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 highly detailed map of the fluid space, making it easy for your doctor to see where nerves are being squeezed or pinched by bone spurs or bulging discs.
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?
No special preparation or fasting is required. You should wear comfortable, loose clothing without any metal zippers, buttons, or snaps. You will be asked to remove all metal objects, including jewelry, hairpins, and keys, as the MRI uses a very strong magnet.
Do I need to stop taking medication?
No. Continue taking all your medications as normal. If you have any metallic implants (such as a pacemaker, cochlear implant, or vascular clips), you must inform the team, as some implants are not safe in the MRI machine.
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?
No. The scan is completely painless. You will not feel any needles or injections. You will only need to lie still on the scan table while the machine operates.
Are there risks?
For most patients, there are no risks. Unlike traditional myelograms, there is no risk of spinal headaches, bleeding, or infection because no needle is inserted into your spine. The scan does not use radiation.
Can children have this scan?
Yes. Children with spinal conditions can have this scan safely. If a child cannot remain still for 30 minutes, mild sedation may be arranged.
Can I have this scan if I am pregnant?
Yes. MRI is safe during pregnancy as it uses no radiation. However, scans are usually postponed until after the first trimester as a precaution.
When will I get my results?
A radiologist will study the spinal images. A detailed report will be sent to your referring doctor within 24 hours.
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.
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.