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Myelography

The purpose of this procedure is to demonstrate abnormalities of the nerves or any compression on the dural sack, which carries the nerve routes from the brain to the rest of the body through the spinal canal.  For example a herniated disk.  Nowadays this study is reserved for patients who cannot undergo a magnetic resonance (MRI) study to investigate their symptoms.  When it is performed it is often combined with a CT study of the region of interest (e.g. lumbar spine).

  • About your Myelography

    • Myelography is the injection of a contrast agent, visible on X-ray images, into the fluid that is contained in the dural sack in spinal canal.
    • The nerves in the bony canal, inside spine, are bathed in this fluid, known as cerebro-spinal fluid.
    • The bony canal protects the nerves, but also means that limited space is available.
    • If a disc herniated into the canal or a growth forms in the canal, the nerves become compressed which causes significant pain or even loss of function of the legs or arms.
    • A myelogram assists us in determining the type and level of pathology that is causing the nerve compression.
    • The procedure is similar to a lumbar puncture.  X-ray imaging is captured during the procedure and these are often followed by a CT scan of the levels where pathology is detected.
    • The CT provides detailed three-dimensional anatomical information of the pathology.  In current modern medical practice the need for myelography has been replaced, in the vast majority of cases with MR scanning.
    • Myelography is nowadays reserved for people who cannot undergo MR scanning and for certain specialised cases.
  • Before your Myelography

    You will be admitted to hospital for the day.

    Allow at least 15 minutes before your study to check in at the radiology reception desk and 1 hour before at the hospital reception desk.

    You will be asked to put on a gown.  You will be asked to remove your watch, jewellery, cellphone, all metal objects including your purse and credit cards, but it is best to bring only the bare essentials with you.  These items will be locked for safe-keeping.

  • During your Myelography

    • You will receive a sedative before the start of the procedure.
    • You will be asked to lie on your side or sit up on a fluoroscopy (screening) table at the beginning of the study.
    • The study is performed under sterilised conditions.
    • Your back will be cleaned with a sterilising agent and the puncture site will be injected with a local anaesthetic.
    • The puncture is then performed under x-ray screening control to ensure accurate placement.
    • A small amount of spinal fluid will be taken off before the contrast agent is injected.
    • The needle is removed after the injection.  We then proceed to capture the necessary X-ray images.
    • During this phase of the procedure it is of the utmost importance that you co-operate fully and follow instructions accurately, to ensure a successful study.
    • We need to place you in various positions, to obtain the correct X-rays, and need your full co-operation to achieve this.  Once the study is completed, you will be moved onto a bed.
    • You need to stay flat, with the head of the bed raised, for the next four hours.
  • Let the Radiographer know

    • For the success of the procedure and for your safety, tell the radiographer:
    • If you are pregnant or suspect you may not be able to have the myelogram for other reasons.
    • If you had previous X-rays of your spine, please bring these with you.  Comparing previous X-rays to current ones assists in more accurate diagnosis.
  • After Myelography

    • Myelography is often combined with CT scanning of the area of interest.  This will be the next step.  It is usually done an hour or so after the myelogram.
    • Once the study and/or CT scan is completed you will be admitted to a hospital bed for at least four to six more hours.
    • During this time you have to stay flat with your head raised.  You may experience mild headache and some people feel some nausea.
    • Staying flat with your head raised lessens the risk of these side effects.
    • Darkening the room also helps to treat any headache that might occur.  Painkillers and anti-nausea medication will be prescribed if you need any.  Our nursing sister or Radiologist will discharge you after 4 to 6 hours.
    • You will not be allowed to drive home. Please arrange for someone to take you home.  You may not go back to work on the same day.
    • For best results stay at rest at home for the remainder of the day and night.
  • Myelography Tips

    • Come to the hospital prepared with what you will need for a short admission.
    • Enquire from your doctor about the continuation of any medication that you are taking.
    • Many medical aids will not fund an overnight stay after myelography.
    • It is therefore best that you ensure your appointment is in the morning, so that we will be able to discharge you on the same day.

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