Myelography - Examination Of The Spinal Canal And Spinal Cord

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Myelography - Examination Of The Spinal Canal And Spinal Cord
Myelography - Examination Of The Spinal Canal And Spinal Cord

Video: Myelography - Examination Of The Spinal Canal And Spinal Cord

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Myelography is an X-ray examination with a contrast agent, during which pathological changes in the spinal canal and the spinal cord located in it can be determined. In addition to a conventional x-ray, a combination with a myelo computed tomography is also possible. Changes in the spinal column and spinal cord are now mainly detected with the aid of magnetic resonance imaging, which, in contrast to myelography, is possible without puncturing the spinal canal. However, myelography is still essential for certain issues.


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  • When is myelography necessary?
  • How is the examination performed?
  • What are the side effects / complications?
  • Where is myelography done?
  • How are the costs going to be covered?

When is myelography necessary?

The vertebrae, which are strung together, form the bony shell of the vertebral canal inside. In this is the dural sac, in which the spinal cord and the nerve roots arising from it are located. The spinal cord is surrounded by cerebrospinal fluid (liquor). Without a contrast medium, the contents of the spinal canal cannot be seen in the X-ray. If there is a constriction of the spinal cord or the nerve roots, for example due to a herniated disc or a narrowing of the bony spinal canal, this can lead to pain and paralysis in those regions supplied by the nerves. The exact amount of constriction or displacement of the spinal cord can be determined with the help of myelography.

How is the examination performed?

The examination is carried out sitting or lying on your side. After any local anesthesia of the puncture site, a thin hollow needle is inserted into the spinal canal between two lumbar vertebrae. There is no spinal cord at this height, only nerve roots. A few milliliters of cerebrospinal fluid (liquor) are first removed through the hollow needle with a syringe and examined in the laboratory. This also ensures that the needle is positioned in the right place. Then contrast medium is injected into the spinal canal through the hollow needle lying on the floor.

The patient is then placed in a head-down position so that the contrast agent can spread into the thoracic and cervical spine. Then x-rays are made in different planes or sectional image series (CT).

After the examination, the patient has to lie flat for several hours and stay in bed for the rest of the day, as otherwise the changed pressure conditions in the spinal canal can lead to severe headaches, nausea and vomiting. The contrast agent is completely excreted in the urine within a few hours.

What are the side effects / complications?

Myelography is a low-risk diagnostic procedure. Nevertheless, side effects and complications can occur in individual cases. The local anesthetic is done by injecting a pain reliever in the area of ​​the puncture site on the back. The subsequent introduction of the hollow needle should then be painless. In the short term, there may be slight pain in the back, neck or arms and legs, which, however, do not require treatment.

The changed pressure conditions in the spinal canal can lead to severe headaches, nausea, vomiting, a slight fever or shivering after the myelography has been completed. You can prevent these complaints by strict bed rest, elevation of the upper body and plenty of fluids.

In rare cases, brain fluid can accumulate under the skin (liquor cushion) at the puncture site or an artificial channel between the skin and the spinal canal (liquor fistula) is formed. In both cases, an additional puncture under CT view with injection of a blood clot to close the fistula or, more rarely, surgery may be necessary to correct these complications.

Infections at the injection site, which require antibiotic therapy, can also occur very rarely. Spreading the germs can lead to inflammation of the membranes of the spinal cord and meninges (meningitis). For the general side effects of X-ray examinations and the administration of contrast media, see Use of contrast media.

Where is myelography done?

The x-ray examination of the spinal canal is carried out in the hospital by specialists in radiology. A bank transfer is required. In certain cases, we collaborate with specialists in neurology or neurosurgery.

You can find hospitals (with a radiological department) in your area under Clinic search

How are the costs going to be covered?

You will need a doctor's referral for myelography. This is valid for one month from the date of issue. The costs are covered by your health insurance provider.

Danger! This service is not paid for by the health insurance providers for resident specialists.

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