Myelograms detect problems with the spinal cord and spinal nerves including spinal cord stenosis and nerve impingement, cysts and tumors. The procedure involves injection of contrast medium into the lumbar spinal canal, followed by several X-ray projections, and then a CT scan. A CT myelogram is most useful for patients who cannot undergo MRI (for example, those with pacemakers or cochlear implants) or for those in whom MRI provides limited information (including those with extensive metal in the spine).

To prepare, you must not eat or drink anything four hours before the exam. The physician referring you for this exam will review your chart and may restrict particular medications from 48 hours before your exam until after the exam is complete.

Please bring a list of the medications you’re taking, and, if you like, something to read or do while waiting the prescribed time after the CT scan. You will also need to bring someone who can drive you home after the exam.

A radiology nurse will check your vital signs, review your medication list, and explain the procedure to you before the exam. You will remove your clothes and be given a gown to wear.

For the exam, you will lie down on the x-ray table on your stomach, and a preliminary x-ray will be taken. A radiologist will clean your spinal area with Betadine and use a local anesthetic to numb the injection site. After the anesthetic takes effect, he will insert a needle into the spinal column and inject the contrast solution. Then a variety of x-rays will be taken, with you shifting into different positions for different views.

After the x-rays, you will be taken to a different room for a CT scan.

After the CT scan, you will need to remain in the facility on bed rest, with your head elevated at least 30%. A nurse will check your vital signs every thirty minutes, for three hours. If you need to use the restroom, use the call button so someone may assist you. Assuming you do not have complications, you’ll be released three hours after the exam. Be sure you’ve brought someone to drive you home, as you won’t be able to drive yourself.

Afterwards, you are encouraged to follow your regular diet and drink plenty of water or juice. Avoid drinking alcoholic beverages for at least 24 hours after the exam. You may resume your previous medications EXCEPT for those medications that were held 48 hours before the exam. Follow your primary care physician’s instructions about when to resume those medications. Unless your physician tells you not to, you may take Tylenol, aspirin, or ibuprofen (Advil) if you get a headache.

Do not lie flat for the next 12 hours: keep your head elevated at least 30% during this period of time. You may resume light activity on the day of the exam, and regular activity the following day.

If you develop a fever, severe headache or seizures, call your primary care physician or go to the emergency department of the hospital. If you become nauseated or if you vomit, do not use Phenothiazine anti-nauseants (for example, Compazine, Phenargan).


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