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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

  1. The patient will lie on an X-ray table.
  2. Local anesthesia is applied to numb the lumbar region of the spine.
  3. A needle is inserted into the spinal canal to inject a contrast dye.
  4. The patient is tilted to allow the dye to flow toward the posterior fossa.
  5. X-rays are taken from various angles to capture detailed images.
  6. 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.

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