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NEURORADIOLOGY: MYELOGRAPHY (Indications (Spinal nerve root injury,…
NEURORADIOLOGY: MYELOGRAPHY
Radiographic study of spinal cord
Injection of CM into subarachnoid space
Patient Preparation
Consent form signed
Puncture area cleaned
Explain procedure
Indications
Spinal nerve root injury
Neurofibromas
Arachnoiditis
Spinal stenosis
Cysts
Cervical spondylosis
Spinal cord tumors
Contraindications
Infection at the puncture site
Coagulopathy
Intracranial disease
Increased intracranial pressure
Advantages
Defines extent of subarachnoid space
Identifies spinal block
Contrast Media
Water-soluble, non-ionic
Isovue
Omnipaque
Niopam
Disadvantages
Invasive
Limited coverage
Lead to serious complications
CSF leak
Contrast reaction
Equipments
Sterile gloves
Antiseptic solution
Myelography tray
Lab request
Grid cassettes
Large sponge pillow
Procedure
Needle placement
Puncture of subarachnoid space
Lumbar L3/L4
Cervical C1/C2
Prone or left lateral position
Fluoro for needle placement
Needle placement verified by backflow of CSF
Samples collected and labeled
Films
Erect/Semi-erect
Lateral
Laterals in flexion/extension
show posterior disc protrusion and any spinal instability
45 degree RPO & LPO (to see the nerve roots)
AP
Pt supine & table horizontal
Shoot through lateral
AP