Neuroimaging pp 1303-1326 | Cite as


  • Raymond F. Carmody


Computed tomography (CT) and magnetic resonance imaging (MRI) of the spine have drastically reduced the need for myelography. Although it was once the primary procedure for evaluating disorders affecting the spinal cord and nerve roots, today myelography plays only a minor role in neuroradiology. Being an invasive procedure it should not be the initial test performed in the workup of radiculopathies or myelopathies, since both CT and MRI have equal or superior accuracy.1–10 Instead, myelography is now used (1) to clarify equivocal or “soft” findings on CT or MRI, (2) when CT and MRI give conflicting results, (3) when these noninvasive procedures are negative in the face of compelling clinical evidence of disease, or (4) when metallic devices in the spine preclude diagnostic CT and MRI. This last indication is the main season myelograms are still performed at our institution. Moreover, some surgeons, having for years based their surgical decisions on myelographic information, are uncomfortable operating without a myelogram, whereas others simply want an additional confirmatory test before proceeding. Presumably, as clinicians become more familiar and comfortable with spinal CT and MRI, their insistence on myelography will disappear. Meanwhile, radiologists will have to be familiar with and adept at myelographic techniques and interpretation. This chapter is by no means an all-inclusive discussion of myelography or the many disease entities one may demonstrate by this procedure; rather, it is intended more as an introduction to fundamental principles. Most of the diseases discussed in this section on the abnormal myelogram are more thoroughly covered elsewhere in this textbook


Disk Herniation Cervical Spondylosis Root Sheath Postdural Puncture Headache Thoracic Disk Herniation 
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© Springer Science+Business Media New York 2000

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  • Raymond F. Carmody

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