Re: Myelogram

Posted By CCF NEUROLOGY MD/in on May 07, 1998 at 19:29:37:

In Reply to: Myelogram posted by Charlie on May 07, 1998 at 11:57:28:






MRI's have confirmed herniated discs in the lumbar region of my spine.
Conservative treatment which included physical therapy and exercise have failed to provide relief.  Two neurosurgeons indicate surgery is the next step.  One indicates he would first do a myelogram.  The other advises in most cases they no longer utilize this test.  I'm concerned about the difference of opinion to say nothing of the possible complications of that test.  Can you help me sort this out?




Dear Charlie:
MRI has almost replaced the old style myelogram for the imaging of the soine in order to look for disc disease. In some instances, MRI does not show very well the bony structures of the spine. In this situation, there is a test called CT myelogram that can be done. The CT scan of the lumbar spine is done after the injection of the contrast agent normally used for myelography. This test may present some advantages over MRI by better defining and delineating the anatomy of the area.
All depends on the MRI quality and findings and how correlated with the symptoms you are experiencing. In other words if your symptoms such as the distribution of pain, weakness, or sensory problems fit well with the MRI findings some surgeons do not feel the need for CT myelogram.
To summarize, either way of management (MRI alone or CT scan with myelogram) can be justified but not myelogram alone.
Good luck