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Myelography & CT Scan
What are myelography and CT scan?
Sometimes, a combination of myelography and computed tomography (CT) is needed. Myelography alone involves the injection of a contrast dye into the spinal canal followed by X-ray imaging. These X-rays—called myelograms—allow visualization of the spinal cord and nerve roots, showing areas of compression, since the contrast does not spread where pressure exists. When myelography is combined with a CT scan, the results provide excellent imaging of the nervous structures, almost comparable to that of an MRI.
Patient Preparation
The patient is prepared in the CT scanning area. Before the examination:
A) The patient must arrange for someone to accompany and drive them home, as driving is not permitted after the injection.
B) They must not eat or drink anything after midnight the night before the exam.
C) Patients taking medications for diabetes, epilepsy, or anticoagulants must consult their doctor in advance, as some medications may need to be stopped 48 hours prior to the procedure.
D) The technologist must be informed about any possible pregnancy and any allergy to contrast agents.
How the Procedure is Performed
The examination consists of two parts:
- The injection of the contrast agentinto the spine.
- The imaging via CT scan.
The patient lies on the CT scanner table. Under sterile conditions, the contrast agent is injected into the spinal canal: the injection site (usually the lumbar spine) is disinfected, and a small amount of cerebrospinal fluid (CSF) is withdrawn before the contrast agent is administered. The patient is positioned on their side with knees drawn to the chest, which facilitates access to the spinal canal.
To ensure accurate needle placement and proper spread of the contrast agent, the injection is done under fluoroscopic (X-ray) guidance. After the injection, CT images are taken.
After the Procedure
Immediately following the exam, the patient must stay in the facility for a few hours. Once home, the following precautions should be taken:
- Keep the head elevated—do not lie flat without a pillow or bend forward. This helps prevent the contrast from traveling to the brain.
- Rest for several hoursand drink plenty of fluids (about 8 glasses of water).
- Avoid physical activityfor the remainder of the day.
- Contact a doctorif any of the following symptoms occur: severe headache, dizziness, fever, or leg weakness.
Risks of Myelography
Though rare, there are some risks associated with myelography. The most common is headache, which usually resolves in 1–2 days with rest and increased fluid intake. Other mild side effects may include nausea and dizziness. Very rarely, seizures or spinal infections may occur.
If the headache persists, treatment may involve a blood patch (epidural injection of the patient’s own blood), which seals the leak of cerebrospinal fluid and relieves the headache.
Conclusion
CT myelography is an excellent diagnostic tool. Although it is invasive, it is reserved for cases where an MRI cannot be performed. As mentioned above, its diagnostic value is nearly equivalent to that of an MRI.
Χειρουργός Σπονδυλικής Στήλης
- Ο Χειρουργός Σπονδυλικής Στήλης/ Σκολίωσης Δρ. Ηλίας Χαρ. Παπαδόπουλος γεννήθηκε και μεγάλωσε στην Αθήνα. Αποφοίτησε με Άριστα από την Ιατρική Σχολή Αθηνών το 1994 και στη συνέχεια ειδικεύτηκε στην ορθοπαιδική, στην Α’ Ορθοπαιδική Κλινική του Πανεπιστημίου Αθηνών.
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