Fluoroscopy: Myelography

Myelography is an exam that provides a detailed image of the spinal column. To obtain this detailed image, a contrast material is injected directly into the spinal column under the guidance of a radiologist. The contrast material highlights the anatomy of interest and helps to outline it from surrounding structures.

In this exam, the contrast material surrounds the spinal column, nerves, and nerve root for a highly detailed image of the area of interest. The radiologist will use a specialized x-ray machine called a fluoroscope that allows the radiologist to see continuous x-ray images on a television screen, similar to that of a home video camera. This machine provides a guide to the radiologist when injecting the contrast material into the spinal column. The injection generally is performed in the lower back, close to the waistline of the patient. Once the injection is complete, more images will be taken with the fluoroscope, and then the patient is taken to CT Scanner and given a CT scan of the affected area.

The most important preparation for this exam involves medications. Blood thinners, anticoagulants, antidepressants, and some antipsychotic medication need to be discontinued 48 hours in advance.

However, no medications should be abruptly halted without the knowledge and advice of your doctor. The patient must call his/her physician about stopping any medication or finding alternative medications for this time. Do not stop your medications without speaking to your doctor.

During the exam, you will be asked to lie on your stomach for an extended period of time.

Please inform your doctor and the radiology technologist if you have ever had a seizure or are prone to seizures.

The procedure is as follows:

  1. The patient will arrive before the scheduled exam at the outpatient treatment center.
  2. A nurse at the outpatient treatment center will obtain pertinent medical history, place an IV in the patient’s arm, and administer medications for the exam.
  3. When the patient arrives in radiology, he/she will be escorted to a specialized x-ray room with a fluoroscope. The procedure will be explained and reviewed with the patient and questions will be answered.
  4. The patient will be asked to lay face down on the x-ray table. The radiologist will use the fluoroscope to select the area for the injection and mark the patient’s back with a marker. The area will then be cleaned and sterilized.
  5. Before the contrast injection is made, a local anesthetic will be injected into the patient’s back. Then the radiologist will slowly advance a needle into the patient’s back, using the fluoroscope as a guide. Once he reaches the desired location, the contrast will slowly be injected directly into the spinal column.
  6. After the injection, the x-ray table will be tilted slowly to allow the contrast to distribute throughout the spinal column and nerve roots. During this time, the radiologist will take still images with the fluoroscope. Once the contrast is evenly distributed, and all necessary images are taken, the patient is placed on a hospital stretcher and taken for a CT Scan.
  7. After the CT scan is complete, the patient is taken back to the outpatient treatment center and monitored for the next 1-2 hours.
  8. When the patient is discharged to return home, he/she will leave with a list of instructions. These instructions must be followed exactly to ensure that there are no negative outcomes from this procedure. These instructions include the patient lying down for the remainder of the day, and not lifting anything heavy.
  9. The radiologist will review all of the images from both the fluoroscope and the CT Scan and draft a report for your physician within 3-5 days. This report and the films can be obtained at Sparrow Hospital’s Image Library.

After the exam, the patient is encouraged to drink plenty of liquids.

Each individual patient will have specific needs and concerns that we will address before your study begins. Please feel free to ask us questions at any time.