Computed Tomographic Myelography

What you should know

• Computed tomographic (to-MOG-rah-fik) (CT) myelography (mie-LOG-rah-fe) is a procedure to examine the spinal canal with contrast material (dye). A CT myelography uses a special x-ray machine with computer, called CT scan, that takes pictures of the body in slices. The spinal canal contains the spinal cord, which carries messages between your brain and body, and cerebrospinal fluid (CSF). CSF is a clear fluid that also flows around the brain. The spine is made up of vertebrae (small bones) stacked on one another with soft discs in between bones. CT myelography is usually done to get more detailed pictures of an abnormal part of the spinal canal. It may diagnose problems in the spinal cord, disc, or vertebra when a myelography using plain x-ray is not enough. It may also be used when other imaging tests, such magnetic resonance imaging (MRI), cannot be done.
  
  
• In this procedure, dye is injected into the spinal canal to give a better view of the spine. The dye may be made of oil but is usually made of water which can be absorbed by the body. The dye may be put in the lower back area or in the neck area of the spine. Pictures of the spinal canal are then taken using the CT scan. Sometimes, caregivers may take x-ray pictures first before doing a CT scan.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

Having a CT myelography may put you at risk of having other problems. You may have a bad headache, neck or back pain, nausea (upset stomach), and vomiting (throwing up). There may be bleeding, infection, injury to a disk in your spine, or spinal fluid may leak from the injection site. Your nerves or spinal cord may be damaged. The dye used during the procedure may cause an allergy. It may reach the brain and cause seizures or brain problems. The dye may also damage the kidneys. Patients who have blood disorders or who are taking certain medicines are at a higher risk for problems. Talk with your caregiver if you are worried or have questions about your procedure, medicine, or care.

Getting Ready

Before your procedure:

• Tell your caregiver if you have any allergies. This includes an allergy to any food, dye, cleansing solution, such as iodine, or any numbing medicine.
  
  
• Tell your caregiver if you have a blood disorder or have had a bleeding problem in the past. It is also important that your caregiver knows if you have other diseases. These diseases may include diabetes (high blood sugar level), blood vessel disease, or heart, liver, or kidney problems.
  
  
• Tell your caregiver if you are taking any medicine that may make you more likely to bleed. These medicines may include aspirin, clot busters, or blood thinners. Tell your caregiver also if you are taking an anti-depressant. This is medicine given to decrease or stop the symptoms of depression or to treat other behavior problems.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• If you are female, tell your caregiver if you know or think you might be pregnant.
  
  
• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• You may need to have different blood and urine tests. Imaging tests, such as x-rays, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

Day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine. You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be taken to the room where the procedure will be done. There may be large x-ray machines and other equipment inside the room. X-rays with a TV screen will be used to guide caregivers during the procedure. You will be asked to lie on your side on an x-ray bed or table. Your caregiver will clean the area of your spine where the needle will be inserted. You may be given one or more shots of numbing medicine.
  
  
• A needle will be inserted between the bones of the spine and into the spinal canal. Dye will be injected when the needle has entered the canal. You may feel warm after the dye is injected. The table where you lie will be tilted so the dye can move over the spinal area with the problem. A series of x-rays may be taken first while you are moved into different positions. Pictures of the spinal canal will then be taken using a CT scan. When the procedure is finished, the dye will be removed if it is made with oil. The needle will also be removed, and the injection site will then be covered with a bandage or surgical tape.

After your procedure:

You may need to lie flat in bed or with your head slightly raised. This may last for 12 to 24 hours or until the dye is completely absorbed by your body. Caregivers will keep a close watch on you. When caregivers see that you are OK, you may be allowed to go home. If caregivers want you to stay in the hospital, you will be taken back to your hospital room. You may need to drink more liquids than usual after the procedure, or you may need fluids through the vein (IV).

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure appointment on time.
  
  
• You have a skin infection or a wound near the area where the procedure will be done.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• You have a fever.
  
  
• Your signs and symptoms are getting worse.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Computed Tomographic Myelography (Precare)