Myelography

Imaging of the space around the spinal cord and nerve roots after contrast injection into cerebrospinal fluid.

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Examining the space around nerve roots with contrast

Myelography involves injecting contrast into the cerebrospinal fluid space and imaging its distribution. It may be followed by CT. The examination is reserved for selected questions involving nerve roots, the canal or postoperative anatomy, including situations where MRI is unsuitable or insufficient.

The procedure requires a puncture, often in the lumbar region, performed by a specialist team with specific instructions. Risks include headache after puncture, contrast reaction, bleeding and infection, with other complications occurring less commonly. Report anticoagulants, allergies and relevant medical history; do not stop medication independently. Post-procedure monitoring instructions and symptoms requiring contact with the team should be explained before discharge. Myelography should not be confused with an injection intended to treat pain.

Indications and interpretation

Before ordering the test, the clinician should identify the question it needs to answer and how the result could change decisions. Routine imaging for low back pain without warning signs does not necessarily improve care. A result describes structures; it does not measure all aspects of pain or a person's capacity to recover. Age, previous conditions, the affected side and the physical examination help distinguish a relevant abnormality from an incidental finding. More visible detail is useful only when interpreted appropriately.

After the results

The responsible clinician should explain which findings need action, follow-up or no particular intervention. Bringing previous studies can prevent unnecessary repetition. At TAGMED, imaging can help select or exclude particular care options; it cannot establish that traction, laser treatment or manual care will work. Decisions remain clinical and must consider contraindications. Progressive weakness, altered saddle sensation or a new inability to urinate must not wait for a routine imaging appointment: these symptoms need emergency assessment. Follow the preparation and safety instructions supplied by the imaging centre. Ask how and when results will be communicated rather than assuming that silence means everything was normal.

Frequently asked questions

Is myelography a treatment?

No. It is an invasive diagnostic examination intended to answer a specific question.

Does an abnormality necessarily explain pain?

No. Agreement with symptoms and examination findings must be checked.

Should previous results be brought?

Yes when available; comparison may prevent unnecessary repeat studies.

Who explains the report?

The responsible clinician interprets it within the whole clinical picture.

Does the test determine treatment?

It contributes to decisions but does not replace clinical assessment and discussion of options.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.