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In order to perform a
myelogram doctors inject a
radio-opaque dye into your
spinal canal and then take
X-ray pictures of the dye.
Using a local anesthetic the
doctors will make a small
hole directly into your
spine so that they can
inject the dye into the tiny
space around the spinal cord
and the nerves which come
from it. The operation will
be done on a table which
tilts so that the doctors
can move you up and down to
make the dye run up and down
your spine and around
various different nerve
junctions. The whole
procedure lasts around half
an hour.
This is an unpleasant,
tricky and potentially
hazardous procedure, and you
will usually need to spend a
day in hospital if you are
having this test.
The side affects - which
seem to affect quite a
number of patients having
this test - include
headache, nausea and
vomiting. In the past some
patients are believed to
have suffered long -term
problems as a result of
damage - Arachnoiditis -
done by an oil-based dye,
and so today most doctors
use a water-soluble
contrasts material. Because
of the dangers associated
with this procedure it is
usually only performed when
a surgeon intends to operate
and wants an accurate idea
of the sort of damage that
may exist in the spine.
Myelogram
Synonyms: Cervical Myelogram;
Lumbar Myelogram; Thoracic
Myelogram
Indications: Visualize
spinal cord abnormalities;
evaluate signs and/or
symptoms of compression of
the spinal nerve roots or
spinal cord by a herniated
disc, degenerative spur,
traumatic injury, neoplasm,
or other mass
Contraindications: Evidence
of raised intracranial
pressure, such as
papilledema; bleeding
abnormalities, such as
elevated prothrombin and
partial thromboplastin
times, decreased platelet
count, or patients on
anticoagulation
Patient Preparation:
Informed consent is obtained
from the patient. Patient is
made NPO 4 hours before the
procedure. Any bleeding
abnormally is corrected
beforehand. The patient with
chart is sent on a stretcher
to the myelography suite.
Aftercare: The patient is
placed on bed rest with the
head of the bed elevated at
least 30° to 45° for 4
hours. Oral fluids are
encouraged and the diet is
as tolerated. Any nausea or
vomiting which occurs should
not be treated with
phenothiazine antinauseants.
Follow physician's post op
orders.
Special Instructions: Any
previous spine x-rays or any
prior CT or MR studies of
the spine should be made
available to the
radiologist. The patient
should not be on
phenothiazines at the time
of the procedure.
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