About Your Myelogram

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

A myelogram is a procedure that’s done to look at your spinal cord and surrounding tissues. During your myelogram, you will have contrast dye injected into your spinal canal. This helps the doctor see your spinal cord and surrounding tissues more clearly. After the contrast has spread throughout your spinal canal, you will have images taken of your spine.

Before Your Procedure

Tell your healthcare provider if you:

  • Are allergic to IV contrast.
  • Are unable to lie flat on your stomach due to pain or breathing problems.

If you develop any illness (fever, cold, sore throat, or flu) before your procedure, please call a nurse in Interventional Radiology (IR) at 212-639-2236. A nurse is available 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. We have included some common examples below.

Ask the doctor who prescribed the medication(s) if it’s safe for you to stop taking them. Your doctor may or may not tell you to stop taking the medication, depending on the reason you’re taking it. Do not stop taking any of these medications without talking to your doctor.

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

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

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The Day Before Your Procedure

Note the time of your procedure

A staff member from IR will call you 1 business day before your procedure. If your procedure is scheduled on a Monday, you will be called on the Friday before. The staff member will tell you what time you should arrive at the hospital for your procedure. If you don’t receive a call by 2:00 pm the day before your procedure, call 212-639-7298.

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

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The Day of Your Procedure

You may eat a light meal before your procedure. However, remember that you will be lying flat on your stomach during your procedure.

If you usually drive to your appointments, bring someone who can drive you home. You won’t be able to drive for 24 hours after your procedure.

Where to park

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

If you’re having a myelogram as part of your radiation therapy simulation:

  • Enter Memorial Hospital through the entrance at 425 East 67th Street.
  • Take the R elevator to the 2nd floor.
  • Check in at the desk. A staff member will bring you to the nursing unit.

If you’re having a myelogram for any other reason:

  • Enter Memorial Hospital through the entrance at 1275 York Avenue.
  • Take the M elevator to the 2nd floor.
  • Enter the waiting room through the glass doors and check in at the desk. This is the Presurgical Center. Myelograms are performed in Radiology, which shares the same waiting room.

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 gown. Your technologist will bring you to the scanning room and help you onto the scanning table. The table is padded so you’re comfortable during the scan. Your technologist will safely secure you to the table with specialized braces, because the table will tilt slightly during your scan.

Once you’re comfortable on the scanning table, you will get an injection 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 remember to remain 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 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 has spread through all of your spinal canal. Once the contrast has spread, your radiologist will remove the needle and place a small dressing (bandage) over the needle insertion site.

Finally, pictures will be taken of your spine, including your vertebrae, 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.

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After Your Procedure

After your myelogram is finished, your technologist will help you off the scanning table. You will change back into your clothes and gather your belongings.

If you have a radiation simulation appointment after your myelogram, you should leave the building from the 425 East 67th Street exit, between First and York Avenues.

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. If you do, it should go away after 1 to 2 days. If you develop 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.
  • Have drinks with caffeine. Try drinking 1 to 2 cups of coffee or another caffeinated drink such as tea, Coke®, Pepsi®, or Mountain Dew®.

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 our resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for more information.

If your headache doesn’t improve within 2 days, call your doctor.

 

Caring for yourself at home

You can restart your regular diet right 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 submerge yourself in water (such as in a bathtub, pool, or hot tub).
  • Don’t take any NSAIDs.
  • Avoid strenuous activities. Don’t engage in 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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Call Your Doctor or Nurse if You Have:

  • A temperature above 100.4° F (38 °C) and redness, swelling, or discharge at the needle insertion site. This can be a sign of infection.
  • Blood or fluid leaking from the needle insertion site. However, a small amount of blood on the bandage is expected.
  • Pain that isn’t helped by your pain medication.
  • Numbness or tingling in your lower back or legs.
  • A headache that lasts longer than 2 to 3 days.

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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Contact Information

If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________.

After 5:00 pm, during the weekend, and on holidays, call ­____________ and ask for the radiation oncologist on call. If there’s no number listed, or you’re not sure, call 212-639-2000.
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