Myelography
(Myelogram)
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What is the
test?
A myelogram is an x-ray test in which dye is
injected directly into your spinal canal to help
show places where the vertebrae in your back
may be pinching the spinal cord. It is sometimes
used to help diagnose back or leg pain problems,
especially if surgery is being planned.
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How
do I prepare for the test?
Tell your doctor ahead of time if you have ever
had an allergic reaction to lidocaine or the
numbing medicine used at the dentist's office,
or to x-ray dyes. You should also tell your doctor
if you might be pregnant.
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What
happens when the test is performed?
Patients usually wear a hospital gown. Typically,
you lie on your side with your knees curled up
against your chest. In some cases, the doctor
asks you to sit on the bed or a table instead,
leaning forward against some pillows.
The doctor feels your back to locate your lower
vertebrae and feels the bones in the back of
your pelvis. An area on your lower back is cleaned
with soap. Medicine is injected through a small
needle to numb the skin and the tissue underneath
the skin in the area. This causes some very brief
stinging.
A different needle is then placed in the same
area and moved forward until fluid can be injected
through it into the spinal canal. This fluid
is a type of dye that shows up on x-rays; this
allows your doctors to get a clear picture of
the fluid space around your spinal cord and to
see places where the space is narrowed by bones
around it. Because the needle must be placed
through a small opening between two bones, the
doctor must sometimes move the needle in and
out several times to locate the opening. Because
of the numbing medicine used in this area, most
patients experience only a feeling of pressure
from this movement. Occasionally some patients
do get a sharp feeling in the back or (rarely)
in the leg. Let your doctor know if you feel
any pain.
Once the dye has been injected, the needle is
removed and several x-ray pictures are taken
of your back. Sometimes a CT (computed tomography)
scan picture is taken instead.
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What
risks are there from the test?
Risks from this test are minimal. A few people
have an allergic reaction to the dye used in
the test. Some people have a headache or back
soreness for a short time.
As with x-rays, there is a small exposure to
radiation. In large amounts, exposure to radiation
can cause cancers or (in pregnant women) birth
defects. The amount of radiation from a CT scan
is larger than from regular x-rays, but still
very small-too small to be likely to cause any
harm.
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Must
I do anything special after the test is over?
No. Usually a Band-Aid is the only dressing
necessary for your back.
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How
long is it before the result of the test is
known?
It takes about an hour to have your x-rays or
CT scan developed and some time for the films
to be reviewed by a radiologist. Usually your
doctor can get the results within a day.
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