Fluoroscopic myelography

Last revised by Daniel J Bell on 27 Apr 2024

Fluoroscopic myelography is a technique that allows the visualization of the theca by the introduction of contrast medium into the CSF. This is usually accomplished by a lumbar puncture, or less commonly a suboccipital puncture.

The patient can then be tilted and rotated to cause the contrast, which is denser than CSF, to outline the spinal canal and spinal nerve roots and plain films (conventional myelography) or fluoroscopic exposures can be obtained.

Since the advent of CT and MRI, stand-alone fluoroscopic or radiographic myelography is largely no longer performed. Instead, the vast majority of patients are imaged with MRI. Those who have a contraindication to MRI usually undergo a conventional (non-dynamic) CT myelogram.

Fluoroscopic myelography re-emerged in the late 2010s to image potential CSF-venous fistulas 3, although if available digital subtraction myelography or dynamic CT myelography is believed to be superior.

History

Conventional x-ray myelography was first carried out (accidentally) in 1921 by Jean-Athanase Sicard (1872–1929, French physician) 1,2; see the article on myelography for a more complete discussion.

ADVERTISEMENT: Supporters see fewer/no ads