CT Myelogram

A CT Myelogram is an examination which provides detailed information about your spinal cord and spinal nerves. To show these structures on detailed CT scan images, an x-ray contrast dye is injected into the fluid-filled space around the spinal cord. This contrast dye outlines the various structures in the spinal canal so that they are seen more easily on the CT scan.

Before you are referred for a CT Myelogram, you will most likely have been assessed by a specialist surgeon or neurologist who will have taken your history and performed a clinical examination. They will also most likely have referred you for a standard CT or MRI scan to investigate your symptoms. These tests and examinations may help to locate the level of the spine your pain, or other neurological symptom, is originating from. However, additional information is sometimes necessary to identify the exact location and the severity of the cause of your symptoms. If it is decided that you may benefit from further investigation with a CT myelogram, your doctor will refer you to one of our specialist neuroradiology consultants.

Whilst we typically perform CT Myelography for patients to provide more information following an MRI scan, some patients may be referred for a CT Myelogram because they are unable to have an MRI scan. For example, some patients have cardiac pacemaker devices which are not safe to enter an MRI scanner.

When you arrive in the department, we will firstly ask you to complete a simple safety questionnaire. One of our radiographers will then take you to your own private room where we will go through this questionnaire with you.

A radiologist (a radiology doctor) will then explain what will happen, answer any additional questions you may have, and ask for your consent to proceed.

Then, we will ask you to change from your own clothing into a hospital gown. You will be able to keep your belongings locked away safely throughout your visit.

Once you are changed, you will be taken into the CT examination room, where we will ask you to lie on the examination couch either on your front, or on your side. We will normally use various pads and sponges to position your spine in the right way for the test.
Once you are comfortable, we will then begin by taking some simple pictures using the CT scanner. You will feel the table moving slowly during the scan, but we will need you to lie very still so that we achieve clear pictures. You may hear some ‘whirring’ noises, but these are not loud or uncomfortable.

Once the initial scans have been taken and reviewed, the radiologist will then clean the skin and place sterile (clean) drapes over your back. A local anesthetic will be injected to numb the area before a fine needle is inserted into the fluid-filled space around the spinal cord. After the local anaesthetic has taken effect, you should only feel some light pushing, but no pain. We may take more scans to help position the needle correctly.
Once the needle is in the correct position, the radiologist when the inject some x-ray dye very slowly. When the x-ray dye has been injected, we will then begin to take very detailed images of the spine. During these scans, you will feel the table move again, and we may also ask you to hold your breath for a short time.

After the first scan, the needle will be removed. We may then ask you to roll into various position before we take a series of further scans.

After we have taken all the scans we need, you will be transferred onto a comfortable bed and taken to our recovery area. You must remain flat in bed for a minimum of two hours after the procedure. This is very important as we must allow the puncture site to heal to prevent complications from the procedure.

During your time in our recovery area, one of our staff will look after you and take some observations several times. Once you the two hours has passed, and assuming you are feeling well enough, you will then be reviewed by the radiologist who will discharge you. At this point, you will be able to get changed and return home. We will require you to be escorted home by a responsible adult. You will not be able to drive yourself home.

Your CT Myelogram will be reported by the radiologist who performed your procedure. The report will be sent to your doctor within 2 working days, so that they can discuss the results of your scan at your next consultation.

All treatments and procedures have risks, and we will talk to you individually about the risks of C Myelography and the use of x-rays during the CT scan. However, most serious problems are very rare and controlled.