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NEURORADIOLOGY: DISCOGRAPHY (Indications (Traumatic annular tears and…
NEURORADIOLOGY: DISCOGRAPHY
Description
Radiographic investigation of selected intervertebral fibrocartilages (disks)
Normally done in the OT or interventional radiology suite using C-arm.
Functions
Determine intranuclear morphology of disk and the presence and direction of annular damage.
Reproduce pain, determine correct disk, and assess its response to anesthetic injection.
Indications
Traumatic annular tears and ruptures.
Suspected disc prolapse.
Symptomatic disc degenaration without radicular signs.
Acute traumatic intraosseous disc herniation.
Biopsy
Assessment of discs above or below a mechanically altered segment
Contraindications
Recent lumbar puncture
Previous adverse reaction to intrathecal injection of the same CM.
Papilloedema
Any local or distant sepsis will add to the risk of infective discitis
Contrast Media
Meglumine salts
Urografin 310M
Equipments
Fluoroscopy unit with spot film facility
Discography needles
Level 1
Outer needle 21 G, 12.5 cm
Level 2
Inner needle 26 G, 15.8 cm
Patient Preparation
Procedure is done under local anesthesia
Valium for anxious patients
procedure and its aim is explained to the patient
Preliminary Films
AP
Lateral
Procedure
Needle inserted
Contrast media injected up to 1 ml into disk
Prone or left lateral
Patient asked to describe pain
Risks
Urticaria
Nucleus polposus pulmonary embolism
Disktitis