MR Myelography:what to expect

• 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.

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.

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.

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.

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.

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.

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.

Preparation varies by center 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.

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.

The scan takes about 30 to 45 minutes. It is often performed as part of a complete spine MRI.

A radiologist will study the spinal images and send a report to the referring clinician. Timing varies by center and urgency, so ask when and how you will receive the result.

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.

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.

• RadiologyInfo: Spine MRI
• ACR Manual on MR Safety
• FDA: MRI benefits and risks

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.