72255 Myelography, thoracic, radiological supervision and interpretation

Name of the Procedure:

Myelography, Thoracic, Radiological Supervision and Interpretation

Summary

Myelography is a specialized imaging procedure that involves injecting a contrast dye into the spinal canal to provide clear images of the spinal cord, nerve roots, and other structures. In the thoracic region, this helps diagnose issues related to the mid-back area. Radiological supervision and interpretation ensure accurate diagnosis through expert analysis of the images obtained.

Purpose

Myelography is used to diagnose abnormalities of the spinal cord, nerve roots, and surrounding structures within the thoracic region. The primary goals are to identify conditions such as spinal stenosis, herniated discs, tumors, or infections and to guide further treatment planning.

Indications

• Persistent mid-back pain unresponsive to conservative treatment
• Symptoms of nerve compression (e.g., tingling, numbness, or weakness in the thoracic area)
• Suspected spinal tumors or infections
• Degenerative spinal conditions or abnormalities visible on other imaging tests

Preparation

• Patients may need to fast for a few hours before the procedure.
• Medication adjustments might be necessary; specific instructions will be given by the healthcare provider.
• Preliminary diagnostic tests, such as MRI or CT scans, are often required to better assess the condition.

Procedure Description

1. The patient lies face down on an X-ray table.
2. Local anesthesia is administered to numb the area of injection.
3. A contrast dye is injected into the spinal canal using a thin needle.
4. The table may be tilted to allow the dye to flow through the thoracic spine.
5. X-ray or CT images are taken to visualize the dye’s distribution and highlight abnormalities.
6. Radiologists analyze the images to provide a detailed report.

Duration

The procedure typically takes about 1-2 hours, including preparation, imaging, and observation time.

Setting

Myelography is performed in a hospital or an outpatient radiology center equipped with advanced imaging technology.

Personnel

• A radiologist or interventional radiologist
• Radiologic technologists
• Nursing staff
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common risks: Headache, nausea, dizziness
• Rare risks: Infection, bleeding, allergic reaction to the contrast dye, nerve damage
• Management includes symptomatic treatment for headaches and careful monitoring for any serious complications.

Benefits

• Provides detailed images of the thoracic spine, aiding in accurate diagnosis.
• Can guide surgical or non-surgical treatment plans.
• Immediate imaging results available for quick analysis.

Recovery

• Patients are usually monitored for a few hours post-procedure.
• Rest and hydration are recommended to help remove the contrast dye from the body.
• Mild discomfort or headache may occur but typically resolves within a few days.
• Follow-up appointments may be scheduled to discuss results and further treatment.

Alternatives

• MRI and CT scans without contrast: Less invasive but might not provide as detailed images for certain conditions.
• Epidural steroid injections: For treatment rather than diagnosis.
• Observation and conservative management: Physical therapy, medications.

Patient Experience

Patients may feel brief discomfort during the injection. Most experience pressure rather than pain. Post-procedure, they might have a mild headache or soreness. Pain management includes over-the-counter pain relievers and adequate hydration. Nurses and staff will take measures to ensure patient comfort throughout the process.