Myelogram
01/11/2022
Most are a lumbar stick. Only Sud and Johnston do C-spine stick.
PREP: Refer to Lab Work Procedure Page to determine which drugs need to be discontinued and for how long, pt. needs driver.
Patient set up is same as epidural, but sterile tray is different. No steroid.
Sterile myelogram tray: add 25 ½ “gauge needle. (For Dr. Sud and Talley add 25 gauge 3.5” spinal needle. If patient has no metal in the region use Omnipaque 240. If patient has metal, or is obese, use Omnipaque 300).
- 10ml syringe: 9ml lidocaine & 1ml sodium bicarbonate
- 20ml syringe: 20ml omni-300. Be accurate with contrast intra-thecal use only.
USE LEAD MARKER. INSTALL FOOT PLATE.
Radiologist will inject and do fluoro images, after Radiologist is done with fluoro, tech will do a cross table lateral L-spine x-ray. Patient is to be transported to CT on stretcher, with head slightly elevated. Patient will go to recovery room after CT. It is the fluoro tech’s responsibility to recover patient after CT. Check with Radiologist on recovery time. Give patient myelogram discharge sheet located in cabinet above phone in tech area.
For Dr. Sud obtain:
AP and Lateral C-spine X-ray for Cervical Myelogram
AP and Lateral T-spine X-ray for Thoracic Myelogram
AP and Lateral T-spine AND L-spine X-ray for Lumbar Myelogram
For Cervical:
-Place the rolled-up towel, or “cervical pillow” under the patient’s neck
-Be prepared to hold the shoulders when he tilts the table. He does not like the shoulder cradle because it gets in the way. (12/21/2020)
22 ga Spinal needle if they have had previous Lumbar Spine surgery.
25 ga Spinal needle if not.
For Dr. Johnston: If you are doing a Cervical Myelogram, make sure the shoulder cradles are at your location. (There is only one set, but it works on all tables except for DT which has its own) He does not approve of the technologist holding the shoulders.
For Dr. Kyle: He wants warm contrast out of the CT warmer. He wants to draw it up himself. Add 25g 3.5-inch spinal needle.