A myelogram is a procedure done to show if there are any abnormalities in the spine, the spinal cord (the nerves in the spine) or the surrounding structures. It involves placing a needle into the spinal canal and injecting an iodine containing contrast agent into the sac that contains the spinal cord and nerve roots, and then taking images. Franklin Moser, MD, Chief of Neuroradiology, leads our team of imaging physicians, nurses and technologists who specialize in these procedures.
A needle is placed in your lower back (lumbar and lumbosacral region) or occasionally in the neck (cervical region). The area for needle placement is localized using imaging guidance. The radiologist will administer local anesthesia. Since the needle tip is in a location near the nerve roots, you may briefly experience symptoms such as pain or an electric shock sensation down the leg; if this happens, the needle position will be adjusted. A small amount of cerebrospinal fluid is removed and sent to the laboratory for analysis. Contrast is injected, multiple x-ray images are obtained, and the needle is removed. A series of x-ray pictures are obtained. A CT scan is routinely performed after the myelogram to provide additional information. Much of the procedure is performed with you lying prone (face down). The entire procedure from start to finish lasts approximately one hour; the needle is removed at the very beginning of the procedure. You will be awake during the procedure and can ask questions.
Certain medications are contraindicated and should be withheld because they lower the seizure threshold. Seizure is an uncommon complication. If you are on any medications that lower the seizure threshold, please consult your physician in advance of the procedure. If you are taking any anti-depressant medications, e.g. phenothiazines, MAO-inhibitors, tricyclic anti-depressants, Zyban (for smoking cessation), anti-psychotic medications, CNS stimulants, muscle relaxants or any other medication that lowers the seizure threshold, please inform your doctor in advance of the procedure so that these medications can be stopped at least 48 hours before the procedure and resumed no earlier than 24 hours after the procedure. A nurse will call you before the procedure to check if you are on any of these medications and to give you instructions for the procedure. Your physician will decide if it is alright for you to stop these medications and how long they should be withheld.
Sometimes, additional medication must be given at the time of the procedure. Do not eat any solid food after midnight. Take any of your medications that are not contraindicated on the day of the procedure. Do not have any caffeine or alcohol on the day of the procedure.
