Myelography

What is myelography?

The term myelography refers to an X-ray examination of the spinal canal and its associated nerves. The procedure is performed by injecting a contrast agent into the canal in which the cerebrospinal fluid (CSF) and the spinal cord are located. The contrast agent can be used to visualize the spinal cord and its branching nerves or the points where they exit the bony spinal canal.

Nowadays a plain myelography, that means the X-ray examination, is mostly paired with a CT scan. Therefore, a so-called myelo-CT is obtained, offering even more accurate findings.

When is a myelography carried out?

In general, myelography is employed for the investigation of constrictions or compressions of the spinal canal due to a herniated intervertebral disc or tumors, for example. Since this can nowadays be done by less invasive methods such as MRI or CT, myelography or myelo-CT are only performed in certain cases. For instance, in cases where MRI is not possible, like in patients with implants or pacemakers that contain magnetic metals, myelography or myelo-CT are an alternative. Moreover, myelography or myelo-CT may be indicated whenever CT and MRI scans have not provided sufficient data, or whenever implants in the spinal column disturb with the scans, for example.

Myelography can furthermore be helpful when examining symptoms associated with motion, as there is a dynamic version of this examination that can visualize the spine in various positions, such as bent over.

An additional benefit offered by myelography is that a sample of CSF can be collected before injecting the contrast agent into the nerve canal which is subsequently sent to a laboratory for further diagnostics.

How much time does this examination take?

The first step is local anesthesia or applying a numbing agent to the area of the lumbar spine is followed by the injection of the contrast agent. Subsequently, the patient's head will be positioned below the body axis to ensure proper distribution of the contrast medium throughout the entire spine. After that, the X-rays are obtained and in case of myelo-CT, the CT scan is performed, too.

Generally, myelography requires about 20 minutes. However, even though it is a quick procedure, myelography is usually carried out on an inpatient basis, as patients should rest in bed for several hours after the exam.

What are the risks?

Basically, only a few risks are associated with myelography. It is however one of the invasive examination methods, which means that the body is penetrated by incisions, injections, etc. Accordingly, postoperative bleeding or infections can occur at the puncture site. Consequently, bleeding or infection may arise at the puncture site after the examination.

Headaches may also be experienced after the examination in about 10-20% of cases which is due to negative pressure. Bed rest is advised to minimize them. Rarely, myelography can cause transient (intensified) irritation of the nerves that results in pain. It is extremely rare for the spinal nerves to be injured during the examination.

Are there any alternatives to myelography?

MRI (= magnetic resonance imaging) and CT (= computed tomography) of the spine are available as alternatives to myelography. They are nowadays carried out in many facilities, as they require little effort, are non-invasive and yield very accurate recordings, making them the preferred choice over myelography in many cases.

Nevertheless, the most accurate results are provided by a combination of these methods, known as myelo-CT. This method can provide precise images of the structures in the spinal cord area to the millimeter.

Which doctors and clinics are specialists?

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of myelography and are looking forward to your inquiry or wish for treatment.