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University of Iowa Department of Radiology
Peer Review Status: Internally Peer Reviewed
Creation Date: March 1987
Last Revision Date: April 2004
What is a myelogram? A myelogram is an X-ray examination
performed by a radiologist (a physician who specializes in X-ray
procedures and interpretation) in which a contrast material (a dye
that can be seen on an X-ray) is injected into the fluid-filled space
around the spinal cord.
Why a myelogram? To enable the doctor to detect
abnormalities of the spine, spinal cord, or surrounding structures.
- The brain and spinal cord are surrounded by cerebral spinal
fluid, which is a protective clear liquid containing some proteins
and sugar. The body produces this fluid around the brain and
spinal cord as needed.
- The radiologist may use one of two different contrast
materials; a water-based liquid that is not removed after the
X-ray exam
The procedure prior to and following the exam will vary slightly
depending on the type of contrast material used. Preparation for
the exam
- On the day of the exam you will have a regular or liquid
breakfast and then clear liquids only prior to the exam.
- You may receive additional medication or intravenous fluids to
prevent possible side effects (such as seizures and
dehydration)
- When the radiologist talks to you before the exam, be sure to
let him or her know if you have any history of allergy or if you
are taking any tranquilizing drugs or drugs against seizures. If
you are a woman, the test should not be done if there is any
possibility that you may be pregnant, unless it is an
emergency.
During the exam
- You will lie on your side or on your stomach on an X-ray
table.
- After numbing medicine is injected, a needle is inserted into
the spinal canal (in the low back or neck) and a small amount of
spinal fluid is removed for testing. The contrast material is then
injected into the spinal canal.
- The table is tilted to varying degrees to help move the
contrast material through the spinal canal to the desired area.
X-rays are taken to visualize the outlined canal.
Following the exam
- If you received a water-based myelogram, you will be on
bedrest with the head of the bed up 15 to 30 degrees for 4
hours.
- The nurse will check your blood pressure, temperature, pulse,
and respirations as ordered.
- Medication will be available for headache, nausea, or vomiting
if they should develop after the myelogram, but you must request
it.
- You will be encouraged to drink lots of fluids.
Interpretation of results The radiologist will interpret
the results of the procedure and will report the information to your
physician who in turn will discuss the results with you.
Myelogram
This radiographic procedure is to be scheduled. The following list of
medications must be discontined for 48 hours prior to a myelogram.
- amitriptyline (Elavil®)
- amitriptyline/chloridiazepoxide (Limbitrol
DS®)
- amitriptyline/perphenazine
(Etrafon®)
- amoxapine (Asendin®)
- amphetamine
- amphetamine mixture (Adderall®)
- bupropion (Wellbutrin®,
Zyban®)
- chlorpromazine (Thorazine®)
- clomipramine (Anafranil®)
- clozapine (Clozaril®)
- cycloserine (Seromycin®)
- cyclosporine (Sandimmune®,
Neoral®)
- desipramine (Norpramin®)
- dextroamphetamine (Dexedrine®),
Etc.
- doxapram (Dopram®)
- doxepin (Adapin®,
Sinequan®)
- ephedrine
- fentanyl (Duragesic®)
- fluoxetine (Prozac®)
- fluphenzaine (Prolixin®,
Permitil®)
- fluvoxamine (Luvox®)
- haloperidol (Haldol®)
- imipenem-cilastatin (Primaxin®)
- imipramine (Tofranil®)
- lithium (Eskalith®,
Lithobid®, Lithotabs®)
- loxapine (Loxitane®)
- maprotiline (Ludiomil®)
- meperidine (Dermerol®)
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- mesoridazine (Serentil®)
- methamphetamine (Desoxyn®)
- methylpheridare (Ritalin®)
- mirtazapine (Remeron®)
- molindone (Moban®)
- nefazodone (Serzone®)
- nortriptyline (Pamelor®,
Aventyl®)
- olanzapine (Zyprexa®)
- paroxetine (Paxil®)
- perphenazine (Trilafon®)
- pimozide (Orap®)
- prochlorperazine (Compazine®)
- promazine (Sparine®)
- protriptyline (Vivactil®)
- quetiapine (Seroquel®)
- riperidone (Risperdal®)
- sertraline (Zoloft®)
- theophylline (Slo-bid®,
Theo-dur®, Slo-phyllin®,
Theochron®, etc.)
- thioridazine (Mellaril®)
- thiothixene (Navane®)
- trazodone (Desyrel®)
- trifluoperazine (Stelazine®)
- triflupromazine (Vesprin®)
- tramadol (Ultram®)
- trimipramine (Surmontil®)
- venlafaxine (Effexor®)
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1. NPO 4 hours before exam.
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