Myelography

What is myelography?

Myelography also called a myelogram, is an imaging test that checks for problems in your spinal canal. The spinal canal contains your spinal cord, nerve roots, and the subarachnoid space. The subarachnoid space is a fluid-filled space between the spinal cord and the membrane that covers it. During the test, a contrast dye is injected into the spinal canal. Contrast dye is a substance that makes specific organs, blood vessels, and tissue shows up more clearly on an x-ray.

Myelography involves using one of these two imaging procedures:

Fluoroscopy, a type of x-ray that shows internal tissues, structures, and organs moving in real-time.
CT scan (computerized tomography), a procedure that combines a series of x-ray images taken from different angles around the body.

Other names: myelogram

What is it used for?

Myelography is used to look for conditions and diseases that affect the nerves, blood vessels, and structures in the spinal canal. These include:

Herniated disk. Spinal disks are rubbery cushions (disks) that sit between the bones of your spine. A herniated disk is a condition in which the disk bulges out and presses on spinal nerves or the spinal cord.
Tumours
Spinal stenosis, a condition that causes swelling and damage to the bones and tissues around the spinal cord. This leads to narrowing of the spinal canal.
Infections, such as meningitis, that affect the membranes and tissues of the spinal cord
Arachnoiditis, a condition that causes inflammation of a membrane that covers the spinal cord

Why do I need myelography?

You may need this test if you have symptoms of a spinal disorder, such as:

Pain in the back, neck, and/or leg
Tingling sensations
Weakness
Trouble walking
Trouble with tasks that involve small muscle groups, such as buttoning a shirt

What happens during myelography?

A myelography may be done at a radiology center or in the radiology department of a hospital. The procedure usually includes the following steps:

You may need to remove your clothing. If so, you will be given a hospital gown.
You will lie on your stomach on a padded x-ray table.
Your provider will clean your back with an antiseptic solution.
You will be injected with numbing medicine, so you won’t feel any pain during the procedure.
Once the area is numb, your provider will use a thin needle to inject contrast dye into your spinal canal. You may feel some pressure when the needle goes in, but it should not hurt.
Your provider may remove a sample of spinal fluid (cerebrospinal fluid) for testing.
Your x-ray table will be tilted in different directions to allow the contrast dye to move to different areas of the spinal cord.
Your provider will remove the needle.
Your provider will capture and record images using fluoroscopy or a CT scan.

After the test, you may be monitored for one to two hours. You may also be advised to lie down at home for a few hours and to avoid strenuous activity for one to two days after the test.

Will I need to do anything to prepare for the test?

Your provider may ask you to drink extra fluids on the day before the test. On the day of the test, you will probably be asked to not eat or drink anything, except for clear fluids. These include water, clear broth, tea, and black coffee.

Talk to your provider about any medicines you are taking. Certain medicines, especially aspirin and blood thinners, should not be taken before your test. Your provider will let you know how long you need to avoid these medicines. It may be as long as 72 hours before the test.

Are there any risks to the test?

You should not take this test if you are pregnant or think you may be pregnant. Radiation can be harmful to an unborn baby.

For others, there is little risk of having this test. The dose of radiation is very low and is not considered harmful for most people. But talk to your provider about all the x-rays you’ve had in the past. The risks from radiation exposure may be linked to the number of x-ray treatments you’ve had over time.

There is a small risk of an allergic reaction to the contrast dye. Tell your provider if you have any allergies, especially to shellfish or iodine, or if you’ve ever had a reaction to contrast material.

What do the results mean?

If your results were not normal, it may mean you have one of the following conditions:

Herniated disk
Spinal stenosis
Tumor
Nerve injury
Bone spurs
Arachnoiditis (inflammation of the membrane surrounding the spinal cord)

A normal result means your spinal canal and structures were normal in size, position, and shape. Your provider may want to do more tests to find out what is causing your symptoms.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about myelography?

MRI (magnetic resonance imaging) has replaced the need for myelography in many cases. MRIs use a magnetic field and radio waves to create images of organs and structures inside the body. But myelography can be useful in diagnosing certain spinal tumours and spinal disk problems. It’s also used for people who are unable to have an MRI because they have metal or electronic devices in their bodies. These include a pacemaker, surgical screws, and cochlear implants.

References

Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2020. Myelogram: Overview; [cited 2020 Jun 30]; [about 3 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/4892-myelogram
Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2020. Myelogram: Test Details; [cited 2020 Jun 30]; [about 4 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/4892-myelogram/test-details
Johns Hopkins Medicine [Internet]. Baltimore: The Johns Hopkins University; c2020. Health: Myelopathy; [cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/myelopathy
Mayfield Brain and Spine [Internet]. Cincinnati: Mayfield Brain and Spine; c2008–2020. Myelogram; [updated 2018 Apr; cited 2020 Jun 30]; [about 3 screens]. Available from: https://mayfieldclinic.com/pe-myel.htm
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2020. CT Scan: Overview; 2020 Feb 28 [cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2020. Herniated disk: Symptoms and Causes; 2019 Sep 26 [cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2020. MRI: Overview; 2019 Aug 3 [cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768
National Institute of Neurological Disorders and Stroke [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Neurological Diagnostic Tests and Procedures Fact Sheet; [updated 2020 Mar 16; cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurological-Diagnostic-Tests-and-Procedures-Fact
RadiologyInfo.org [Internet]. Radiological Society of North America, Inc.; c2020. Myelography; [cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.radiologyinfo.org/en/info.cfm?pg=myelography
Spine Universe [Internet]. New York (NY): Remedy Health Media; c2020. Myelography; [cited 2020 Jun30]; [about 3 screens]. Available from: https://www.spineuniverse.com/exams-tests/myelography-myelogram
University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2020. Health Encyclopedia: Myelogram; [cited 2020 Jun 30]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07670
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: How It Is Done; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html#hw233075
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: Results; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html#hw233093
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: Risks; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 7 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html#hw233088
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: Test Overview; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: What To Think About; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 10 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html#hw233105
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Myelogram: Why It Is Done; [updated 2019 Dec 9; cited 2020 Jun 30]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/myelogram/hw233057.html#hw233063