Your doctor may recommend that you have a myelogram. You may have some questions about this. What is a myelogram? Myelography (CT myelography) is an invasive diagnostic method used to discern the cause of a patient’s symptoms, which can include symptoms such as pain, numbness, tingling sensations in the torso, or some unexplained muscle weakness. This is done by inserting a puncture needle into the subarachnoid space at the back of the patient’s spine – the cavity where the cerebrospinal fluid is located – injecting contrast and then withdrawing the needle. Myelogram X-rays Cervicography CT images Is the puncture procedure painful? Not usually. Most patients report that it is “not as painful as I thought it would be”. The doctor will anesthetize the puncture site with some numbing medicine, and there will be some tingling during the anesthetic. Patients often report that the pain is like “a bee sting”. Once the skin surface is anesthetized, the patient will only feel a pressure on the skin from the puncture needle. Sometimes there is a mild discomfort during the injection of the contrast medium into the subarachnoid space, which does not last long and disappears after a few months. What does the patient need to do to prepare for such a test? Do not eat caffeinated beverages (coffee, tea or cola) 8 hours before the day you are ready for the myelogram and may take antihypertensive medication. If the patient is diabetic, blood sugar should be checked again when preparing to leave the hospital after the myelogram Do not use hypoglycemic medication the morning of the day you are preparing for the myelogram; if you do, it will make the patient very uncomfortable (if you did not eat breakfast in the morning, there is no need to take hypoglycemic medication). So what else should you do as a patient again? Patients should be prepared to stay in the hospital for approximately 8 hours and should be accompanied by a family member or friend. The patient should arrive at the hospital an hour early to allow the doctor to complete the hospital paperwork on you, and will be given some oral sedation and sometimes an IV will have to be prepared. In the operating room, the patient is placed on his or her side, the doctor will sterilize the patient, then the puncture needle will be inserted into the patient’s lower back, and the patient will be able to rest on his or her back after injecting the contrast. 2 hours or so for the scan in the CT room. After the scan, it is time to eat and drink. Generally, if there is no special discomfort, you can sit and do not necessarily need to lie down. 5-6 hours later, you can go home. In general, cold towels or ice can be applied to the puncture site for 30 minutes to 1 hour. There may be pain and discomfort in the upper or lower extremities, which lasts for 1-2 days at most and is usually relieved. If taking glucose-lowering medications (e.g., metformin) to treat the patient’s diabetes, do not take them for 48 hours after the procedure.