How to Prepare for a Myelogram

Your doctor will give you detailed instructions on how to prepare for your myelogram.

You should inform your doctor of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

Specifically, your doctor needs to know if (1) you are taking medications that need to be stopped a few days before the procedure and (2) whether you have a history of reaction to the contrast material used for the myelogram.

Some drugs should be stopped one or two days before myelography. These include certain antipsychotic medications, antidepressants, blood thinners, and drugs that are used to treat diabetes. The most important type of medication that must be stopped is blood thinners (anticoagulants). If you are taking blood thinners, you should speak with your physician about alternative methods of maintaining anticoagulation while you are undergoing a myelogram. For example, intravenous blood thinners such as heparin can be used after stopping the conventional, more long-acting blood thinners.

Many drugs used to treat seizures are not indicated before a myelogram. Therefore, it is also important that medical staff know in advance if you have a seizure disorder and they can help you plan to stop taking the seizure medications a few days before the myelogram. Although reactions to the iodinated contrast material used in the myelogram are extremely uncommon, you should inform your physician if you have previously had a severe allergic reaction to contrast material or other medication. In addition, please mention if you have any allergies to other non-medical substances or have a history of asthma. If this is the case, you will be watched especially carefully to check for a reaction when injecting the contrast material. Allergy to iodine-containing substances can be especially risky.

Usually patients are advised to increase their fluid intake the day before a scheduled myelogram, as it is important to be well hydrated. Solid foods should be avoided for several hours before the exam, but fluids may be continued.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their doctor or X-ray technician if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

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