This information will help you get ready for your myelogram at MSK.
What is a myelogram?
A myelogram is an imaging test of the spinal cord, nerves, and the tissues around them. A radiologist (RAY-dee-AH-loh-jist) or radiologist assistant will do your myelogram. A radiologist is a doctor with special training in using imaging to diagnose and treat disease.
During your myelogram, your doctor will give you an injection (shot) of contrast into your spinal canal. Contrast is a special dye that helps make the images from your scan clearer. As the contrast travels through your spinal canal, your doctor will take X-rays of your spine.
Contrast will leave your body through your urine (pee) within 24 hours (1 day).
Your healthcare provider will give you local anesthesia (A-nes-THEE-zhuh) before your procedure. Local anesthesia is medicine that numbs an area of your body. If you’re getting anesthesia, read “For people getting anesthesia” at the end of this resource. Talk with your healthcare provider about whether you’ll get anesthesia.
What to do before your myelogram
Tell your healthcare provider if you:
- Have an allergy to intravenous (IV) contrast dye or have had a reaction to contrast before. You may get medicine to lower your risk of having another allergic reaction. If you do, you’ll get a resource called Preventing An Allergic Reaction to Contrast Dye.
- Cannot lie flat on your stomach because of pain or breathing problems.
- Take prochlorperazine, such as Compazine®. You’ll need to stop taking it for 24 hours (1 day) before your procedure. Your healthcare provider will prescribe a different medicine if you need it.
Ask about your medicines
You may need to stop taking some of your usual medicines before your procedure. Talk with your healthcare provider about which medicines are safe for you to stop taking.
We’ve included some common examples below, but there are others. Make sure your care team knows all the prescription and over-the-counter medicines you take. A prescription medicine is one you can only get with a prescription from a healthcare provider. An over-the-counter medicine is one you can buy without a prescription.
It is very important to take your medicines the right way in the days leading up to your procedure. If you don’t, we may need to cancel your procedure.
Blood thinners (anticoagulants)
A blood thinner is a medicine that changes the way your blood clots.
If you take a blood thinner, ask the healthcare provider doing your procedure what to do before your procedure. They may tell you to stop taking the medicine a certain number of days before your procedure. This will depend on the type of procedure you’re having and the reason you’re taking a blood thinner.
Examples of common blood thinners are listed below. There are others, so be sure your care team knows all the medicine you take. Do not stop taking your blood thinner without talking with a member of your care team.
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Read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil. It has information about medicines you must avoid before your procedure.
Diabetes medicines
If you take insulin or other diabetes medicines, ask the healthcare provider who prescribes it what to do before your procedure. You may need to stop taking it or take a different dose (amount) than usual. You may also need to follow different eating and drinking instructions before your procedure. Follow your healthcare provider’s instructions.
Your care team will check your blood sugar levels during your procedure.
Diuretics (water pills)
A diuretic is a medicine that helps control fluid buildup in your body. Hydrochlorothiazide (Microzide®) and furosemide (Lasix®) are examples of diuretics.
If you take a diuretic, ask the healthcare provider doing your procedure what to do before your procedure. You may need to stop taking it the day of your procedure.
Take devices off your skin
You may wear certain devices on your skin. Before your scan or procedure, device makers recommend you take off your:
- Continuous glucose monitor (CGM)
- Insulin pump
Talk with your healthcare provider about scheduling your appointment closer to the date you need to change your device. Make sure you have an extra device with you to put on after your scan or procedure.
You may not be sure how to manage your glucose while your device is off. If so, before your appointment, talk with the healthcare provider who manages your diabetes care.
Breastfeeding and pregnancy
Your healthcare provider will ask you if you’re pregnant or think you may be pregnant. If you are pregnant, your doctor may choose not to give you contrast. If you think you may be pregnant or plan to become pregnant, talk with your healthcare provider.
If you have questions, talk to your doctor about your options. You can also talk to the radiologist on the day of your MRI.
Travel
Talk with your healthcare provider if you have any plans to fly in an airplane within 24 hours of your procedure.
Tell us if you’re sick
If you get sick (including having a fever, cold, sore throat, or flu) before your procedure, call your IR doctor. You can reach them Monday through Friday from to
After , during the weekend, and on holidays, call 212-639-2000. Ask for the Interventional Radiology fellow on call.
Note the time of your procedure
A staff member from General Radiology will call you 1 business day (Monday through Friday) before your procedure. If your procedure is scheduled on a Monday, you’ll be called on the Friday before.
The staff member will tell you what time you should arrive at the hospital for your procedure. They will also tell you where to go for your procedure. If you don’t receive a call by noon the business day before your procedure, call 212-639-7298.
If you need to cancel your procedure for any reason, call the healthcare provider who scheduled it for you.
What to do the day of your procedure
You can eat a light meal before your procedure, unless your healthcare provider gives you other instructions. It’s also important to remember that you’ll be lying flat on your stomach during your procedure.
Where to go
Visit www.msk.org/parking for parking information and directions to all MSK locations.
Enter Memorial Hospital through the entrance at 425 East 67th Street. Take the R elevators to the 2nd floor. After you check-in at the reception desk, a staff member will bring you to the nursing unit.
What to expect when you arrive
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.
When it’s time for your procedure, you will get a hospital gown and non-skid socks to wear. A staff member will bring you to the locker room.
You’ll remove your clothes and change into a hospital gown. You’ll place your clothing and all of your items (phone, jewelry, coins, glasses, bags) into a patient bag. Do not use any of the locker. Leave any valuables at home if you do not need them.
Your technologist will bring you to the scanning room and help you onto the fluoroscopy table.
In the procedure room
A member of your care team will go over the procedure with you and have you sign a consent form. This is a form that says you agree to the procedure and understand the risks.
Then, they will help you into position on the fluoroscopy table. The table is padded so you’re comfortable during the scan. Your technologist will safely secure you to the table with special ankle and foot braces. This is because the table will tilt during your scan.
A radiologist will clean your lower back with an antiseptic solution, which kills germs and bacteria. They will give you an injection of local anesthetic in your lower back to numb the area. Once the area is numb, your radiologist will guide a needle into your spinal canal. You may feel a little pressure in your lower back. You must stay still.
When the needle is in place, your radiologist will remove a small amount of spinal fluid from your spinal canal. They will use the same needle to inject contrast dye. Then, they will remove the needle and cover the area with a bandage or dressing.
The technologist will tilt the fluoroscopy table to help the contrast travel throughout your spinal canal. Your radiologist will watch the flow of the contrast on a TV monitor and take X-rays of your spine.
After your myelogram is finished, your care team will move you onto a stretcher. They will take you to have a computed tomography (CT) scan of your spine. It’s important to stay still during the scan.
The whole procedure will take about 30 to 40 minutes.
If you have a radiation simulation appointment after your myelogram, a staff member will take you there on a stretcher.
What to do after your myelogram
After your myelogram and CT scan, you’ll change back into your clothes and get anything you brought with you. If you have a radiation simulation appointment, you will change there.
Side effects
You may get a headache after your myelogram. Sometimes this headache may make you feel nauseous (feeling like you might throw up). If you do get a headache, you can lie down, or try these things.
Pain medicine
Take an over-the-counter pain medicine, such as acetaminophen (Tylenol®). Over-the-counter medicine is medicine you can get without a prescription. Check with your healthcare provider before taking acetaminophen. If you have liver problems, it may not be safe for you to take.
Do not take more than 3,000 mg of acetaminophen in a 24 hour period.
Have caffeine
Try drinking 1 to 2 cups of drinks that have caffeine, such as coffee, tea or soda. If your headache does not get better within 2 days, call your healthcare provider.
Do not take NSAIDs such as ibuprofen (Advil®, Motrin®) for 24 hours after your myelogram. NSAIDs can cause bleeding and keep the needle insertion site from healing properly. Read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil to learn more.
How to care for yourself at home
You can continue your usual diet after your myelogram, unless your healthcare provider gives you other instructions.
For the first 24 hours after your myelogram:
- Do not shower or put your body in water, such as in a bathtub, pool, or hot tub.
- Do not take any NSAIDs.
- Avoid bending over or doing strenuous activities. Do not do any heavy work, play, or lift heavy objects.
- Do not drive a car or operate any heavy machinery. Get a ride or take public transportation instead, if you can.
- Do not travel in an airplane.
- Try to drink at least 8 to 10 (8-ounce) glasses of liquids, unless your healthcare provider gives you different instructions.
- Do not drink alcohol.
After 24 hours, you may shower and remove the bandage.
Getting your results
Your radiologist will send a report of your scan to your healthcare provider. Your healthcare provider will use the results of your myelogram to help plan your care. Your results will be available within 5 days.
When to call your healthcare provider
Call your healthcare provider if you have any of the following:
- A fever of 100.4° F (38 °C) or higher.
- Redness, swelling, or discharge in the area where the needle was placed on your back. This can be a sign of infection.
- Blood or fluid leaking from the area where the needle was placed on your back. A small amount of blood on your bandage is normal though.
- Pain that doesn’t go away after taking pain medicine.
- Numbness or tingling in your lower back or legs.
- A headache that lasts longer than 2 to 3 days.
For people getting anesthesia | ||||||
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If you are getting anesthesia (medication to make you sleepy) during your procedure, follow these instructions. What to do the day before your procedureArrange for someone to take you homeYou must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure. If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.
Instructions for eating
If your healthcare provider told you to stop eating earlier than midnight, follow their instructions. Some people need to fast (not eat) for longer before their procedure. What to do the day of your procedureInstructions for drinkingBetween midnight (12 a.m.) and 2 hours before your arrival time, only drink the liquids on the list below. Do not eat or drink anything else. Stop drinking 2 hours before your arrival time.
If you have diabetes, pay attention to the amount of sugar in these drinks. It will be easier to control your blood sugar levels if you include sugar-free, low-sugar, or no added sugar versions of these drinks. It’s helpful to stay hydrated before procedures, so drink if you are thirsty. Do not drink more than you need. You will get intravenous (IV) fluids during your procedure.
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