Radiology Cases Myelography LSBU

Description: Myelography is the demonstration of the contents of the spinal canal by the sub-arachnoid injection of non-ionic water-soluble contrast. The procedure involves stabbing the patient in the back with a needle under fluoroscopic control. Contrast was introduced into the theca by a needle, placed between the spines of the lower lumbar vertebrae and passing through the avascular interspinous ligament. Local anaesthetic and careful needle placement made this procedure pain-free. In the 'bad old days' iodinated oil was used, but proved irritating to the theca. If oily contrast were left in the spinal canal, there was a risk of thecal irritation and radiologists were trained to use the lowest possible lumbar space. This makes easier the removal of all or most of the contrast after the examination and avoided the divergent nerve-root branches of the cauda equina.
This document references those pathologies that were demonstrated with myelography, but where MRI would now be the investigation of choice.