MYELOGRAPHY

MYELOGRAPHY – Definition, Purpose, Indications, General Instructions, Client Preparation, Procedure and After Care

Myelography or myelogram is an X-ray of the spinal subarachnoid space taken after an opaque or air is injected into the spinal subarachnoid space through a spinal puncture. It is also a diagnostic procedure used to visualize the lumbar, thoracic or cervical areas or whole spinal axes for diagnosis of a spinal tumor, a herniated intervertebral disc or a ruptured disc

DEFINITION

Myelography is an X-ray examination of the spinal subarachnoid space taken after an opaque medium or air is injected into the spinal subarachnoid space through a spinal puncture. It shows any distortion of the spinal cord or spinal dural sac caused by tumors, cysts, herniated intervertebral discs or other lesions

PURPOSE

  • To identify space-occupying lesions of the spinal cord
  • To help diagnosis a herniated nucleus pulposus
  • To diagnose intramedullary tumors
  • To identify the traumatic lesion and cysts of the vertebrae or the spinal cord

INDICATIONS

  • Spinal cord tumors
  • Traumatic lesions of the spinal cord
  • Herniated intervertebral disc

GENERAL INSTRUCTIONS

  • The client should be prepared physiologically and psychologically
  • Strict aseptic technique should be followed throughout the procedure
  • The client should be informed that the X-ray table may be titled in varying positions during the study
  • The commonly used dyes are mertrizamide (amipaque) and iophendylate (pantoopaque) so the sensitivity should be checked
  • Instruct the client to remain supine for 12 to 24 hours after the procedure
  • Inform the client that the procedure is done in X-ray department

CLIENT PREPARATION

  • Explain the procedure to the patient and relatives
  • Obtain informed consent
  • The meal that would normally be eaten prior to the procedure is omitted
  • The client may be given a light sedative to help cooperate
  • Sensitivity test for the dye must be checked

PROCEDURE

  • Place the client on the X-ray table
  • Position the client for lumbar puncture
  • LP needle is inserted L4-L5
  • Approximately 10 ml of CSF is removed
  • Water soluble nonionic contrast medium is then injected
  • The table is titled to allow the column of the dye to move up and down within the subarachnoid space
  • By minimal changes in position of the table and patient, various regions of the spine are screened and films taken at appropriate levels

AFTER CARE

  • Keep the client strict bed rest
  • Position the client’s head elevated 30 degree
  • Check the neurological and vital signs
  • Encourage more oral fluids
  • Provide light soft diet if no nausea and vomiting
  • Mild analgesics may be given if headache persists
  • Check the client’s ability to void
  • Observe for fever, stiff neck, photophobia or the signs of chemical or bacterial meningitis
MYELOGRAPHY – Definition, Purpose, Indications, General Instructions, Client Preparation, Procedure and After Care
MYELOGRAPHY – Definition, Purpose, Indications, General Instructions, Client Preparation, Procedure and After Care

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