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Spine
Diagnosis
Spine Postprocedural Imaging
Postoperative Imaging and Complications
Myelography Complications
Myelography Complications
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Any unexpected sequela following myelography
              • Minor complications
                • Postdural puncture headache (PDPH)
                • Incorrect needle position (subdural, epidural)
                • Transient neurologic sequela
                • Contrast reaction (minor)
              • Major complications
                • CSF leak
                • Symptomatic spinal subdural, epidural, or subarachnoid hemorrhage
                • Contrast reaction (major)
                • Cord injury
                • Intracranial hemorrhage
                • Seizure
                • Paralysis
                • Death
              • Delayed complications
                • Iatrogenic epidermoid

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Nonvascular Interventions

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Özütemiz C et al: Lumbar puncture under fluoroscopy guidance: a technical review for radiologists. Diagn Interv Radiol. 25(2):144-56, 2019
                                        2. Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
                                        3. Soliman HM et al: Post-myelography paraplegia in a woman with thoracic stenosis. J Spinal Cord Med. 36(3):247-9, 2013
                                        4. Chin KR et al: Myelographic evaluation of cervical spondylosis: patient tolerance and complications. J Spinal Disord Tech. 21(5):334-7, 2008
                                        5. Cordier D et al: Acute paraplegia after myelography: decompensation of a herniatad thoracic disc. Br J Neurosurg. 22(5):684-6, 2008
                                        6. Sather MD et al: Spinal subarachnoid hematoma resulting from lumbar myelography. AJNR Am J Neuroradiol. 28(2):220-1, 2007
                                        7. Sandow BA et al: Myelography complications and current practice patterns. AJR Am J Roentgenol. 185(3):768-71, 2005
                                        8. Klein KM et al: Status epilepticus and seizures induced by iopamidol myelography. Seizure. 13(3):196-9, 2004
                                        9. Ziv ET et al: Iatrogenic intraspinal epidermoid tumor: two cases & review of the literature. Spine. 29(1):E15-8, 2004
                                        10. Park JC et al: Iatrogenic spinal epidermoid tumor. A complication of spinal puncture in an adult. Clin Neurol Neurosurg. 105(4):281-5, 2003
                                        11. Turnbull DK et al: Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 91(5):718-29, 2003
                                        12. Dunford J: Fatal ascending tonic-clonic seizure syndrome. Ann Emerg Med. 32(5):624-6, 1998
                                        13. Peterman SB: Postmyelography headache: a review. Radiology. 200(3):765-70, 1996
                                        14. Nakakoshi T et al: Aseptic meningitis complicating iotrolan myelography. AJNR Am J Neuroradiol. 12(1):173, 1991
                                        15. Katoh Y et al: Complications of lateral C1-2 puncture myelography. Spine. 15(11):1085-7, 1990
                                        16. Robertson HJ et al: Cervical myelography: survey of modes of practice and major complications. Radiology. 174(1):79-83, 1990
                                        17. Kostiner AI et al: Outpatient lumbar myelography with metrizamide. Radiology. 155(2):383-5, 1985
                                        18. Sarno JB: Transient expressive (nonfluent) dysphasia after metrizamide myelography. AJNR Am J Neuroradiol. 6(6):945-7, 1985
                                        19. Baker FJ et al: Aseptic meningitis complicating metrizamide myelography. AJNR Am J Neuroradiol. 3(6):662-3, 1982
                                        20. Brodey PA et al: Nerve rootlet avulsion. A complication of myelography using the Chynn needle. Radiology. 125(3):734, 1977
                                        21. Kennedy TF et al: Nerve rootlet avulsion as a complication of myelography with the Cualtico needle. Radiology. 119(2):389, 1976
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Any unexpected sequela following myelography
                                                    • Minor complications
                                                      • Postdural puncture headache (PDPH)
                                                      • Incorrect needle position (subdural, epidural)
                                                      • Transient neurologic sequela
                                                      • Contrast reaction (minor)
                                                    • Major complications
                                                      • CSF leak
                                                      • Symptomatic spinal subdural, epidural, or subarachnoid hemorrhage
                                                      • Contrast reaction (major)
                                                      • Cord injury
                                                      • Intracranial hemorrhage
                                                      • Seizure
                                                      • Paralysis
                                                      • Death
                                                    • Delayed complications
                                                      • Iatrogenic epidermoid

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Nonvascular Interventions

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Özütemiz C et al: Lumbar puncture under fluoroscopy guidance: a technical review for radiologists. Diagn Interv Radiol. 25(2):144-56, 2019
                                                                              2. Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
                                                                              3. Soliman HM et al: Post-myelography paraplegia in a woman with thoracic stenosis. J Spinal Cord Med. 36(3):247-9, 2013
                                                                              4. Chin KR et al: Myelographic evaluation of cervical spondylosis: patient tolerance and complications. J Spinal Disord Tech. 21(5):334-7, 2008
                                                                              5. Cordier D et al: Acute paraplegia after myelography: decompensation of a herniatad thoracic disc. Br J Neurosurg. 22(5):684-6, 2008
                                                                              6. Sather MD et al: Spinal subarachnoid hematoma resulting from lumbar myelography. AJNR Am J Neuroradiol. 28(2):220-1, 2007
                                                                              7. Sandow BA et al: Myelography complications and current practice patterns. AJR Am J Roentgenol. 185(3):768-71, 2005
                                                                              8. Klein KM et al: Status epilepticus and seizures induced by iopamidol myelography. Seizure. 13(3):196-9, 2004
                                                                              9. Ziv ET et al: Iatrogenic intraspinal epidermoid tumor: two cases & review of the literature. Spine. 29(1):E15-8, 2004
                                                                              10. Park JC et al: Iatrogenic spinal epidermoid tumor. A complication of spinal puncture in an adult. Clin Neurol Neurosurg. 105(4):281-5, 2003
                                                                              11. Turnbull DK et al: Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 91(5):718-29, 2003
                                                                              12. Dunford J: Fatal ascending tonic-clonic seizure syndrome. Ann Emerg Med. 32(5):624-6, 1998
                                                                              13. Peterman SB: Postmyelography headache: a review. Radiology. 200(3):765-70, 1996
                                                                              14. Nakakoshi T et al: Aseptic meningitis complicating iotrolan myelography. AJNR Am J Neuroradiol. 12(1):173, 1991
                                                                              15. Katoh Y et al: Complications of lateral C1-2 puncture myelography. Spine. 15(11):1085-7, 1990
                                                                              16. Robertson HJ et al: Cervical myelography: survey of modes of practice and major complications. Radiology. 174(1):79-83, 1990
                                                                              17. Kostiner AI et al: Outpatient lumbar myelography with metrizamide. Radiology. 155(2):383-5, 1985
                                                                              18. Sarno JB: Transient expressive (nonfluent) dysphasia after metrizamide myelography. AJNR Am J Neuroradiol. 6(6):945-7, 1985
                                                                              19. Baker FJ et al: Aseptic meningitis complicating metrizamide myelography. AJNR Am J Neuroradiol. 3(6):662-3, 1982
                                                                              20. Brodey PA et al: Nerve rootlet avulsion. A complication of myelography using the Chynn needle. Radiology. 125(3):734, 1977
                                                                              21. Kennedy TF et al: Nerve rootlet avulsion as a complication of myelography with the Cualtico needle. Radiology. 119(2):389, 1976