Myelogram

Myelogram is a diagnostic test that helps in detecting abnormalities of the spine, spinal cord and spinal fluid. A contrast dye is injected into the the neck area (cisternal myelogram) or in the lower back area (lumbar myelogram). Any abnormality or indentation on the spinal cord can be identified with a myelogram test. A bulging disc, tumor or herniated disk can lead to indentations on the spinal cord. A myelogram is conducted for patients who suffer spinal stenosis, herniated disc or inflammation of the arachnoid membrane. Myelogram aids in diagnosing problems of blood supply to the spine and tumors.

A myelogram is ideal for patients who have had metal implants in their spine, preventing them from undergoing an MRI scan or CT scan. A spinal tap is performed to inject the dye into the spinal sac. When combined with a CT scan, a myelogram helps in understanding the condition of the spinal bones and muscles. A patient scheduled for a myelogram must not eat for few hours prior to the test. Pregnant women and those with a history of asthma or epilepsy must keep the doctor informed.

Fluid intake must be maintained so as to remain well hydrated. Medications such as blood thinners, antidepressants and diabetes medicines may need to be temporarily stopped. A person is asked to lie down with head in elevated position for few hours after the myelogram test. The risks associated with a myelogram include meningitis, spinal headache and allergic reactions.

Myelography

Myelography or Myelogram is used to make a diagnosis of spinal canal and spinal cord disorders like nerve compression that in turn causes pain and weakness. A special dye is introduced into the spinal sac that in turn shows up in the x-ray to signify any deformities. The dye acts as an exclusive agent to outline the nerve roots and the spinal cord thus helping the doctor determine if there are any abnormal shapes in the spinal cord. Before CT scans and MRI scans were introduced, it was myelography that was used to study any abnormalities in the spinal cord. Current medical world uses myelography only for complicated revision spine surgeries and for patients who have metal plates or screws in their spine. Myelography is primarily used to identify slipped disk by exactly locating the disk or disks concerned. Spinal arthritis can develop bone spurs that may press against the nerves and cause pain, myelography can help identify if surgery is required and can also help spot if the spinal canal is narrowed. Tumors can be accurately located. A patient preparing for myelogram must stop a solid diet for a day and drink plenty of clear fluids.

Cauda Equina Syndrome

Lower back pain is normally not a panic situation. However in a few cases the pain could be due to cauda equina syndrome, which is a rare neurological condition and requires immediate medical attention rather surgical intervention.

Cauda equina is a Latin term which means horse's tail; the nerves at the end of the spine resemble the horse tail. Cauda equina is formed by the nerve roots caudal close to the termination point of the spine. Extreme compression or inflammation of the spinal nerve roots (nerves branching off the spinal cord). These nerves are located at the lumbar spine i.e. the lower end of the spinal cord. They help in transmitting messages to and from the legs, pelvic organs and feet. The syndrome is more common in adults but can occur in children too. If not treated immediately, it may lead to paralysis of the lower limbs, urinary incontinence, etc.

Cauda equina syndrome causes

• Spinal tumor or lesion
  
• Narrowing of the spinal canal or spinal stenosis
  
• Spinal infection, hemorrhage or fracture
  
• Ruptured disc in the lumbar region
  
• Herniated disc
  
• Inflammatory conditions
  
• Birth defect, this condition is more prevalent in adults however it can occur in children who are born with defects of the spine.
  
• Spondylolisthesis
  
• Accident/trauma

The condition is as such that it cannot be diagnosed very easily, common symptoms reported include severe lower back pain, sudden sexual dysfunction, pain, numbness or weakness in either one or both the legs or incontinence of bowel or bladder or retention of bowel or bladder movements. Diagnostic methods include:

• MRI
  
• Myelogram
  
• CT scan
  
• Urodynamic studies to monitor bladder function

Cauda Equina Syndrome Treatment

The condition cannot be prevented however it can be diagnosed at the early stages so as to prevent irreparable damages.

• Immediate treatment to ease pressure off the nerves.
  
• Surgery so as to prevent any further related complications caused by the condition.
  
• Treatment has to be given within 48 hours of onset of pain.
  
• Rehabilitation includes physical therapy and measure to handle bowel and bladder control.
  
• Anti-inflammatory medications.