d. Cervical Diskography. For cervical diskography, the technical procedure
closely follows that described for lumbar diskography with the following exceptions:
(1) The patient is placed in the supine position on the tilt-table unit. Pre-
injection radiography is carried out according to the demands of the situation.
(2) The antero-lateral aspect of the patient's neck on the side of interest (or
the most suitable site of access) is made aseptic and local anesthetic is administered.
(3) The examiner inserts the injection needle(s) into the tissues lying in the
antero-lateral aspect of the cervical region and directs it toward the intervertebral disk(s)
under consideration. A single 21-gauge, 9-cm spinal needle, or a pair of needles,
consisting of a No. 20 (2 inches long) through which a smaller caliber (No. 25, 2 1/2
inches long) needle is passed may be used.
(4) Before the injection needle(s) is/are advanced into the nucleus pulposes
of the intervertebral disk, AP and lateral projections are exposed without changing the
position of the patient. These films are made to check the exact position and alignment
of the needle(s).
(5) The patient is cautioned not to move; cough, or talk while the needle is
in place. A syringe filled with the contrast medium (sterile aqueous solutions containing
50 percent iodine compound) is attached to the needle and approximately 0.2 to 0.5 cc
of the contrast medium is injected into each of the intervertebral disks to be studied.
(6) AP and lateral projections (also oblique projections, if indicated) of the
cervical region are obtained without changing the position of the patient. The films are
processed for immediate inspection.
(7) If injection of additional contrast solution is not required, the injection
needles are removed and further radiography is carried out according to the instructions
of the examiner. Sterescopic exposures are made as indicated.
(8) All exposed films should be developed and presented to the examiner
for inspection before the patient is returned to the ward.