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Radiology Exam: Myelogram

This X-ray examination produces images (films) of your spinal cord and spinal nerves after contrast (sometimes called dye) is injected into the fluid within the spinal column. Myelography can diagnose specific abnormalities, such as herniated discs, spinal canal narrowing and tumors. These images assist physicians in evaluating your medical condition.

Myelogram: What You Need to Know

A myelogram may be done to assess the spinal cord, subarachnoid space, or other structures for changes or abnormalities. It may be used when another type of exam, such as a standard X-ray, does not give clear answers about the cause of back or spine problems. Myelograms may be used to evaluate many diseases, including herniated discs, spinal cord or brain tumors, infection and/or inflammation of tissues around the spinal cord and brain, spinal stenosis, ankylosing spondylitis, bone spurs, arthritic discs, cysts, or arachnoiditis. 

Why Choose Johns Hopkins Radiology for Myelography?

Our Physicians

Our diagnostic radiologists have subspecialty training in neuroradiology. Our state-of-the-art equipment and technology is combined with providing the highest level of patient care.

Find a Johns Hopkins radiologist who specializes in myelography procedures.

How to Prepare for the Procedure

After the Procedure

Following the myelogram, you will be assisted onto a stretcher and positioned with your head raised at least 30 degrees. In almost all cases, a CT scan follows the myelogram to obtain even further information about the spine while the dye is still present in the spinal fluid. There may be a short time span between the myelogram and the spinal CT scan or several hours will pass before the scan is begun. This is determined by how much contrast is used. When CT scanning is to occur right after the myelogram, you will wait in the Neuroradiology Division. Inpatients may be returned to their room and scanned several hours later. Images will be evaluated by the neuroradiologist. A copy of the report will be sent to your referring physician.

After Leaving Neuroradiology

Inpatients

You will be returned to your room on a stretcher. A nurse will assist you into bed where you should rest for at least eight hours, other than sitting in a chair for short periods or getting up to use the bathroom. We recommend that while in bed, you lie with the head of the bed elevated at least 30 degrees. During these eight hours after the myelography/CT scan, please do not bend over. Drinking plenty of liquids after the procedure is also very helpful. Solid foods may be eaten later as desired. Following the eight-hour period, you may resume normal activity if you are feeling well. If you experience a headache, it is best to remain in bed at this time for another eight to 10 hours.

Outpatients

After the myelogram is complete, you must remain in the neuroradiology area at bed rest and to be monitored by our nursing staff for approximately two hours to reduce the risk of postprocedural headache or allergic reaction. Your CT scan may be performed during this time. After the observation period and the CT scan you may be driven home by a friend or relative. Plan to have someone with you to drive you home. Taxi drivers are not a good substitute and will not look after you the way a significant other will. If your ride home is longer than 30 minutes, we advise that you spend this time in your automobile in a reclined position with one or two pillows supporting your head. After returning home, please rest eight hours on a couch or bed, supporting your head with at least two pillows.

Potential Side Effects

The most common side effect from this procedure is a headache, and it can be quite severe and last days after the spinal tap. In order to minimize the chance of a headache developing you should restrict all activity for the day of the myelogram. The longer you rest in bed, the less likely you will have a very bad headache. If your headache lasts more than 24 hours, call us at 410-955-7432 and we may suggest you get an epidural blood patch that will relieve your headache quickly. This can be done at The Johns Hopkins Hospital or any nearby medical facility. Other side effects include nausea/vomiting, worsening of pain and dizziness.

These symptoms may result from either the spinal tap or the contrast that is injected. Our use of the smallest sized needles and the injection of the smallest amount of contrast possible result in our patients having experienced a low occurrence of side effects. When side effects occur, they generally last less than 24 hours and are not usually dangerous. If you have any questions or concerns about side effects, please call 410-955-7432.

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