Myelography Procedure Guide, Slides of Radiology

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Presented

by:

1.Saeedullah 8980 2.Laiba Khan 10018

**Demonstration of Myelography Myelography is a diagnostic imaging procedure that involves the injection of a contrast agent into the spinal canal to visualize the spinal cord, nerve roots, and surrounding structures using X-rays, fluoroscopy, or CT (CT myelography). Myelogram Fat Spinal Catheter with canal contrast dye FJ cteveland Clinic ©2023 Disc ** ye Contraindications** ** Absolute Contraindications** - **|ncreased intracranial pressure (risk of herniation)** - ** Active infection near puncture site (risk of meningitis)** - **Severe bleeding disorders or anticoagulant use (risk of spinal hematoma)** - **Known allergy to contrast agents** **Relative Contraindications** - **Pregnancy** (unless absolutely necessary) - **Severe sc oliosis or spinal deformities** (difficult needle placement) - **Seizure disorders** (risk of contrast-induced seizures) **y& Contrast Agents** - **|odinated contrast agents** (e.g., lohexol, lopamidol) - most commonly used - **Non-ionic, water-soluble agents** (preferred for lower neurotoxicity) - **Qil-based agents (e.g., Pantopaque)** - rarely used today due to complications ** ye Patient Preparation** 1. **Informed consent** (explain risks, benefits, alternatives) 2. **Fasting** (4-6 hours before the procedure to reduce nausea) 3. **Discontinue anticoagulants*® (if possible, to prevent bleeding) 4. **Pre-procedure hydration** (reduces risk of contrast-induced nephropathy) 5. **Remove metal objects** (jewelry, belts) 6. **Sedation (if anxious)** - but patient must remain cooperative ** ye Techniques** **1. Lumbar Puncture (Most Common)** - Patient lies **prone or lateral decubitus**. - **Needle inserted into the subarachnoid space** (L3-L4 or L4-L5 level). - **CSF flow confirms correct placement** before contrast injection. - **Contrast is injected slowly** under fluoroscopic guidance. - **X-rays/CT taken in various positions** (supine, prone, lateral). **2. Cervical Myelography (Less Common)** - Performed via **lumbar route** or **C1-C2 puncture*®* (riskier). - **Tilting the table** helps contrast flow to the cervical region. *k WY Aftercare** 1. **Bed rest for 4-6 hours** (head elevated to reduce headache risk). 2. **Hydration** (helps flush out contrast and reduce headache). 3. **Monitor for complications** (headache, fever, neurological deficits). 4. **Avoid strenuous activity for 24 hours**, 5. **Follow-up imaging (CT/MRI myelography) if needed**.