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Ultrasound, spinal canal and contents

CPT4 code

Name of the Procedure:

Ultrasound, Spinal Canal and Contents Common name(s): Spinal Ultrasound, Spinal Sonography

Summary

A spinal ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to create detailed pictures of the spinal canal and its contents, including the spinal cord and related structures. This procedure is usually performed on infants and young children, as their spinal bones are not fully hardened, allowing clearer images.

Purpose

The procedure is used to diagnose congenital conditions, abnormalities, infections, or issues affecting the spinal cord and canal. The goal is to provide clear, real-time images that assist healthcare providers in identifying and addressing any spinal issues early.

Indications

  • Unexplained back pain or neurological symptoms in infants
  • Suspected spinal cord abnormalities or congenital conditions, such as tethered cord syndrome or spina bifida
  • Monitoring known spinal abnormalities over time

Preparation

  • No specific fasting or medication adjustments are usually required.
  • Ensure the patient is calm; for infants, a feeding might be scheduled before to ensure they are relaxed.

Procedure Description

  1. The patient will lie face down or on their side on an examination table.
  2. A special gel is applied to the lower back to facilitate sound wave transmission.
  3. The technician moves a transducer along the spine, which emits sound waves that bounce off spinal structures and create images on a monitor.
  4. The technician or radiologist captures multiple images from various angles for thorough examination.
  5. The gel is wiped off, and the patient is cleaned.

Tools and Equipment:

  • Ultrasound machine
  • Transducer
  • Conductive gel

Anesthesia or Sedation:

  • Not typically required due to the non-invasive nature of the procedure.

Duration

The procedure typically takes 15 to 30 minutes.

Setting

Usually performed in a radiology department, outpatient clinic, or pediatric diagnostic center.

Personnel

  • Radiologist or pediatric radiologist
  • Ultrasound technician (sonographer)
  • Nurse or medical assistant (occasionally to help with patient positioning and comfort)

Risks and Complications

  • Ultrasound is a very safe procedure with minimal risks.
  • Rarely, some minor skin irritation may occur from the gel.

Benefits

  • Provides detailed, real-time images for an accurate diagnosis.
  • Non-invasive and painless.
  • No exposure to ionizing radiation, making it safe for infants and young children.

Recovery

  • The patient can return to normal activities immediately after the procedure.
  • No special post-procedure care is needed.

Alternatives

  • MRI: Provides more detailed images but may require sedation in young children and involves a longer procedure time.
  • CT Scan: Uses ionizing radiation and generally provides less detail on soft tissues of the spinal cord compared to ultrasound or MRI.
  • Physical Examination: Can provide clues but lacks the detailed internal visualizations.

Patient Experience

  • The patient will feel the transducer moving along their back and the coolness of the gel.
  • Infants might cry or squirm but can be comforted by a parent or caregiver.
  • Pain is minimal to nonexistent, and comfort measures include keeping the child calm and secure.

Overall, a spinal ultrasound is a valuable, safe, and effective imaging tool for diagnosing spinal issues in infants and young children.

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