Water soluble non-ionic iodinated contrast agent is used nowadays and cause very little complication, unlike oil-based dye that was used previously which can cause arachnoiditis. However, history of allergy to iodine is contraindicated for the use of iodinated contrast. A CT scan is typically performed after radiographic contrast media (dye) has been placed with fluoroscopic guidance into a sac-like lining (the first- and hardest and outermost- layer of the spinal meninges, the spinal dura mater) surrounding the spinal cord and nerves. The material is typically water-soluble, which has largely replaced nonsoluble oil-based fluids, while CT has largely replaced the conventional X-ray projections used for image acquisition in the past. The process usually involves lying face down on a table, with the lower extremities secured tightly with straps to the table. After the skin area has been numbed, the dye is injected into the thecal sac, then the table is slowly rotated in a circular motion, first down at the head end for approximately 4 to 6 minutes, then rotated up at the head end for the same duration. Several more minutes lying flat and the process is complete. This movement ensures the contrast has sufficiently worked its way through the spinal cord, followed by X-rays or a CT scan. Post-procedure care centers around ensuring that infection (especially skin or subcutaneous infections, myelitis or meningitis or encephalitis, or sepsis) does not set in and that the "plug" at the site of the spinal tap does not become dislodged. Patients are usually instructed to avoid strenuous activity and heavy lifting, for example. Some patients are given instructions to keep their heads elevated at least 30 degrees for a specified number of hours. Complications from the surgery can cause a loss of cerebrospinal fluid (CSF), which could cause severe headaches. This can be corrected by returning to the medical facility and having them perform a blood patch. In this procedure, a small amount of blood is taken from the arm and injected into the exact spinal tap location to stop the leaking of CSF.
Myelography
Magnetic resonance myelography
Spinal fMRI
Cervicography
Nerve biopsy
Neuroimaging
Electromyography
Lumbar provocative discography