(g) Arrangements should be made for the films to be developed and
presented to the radiologist for reading immediately upon completion of the exposures.
(h) If additional films are not required, the examiner will posturally
manipulate the patient (with the help of the specialist or an assistant) in such a way as
to cause the contrast medium to collect in the dural sac for subsequent removal by
(1) Myelography is a procedure for the investigation of the spinal cord and
subarachnoid spaces following the introduction of contrast medium into the spinal canal.
(2) Pantopaque (ethyl iodophyenylunde-cylenate), an oily iodinated organic
compound, is the preferred contrast media; however, in some localities or in special
situations, substances in the sterile aqueous category (for example, Hypaque) may be
used. The following concerns techniques in which Pantopaque is used. When air or
oxygen is used for the contrast medium, the procedure is termed pneumomyelography.
(3) Since the majority of myelographic studies are concerned with the
lumbar region of the spine, emphasis is placed on the techniques used in studies
dealing with that region (commonly termed lumbar myelography). Not infrequently,
however, it is the thoracic or the cervical region that is the site of prime diagnostic
interest. For pertinent technical details relating to thoracic myelography and cervical
myelography, see g and h below; otherwise, the essential technical details are the same
as those described for lumbar myelography.
b. Patient Preparation and Scheduling. Except in emergencies, myelographic
examinations are scheduled according to the established clinical procedure. Sedation
is administered by the responsible clinician approximately one hour prior to the
c. Preliminary Procedure.
(1) Upon arriving at the x-ray department, the patient is properly gowned for
the examination and the pertinent aspects of the procedure are explained to him.
(2) The patient is placed on the horizontally adjusted radiographic-
fluoroscopic tilt-table unit, either prone or on his side depending upon the preference of
the examiner. If preliminary radiography is not required, the positioning procedure is as