![]() infection involving the bony spine, intervertebral discs, meninges and surrounding soft tissues.tumors involving the bony spine, meninges, nerve roots or spinal cord.Myelography can also be used to assess the following conditions when MR imaging cannot be performed, or in addition to MRI (when MR does not provide sufficient information): In this condition, the spinal canal narrows as the surrounding tissues enlarge due to the development of bony spurs (osteophytes) and thickening of the adjacent ligaments. to depict a condition that often accompanies degeneration of the bones and soft tissues surrounding the spinal canal, termed spinal stenosis.to show whether a herniation of the intervertebral disk between the successive vertebral bodies is compressing the nerve roots or the spinal cord.Myelography is most commonly used to detect abnormalities affecting the spinal cord, the spinal canal, the spinal nerve roots and the blood vessels that supply the spinal cord, including: In such cases, myelography and/or a CT scan, in lieu of MRI, is performed to better define abnormalities. However, on occasion, a patient has a medical device, such as a cardiac pacemaker, that may prevent him or her from undergoing MRI. Magnetic resonance imaging (MRI) is often the first imaging exam done to evaluate the spinal cord and nerve roots. What are some common uses of the procedure? In many of these cases, the myelogram may be followed by a computed tomography (CT) scan to better define the anatomy and any abnormalities. The radiologist views the passage of contrast material in real-time within the subarachnoid space as it is flowing using fluoroscopy but also takes permanent images, called x-rays or radiographs, of the contrast material around the spinal cord and nerve roots in order to document abnormalities involving or affecting these structures. Myelography provides a very detailed picture ( myelogram) of the spinal cord, nerve roots, subarachnoid space and spinal column. The meninges are the membranes which surround and cover the spinal cord and nerve roots. When the contrast material is injected into the subarachnoid space, the radiologist is able to view and evaluate the status of the spinal cord, the nerve roots and the meninges. X-rays are the oldest and most often used form of medical imaging. It exposes you to a small dose of ionizing radiation to produce pictures of the inside of the body. Assessment requires a systematic approach.Myelography is an imaging examination that involves the introduction of a spinal needle into the spinal canal and the injection of contrast material in the space around the spinal cord and nerve roots (the subarachnoid space) using a real-time form of x-ray called fluoroscopy.Īn x-ray exam helps doctors diagnose and treat medical conditions. The lateral view is often the most informative image. If the lateral view does not show the vertebrae down to T1 then a repeat view with the arms lowered or a ' Swimmer's view' may be required. In the context of trauma these images are all difficult to acquire because the patient may be in pain, confused, unconscious, or unable to cooperate due to the immobilisation devices. The 3 standard views are - Lateral view - Anterior-Posterior (AP) view - and the Odontoid Peg view (or Open Mouth view). Imaging should not delay resuscitation.įurther imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit.Ĭlinico-radiological assessment of spinal injuries should be managed by experienced clinicians in accordance with local and national clinical guidelines. ![]() Bones - Cortical outline/Vertebral body heightĬlinical considerations are particularly important in the context of Cervical spine (C-spine) injury.Alignment - Anterior/Posterior/Spinolaminar.Look at all views available in a systematic manner.Clinical considerations are of particular importance when assessing appearances of C-spine X-rays.Normal C-spine X-rays do not exclude significant injury. ![]()
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