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Myelogram/ct scan
Jan 14, 2017
CT POST MYELO L SPINE - Details
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About This Test

Details
Study Result
Impression
1. Postsurgical changes of L2-biiliac posterior instrumented fusion and decompression with no evidence of hardware complication.
2. Mild degenerative changes at L3-L4 with endplate spurring eccentric to the right causing mild right neural foraminal stenosis.

Steven Hang, M.D.
Resident Physician, Radiology

I, the attending physician, was present for the key portions of the procedure which include fluoroscopic guided lumbar puncture and injection of contrast into subarachnoid space, and immediately available for the remainder of the procedure.

Carlos Leiva-Salinas, M.D.
Attending Physician, Radiology

Narrative
ADDITIONAL CLINICAL DATA: Lumbar spinal stenosis status post fusion

COMPARISON: CT L-spine October 12, 2016 and L-spine radiographs December 7, 2016

EXAMINATION PERFORMED:
1. Lumbar myelogram.
2. Post myelographic CT, lumbar spine.

OPERATOR: Steven Hang, MD, and Carlos Leiva-Salinas, MD, the attending physician

MATERIALS: 22 gauge spinal needle.

ACCESS: L2-L3 interlaminar space.

CONTRAST: 15 ml of Omnipaque 180 administered intrathecally.

TECHNIQUE: Following explanation of the risks, benefits, and alternatives, the patient signed written consent. The patient was then placed in the prone position on the fluoroscopic table. The skin over the lower lumbar spine was prepped and draped in the usual sterile fashion. One percent lidocaine was used as a local anesthetic. Under fluoroscopic guidance, a 22 gauge needle was advanced into the subarachnoid space via the L2-L3 interlaminar space. Following confirmation of needle placement, 15 cc of Omnipaque 180 was administered. The needle was then removed. There were no immediate complications. The patient was taken to the CT scanner for a post myelographic CT examination of the lumbar spine. Spiral acquisition of overlapping 2.5mm images of the lumbar spine. Sagittal and coronal 2D reformations by technologist.
The patient tolerated the procedure well and left the radiology department in stable condition.

FINDINGS:

The last well-formed disk is designated as L5-S1 for the purpose of this report. Vertebral bodies were numbered using this convention.

LUMBAR MYELOGRAM:

The conventional myelogram demonstrates patency of the thecal sac throughout the lumbar spine. Postsurgical changes of L2-biiliac posterior decompression and fusion with no evidence of hardware complication.

LUMBAR CT-MYELOGRAM:
Postsurgical changes of L2-biiliac posterior instrumented fusion with no evidence of hardware complication. Redemonstrated partially imaged spinal cord stimulator with leads extending into the lower thoracic spinal canal. Unchanged hyperdense cement material within the L2 vertebral body. Lumbar spine alignment appears within normal limits. Vertebral body heights appear maintained, unchanged from prior. Visualized soft tissues are unremarkable.

L1-2: No significant central canal or neural foraminal stenosis.

L2-3: Status post posterior decompression. No significant central canal or neural foraminal stenosis.

L3-4: Status post posterior decompression. Endplate spurring eccentric to the right causing mild right neural foraminal stenosis. No significant central canal or left neural foraminal stenosis.

L4-5: No significant central canal or neural foraminal stenosis.

L5-S1: No significant central canal or neural foraminal stenosis.
look at finding L3-L4 Endplate spurring eccentric to the right causing mild right neural foraminal stenosis.
I had a similar test before in 9/6/2016 L3-4: The central canal is decompressed without significant central canal stenosis. No significant neuroforaminal stenosis. this was before surgery
thanks





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