Myelography is an imaging examination that involves inserting a needle into the spinal canal and injecting contrast dye to visualize the spinal cord, nerve roots, and surrounding structures using fluoroscopy and x-rays. It is used to evaluate herniated discs, tumors, infections, inflammation, spinal lesions, and stenosis. Patients are prepped and positioned for the procedure, a needle is inserted to draw fluid and inject contrast dye, and x-rays are taken. Post-procedure care involves rest, monitoring for side effects, and encouraging fluids to eliminate the dye.

2. Myelography:
 Myelography is an imaging examination that
involves the introduction of a spinal needle into
the spinal canal and the injection of contrast
material in the space around the spinal cord and
nerve roots (the subarachnoid space) using a
real-time form of x-ray called fluoroscopy.

3. Uses:
 Herniation of the intervertebral disk .
 tumors involving the bony spine, meninges, nerve
roots or spinal cord
 infection involving the bony spine, intervertebral
discs, meninges and surrounding soft tissues
 inflammation of the arachnoid membrane that
covers the spinal cord
 spinal lesions caused by disease or trauma
 Spinal stenosis

4. contraindication
 Pregnant women
 Allergies
 aspirin
 precaution in diabetes, asthma, a heart
condition, kidney problems, or thyroid
conditions

5. procedure
 wear comfortable clothes that are easy to remove
and leave jewellery at home Please note that
some of the disinfectant agents used during these
procedures may stain light-coloured clothing.
 Step 1: prepare the patient
lie patient on stomach with a pillow beneath it.
Cleaning patient back with a cooling
antiseptic and numb the area of back where
the needle will be inserted. This may cause
some brief stinging.

6.  Step 2: insert the needle into the spinal canal
Next, a slender, hollow needle is inserted into
your spinal canal to draw out some
cerebrospinal fluid for testing. The contrast
dye is inserted into the spinal canal through
the hollow needle. patient will probably only
feel pressure, though some people feel a
sharp stinging sensation..

7.  Step 3: take X-ray pictures
After the dye is injected patient will lie on
stomach with a pillow under your abdomen.
The table may be tilted to move the contrast
dye through your spinal canal and X-ray
pictures will be taken of your back. At this
point patient should remain very still so that
the x-ray images will not be blurred. Most
patients will have a CT scan following the
myelogram.

8. Nursing intervention
Preparation of the client
 Ensure a signed consent form
 Ask the client to empty the bladder before the
procedure begins.
During procedure:
 Ask patient stay still.
 Call on any difficulties.
 Notify if any sign of allergy to dye.

9. Post care
 Encourage fluids to aid in elimination of contrast
medium, decrease likelihood of headache, and
replace cerebrospinal fluid
 If oil medium was used, maintain bed rest for 8
hours in flat, supine position
 If water medium was used, maintain bed rest for
3 hours (or as prescribed) with head elevated 30
degrees
 Assess lumbar puncture site for bleeding

10.  Observe patient for side effects to contrast
medium — nausea, vomiting, headache
 Perform neurological checks and monitor vital
signs
 Instruct patient to avoid lifting for 24 hours, report
any signs of infection, any drainage from
the lumbar puncture, and any photophobia,
persistent
nausea, or vomiting

11. Discharge instruction
 Be in bed for 24 hours after your myelogram.
Do not lie flat. Instead, elevate the head of your
bed 30 degrees or use 2 pillows. You may get up
for short periods (e.g., for the bathroom and
meals).
 Encourage lots of fluids for 18 hours, at least 8
ounces every 2 hours while awake. Provide
caffeinated beverages, which create a diuretic
effect, causing increased urination and thus
eliminating the dye used during the myelogram.
 If headache, nausea, or vomiting persists after 48
hours of bed rest.
 In general, resume normal activities the next day.