About Your Myelogram

This information will help you get ready for your myelogram at MSK.

A myelogram is a procedure that’s done to look at your spine, spinal cord, and the tissues around them. During your myelogram, your doctor will inject contrast dye into your spinal canal. This will help your doctor see your spinal cord and tissues around it more clearly. After the dye spreads throughout your spinal canal, your doctor will take pictures of your spine.

Before your procedure

Tell your healthcare provider if you:

• Have an allergy to intravenous (IV) contrast dye. Contrast dye is a special dye that makes it easier for your healthcare provider to see your internal organs.
• Can’t lie flat on your stomach because of pain or breathing problems.
• Take prochlorperazine (Compazine®). You’ll need to stop taking it for 24 hours (1 day) before your procedure. Your healthcare provider will prescribe a different medication 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.

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.

Arrange for someone to take you home

You 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.

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 9 a.m. to 5 p.m.

After 5 p.m., 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 2 business days (Monday through Friday) before your procedure. If your procedure is scheduled on a Monday, you’ll be called on the Thursday 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.

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 67^th Street. Take the R elevators to the 2^nd floor. After you check-in at the reception desk, a staff member will bring you to the nursing unit.

What to expect

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.

During your procedure

When it’s time for your myelogram, you’ll be asked to change into a hospital gown. Your technologist will bring you to the scanning room and help you onto 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 braces. This is because the table will tilt slightly during your scan.

Once you’re comfortable on the fluoroscopy table, you’ll get an injection (shot) of local anesthetic (medication to make an area numb) in your lower back.

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, but you must stay still. Your radiologist will use the needle to remove a small amount of fluid from your spinal canal. After the fluid is removed, they will use the same needle to inject contrast dye.

After the contrast dye is injected, the scanning table will be tilted and your technologist will help you move back and forth slightly to help the contrast travel throughout your spinal canal. Then, your radiologist will use a special type of x-ray to check that the contrast dye spread through your spinal canal. Once the contrast has spread, your radiologist will remove the needle and place a small dressing (bandage) over the area where the needle was placed.

Then you’ll have a computed topography (CT) imaging scan. This scan will take pictures of your spine, including your vertebrae (bones in your back), the space between your vertebrae, and spinal cord. 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, you’ll be taken to your simulation appointment with MSK patient transport services.

After your procedure

After your myelogram is finished, you’ll change back into your clothes and gather anything you brought with you. 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.

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 try the following things:

• Take an over-the-counter pain medication such as acetaminophen (Tylenol®).
  • Check with your healthcare provider before taking acetaminophen. If you have liver problems, it may not be safe for you to take.
  • Don’t take more than 3,000 mg of acetaminophen in a 24 hour period.
• Lie down. This may make you feel better.
• Have drinks that contain caffeine. Try drinking 1 to 2 cups of coffee or another caffeinated drink such as tea or soda.
• If your headache doesn’t get better within 2 days, call your healthcare provider.

Don’t 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 for more information.

Caring 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:

• Avoid bending over.
• Don’t shower or put your body in water, such as in a bathtub, pool, or hot tub.
• Don’t take any NSAIDs.
• Avoid strenuous activities. Don’t do any heavy work, play, or lift heavy objects.
• Don’t drive a car or operate any heavy machinery.
• Don’t 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.
• Don’t drink any alcoholic beverages.

After 24 hours, you may shower and remove the bandage.

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 medication.
• Numbness or tingling in your lower back or legs.
• A headache that lasts longer than 2 to 3 days.