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Lumbar Myelography is a special x-ray to evaluate the bones and nerves in the low back.
How is the lumbar myelography performed?
After administering local anesthesia, a specially designed needle is guided into the fluid filled space surrounding the nerve roots in the low back, using x-ray guidance. X-ray dye is then injected into this space which outlines the nerve roots and other structures in the low back. X-rays are then taken and a CT scan (CAT scan) is performed to give additional information. The procedure usually takes about 20 minutes.
What happens the day of the procedure?
Lumbar myelography is performed as an outpatient procedure. It is important you take any usual medications the morning of the procedure EXCEPT aspirin, Plavix or coumadin. If you are taking Plavix, you should discontinue this for 7 days prior to the procedure, with the approval of your doctor. If you are taking coumadin, you should discontinue this for 3 days prior to the procedure, with the approval of your doctor. You will also be asked to temporarily stop taking certain other medications prior to the procedure, mainly tricyclic antidepressants and phenothiazines. When you are scheduled for the procedure, you will be given instructions as to what medications you may need to temporarily discontinue.
You will report to the hospital in the morning, prior to the scheduled start of the procedure. You will be checked into the same day care ward, have an IV line placed, and be prepared for the procedure. After the procedure you will return to the same day care ward to be observed for about 2 hours. Someone must accompany you to drive you home.
Are there risks associated with myelography?
If you have had a significant allergic reaction to x-ray dye, you should not have this procedure, or at least you would require premedication with steroids. Some patients may experience a headache after the procedure. If this occurs, you will be given instructions for treating this headache. There is also a very small risk of bleeding or infection resulting from the procedure. There is a rare risk of seizure as a reaction to the injected x-ray dye.
The procedure is identical as described above for lumbar myelogram, although you will have x-ray and CT scan of the neck, rather than the low back.