Injection procedure for myelography and/or computed tomography, lumbar
CPT4 code
Name of the Procedure:
Injection procedure for myelography and/or computed tomography, lumbar
(Common names: Lumbar myelography, CT myelography)
Summary
Lumbar myelography is a diagnostic procedure where a contrast dye is injected into the spinal canal to enhance imaging of the spinal cord and nerve roots. This is followed by X-rays or CT scans to get detailed images that help diagnose spine-related issues.
Purpose
The procedure is used to diagnose issues with the spinal cord, nerve roots, or other structures within the spinal canal. It aims to identify conditions such as herniated discs, tumors, infections, or spinal stenosis.
Indications
- Persistent unexplained back or leg pain
- Symptoms suggesting nerve compression or spinal cord problems
- Previous inconclusive imaging results
- Suspected spinal abnormalities
Preparation
- Fasting for 6-8 hours before the procedure.
- Discontinuation or adjustment of certain medications (e.g., blood thinners).
- Pre-procedure imaging studies and general health assessments.
Procedure Description
- The patient lies on their stomach or side on the examination table.
- The area of the lower back is cleaned and numbed with a local anesthetic.
- Using fluoroscopy (live X-ray), a needle is inserted into the spinal canal to inject the contrast dye.
- X-rays or CT scans are taken to capture detailed images.
- The needle is removed, and the injection site is covered with a bandage.
Tools/Equipment: Needles, contrast dye, fluoroscope, X-ray or CT scanner.
Anesthesia: Local anesthesia; mild sedation may be used if necessary.
Duration
The procedure typically takes about 30-60 minutes.
Setting
Performed in a hospital radiology or imaging department.
Personnel
- Radiologist or neuroradiologist
- Radiology technician
- Nurse
- Anesthesia personnel (if sedation is used)
Risks and Complications
- Common: Pain at the injection site, headache, nausea.
- Rare: Infection, bleeding, allergic reaction to contrast dye, nerve damage.
Benefits
- Provides clear, detailed images of the spinal cord and nerve roots.
- Helps in accurate diagnosis and treatment planning.
- Immediate results commonly available.
Recovery
- Monitor for a few hours post-procedure.
- Increase fluid intake to help flush out the contrast dye.
- Avoid strenuous activities for 24 hours.
- Follow-up appointment as recommended by your doctor.
Alternatives
- MRI: Non-invasive but may not be suitable for all patients.
- CT scan without contrast: Less detailed images.
- Electromyography (EMG): Measures muscle response but doesn’t provide direct imaging.
Patient Experience
Patients may feel pressure or slight pain during the injection. Post-procedure, there may be mild discomfort or headache. Pain management with over-the-counter medications like acetaminophen is usually effective. Comfort measures include lying down with head elevated post-procedure.