MR myelography (or an MR myelogram) is a specialized type of MRI scan that focuses on the spinal canal and the fluid-filled space (subarachnoid space) surrounding your spinal cord and nerves. Unlike a traditional X-ray myelogram, which requires inserting a needle into your spine to inject contrast dye, MR myelography uses specialized MRI settings to make the natural spinal fluid glow brightly on the screen.
This creates a detailed map of the fluid space that can help your doctor identify narrowing or displacement around the spinal cord and nerve roots.
Common Indications for MR Myelography
- Evaluating narrowing of the spinal canal (spinal stenosis).
- Checking for pressure on spinal nerve roots caused by herniated or bulging discs.
- Investigating spinal fluid (CSF) leaks.
- Pre-operative planning before spinal surgeries.
- Evaluating patients with back or neck pain who cannot undergo traditional X-ray myelography due to dye allergies.
What exactly does MR myelography show?
The scan shows a clear, high-contrast map of the fluid surrounding your spinal cord. It highlights any areas where the fluid channel is narrowed, pinched, or blocked, indicating pressure on the spinal cord or nerve roots.
How should I prepare for MR Myelography?
Preparation varies by centre and by whether sedation or another MRI sequence is planned. Follow your appointment instructions. You will be asked to remove metal objects and may need to change into approved clothing because MRI uses a very strong magnet.
Do I need to stop taking medication?
Do not stop prescribed medication unless your clinical team tells you to. Ask in advance if you use medicine patches, an insulin pump, or another wearable device. Tell the team about every implant, operation, metal fragment, or device so its exact MRI conditions can be checked.
What happens when I arrive for my scan?
You will change into a hospital gown. The radiographer will guide you to the MRI room and ask you to lie down on the scan table. They will position you comfortably, usually on your back, and place a specialized antenna coil over your spine. You will be given earplugs or headphones to protect your ears from the loud tapping noise of the scanner.
How is the procedure performed?
The table will slide slowly into the tunnel-shaped MRI scanner. The scanner will make loud tapping, humming, and knocking noises as it takes images. You must lie completely still during these sequences to prevent the images from blurring. The scan does not require any spinal injections or needles.
How long does MR myelography take?
The scan takes about 30 to 45 minutes. It is often performed as part of a complete spine MRI.
Is there any discomfort?
The imaging itself does not usually hurt, but lying still can be uncomfortable if you already have back or neck pain. Tell the radiographer about pain, heating, burning, tingling, or panic during the scan.
Are there risks?
Standard non-invasive MR myelography does not use ionising radiation or a spinal needle, so it avoids the needle-related headache, bleeding, and infection risks of conventional X-ray myelography. It still has the usual MRI considerations, including implants, metal, noise, heating, claustrophobia, and any risks from sedation if used. Confirm that your appointment is for non-invasive MR myelography, because terminology and protocols can vary.
Can children have this scan?
Children can have this scan when it is clinically justified. If a child cannot remain still, the team may discuss preparation, distraction, sedation, or anaesthesia; these require their own fasting and safety instructions.
Can I have this scan if I am pregnant?
MR myelography uses no ionising radiation. A noncontrast examination may be performed during pregnancy when the expected benefit justifies it; it is not automatically prohibited in the first trimester. Tell the team before the scan so the protocol can be reviewed.
When will I get my results?
A radiologist will study the spinal images and send a report to the referring clinician. Timing varies by centre and urgency, so ask when and how you will receive the result.
What if the scan finds something?
If the scan shows nerve root compression or spinal stenosis, your referring doctor (often an orthopedic surgeon or neurosurgeon) will discuss management, which may include physical therapy, pain injections, or spinal decompression surgery.
Questions to ask your team
- Is this a non-invasive heavily T2-weighted MR myelogram or another procedure?
- Will contrast, sedation, or special positioning be required?
- Which new weakness or bladder/bowel symptoms need emergency assessment?
Sources and further reading
Conclusion
MR myelography is a safe, injection-free way to obtain a detailed map of your spinal nerves. To ensure a comfortable scan, remember to disclose any implants to the team and wear metal-free clothing.