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Myelography, posterior fossa, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Myelography, Posterior Fossa
- Common Name(s): Brainstem Myelography
- Technical/Medical Term: Posterior Fossa Myelogram with Radiological Supervision and Interpretation
Summary
Myelography is a diagnostic imaging procedure that uses a contrast dye and X-rays to visualize the spinal cord, nerve roots, and surrounding structures. Specifically, posterior fossa myelography focuses on the area around the brainstem and cerebellum to detect abnormalities.
Purpose
- Medical Condition: Diagnoses conditions affecting the brainstem, cerebellum, and upper spinal cord.
- Goals: To identify structural abnormalities such as cysts, tumors, herniated disks, infections, or bleeding in the posterior fossa region.
Indications
- Symptoms such as chronic headache, dizziness, balance problems, or neurological deficits.
- Conditions like unexplained neurological symptoms, suspected tumors, cysts, or infections in the posterior fossa region.
Preparation
- Patients may need to fast for several hours prior to the procedure.
- Adjustments to medications as directed by their physician.
- Pre-procedure imaging tests like MRI or CT scans to better plan the myelography.
Procedure Description
- The patient will lie on an X-ray table.
- Local anesthesia is applied to numb the lumbar region of the spine.
- A needle is inserted into the spinal canal to inject a contrast dye.
- The patient is tilted to allow the dye to flow toward the posterior fossa.
- X-rays are taken from various angles to capture detailed images.
- The radiologist supervises and interprets the images to provide a diagnosis.
- Tools: X-ray machine, needle, contrast dye.
- Anesthesia: Local anesthesia to numb the lumbar puncture area.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Performed in a hospital's radiology department or an outpatient imaging center.
Personnel
- Radiologist to perform and interpret the procedure.
- Radiologic technologists to assist with imaging.
- Nurses for patient preparation and post-procedure care.
Risks and Complications
- Common risks: Headache, nausea, dizziness, and mild discomfort at the injection site.
- Rare risks: Infection, bleeding, allergic reactions to the dye, or nerve damage.
Benefits
- Provides detailed images of the posterior fossa, aiding in accurate diagnosis.
- Helps in planning further treatment or surgical interventions.
- The benefits are often realized immediately after interpreting the results.
Recovery
- Patients are observed for a few hours post-procedure to monitor for any adverse effects.
- Instructions to avoid strenuous activities for 24 hours.
- Follow-up appointments may be required to discuss results and next steps.
Alternatives
- MRI or CT scan: Non-invasive alternatives; however, they may not provide the same level of detail in some cases.
- Pros: Less invasive, no dye injections.
- Cons: May lack the diagnostic precision of myelography in specific situations.
Patient Experience
- During: Mild discomfort or pressure during the lumbar puncture; lying still for extended periods.
- After: Some patients may experience headaches or mild nausea; pain management is available to ensure comfort.
- Most patients can resume normal activities within a day, adhering to specific post-procedure guidelines.