Myelogram CT

[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.