Myelography

Myelography or Myelography is an imaging method in which a dye is injected into the spinal canal and then an x-ray is performed.

Prior to the development of computed tomography designated as " Great Radiology " (CT) and magnetic resonance imaging ( MRI), it was difficult to assess herniated discs and other space-occupying lesions in the spinal canal. Myelography provides a way of further diagnostic tests. Between the vertebral arches of the third and fourth lumbar vertebra, a special needle is inserted ( lumbar puncture ), which extends into the dural sac ( subarachnoid space ). The location is correct when spinal fluid dripping out of the cannula.

In the modern non-invasive cross-sectional imaging MRI and CT availability the importance of myelography has decreased in human medicine. However, myelography for specific problems in neurosurgery and non feasibility of CT or MRI still has its indication. In principle served myelography especially the diagnosis of space-occupying lesions in the spinal canal. In the evaluation is to pay attention to contrast agent crashes and recesses. In veterinary medicine, myelography still plays a major role due to the little availability of MRI and CT.

In spinal root compression syndromes can in a myelography of advantage be used the dynamic recording capability to detect filling defects of the so-called root bags. Therefore, myelography is used preoperatively to clarify outstanding questions when an MRI or CT can not or will not be carried out free of artifacts ( eg, scoliosis ).

After administration of contrast medium and CT myelography also can be customized by an additional layer to obtain images with contrast agent.

Complications

The first contrast agents that were available, had an oily base and could not be absorbed by the body. Much more burdensome than the introduction of the contrast agent is to remove the end of the study, the oily liquid through the still lying puncture needle was again. In many cases, did not succeed completely, in the lowest part of the dural sac a few drops remained lying and led to scarring. Today, however, we used absorbable contrast medium in which this problem no longer occurs.

For all interventions that penetrate the intact skin, it can cause an infection. Pus in the spinal canal are a very serious problem, a purulent meningitis can lead to death. These disasters are thankfully a rare quality.

Quite often, however, it comes after puncture of the dural sac in the loss of spinal fluid. The cerebrospinal fluid as water flows off looking through the resulting hole, inside the skull, creating a vacuum. The consequences are severe headache ( postpunktioneller headache ).