70010 Myelography, posterior fossa, radiological supervision and interpretation

Name of the Procedure:

Myelography, Posterior Fossa

• Common Name(s): Brainstem Myelography
• Technical/Medical Term: Posterior Fossa Myelogram with Radiological Supervision and Interpretation

Summary

Myelography is a diagnostic imaging procedure that uses a contrast dye and X-rays to visualize the spinal cord, nerve roots, and surrounding structures. Specifically, posterior fossa myelography focuses on the area around the brainstem and cerebellum to detect abnormalities.

Purpose

• Medical Condition: Diagnoses conditions affecting the brainstem, cerebellum, and upper spinal cord.
• Goals: To identify structural abnormalities such as cysts, tumors, herniated disks, infections, or bleeding in the posterior fossa region.

Indications

• Symptoms such as chronic headache, dizziness, balance problems, or neurological deficits.
• Conditions like unexplained neurological symptoms, suspected tumors, cysts, or infections in the posterior fossa region.

Preparation

• Patients may need to fast for several hours prior to the procedure.
• Adjustments to medications as directed by their physician.
• Pre-procedure imaging tests like MRI or CT scans to better plan the myelography.

Procedure Description

1. The patient will lie on an X-ray table.
2. Local anesthesia is applied to numb the lumbar region of the spine.
3. A needle is inserted into the spinal canal to inject a contrast dye.
4. The patient is tilted to allow the dye to flow toward the posterior fossa.
5. X-rays are taken from various angles to capture detailed images.
6. The radiologist supervises and interprets the images to provide a diagnosis.

• Tools: X-ray machine, needle, contrast dye.
• Anesthesia: Local anesthesia to numb the lumbar puncture area.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Performed in a hospital's radiology department or an outpatient imaging center.

Personnel

• Radiologist to perform and interpret the procedure.
• Radiologic technologists to assist with imaging.
• Nurses for patient preparation and post-procedure care.

Risks and Complications

• Common risks: Headache, nausea, dizziness, and mild discomfort at the injection site.
• Rare risks: Infection, bleeding, allergic reactions to the dye, or nerve damage.

Benefits

• Provides detailed images of the posterior fossa, aiding in accurate diagnosis.
• Helps in planning further treatment or surgical interventions.
• The benefits are often realized immediately after interpreting the results.

Recovery

• Patients are observed for a few hours post-procedure to monitor for any adverse effects.
• Instructions to avoid strenuous activities for 24 hours.
• Follow-up appointments may be required to discuss results and next steps.

Alternatives

• MRI or CT scan: Non-invasive alternatives; however, they may not provide the same level of detail in some cases.
• Pros: Less invasive, no dye injections.
• Cons: May lack the diagnostic precision of myelography in specific situations.

Patient Experience

• During: Mild discomfort or pressure during the lumbar puncture; lying still for extended periods.
• After: Some patients may experience headaches or mild nausea; pain management is available to ensure comfort.
• Most patients can resume normal activities within a day, adhering to specific post-procedure guidelines.