Myelogram CT

[grumpyone]

Hi all,

So I saw the PM doc today and he is ordering a Myelogram ct. Before he does the nerve root blocks, has anyone had this done?

Thank you

[AQA]

It is like an x-ray except that they inject you with a dye. If it is like the one I had, well, trust me. that table is going to be COLD.

[jayne]

and hard.....closer to a cat scan

[inpainokla]

if its anything like a discogram were they also injected dye into my disks it hurts like haities!!!...i hope its not though bc it hurts terribly

[Cycler]

no. it's a mylogram and does not hurt (much) unless there is a spinal cord fluid leak and then you will gain new respect for the word headache

[grumpyone]

I've had spinal taps done before and I have had epidurals so I am thinking it can't be much worse then that. I was told I was going to be admitted for the day.

[inpainokla]

grumpyone Wrote:I've had spinal taps done before and I have had epidurals so I am thinking it can't be much worse then that. I was told I was going to be admitted for the day.

im sure if cycler says they do not hurt to bad then im sure they dont..but ive heard ppl say that e.s.i's hurt and i just dont know how to veiw that bc ive had 5 in total and the only thing i ever feel is the numbing medication i would have 1000 e.s.i's before i would have another discogram

[jayne]

disc o grams only hurt if you have a bad disc and they find it.........I dont ever want another one either......

[Cycler]

discograms hurt always as it is the intent of the procedure to induce the pain coming from the suspected injured disc. Recent medical evidence also suggest that discograms actually cause disc degeneration and that the surgeries that follow a positive discogram are unlikely to result in any improvement and so are uneccesary, same as most back surgeries.

ESI's on the other hand can be both a diagnostic test, identifying a painful inflammatory injury site at the epidural space when the pain temporarily eases from the numbing medication, but also therapeutic if the steroid then settles the injury response down and healing occurs. Same for facet blocks which is the exact same medication mix but injected into the joint spaces to sooth the facets, the mating surfaces of the lumbar joints; i.e. both diagnostic AND potentially therapeutic.

A CT/Mylogram is wholly a diagnostic test with no therapeutic potential. It is simply injecting contrast material ( dye ) into the epidural space where the spinal cord is floating in spinal fluid, the same space where an ESI enters. After the dye is filling the lumbar spinal canal, a regular X-ray series is taken and then a CAT scan. Each gives a different look at how the dye is filling the canal and a "positive" test is when the dye can be seen to not be filling a particular spot and that would be because something is blocking the dye.

This is called a "filling defect" ;i.e. the dye did not fill a spot, and can be due to tumor, dense scar tissue, disc herniation, or bone. So it is giving different but complimentary information than an MRI which can miss some of this stuff due to the limitations of MRI technique.

The test has long been the gold standard test for spine problems but not often done because of the complications, the most common is a persistent leak from the puncture site. ALL Mylograms will cause a pretty bad 3 day headache but the leak will take that to the next level and often requires a blood patch to close.

So, there you have it.

[jayne]

another way to look at it cycler is the positive way...I had a great Dr for all my tests at Okla spine intitute....they made sure I was in no extra pain they could fix....I heard horror stories about some of these test before I had them done and was scared spitless.....But my Dr was also a PM Dr and he knew his stuff.....I hope to never to another but if I do it will be thru him.....he was also able to work with my PCP and get my pain management going......I was lucky I had a good lawyer and a judge that was upset with the WC IC for their Bull kaka.....always have these type tests run thru a pain managment Dr it is so much better....and easier on you