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Myelography
| Question | Answer |
|---|---|
| Myelogram | -radiologic exam of central nervous system structures within the spinal canal |
| Most common site of contrast injection | -L2-L3 |
| Injection site for cervical exams | -C1-C2, cisterna cerebromedullaris |
| Structure that contrast is injected into | -subarachnoid space |
| Number of pairs of spinal nerves | -31 |
| Spinal cord ends at the level of | -L1-L2 |
| Spinal cord ends in a point called | -conus medullaris |
| Most common disk to herniate | -L5-S1 |
| Types of contrast used | -opaque non-water-soluble / water-soluble nonionic iodinated / gas- air or O^2 (rarely used) |
| Pantopaque | -opaque non-water-soluble contrast used |
| Metrizimide | -water-soluble nonionic iodinated contrast used |
| Omnipaque 300 | -2nd generation; method of choice for cervical (or Pan myelogram) |
| Omnipaque 180 | -2nd generation; method of choice for lumbar |
| Type of contrast preferred due to fewer side effects | -Omnipaque |
| 2 Disadvantages of pantopaque (and other non-water soluble contrast) | -poor visualization of nerve root sheaths / body doesn’t absorb so has to be removed |
| 2 Advantage of water-soluble contrasts | - good visualization of nerve root sheaths / body absorbs readily |
| Common pt. positions (to open intervertebral spaces) | -prone with pillow under abd / lateral with spine flexed |
| This has to be done prior to contrast injection | -some CSF removed |
| Used to control direction and flow of contrast after injection | -gravity via use of tilting table |
| Reason head is extended and resting on chin during exam | -to compress cisterna magna which prevents contrast from reaching ventricles |
| Most common finding during myelogram | - HNP (herniated nucleus pulposus), slipped disc |
| Pan myelogram | -complete myelogram (cervical and lumbar) |
| 4 Indications for a myelogram | -HNP / bone fragments / tumors / swelling of spinal cord (due to injury) |
| Incomplete or partial dislocation of a vertebral body; usually due to injury | -subluxation |
| 2 Causes of compression fx | -injury to anterior section of vertebral body / spontaneously due to age (bone demineralization) |
| 750,000 Americans are affected by this type of spinal pathology each year | -compression fx |
| Deffective closure of the encasement of spinal cord; spinal cord and meninges may protrude through opening | -Spina Bifida |
| Forward displacement of one vertebra over another; commonly L5-S1 & L4-L5 | -Spondylolisthesis |
| Inflammation of vertabrae | -Spondylitis |
| Abnormal lateral curvature of the spine | -Scoliosis |
| Of the 4 types of Scoliosis, these 2 are most common | -Dextroscoliosis (spine shifts to R of body) / Levoscoliosis (spine shifts to L side of body) |
| 4 Contraindications | -prior lumbar puncture 2 wks ago / arachnoiditis / increased intracranial pressure / blood in CSF |
Created by:
kairis276
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