Risks/benefits of CT myelogram

What are the risks of CT myelograms?

Myelograms are very safe procedures done on an outpatient basis with minimal possible risks.
•With any procedure involving a needle there is always a risk for infection, this risk is very low, and sterile technique is used to significantly reduce this risk.
•Allergic reactions to the contrast material are extremely uncommon, but may occur. Allergic reactions may be mild to severe. Mild reactions include: itching, nausea, hives. A more severe reaction would include: nausea, shortness of breath, difficulty breathing or swallowing. Reactions to the contrast typically happen immediately after injection.
•There is a low risk for a "spinal headache." This is a headache that will not be relieved using medications. This headache is caused by a leaking of the spinal fluid from the injection site. (Following the bed rest protocol for 24hrs will reduce this risk).
•There is a risk for bleeding. This risk is especially low if you are not on blood thinning agents. Blood thinners are held due to this concern.
•A risk for seizures is also uncommon, but may occur if you are on a contraindicated medication. Certain medications may put you at an increased risk, please let the technologist know about all medications you currently take.

What are the benefits?

Myelograms use high resolution imaging of the spinal column for a detailed study that can assist your physician in evaluating your medical condition, and diagnosing abnormalities of the spine. Myelography may be used in planning for surgical treatment of the spine. These highly detailed images help to demonstrate:
•Compression of nerve roots caused by herniations of intervertebral discs.
•Degenerative Changes in the bone and tissues surrounding the spinal canal.
•Spinal stenosis.
•Tumors involving the spine, nerve roots or spinal cord.
•Infections involving the spine, the discs, or surrounding tissues.
•Spinal lesions caused by disease or trauma.
•Spinal fluid leaks.

After your CT myelogram

Upon discharge you will be given post procedure instructions and a copy of your medication reconciliation form to take home with you. It is important to follow all instructions carefully to prevent any complications such as: headaches, seizures, and pain. Post procedure instructions include:

•24 hours bed rest. You may not return to work or participate in strenuous activities within this time period.
•No driving or operating machinery for 24 hours.
•Continue holding contraindicated medications for 24 hours post procedure
•Stay well hydrated, drink plenty of fluids.

How will I get the test results?

The Radiologist will review all images, and send a report to your ordering physician within 24 hours. Your physician will talk with you about your test results at the time of your followup appointment.

How do I contact someone in Radiology at SAMC about my concerns?

You may contact our radiology department directly at (334)793-5843, to speak to a Radiologic Technologist about your procedure. Please call between 7 a.m.-4 p.m.

If you develop problems after the procedure, call your ordering Physician.

If you have an emergency, call 911 or proceed to the nearest emergency room.

During your CT myelogram

You will be taken to a dressing room to change into a gown. The technologist will escort you to the fluoroscopy suite and take a blood pressure reading. Next, you will sign forms giving the radiologist permission to perform the myelogram. You will be assisted to the X-ray table, and positioned for preliminary x-rays. The technologist will prepare you for the procedure.

You will lie on your abdomen for the procedure; if this is uncomfortable cushions can be applied to ease the discomfort. Every effort will be made to make you comfortable, and to complete the exam as quickly as possible. An area on your back will be exposed and cleansed using an antiseptic solution. Sterile drapes will be applied to reduce the risk of infection.

A local anesthetic, such as lidocaine will be injected into the skin for numbing. This may feel like a pinch or burning sensation. Next, the spinal needle will be guided into the spinal space using fluoroscopic (x-ray) guidance. This could feel like mild pressure in your lower back, or you may notice nothing at all. A small amount of contrast ("x-ray dye"), about 10-20mL, will be injected slowly into the spinal column containing the nerve roots.

At this time you might experience sensations of pressure, cramping, tingling, or an increase in your previous symptoms. This is normal, and usually subsides within a few hours. Once the contrast is in place the needle will be removed and images obtained.

The table will tilt in several directions during image acquisition; for instance you may be tilted down towards your head, or tilted to stand onto your feet. Tilting the table allows gravity to move the contrast to the desired location to obtain the best images.

When all images required by the radiologist have been taken, your back will once again be cleansed, and you will be moved to a stretcher to be taken for a CAT Scan (CT). The myelogram takes approximately 30-45 minutes. The CT will take approximately 10-15 minutes, and you will recover in a room on the second floor in our same day surgery area for 2 - 4 hours.