What is a myelogram?
A myelogram is a diagnostic imaging test generally done by a radiologist. It uses
a contrast dye and X-rays (fluoroscopy) or computed tomography (CT) to look for problems
in the spinal canal. Problems can develop in the spinal cord, nerve roots, and other
tissues. This test is also called myelography.
The contrast dye is injected into the spinal column before the procedure. The contrast
dye appears on an X-ray screen allowing the radiologist to see the spinal cord, subarachnoid
space, and other nearby structures more clearly than with standard X-rays of the spine.
The radiologist may also use a CT scan when doing a myelogram. A CT scan is an imaging
test that uses X-rays and a computer to make detailed images of the body. A CT scan
shows detailed images of the spinal canal. CT scans show more details than standard
Why might I need a myelogram?
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, doesn't give clear answers about the cause of back or spine problems.
Myelograms may be used to evaluate many diseases, including:
Herniated disks. These are disks that bulge and press on nerves or the spinal cord.
Spinal cord tumors
Infection or inflammation of tissues around the spinal cord
Spinal stenosis. This is a breakdown and swelling of the bones and tissues around
the spinal cord. This breakdown makes the canal narrow.
Cysts. These are noncancerous (benign) capsules that may be filled with fluid or solid
Tearing away or injury of spinal nerve roots
Arachnoiditis. This is inflammation of a delicate membrane that covers the nerve roots
in the lower spine.
There may be other reasons for your healthcare provider to recommend a myelogram.
Talk with your provider about the reason for your test.
What are the risks of a myelogram?
You may want to ask your healthcare provider about the amount of radiation used during
the procedure and the risks related to your situation. It's a good idea to keep a
record of your radiation exposure, such as previous CT scans and other types of X-rays,
so that you can inform your provider. Risks associated with radiation exposure may
be related to the cumulative number of X-ray exams or treatments over a long period.
If you're pregnant or think you may be, tell your provider. Radiation exposure to
the fetus may cause birth defects.
There is a risk of an allergic reaction to the contrast dye. Be sure to let your provider
know if you have any allergies, especially to shellfish or iodine; ever had a reaction
to any contrast dye, or have any kidney problems.
Because the contrast is injected into the cerebrospinal fluid (CSF), which also surrounds
the brain, there is a small risk of seizure after the injection. Some medicines may
place you at greater risk for seizure and you may be asked to stop taking these for
48 hours before and after the study. Make sure your provider has a list of all medicines
(prescribed and over-the-counter) and all herbs, vitamins, and supplements that you're
Because this procedure involves a lumbar puncture, these potential complications may
A small amount of CSF can leak from the needle insertion site. This can cause headaches
after the procedure. If there's a persistent leak, the headache can be severe.
There is a slight risk of infection because the needle breaks the skin's surface,
providing a possible entry point for bacteria.
You could have short-term numbness of the legs or lower back pain.
There is a risk of bleeding in the spinal canal or in the soft tissues around it.
There may be other risks depending on your specific medical condition. Be sure to
discuss any concerns with your provider before the procedure.
How do I get ready for a myelogram?
Your healthcare provider will explain the procedure to you and ask if you have any
You'll be asked to sign a consent form that gives your permission to do the procedure.
Read the form carefully and ask questions if anything isn't clear.
Follow any directions you're given for not eating or drinking before the test.
Tell your provider or the radiologist if you have ever had a reaction to any contrast
dye or if you're allergic to iodine.
Tell your provider if you have a history of seizures or are taking any medicines for
Tell your provider if you have a history of bleeding disorders or are taking any blood-thinner
(anticoagulant) medicine, aspirin, or other medicines that affect blood clotting.
You may need to stop these medicines before the procedure.
Give your provider a list of all prescribed and over-the-counter medicines, herbs,
vitamins, and supplements that you're taking.
If you have the procedure as an outpatient, you may be asked to stay in the hospital
for several hours afterward. Plan to have another person drive you home.
Your provider may give you other instructions on what to do before the procedure.
What happens during a myelogram?
A myelogram may be done on an outpatient basis or as part of your stay in a hospital.
The procedure takes about an hour, but may vary depending on your condition and the
Generally, a myelogram follows this process:
You'll be asked to remove any clothing, jewelry, or other objects that may get in
the way of the procedure.
If you're asked to remove your clothing, you'll be given a gown to wear.
You will be reminded to empty your bladder before the start of the procedure.
You'll lie on our stomach or side on a padded table.
Your back will be cleaned with an antiseptic solution and draped with sterile towels.
The radiologist will numb the skin of your lower spine by injecting a numbing medicine
using a thin needle. This injection may sting for a few seconds, but it makes the
procedure less painful.
A needle will be inserted through the numbed skin, between 2 spinal bones (vertebrae),
and into the subarachnoid space where the spinal fluid is located. You'll feel some
pressure while the needle goes in, but it shouldn't be painful. You must stay very
The radiologist may remove some of the spinal fluid from the spinal canal. Next, a
small amount of contrast dye will be injected into the spinal canal through the needle.
You may feel a warming sensation and a metallic taste in your mouth when the contrast
dye is injected. This should last only a few minutes. Then you'll lie on your stomach,
if you're not already in this position.
The X-ray table will be tilted in various directions to allow gravity to help move
the contrast dye to different areas of your spinal cord. You'll be held in place by
a special brace or harness. More contrast dye may be given during this process through
the secured lumbar puncture needle.
The needle is then removed and the X-rays or CT scan pictures are taken.
You should tell the radiologist right away if you feel any numbness, tingling, headache,
or lightheadedness during the procedure.
You may have discomfort during the myelogram. The radiologist will use all possible
comfort measures and complete the procedure as quickly as possible to minimize any
discomfort or pain.
What happens after a myelogram?
You need to sit or lay down for several hours after the procedure to reduce your risk
of developing a cerebral spinal fluid leak.
You'll be asked to drink extra fluids to rehydrate after the procedure. This helps
your body wash out the contrast dye and replace the spinal fluid that was removed.
It also reduces the chance of developing a headache.
A nurse will monitor your vital signs (blood pressure, temperature, pulse, and respirations)
frequently after the test. You'll be given pain medicine if you develop a headache.
When you have completed the recovery period, you'll be taken to your hospital room
or discharged to your home.
Once you are at home, tell your healthcare provider of any changes including:
Numbness and tingling of the legs
Blood or other drainage from the injection site
Pain at or near the injection site
Nausea or vomiting
Inability to urinate
If the headaches persist for more than 24 hours after the procedure or get worse when
you change positions, you should contact your provider.
You may be instructed to limit your activity for 24 hours after the procedure. Generally,
if you don’t have any problems, you may return to your normal diet and activities.
Your provider may give you other instructions after the procedure, depending on your
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you're having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you're to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you didn't have the test or procedure
Any alternative tests or procedures to think about
When and how you'll get the results
Who to call after the test or procedure if you have questions or problems
How much you'll have to pay for the test or procedure