CT Guided Lumbar Puncture or Myelogram

The procedure, performed using x-ray or CT guidance, involves placing a small needle into the spine. A myelogram is a similar procedure where contrast is injected into the spinal canal, and a CT scan is performed afterwards to image the spinal canal.

Procedure

You will lie on your side or stomach for the procedure. Your skin will be cleaned with antiseptic where the needle will be given, and local anaesthetic injected. The radiologist inserts a very fine needle into the location that your doctor has asked us to inject using an aseptic technique (strict infection control procedures). We use an x-ray or CT machine to guide the placement of the needle safely and accurately into the correct position. A small sample of the CSF will be taken and sent for analysis. After the procedure, you will be instructed to lie flat to reduce the risk of a headache.

Risks / Side Effects

There is a risk of headache, due to leakage of the cerebrospinal fluid from the site of the lumbar puncture (where the needle was given). Having you lie down for at least a few hours after the procedure helps to minimize this risk.

There is a small risk of bleeding and infection from the injection site, which is uncommon but potentially serious.

Before your Scan

Please inform us if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel). You may need to stop this medication prior to the procedure, but only after discussion with your doctor.

Before the procedure, you may be asked to change into an examination gown for your comfort, and to ensure clothing does not affect the imaging. You may also be asked to remove jewellery, eye-glasses and any metal objects that might interfere with the imaging.

You will be required to fast (not eat or drink anything) for four hours and a short stay hospital admission will be necessary. Occasionally you may require overnight admission.

You will require someone to collect you and take you home after the procedure. 

Other Information

After the procedure, you will need to drink plenty of fluids (about 2 litres per day) for 2 – 3 days.

If required, paracetamol (such as Panadol) can be taken every 4 – 6 hourly, for up to 2 days.

No vigorous activity for the first 2-3 days after the procedure, then return to normal activity.

Your headache may increase over the next 2 days as you increase your activity but should start to get better by day 2 or 3. 

If you have any concerns about nausea, vomiting, pain at the injection site, tingling in your arms and/or legs, a fever or an increasing headache, notify your referring doctor or immediately call the clinic where the injection was performed.