should be aware of before getting a myelogram:
- There is a significant risk of experiencing severe headaches, nausea or vomiting after the procedure. The risk is higher in females, particularly young females.
- There is a risk of seizure if the dye enters your brain, which is why you are advised to avoid lowering your head below your center of gravity until after the dye has had a chance to clear your system.
- Some people may have an allergic reaction to the dye, in which case medications are given to relieve the allergy.
- There is a small risk of infection to the lumbar puncture site as well as meningitis. There is also a risk that the puncture to the spinal sac may not heal. A procedure to repair the puncture may be required if this happens.
- There is a small risk of spinal hematoma requiring surgical drainage, particularly those taking blood thinning medications.
Always make sure you are completely comfortable with any diagnostic procedure that your physician recommends. Ask questions and do your own research on the subject so that you will be prepared and know what to expect.