Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)
CPT4 code
Name of the Procedure:
Myelography via Lumbar Injection
Common Names: Myelogram, Lumbar Myelogram
Technical Terms: Myelography, Lumbar Puncture with Contrast
Summary
In a myelography via lumbar injection, a special dye is injected into the spinal canal through the lower back (lumbar region). The dye enhances the contrast of spinal cord and nerve root images captured by X-ray or CT scans, helping diagnose spinal cord issues.
Purpose
Medical Conditions Addressed: Myelogram helps with diagnosing issues such as herniated discs, spinal tumors, infections, inflammation, and spinal stenosis.
Goals: The aim is to obtain clear images of the spinal cord and nerve roots, leading to accurate diagnosis and appropriate treatment planning.
Indications
Symptoms: Persistent back pain, numbness, weakness, unexplained limb pain.
Conditions: Suspected spinal cord or nerve root issues, abnormal MRI findings, trauma, pre-surgical planning.
Preparation
Pre-Procedure Instructions:
- Fast for 4-6 hours before the procedure.
- Discontinue certain medications as instructed by the physician.
Diagnostic Tests: MRI or CT scans may be required before a myelogram for comprehensive evaluation.
Procedure Description
- Preparation and Positioning: Patient lies face down on the procedure table.
- Anesthesia: Local anesthesia is administered to numb the lumbar region.
- Lumbar Puncture: A sterile needle is inserted into the lower back to access the spinal canal.
- Contrast Injection: A contrast dye is injected into the spinal fluid.
- Imaging: X-rays, fluoroscopy, and possibly CT scans are taken to capture enhanced images.
- Needle Removal: The needle is removed, and a bandage is applied over the puncture site.
Tools/Equipment: Sterile needles, contrast dye, X-ray/fluoroscopy machine, CT scanner.
Anesthesia: Local anesthesia is typically used, rarely mild sedation may be applied.
Duration
Typically, the procedure takes about 30-60 minutes.
Setting
The procedure is usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
Healthcare Professionals Involved: Radiologist, radiology technician, nurse, and possibly a physician assistant.
Risks and Complications
Common Risks: Headache, nausea, dizziness.
Rare Risks: Infection, bleeding, allergic reaction to contrast dye, nerve damage. Management: Risks are managed with close monitoring, appropriate medication, and prompt treatment of complications.
Benefits
Enhanced imaging allows for accurate diagnosis and targeted treatments, often yielding quick results with minimal downtime.
Recovery
Post-Procedure Care: Lie down for several hours to reduce headache risk. Drink plenty of fluids to help flush out the dye.
Expected Recovery Time: Most patients resume normal activities within a day or two, but strenuous activity should be avoided for a few days.
Follow-Up: Follow-up appointments are typically scheduled to review results and plan further treatment if necessary.
Alternatives
Other Treatments: MRI, CT scan without contrast, spinal tap without imaging.
Pros and Cons: MRI is non-invasive but may not provide as detailed images. CT scan without dye may miss subtle issues. Spinal tap is less informative for structural problems.
Patient Experience
During Procedure: Minor discomfort or pressure during needle insertion, but generally well-tolerated due to local anesthesia.
After Procedure: Possible mild headache or nausea. Comfort measures include lying down and staying hydrated. Pain can often be managed with over-the-counter analgesics.
This markdown-styled description aims to provide a comprehensive understanding of the myelography via lumbar injection procedure, making it accessible to patients and healthcare providers alike.