[annapurna]

Posted in 2004, more can be found in FAQ and site search


I had a myleogram about a year and a half ago for the same reason - unresolved nerve pain post ADR. Myleo's are great in that they don't require computer-assembled imaging to show nerve compression - they just outline your nerves with dye so that they're visible on a plain x-ray. If you were at Mark *******'s last luncheon, you will remember Dr. Zeeger's excellent description of how a myleogram works (champagne glass and other "thought aides").

In terms of what to expect, I think that it's a lot like getting an epidural shot or facet injection. You get scrubbed, get a "bee-sting" local shot, then the doc inserts a super-fine spinal needle right into the fluid around the nerves in the central canal (mine was put in near L3-L4). Once the dye is in, they tilt the table you're on to get the dye to go to all the nerves (above and below) and take pictures from as many angles as possible. If there is some compression (like a pinched nerve), the dye will stop and not travel where it should, and you can tell that that nerve is compressed (really simple).

Here's the big cincher!!!! Since you're poking a hole in the dural sac (fluid bag that's around all the nerves), you can have some problems. The big, big problem is reaction to the myleogram dye that results in nerve root scarring, or arachnoiditis. This is bad news on burnt toast, so to speak. You can avoid it by making sure that your doc uses water-based dyes that are know to not cause this condition - I'd ask ahead of time. The second problem you can get is a "wet-tap" where the hole from the needle does not close over and keeps leaking spinal fluid due the pressure-head (no pun intended) of the fluid above the hole. When you loose enough fluid, you can get a MASSIVE headache that goes away more or less completely when you lay down. I got a mild one for about 72-hours post-myleo that went away on it's own. There are special needles that leave a flap that helps the holes seal and are intended specifically for myleograms and spinal taps. It would be a good idea to ask about that too.

Having given all the dire warnings, I can tell you that it is a good test that is relatively free of artifacts. The doc positioned the fluroscopy monitor where I could see it, and I got to watch my nerves get outlined with the dye as it migrated up and down my spine - very neat! You can do a CT scan afterwards as well, which can give more info, however, expect some artifact on the CT around your ADR.