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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