3. What is a myelogram? A myelogram is a radiographic study combining the use of a contrast medium with a fluoroscopy to evaluate abnormalities of the spinal cord and its nerve root branches. usually completed within 30 to 60 minutes
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6. Puncture Positions Body position for lumbar puncture: Prone position. Left lateral position, with spine flexed to widen the interspinous space. Body position for cervical puncture: Erect position. Prone position, with the head flexed to open the interspinous space.
7. Imaging Technique After injection, the table is tilted slowlyto allow the CM to reach different levels in the spinal canal. (A footrest and shoulder straps or supports will keep the patient from sliding) under fluoroscopy, spot films are taken by the radiologist in different positions. the table tilt is adjusted to concentrate the CM in the interested area. Conventional x-ray images is taken by the technologist as requested.
10. Solid foods are avoided for several hours before the exam.
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12. CERVICAL MYELOGRAM LATERAL VIEW CERVICAL MYELOGRAM LATERAL VIEW IODINATED CONTRAST IN THECAL SAC C-2 C-3-4 DISC THECAL SAC POST OF FUSION C-5-6
13. Position images(B) cont. 3- LUMBAR MYELOGRAPHY With the patient prone, arms flexed above head Table tilted , concentrated CM in interested area. cp: to L3 CR: Horizontal beam > ALL in Suspended respiration
22. headache may follow the myelographydue to the leakage of a small amount of CSF from the needle insertion site.Benefits outweighs
23. Limitations of Myelography It’s only sees inside the spinal canal and the very proximal nerve roots. Abnormalities outside these areas may be better imaged with MRI. It may be difficult to inject contrast material in patients with structural defects of the spine or some forms of spinal injury. Myelography usually is avoided during pregnancy ( If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby).
24. This procedure has largely been replaced by non-invasive MRI or CT procedures
Bec. Of relatively low osmolalitypast., air cm + oil based
Either as lumbar(safer, most common) or cervical-
Depending on the location of the puncture, the patient will be positioned. widen= facilitate intro of spinal needle
basic
some
1- However, the benefit of an accurate diagnosis far outweighs the risk.(because the needle breaks the skin’s surface, providing a possible portal of entry for bacteria).
