Name of the Procedure:

Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral

Summary

Myelography via lumbar injection is a diagnostic imaging procedure used to evaluate abnormalities in the spinal canal, specifically in the lumbosacral region. It involves the injection of a contrast dye into the lumbar spine, followed by X-rays or CT scans to visualize the spinal cord, nerve roots, and surrounding structures.

Purpose

The procedure is performed to diagnose or evaluate:

• Spinal cord abnormalities
• Nerve root issues
• Spinal stenosis
• Herniated discs
• Tumors or infections in the spinal canal

The goal is to obtain detailed images that help in diagnosing spinal conditions and guiding treatment plans.

Indications

This procedure is indicated for patients with:

• Persistent back pain unresponsive to conservative treatment
• Numbness or weakness in the legs
• Unexplained symptoms suggesting spinal pathology
• Prior inconclusive imaging results (e.g., MRI or CT)

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustments to certain medications, especially blood thinners, may be necessary.
• Pre-procedure imaging studies such as MRI or CT scans may be required.
• Informed consent must be obtained.

Procedure Description

1. The patient lies face down on an X-ray table.
2. Local anesthesia is administered to numb the injection site in the lower back.
3. A needle is inserted into the lumbar spinal canal, and a contrast dye is injected.
4. Radiographic images are taken to capture detailed views of the spinal canal.
5. The needle is removed, and a small bandage is applied.

Advanced imaging equipment such as fluoroscopy or CT may be used for guidance during the procedure.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Myelography via lumbar injection is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiology technician
• Nurse or medical assistant

Risks and Complications

• Infection at the injection site
• Allergic reactions to the contrast dye
• Headache due to cerebrospinal fluid leakage
• Bleeding or hematoma formation
• Short-term pain or discomfort at the injection site

Benefits

• Provides detailed images of spinal anatomy and abnormalities
• Aids in accurate diagnosis and type of treatment
• Can help pinpoint precise locations of nerve root compression

Recovery

• Patients are usually observed for a short period after the procedure.
• They may need to lie flat for a few hours to minimize headache risk.
• Drinking plenty of fluids to stay hydrated and help clear the contrast dye from the body is encouraged.
• Normal activities can typically resume within 24 hours, but follow specific instructions from the healthcare provider.

Alternatives

• MRI or CT scans without contrast
• Epidural steroid injections for pain relief
• Surgical exploration if indicated
• Pros and cons: Non-invasive imaging may be less detailed, surgical options carry higher risks but can be therapeutic as well as diagnostic.

Patient Experience

• Patients may feel pressure or slight discomfort during the injection.
• Temporary headache or dizziness post-procedure.
• Pain management typically involves over-the-counter analgesics and hydration.
• Comfort measures include lying flat and resting after the procedure to minimize risks.