CT Myelogram
Date issued: November 2024
For review: November 2026
Ref: B-391/Radiology/WJ/CT Myelogram v2
PDF: CT Myelogram.pdf [pdf] 237KB
This leaflet tells you about having a CT myelogram.
It explains what is involved and what the possible risks are. It is not meant to replace informed discussion between you and your doctor but can act as a starting point for such discussions. If you have any questions about the procedure, please ask the doctor who has referred you or the department which is going to perform it.
Referral and consent
The referring clinician should have discussed the reasons for this examination with you in the clinic and you should make sure that you understand these before attending. You will be referred to an Interventional Neuroradiologist for this procedure who is trained and specialised in imaging and x-ray treatments.
Before the procedure you will need to sign a consent form, if one hasn’t previously been completed. This form says that you need to know what risks are involved. This is a legal requirement and ensures that you are fully informed about your procedure.
If after discussion with your hospital doctor or neuroradiologist you do not want this examination, then you can decide against it. If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary, then they will explain this to you and communicate with the referring clinician. You will return to your referring clinician for review.
At all times the Interventional Neuroradiologist and referring clinician will be acting in your best interests.
What is a CT Myelogram?
A myelogram is an examination which provides detailed information about your spinal cord and nerve roots (the nerves which come off the spinal cord).
Special x-ray dye (contrast) is injected into the fluid filled space around the spinal cord.
A CT scan is then performed, and the injected dye can be seen on the scan.
A CT scanner is a type of x-ray machine that produces highly detailed cross-sectional images of the inside of the body.
Are there any risks?
Most patients do not have any side effects during a myelogram. You may experience a headache which will clear up within 1-2 days with rest, paracetamol and plenty of fluids.
Problems that are rare but serious include:
Nerve root damage
Meningitis
Epidural Abscess
CSF leak or haemorrhage
We have had no reported cases of the above at Derriford.
CT scanners produce harmful x-rays which can cause tumours to develop in the future. These doses are kept as low as possible and about the same as you experience in your normal day living in the UK over 4-5 years. The benefit of an accurate diagnosis far outweighs the risk.
If you are pregnant or suspect that you may be pregnant you should notify the department. A baby in the womb may be more sensitive to radiation than an adult. There is no problem with something like an x-ray of the hand or chest because the radiation field is at a safe distance from the foetus. However, special precautions are required for examinations where the womb is in, or near, the beam of radiation. If you are a female of childbearing age the radiographer will ask you if there is any chance of you being pregnant before the examination begins and you will be asked to sign a form. If there is a possibility of pregnancy, then your case will be discussed with the team looking after you to decide whether or not to recommend postponing the investigation.
There will be occasions when diagnosing and treating your illness is essential for your health and where the benefit clearly outweighs the small radiation risks. The procedure may go ahead after discussing all the options with you.
Allergic reactions to the dye are also possible but are very rarely serious.
Are you required to make any special preparations?
A myelogram can be carried out as a day case or inpatient procedure under local anaesthetic.
You may eat and drink as normal unless sedation has been discussed beforehand with the referring team/radiologist.
Before coming into hospital, you will have been asked about certain risk factors for vascular disease, unless you have to come into hospital as an emergency. These factors include checking your blood pressure; your kidney function and making sure you are not on treatment for diabetes or blood clots.
If you are taking warfarin, rivaroxaban, apixaban, ticagrelor (anticoagulants) this will be stopped before the procedure and you may require admission to hospital to give you an alternative.
If you are diabetic, your doctors will advise you about any changes needed to your normal medication. If you have any allergies or have previously had a reaction to the dye (contrast agent), you must tell the radiology staff before you have the test.
Who will you see?
A specially trained team led by a Neurointerventional Radiologist within the radiology department. Neurointerventional Radiologists have special expertise in reading the images and using imaging to guide catheters and wires to aid diagnosis and treatment.
Where will the procedure take place?
The first part of the procedure is performed in the interventional radiology suite which is located within the radiology department. This is similar to an operating theatre into which specialised X-ray equipment has been installed. You will then be transferred to the CT scanner to complete the examination.
What happens during a myelogram?
Before the myelogram, the doctor will explain the procedure. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
You will be asked to lie on the X-ray table, generally on your left side. The X-ray machine will be positioned above you.
A myelogram is performed under sterile conditions and the Interventional Neuroradiologist and radiology nurse will wear sterile gowns and gloves to carry out the procedure.
Your skin near the point of insertion on your lower back will be swabbed with antiseptic and then covered with a sterile drape. The skin and deeper tissues over the area will be numbed with local anaesthetic.
A needle will be inserted and guided to the correct position to allow the special dye to be injected.
If cerebrospinal fluid is required for analysis in the laboratory, then a small amount can be taken at this point.
Once the doctor is satisfied with the images and position of the dye then the needle will be removed, and you will be transferred onto a trolley and taken to CT for your scan.
Will it hurt?
It may sting a little when the local anaesthetic is injected. You may feel a dull ache in your back and a heavy feeling down your legs.
How long will it take?
Every patient's situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be.
As a guide, expect to be in the X-ray department for about an hour and a half altogether.
What happens afterwards?
You will be taken back to your ward. Nursing staff will carry out routine observations including pulse and blood pressure. You will generally stay in bed for a few hours, until you have recovered and are ready to go home. It is very important that you do not lie flat in order to prevent a headache occurring.
You will need someone to drive you home and ensure that an able-bodied person remains with you until morning. Ch
Other Risks
Myelography is a very safe procedure but as with any procedure or operation complications are possible. We have included the most common risks and complications in this leaflet.
We are all exposed to natural background radiation every day of our lives. This comes from the sun, food we eat, and the ground. Each examination gives a dose on top of this natural background radiation.
Any exposure to ionising radiation (e.g. X-rays) has the potential to cause cancer later in life. This is much lower than the risk we all have of developing cancer in our life of ~1 in 3 and will be considered by the doctor before your procedure.
For information about the effects of X-rays read the publication: “X-rays how safe are they” on the Health Protection Agency
Recommendations following a myelogram
2 hours bedrest and 2 hours mobilising are recommended after this procedure. You will be observed by the nursing staff throughout. You must drink 1 litre of fluid in this 4-hour period.
Finally
Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact
Interventional Radiology Department
01752 430838 - IR Co-ordinator
01752 432063 – Bookings Clerk
Additional Information
Bus services:
There are regular bus services to Derriford Hospital. Please contact:
Car parking:
Hospital car parking is available to all patients and visitors. Spaces are limited so please allow plenty of time to locate a car parking space. A charge is payable.
Park and Ride:
Buses (1/1A/42C/34) run from the George Junction Park and Ride Mon-Sat (except Bank Holidays) every 15/20 mins from 6am. The last bus leaves the hospital at 11:30pm.
Plympton Park and Ride (52) runs from Coypool Park and Ride.
Parking is free although you will need to purchase a ticket to travel on the bus.
Patient Transport:
For patients unable to use private or public transport please contact The Patient Transport Service:
Devon GP: 0345 155 1009
Cornwall GP: 01872 252211
