What is a myelogram
A myelogram is a special test to see if there are any problems with the spine, spinal cord or the surrounding structures. The procedure uses a special dye called contrast, which makes the nerves and spinal cord in the spinal canal show up on X-ray.
Myelograms are done using image guidance by interventional radiologists.
Risks of a myelogram for your child
Myelograms are usually considered low-risk procedures. The risk may increase depending on your child’s condition, age and health.
The risks of a myelogram include:
- infection
- headache
- leakage at the site of the needle insertion
- change in sensation or numbness in the lower limbs
- difficulty peeing or having unexpected accidents after the procedure
- nausea and vomiting
Giving consent before the procedure
Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the myelogram and that all of your questions are answered. If you agree to the procedure, you can give consent by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.
How to prepare your child for the procedure
Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.
Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.
If your child becomes ill within two days before the procedure
It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before the myelogram, let your doctor know. Your child may need to be rebooked.
Food, drink, and medicines before the procedure
- Your child’s stomach must be empty before sedation or general anaesthetic.
- If your child has special needs during fasting, talk to your doctor to make a plan.
- Your child can take their regular morning medicine with a sip of water two hours before the procedure.
- Medicines such as acetylsalicylic acid (ASA), naproxen or ibuprofen, warfarin, or enoxaparin may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.
On the day of the myelogram
Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the myelogram and the anaesthetist who will be giving your child medication to make them comfortable for the procedure.
During the myelogram, you will be asked to wait in the waiting area.
Your child will have medicine for pain
Children are given medicine for treatments that may be frightening, uncomfortable, or painful. This includes local anaesthesia, sedation or general anaesthesia. For myelograms, most children are given a general anaesthetic.
How a myelogram is done
The interventional radiologist uses X-rays to identify the part of the spine where a needle will be inserted. Once the needle is inserted, X-ray dye called contrast, is injected into the spinal canal. The examination table that your child is lying on will then be tilted to allow the dye to move along the entire spinal canal. Once this is completed, your child will have X-rays and a computed tomography (CT) scan to look at their spine.
Your child will not need any stitches. Your child will have a small bandage where the needle was inserted that can be removed after 24 hours.
This procedure should take 60 minutes.
After the myelogram
Once the myelogram is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.
Pain after the myelogram
Your child may have some discomfort in their back immediately after the myelogram. If this happens, your child will be given pain medicine.
At home, you can give your child acetaminophen if needed or medications as prescribed by your doctor.
For more details on how to care for your child after a myelogram, see Myelogram: Caring for your child at home after the procedure.
Going home
In most cases, children can go home the same day as the procedure. If your child’s doctor has arranged this, your child will be ready to go home about four to six hours after the procedure, depending on the effects of the anaesthesia. Your child’s nurse will let you know when they are well enough to go home.
Results
The results of the procedure will be sent to your family doctor or referring doctor. You should arrange a follow up appointment with them to discuss the results.
At SickKids
At SickKids, the interventional radiologists work in the Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT). You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.
For more information on fasting see Eating and drinking before surgery.
For more information on preparing your child for their procedure see Coming for surgery.