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What exactly does a myelogram show?

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Old 01-02-2009, 07:17 AM   #1
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What exactly does a myelogram show?

I'm scheduled for a myelogram in a couple of weeks and I'm wondering what exactly the test will show. I've read posts about how the procedure is done, and while I'm not necessarily looking forward to it I'm getting used to all of these tests so I'm sure I can make it through it.

I had two back surgeries in 2008 (laminectomy/discectomy/foraminectomy at L4-L5 and hematoma/infection correction, no fusion yet) and have been having continued sciatic pain down my left leg. I've been telling my surgeon that something is still wrong, and a recent MRI shows a protuding piece of disc causing mass effect on the dorsal root ganglion and nerve root at L4-L5. However, the sciatic pain I have goes into the bottom of my heel and along the outer side of my left foot which is consistent with an L5-S1 herniation, but that disc looks fine on my MRI. The MRI does show that my facet joints are moderately degenerated at both L4-L5 and L5-S1. I'm 41 years old and it sure make me feel older to be told I'm degenerating!

A recent visit to a fellowship-trained neurosurgeon for a 2nd opinion has him wanting a myelogram and he said it would show more detail than an MRI. He wants to do a microdiscectomy to remove the disc protrusion at L4-L5 but wants to make sure that is the only problem. He said an extremely rare condition known as conjoined nerve roots might cause the disc to not match up with it's dermatome, but he doubts it since it is so uncommon. I did have a selective nerve root block at L4 prior to my first surgery that took the pain away for the 3 hours I was numbed up, and I am also scheduled for another one of those next week.

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Old 01-02-2009, 05:23 PM   #2
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Re: What exactly does a myelogram show?

I had a mylogram few months ago and basically in some cases it more clear than a MRI. They will release a dye on you spine area to light up the affected area. X-rays will be taken and maybe follow up with CT Scan. You may have to remain in hospital for several hours for observation. The dye sometime react with head-aids and other minor problems.

I just completed a mycrodicectomy on Monday 29, and after 5days post OP I am feeling well from the surgery but my leg pain is about 80% well. they say it take times so i can no complain at this point.

Old 01-03-2009, 12:32 PM   #3
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Re: What exactly does a myelogram show?

A myelogram is done to see if there is compression of the spinal cord or nerve roots and if so, how badly.
It's not a fun test, but it's not nearly as bad as it is made to sound on the internet.
They will have you come to the hospital a few hours before the test is scheduled to get you set up in a room and then down you will go to radiology. They have you lay on your side or stomach, whichever is easier for the radiologist, and then they give you a small injection of lidocaine or something similar, wait a few seconds and then introduce the needle into the spinal cord. It is really important that you don't move during this part.
They withdraw a small amount of fluid then inject the dye. You can actually watch it on the fluroscope monitor by your head.
After that is done, they take a few xrays right there, and transfer you on a gurney and take you over to the CT scanner for a few more pictures.
All in all, I think it took about an hour for mine, each time.
After that, it is back upstairs for a period of time before you go home. The biggest thing you will need to remember is to follow the directions of the nursing staff once you go home.

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