Myelogram

A myelogram is a specialized diagnostic imaging test that uses contrast dye and fluoroscopy (real-time x-ray) to take detailed spine images, including bones, discs, nerves, and soft tissues. In some cases, a computed tomography (CT) scan may be performed following the myelogram to provide additional clarity.

Myelograms can enhance the visualization of spinal structures and potential abnormalities contributing to your symptoms.

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What Is a Myelogram?

A myelogram is an advanced imaging procedure that combines contrast dye with fluoroscopy or CT scanning to evaluate spinal structures in detail. By injecting contrast dye into the spinal canal, the test allows doctors to observe real-time movement and identify potential issues, such as nerve compression or spinal cord abnormalities.

Unlike standard X-rays, which primarily highlight bone structures, a myelogram enhances the visibility of soft tissues using contrast dye. The test is often specified by the area of focus, such as a cervical (neck) myelogram or lumbar (lower back) myelogram.

Your doctor may recommend a myelogram to determine the cause of chronic back pain when previous imaging tests, such as MRI or CT scans, have not provided sufficient detail.

Is a myelogram similar to a spinal tap?

A myelogram shares some procedural similarities with a spinal tap (lumbar puncture), as both involve inserting a needle into the spinal canal. However, a spinal tap is performed to collect cerebrospinal fluid (CSF) for laboratory analysis or to administer medication, whereas a myelogram focuses on imaging and diagnosing spinal conditions.

Types of myelograms

Different types of myelograms are performed depending on the location of spinal pain or suspected pathology:

Cervical myelogram – Examines the structures in the neck.
Lumbar myelogram – Evaluates the lower back.
Thoracic myelogram – Focuses on the mid-to-upper back.

Conditions diagnosed with myelogram

A myelogram can help diagnose a range of spinal conditions, including:

Chronic back pain in the cervical, thoracic, or lumbar regions.
Herniated or bulging discs.
Osteophytes — Bone spurs.
Post-surgical complications.
Spinal arthritis.
Spinal stenosis — Narrowing of the spinal canal.
Spinal tumors.

Why would I need a myelogram?

A myelogram is typically recommended when previous imaging tests, such as x-rays, CT scans, or MRIs, fail to provide enough diagnostic information. It may also be performed post-surgery to assess spinal structures and determine the effectiveness of treatment.

Who is a candidate for a myelogram?

You may be a candidate for a myelogram if:

Previous imaging tests have not conclusively identified the source of your pain.
You have persistent back pain that has not responded to conservative treatment.
Your doctor requires more detailed images of your spinal structures.

Alternative imaging tests

Depending on your condition, alternative imaging tests may be considered:

X-ray – Produces images of bones and structural abnormalities.
CT scan – Provides cross-sectional images of bones, discs, and nerves.
MRI – Uses magnetic fields and radio waves to create detailed images of soft tissues and spinal structures.

What Are the Risks and Complications of a Myelogram?

As with any medical procedure, myelograms carry some risks, including:

Allergic reaction to contrast dye or anesthesia.
Bleeding or infection at the injection site.
Cerebrospinal fluid (CSF) leakage.
Headache.
Nausea and vomiting.
Nerve damage.

How painful is a myelogram?

The procedure itself should not be painful, as local anesthesia is used to numb the injection site. However, some patients may experience mild soreness at the injection site or a temporary headache afterward.

What to Expect from a Myelogram

Before the procedure: How to prepare

Before your myelogram, you will undergo a consultation with your healthcare provider.

You may need to complete the following preparatory steps:

Arrange for transportation home, as you will not be able to drive after the test.
Avoid eating or drinking for several hours before the procedure if instructed.
Inform your doctor about any allergies, especially to contrast dye, iodine, latex, or anesthesia.
Provide a list of medications, including blood thinners, as some may need to be temporarily discontinued.
Undergo blood or urine tests to confirm you are healthy for the procedure.

During the procedure

As you are positioned on your stomach or side on an x-ray table:

A local anesthetic will be administered to numb the area where the needle will be inserted.
The doctor will guide a needle into your spinal canal using fluoroscopic guidance.
Contrast dye will be injected, and the table may be tilted slightly to help distribute the dye.
X-ray and/or CT images will be taken to capture detailed views of your spine.
The procedure typically takes 30 minutes to an hour.

Recovery after a myelogram

Following the procedure, you will be monitored in a recovery area for approximately one hour. Mild discomfort is normal, but most side effects should resolve within a day or two.

Before discharge, your care team will provide instructions on:

Medications and activity restrictions.
Wound care and signs of infection.
When to seek medical attention for unusual symptoms.
When you can resume normal activities.

How long does it take to recover?

You will need to rest for at least 24 hours after your myelogram to reduce the risk of complications, such as a CSF leak.

When to call your doctor

Contact your healthcare provider if you experience:

Difficulty walking or balancing.
Fever over 100.0°F.
Numbness, tingling, or weakness in your limbs.
Severe headaches that do not improve with medication.
Signs of infection, such as redness, swelling, or drainage at the injection site.

Why Choose UPMC for Your Myelogram?

UPMC’s team of back pain specialists provides advanced diagnostic techniques and personalized treatment plans to address a variety of spinal conditions. Our state-of-the-art imaging technology ensures the most precise and minimally invasive approach, leading to better outcomes and improved quality of life.

By UPMC Editorial Staff. Last reviewed on 2025-06-26.