72132 Computed tomography, lumbar spine; with contrast material

Name of the Procedure:

Computed Tomography (CT) Scan of the Lumbar Spine with Contrast Material
Common name(s): CT Lumbar Spine with Contrast, Lumbar Spine CT Scan with Dye

Summary

A Computed Tomography (CT) scan of the lumbar spine with contrast material is an imaging procedure that uses X-rays and a special dye to create detailed pictures of the lower back region. The contrast material helps to highlight specific areas, providing clearer images for diagnosis.

Purpose

The procedure is used to diagnose problems in the lower back, such as herniated discs, spinal stenosis, tumors, infections, and other abnormalities. The goal is to obtain high-quality images that allow for accurate diagnosis and to guide appropriate treatment plans.

Indications

• Persistent lower back pain that isn't responding to treatment
• Suspected disc herniation or nerve impingement
• Evaluation of spinal injuries or fractures
• Detection of tumors, infections, or inflammatory diseases
• Pre-surgical planning or post-surgical follow-up
• Unexplained neurological symptoms affecting the legs

Preparation

• The patient may need to fast for a few hours before the scan.
• Inform the healthcare provider of any allergies, especially to contrast material or iodine.
• Discuss any existing medical conditions and medications being taken.
• A blood test may be necessary to check kidney function before administering the contrast material.

Procedure Description

1. The patient will lie down on a motorized exam table.
2. An intravenous (IV) line will be placed in the patient's arm to administer the contrast material.
3. The table will move through the CT scanner, a doughnut-shaped machine.
4. The scanner will take multiple X-ray images from different angles, which a computer will compile into detailed cross-sectional pictures.
5. The radiologist may instruct the patient to hold their breath for short periods to obtain clear images.
6. Once the images are captured, the IV line will be removed.

Duration

The entire procedure typically takes 30 to 60 minutes.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nursing staff (for IV insertion and patient monitoring)

Risks and Complications

• Allergic reactions to the contrast material, ranging from mild (rash) to severe (anaphylaxis)
• Kidney function impairment, particularly in patients with pre-existing kidney conditions
• Exposure to a small amount of ionizing radiation
• Injection site discomfort or infection

Benefits

• Provides highly detailed images of the lumbar spine, aiding accurate diagnosis
• Helps in planning appropriate treatments or surgeries
• Non-invasive and quick procedure
• Immediate results in urgent situations

Recovery

• Most patients can resume normal activities immediately after the scan.
• Drink plenty of fluids to help flush the contrast material from the body.
• Follow any specific instructions given by the healthcare provider.
• A follow-up appointment may be necessary to discuss the results.

Alternatives

• MRI (Magnetic Resonance Imaging): Provides detailed images without radiation but may not be suitable for all patients.
• X-rays: Less detailed than CT scans but involve less radiation and no contrast material.
• Ultrasound: Limited use in imaging the spine but useful for certain soft tissue assessments.
• Physical Therapy: Non-imaging option for managing certain back problems.

Patient Experience

• The patient may feel a warm sensation or a metallic taste when the contrast material is injected.
• Lying still on the table for the scan can cause discomfort for some patients.
• Any pain from the IV insertion is usually minimal and brief.
• Most patients report little to no discomfort during the actual scanning process.