How to Prepare for a Myelogram?



A myelogram is an X-ray examination of the spine after the injection of a dye-like contrast material to outline the spinal canal and nerves. It is commonly performed to evaluate back pain, radiculopathy, spinal stenosis, and disc herniation.

HOW SHOULD I PREPARE FOR THE PROCEDURE?

  1. Drink plenty of clear liquids but no solid food for 4 hours before the procedure.
  2. A Myelogram is generally not performed during pregnancy because of the risk of embryo/fetal injury. Advise the technologist if you are, or may be, pregnant.
  3. Discontinue Coumadin (Warfarin), Plavix (Clopidogrel), Ticlid (Ticlopidine), and Pletal (Cilostazol) with permission from the prescribing physician for 5 days prior to the procedure. If you take Coumadin (warfarin), a Prothrombin time (PT) and INR will be obtained here at the clinic before the procedure.
  4. Discontinue low-molecular weight heparin therapy with Lovenox (Enoxaparin), Fragmin (Dalteparin), Normiflo (Ardeparin), or Orgaran (Danapararoid) with permission from the prescribing physician for 24 hours prior to the procedure.
  5. Arrange for someone to drive you home after the procedure.

HOW IS THE INJECTION PERFORMED?

Prior to the injection, your skin is cleansed with antiseptic soap and numbed with local anesthetic. The physician uses fluoroscopy to accurately place a needle in the spinal canal. A small amount of fluid may be removed for further study. The contrast material is then injected and the needle removed. Following the injection, several X-ray images will be made. The procedure typically takes 20-30 minutes.

WHAT SHOULD I DO AFTER THE MYELOGRAM?

  1. Resume a regular diet.
  2. Drink plenty of clear liquid - at least 8 oz. every hour.
  3. Lie flat with your head slightly elevated for 8 hours.
  4. Do not engage in strenuous work, exercise, physical therapy or lifting for 48 hours.
  5. No driving the day of the procedure.
  6. Resume your regular medications (including pain medications) prescribed by your physician(s). If you take a blood thinner you may resume taking it 12 hours after the procedure.
  7. Remove your bandage in 24 hours.

COMMON SIDE EFFECTS:

  1. Headache: This is the most common complication and occurs in about 20% of patients. These usually resolve within 2-3 days. Lie flat in bed, increase your fluid intake, and take your usual medications as directed by your physician. A blood patch is occasionally needed.
  2. Increased pain: a temporary increase in pain for a day or two following your procedure is not unusual. Take your usual pain medication prescribed by your physician.

SERIOUS COMPLICATIONS ARE RARE BUT POTENTIALLY INCLUDE:

  1. Infection:Severe infections, such as meningitis, are rare.
  2. Bleeding:Bleeding is a rare complication and is more common in patients taking anticoagulants, such as Coumadin/Warfarin, Lovenox, Plavix and Ticlid.
  3. Nerve damage:Extremely rare but can occur from needle trauma, infection, and bleeding.
  4. Seizures:Extremely rare.
  5. Allergic reaction: Allergic drug reactions are uncommon.

CONTACT OUR OFFICE AT 615-356-3999 FOR THE FOLLOWING SYMPTOMS:

  1. Fever greater than 100°
  2. Headache that is unresolved with medication, bed rest, and fluids after 2-3 days.
  3. Increased pain, swelling, or redness at the injection site.
  4. Difficulty walking or profound weakness of the arms or legs.

 

28 White Bridge Road
Suite 111
Nashville, Tennessee
37205

Phone (615) 356-3999
Fax (615) 353-0462