A myelogram is a specialized diagnostic imaging test that allows physicians to visualize the spinal canal, cord, and nerve roots. This procedure involves injecting a water-soluble contrast dye into the cerebrospinal fluid (CSF) space surrounding the spinal cord, followed by X-rays or a Computed Tomography (CT) scan. Understanding the recovery process is important, as patient compliance with post-procedure instructions directly influences the speed of recovery and the avoidance of complications. The recovery is generally quick, but it requires specific adherence to care protocols.
Immediate Post-Procedure Care
The first few hours following a myelogram are supervised and focus on stabilizing the patient and mitigating the risk of complications. Immediately after the procedure, patients are moved to a recovery area for close observation, typically lasting between one and four hours. Healthcare providers monitor for any immediate adverse reactions, such as severe headache, nausea, or changes in neurological function.
During this time, patients are required to lie flat or with the head slightly elevated at a 30-degree angle for a specific period, usually between one and six hours. This positioning helps the puncture site seal properly and is a direct effort to reduce the potential for cerebrospinal fluid leakage. Increased fluid intake is strongly encouraged, and sometimes administered intravenously, to help flush the contrast dye from the body. Adequate hydration also aids the body in replenishing the spinal fluid that was sampled or lost, contributing to a smoother recovery.
Managing Common Recovery Symptoms and Duration
Most patients feel better within 24 hours of the myelogram, but the process of full symptom resolution can take between three and seven days. The most common side effect experienced is a post-myelogram headache, often called a spinal headache. This occurs when cerebrospinal fluid leaks through the tiny hole created by the injection needle, causing a decrease in pressure around the brain.
This characteristic headache is positional, meaning the pain worsens when sitting or standing upright and improves when lying flat. To manage this discomfort at home, patients are advised to maintain bed rest for the remainder of the procedure day. Increasing caffeine intake, through coffee or soda, can be helpful, as caffeine causes cerebral blood vessels to constrict, which may alleviate the low-pressure headache. Over-the-counter analgesics are recommended for mild discomfort.
Some patients may also experience mild lower back discomfort at the injection site or temporary nausea and vomiting. These minor symptoms are usually short-lived and should resolve within a day or two. If conservative measures like rest, hydration, and caffeine do not relieve a spinal headache within several days, further medical intervention like an epidural blood patch may be needed to seal the leak.
Resuming Daily Life and Recognizing Serious Signs
Patients must arrange for someone to drive them home after the procedure, as residual sedation and the risk of a new headache make driving unsafe. Most individuals can safely return to work and resume light activities 24 hours after the procedure. However, those with physically strenuous jobs should typically wait longer, often 48 hours, or follow specific advice from their physician.
Avoid heavy lifting, bending, or twisting motions for at least one to two days to allow the puncture site to heal completely. When resuming exercise, start slowly with low-impact activities and gradually increase the intensity as symptoms permit. If a spinal headache persists and is severe enough to be debilitating, contact your healthcare provider for evaluation.
While myelograms are generally safe, serious complications require immediate medical attention. Seek urgent care if you experience:
- A high fever or severe neck stiffness
- A sudden change in mental status
- New or worsening numbness or tingling in the legs
- Loss of bladder or bowel control
- The onset of seizures