A myelogram is an x-ray image of the spine in which the space around the spine has been injected with contrast material to increase visibility. Myelograms are used to provide more information about medical issues such as numbness, tingling, and back pain. Alternatives to this procedure include MRI and CT scans, which may not be an option for all patients; MRI, for example, cannot be used with patients who have metallic medical devices implanted in their bodies, such as pacemakers or spinal rods.
In this procedure, the patient is given an injection of contrast dye, with the assistance of a series of x-rays which guide the needle so that the dye can be injected into the right spot. Then, the spine is x-rayed. The dye makes the spinal cord and nerves highly visible, highlighting problems such as pinched nerves, herniated discs, and tumors. This test is often done under fluoroscopy, in which x-ray images are converted to video to create a real time image.
When a myelogram is recommended, a patient does need to take some steps to prepare. Patients are often asked to refrain from eating and drinking before the test, and they will need to wear a hospital gown for the test and remove jewelry so that it does not interfere with the visibility of the x-ray. After the test, patients need to lie with their heads elevated for several hours, and they are advised to arrange rides home from the hospital, as they will not be able to drive immediately after discharge.
There are some risks to a myelogram. Many patients experience headaches and nausea as a result of the contrast dye. Rarely, seizures can occur. Other rare complications can include loss of bowel control or paralysis. The radiation exposure is designed to be minimized, but repeat x-ray procedures can be a cause for concern. As with all medical procedures, the risks can be greatly reduced by discussing patient history in detail before the test, to confirm that a patient is a good candidate for a myelogram and to identify issues which may be concerns.
The results of a myelogram will be read and discussed with the patient. If the results are normal, other tests may be conducted to get at the root of the patient's symptoms. If the results suggest that abnormalities are present, the doctor can talk about what the results mean, and what the patient's options are. These options can include additional testing and surgery to correct a problem.