Myelography is a specialised diagnostic imaging technique that visualises the spinal cord, nerve roots, and subarachnoid space by introducing a contrast medium into the cerebrospinal fluid (CSF). This procedure is typically employed to detect abnormalities such as herniated discs, spinal stenosis, tumours, or infections that might not be visible on standard X-rays or may require more detailed examination than MRI or CT scans can provide.
The process begins with the patient lying face down on a radiographic table. After cleansing the skin with antiseptic, a local anaesthetic is administered to numb the needle’s insertion area. Using fluoroscopic guidance, a fine needle is then inserted into the lumbar region of the spine to access the CSF. Once the needle is correctly positioned, the contrast medium is injected. The patient may feel some pressure during this injection, but significant discomfort is uncommon.
Following the injection, a series of X-rays or CT scans are taken as the contrast medium flows through the spinal canal. These images help highlight any irregularities in the spinal cord or nerve roots, providing a clear and detailed view of the spinal anatomy. Patients may be asked to change positions to ensure the contrast medium distributes evenly, aiding in comprehensive imaging.
After the procedure, patients are typically monitored for a few hours to ensure no adverse reactions occur. Common side effects include headaches, nausea, or dizziness, which usually resolve on their own. Drinking plenty of fluids post-procedure can help mitigate these effects.
Myelography is particularly useful when MRI is contraindicated, such as in patients with pacemakers or certain implants. It can also be beneficial when previous imaging results are inconclusive or when more detailed views of bony structures are needed.
However, despite its utility, myelography does have risks, including infection, bleeding, or a reaction to the contrast medium. However, these complications are relatively rare. Advances in imaging technology and contrast mediums have made myelography safer and more effective over the years.
Therefore, myelography remains a valuable diagnostic tool in modern medicine. It offers detailed insights into spinal conditions that might otherwise be difficult to diagnose. Its ability to provide precise images of the spinal cord and nerve roots makes it indispensable in assessing and managing spinal disorders.
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