About Your Myelogram

This information will help you get ready for your myelogram at Memorial Sloan Kettering (MSK).

A myelogram is a procedure that’s done to look at your spine, spinal cord, and the tissues around them. During your myelogram, your doctor will inject contrast dye into your spinal canal. This will help your doctor see your spinal cord and tissues around it more clearly. After the dye spreads throughout your spinal canal, your doctor will take pictures of your spine.

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Before Your Procedure

Tell your healthcare provider if you:

  • Have an allergy to intravenous (IV) contrast dye.
  • Can’t lie flat on your stomach because of pain or breathing problems.

If you feel sick and have any symptoms such as a fever, cold, sore throat, or the flu before your procedure, call your doctor. They can be reached Monday through Friday from 9:00 am to 5:00 pm. After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask for the IR fellow on call.

Ask about your medications

You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you to stop taking. We have included some common examples below.

Anticoagulants (blood thinners)

If you take a blood thinner (medication that affects the way your blood clots), ask the doctor performing your procedure what to do. Their contact information is listed at the end of this resource. Whether they recommend you stop taking the medication depends on the reason you’re taking it.

Do not stop taking your blood thinner medication without talking with your doctor.

Examples of Blood Thinners
apixaban (Eliquis®) dalteparin (Fragmin®) meloxicam (Mobic®) ticagrelor (Brilinta®)
aspirin dipyridamole (Persantine®) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil®) or naproxen (Aleve®) tinzaparin (Innohep®)
celecoxib (Celebrex®) edoxaban (Savaysa®) pentoxifylline (Trental®) warfarin (Coumadin®)
cilostazol (Pletal®) enoxaparin (Lovenox®) prasugrel (Effient®)  
clopidogrel (Plavix®) Fondaparinux (Arixtra®) rivaroxaban (Xarelto®)  
dabigatran (Pradaxa®) heparin (shot under your skin) sulfasalazine (Azulfidine®, Sulfazine®)  
  • If you’re taking low dose aspirin of 81 milligrams (mg) or less, you may continue to take it.
  • Tell your doctor if you’re taking prochlorperazine (Compazine®). You will need to stop taking it for 24 hours before your procedure. Your doctor will prescribe a different medication if you need it.

Please read our resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). It has important information about medications you’ll need to avoid before your procedure and what medications you can take instead.

Medications for diabetes

If you take insulin or other medications for diabetes, ask the doctor who prescribes the medication what you should do the morning of your procedure. You may need to change the dose before your procedure.

Diuretics (water pills)

If you take any diuretics (medications that make you urinate more often), ask the doctor performing your procedure what to do. You may need to stop taking them the day of your procedure. Diuretics are sometimes called water pills. Some examples are furosemide (Lasix®) and hydrochlorothiazide.

Arrange for someone to take you home

You must have a responsible care partner take you home after your surgery/procedure. Make sure to plan this before the day of your surgery/procedure.

If you don’t have someone to take you home, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

Travel

Talk with your doctor if you have any plans to fly in an airplane within 24 hours (1 day) of your procedure.

Tell us if you’re sick

If you develop any illness (fever, cold, sore throat, or the flu) before your procedure, call your doctor. They can be reached Monday through Friday from 9:00 am to 5:00 pm. After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask for the Interventional Radiology (IR) fellow on call.

Note the time of your procedure

A staff member from General Radiology will call you 2 business days before your procedure. If your procedure is scheduled on a Monday, you will be called on the Thursday before.

The staff member will tell you what time you should arrive at the hospital for your procedure. They will also tell you where to go for your procedure. If you don’t receive a call by noon the business day before your procedure, call 212-639-7298.

If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.

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The Day of Your Procedure

You can eat a light meal before your procedure, unless your nurse or doctor gives you other instructions. It’s also important to remember that you will be lying flat on your stomach during your procedure.

Parking when you arrive

Parking at MSK

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212- 639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

Enter Memorial Hospital through the entrance at 425 East 67th Street.

  • Take the “R elevators” to the 2nd floor.
  • Check in at the reception desk. A staff member will bring you to the nursing unit.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

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During Your Procedure

When it’s time for your myelogram, you will be asked to change into a hospital gown. Your technologist will bring you to the scanning room and help you onto the fluoroscopy table. The table is padded so you’re comfortable during the scan. Your technologist will safely secure you to the table with special braces. This is because the table will tilt slightly during your scan.

Once you’re comfortable on the fluoroscopy table, you will get an injection (shot) of local anesthetic (medication to make an area numb) in your lower back.

Once the area is numb, your radiologist will guide a needle into your spinal canal. You may feel a little pressure in your lower back, but you must stay still. Your radiologist will use the needle to remove a small amount of fluid from your spinal canal. After the fluid is removed, they will use the same needle to inject contrast dye.

After the contrast dye is injected, the scanning table will be tilted and your technologist will help you move back and forth slightly to help the contrast travel throughout your spinal canal. Then, your radiologist will use a special type of x-ray to check that the contrast dye spread through your spinal canal. Once the contrast has spread, your radiologist will remove the needle and place a small dressing (bandage) over the area where the needle was placed.

Then you will have a computed topography (CT) imaging scan. This scan will take pictures of your spine, including your vertebrae (bones in your back), the space between your vertebrae, and spinal cord. It’s important to stay still during the scan.

The whole procedure will take about 30 to 40 minutes.

If you have a radiation simulation appointment after your myelogram, you will be taken to your simulation appointment with MSK patient transport services.

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After Your Procedure

After your myelogram is finished, you will change back into your clothes and gather anything you brought with you. Your radiologist will send a report of your scan to your doctor. Your doctor will use the results of your myelogram to help plan your care.

Side effects

You may get a headache after your myelogram. Sometimes this headache may make you feel nauseous (feeling like you might throw up). If you do get a headache, you can try the following things:

  • Take an over-the-counter pain medication such as acetaminophen (Tylenol®).
    • Check with your doctor before taking acetaminophen. If you have liver problems, it may not be safe for you to take.
    • Don’t take more than 3,000 mg of acetaminophen in a 24 hour period.
  • Lie down. This may make you feel better.
  • Have drinks that contain caffeine. Try drinking 1 to 2 cups of coffee or another caffeinated drink such as tea, Coke®, Pepsi®, or Mountain Dew®.
  • If your headache doesn’t get better within 2 days, call your doctor.

Don’t take NSAIDs such as ibuprofen (Advil®, Motrin®) for 24 hours after your myelogram. NSAIDs can cause bleeding and keep the needle insertion site from healing properly. Read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for more information.

Caring for yourself at home

You can continue your usual diet after your myelogram, unless your doctor or nurse gives you other instructions.

For the first 24 hours after your myelogram:

  • Avoid bending over.
  • Don’t shower or put your body in water, such as in a bathtub, pool, or hot tub.
  • Don’t take any NSAIDs.
  • Avoid strenuous activities. Don’t do any heavy work, play, or lift heavy objects.
  • Don’t drive a car or operate any heavy machinery.
  • Don’t travel in an airplane.
  • Try to drink at least 8 to 10 (8-ounce) glasses of liquids, unless your doctor or nurse gives you different instructions.
  • Don’t drink any alcoholic beverages.

After 24 hours, you may shower and remove the bandage.

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When to Call Your Healthcare Provider

Call your healthcare provider if you have any of the following:

  • A fever above 100.4° F (38 °C) and redness, swelling, or discharge in the area where the needle was placed on your back. This can be a sign of infection.
  • Blood or fluid leaking from the area where the needle was placed on your back. A small amount of blood on your bandage is normal though.
  • Pain that doesn’t go away after taking pain medication.
  • Numbness or tingling in your lower back or legs.
  • A headache that lasts longer than 2 to 3 days.
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Contact Information

If you have any of the above symptoms within 24 hours of your procedure, call the IR team at 212-639-2236. You can reach a staff member Monday through Friday from 9:00 am to 5:00 pm. After 5:00 pm, during the weekend, and on holidays, please call 212-639-2000 and ask for the fellow on call for IR.
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