Myelogram

A myelogram is a diagnostic test designed to make very detailed images of the spine, spinal cord, and nerves.  While we can see these structures on the MRI, the myelogram is a more sensitive test for looking at the nerves and allows us to take pictures of these nerves while the patient is standing, in flexion (bending over) and in extension (arching the back).

In a myelogram, the radiologists will freeze the patient’s back with local anesthetic, and, while watching the X-ray machine, will put a very small needle (24 or 25 gauge) into the spine and inject some X-ray dye that will mix with spinal fluid and outline the nerves, spinal cord, and the discs and bones.  The needle is then taken out and multiple X-rays taken.  After the X-rays are taken, a CAT scan is performed.  The reason for this is that the X-rays will tell us if a nerve (or the spinal cord) is compressed.  The CAT scan will tell is what is causing the compression.  This test usually takes about 30 minutes and but we will keep you in our office for observation for an additional 30 minutes or so.  After the myelogram, you will need to stay flat in bed or nearly flat in a recliner for 18-24 hours to give the small injection site time to heal.

While the test sounds unpleasant, it is not. It is very rare for patients to experience severe pain.  Should this happen, we will provide you with pain medication. 

This is also a test that has a lot of false information associated with it. 

You cannot be paralyzed or suffer nerve damage from this test. While post-myelogram headaches are possible, they are very rare due to our use of very small injection needles.  Our incidence of post-myelogram headaches is less than one percent.