Name of the Procedure:

Myelography via Lumbar Injection with Radiological Supervision and Interpretation; Thoracic

Summary

Myelography via lumbar injection is an imaging procedure where a contrast dye is injected into the lumbar region of the spine to visualize the spinal cord and thoracic area under X-ray guidance. This helps in diagnosing spinal conditions that other imaging tests may not clearly reveal.

Purpose

The procedure aims to detect abnormalities such as herniated discs, spinal tumors, infections, or injuries to the spinal nerve roots. By providing detailed images of the spinal cord and surrounding structures, myelography can guide doctors in choosing the most appropriate treatment.

Indications

• Unexplained back pain or leg pain
• Numbness, tingling, or weakness in the limbs
• Suspected spinal tumors or infections
• Herniated discs or spinal stenosis
• Previous inconclusive MRI or CT scans

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, particularly blood thinners, may need to be adjusted or paused.
• Pre-procedure imaging tests like MRI or CT scans may be required.
• A detailed medical history and examination will be conducted.

Procedure Description

1. The patient lies on their stomach or side on an X-ray table.
2. The lower back (lumbar region) is cleaned and numbed with local anesthesia.
3. A spinal needle is carefully inserted into the lumbar spine and contrast dye is injected.
4. X-ray or fluoroscopy images are taken to track the flow of the dye through the spinal canal, focusing on the thoracic region.
5. The radiologist interprets the images in real-time to identify any abnormalities.

Duration

The procedure typically takes about 1 to 2 hours, including preparation and image review.

Setting

It is performed in a hospital radiology department or an outpatient radiology clinic equipped with specialized imaging technology.

Personnel

• Radiologist
• Radiologic technologist
• Nurse or healthcare assistant

Risks and Complications

• Headache
• Infection at the injection site
• Bleeding or bruising
• Allergic reaction to the contrast dye
• Rarely, nerve damage

Benefits

• Provides detailed imaging of the spinal cord and surrounding structures.
• Helps in accurate diagnosis and planning of treatment.
• Can reveal conditions that are not visible on standard X-rays or MRI scans.

Recovery

• Patients are usually monitored for a few hours post-procedure for any adverse reactions.
• Avoid strenuous activity for at least 24 hours.
• Drink plenty of fluids to help eliminate the contrast dye from the body.
• A follow-up appointment may be scheduled to discuss the results.

Alternatives

• MRI or CT scans, which may be less invasive but not as detailed in certain cases.
• Electromyography (EMG) for assessing muscle activity.
• Medical management with medications or physical therapy.

Patient Experience

During the procedure, patients might feel pressure or discomfort when the needle is inserted, but pain should be minimal due to local anesthesia. Afterward, some patients may experience a headache or mild back pain, which can be managed with over-the-counter pain medications and rest. Most can resume normal activities within a day, depending on their individual condition and healthcare provider's advice.