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PubMed · 9754339

-Cervical myelography using the lumbar route-.

C Parlier-Cuau·M Wybier·L Moutounet·P Champsaur·J D Laredo
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Abstract

Cervical myelography is obtained after injection of contrast medium into the lumbar subarachnoid space through a lumbar puncture. The patient is prone with a large radiolucent block under the pelvis so that the site of lumbar puncture is at a higher level than that of the cervical spine lordosis. Lumbar contrast is injected gently so that the contrast fluid slides along the ventral aspect of the dural sac and immediately reaches the cervical subarachnoid space. Then AP and lateral (with a horizontal X-ray beam) views are obtained. The patient has to remain firmly immobilized during the whole procedure to avoid blending of the contrast medium with CSF. This procedure is safe and allows cervical myelography to reach the same quality as that obtained through cervical puncture.

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Cerebrospinal FluidCervical VertebraeContrast MediaHumansImmobilizationInjections, SpinalIopamidolMyelographyProne PositionSafetySpinal PunctureSubarachnoid SpaceEnglish AbstractJournal Article

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C Parlier-Cuau, M Wybier, L Moutounet, P Champsaur, J D Laredo. 1997. -Cervical myelography using the lumbar route-.. https://pubmed.ncbi.nlm.nih.gov/9754339/

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PubMed2006

Cerebrospinal fluid dissecting into spinal epidural space after lumbar puncture causing cauda equina syndrome: review of literature and illustrative case.

OBJECTS: We report a case of epidural cerebrospinal fluid (CSF) leak after lumbar puncture caused by CSF dissecting into the spinal epidural space. The incidence of this phenomenon may be higher than suspected, although most cases may remain asymptomatic. MATERIALS AND METHODS: A 4-year-old girl with new-onset seizure underwent a diagnostic lumbar puncture, the results of which were normal; 3 h later, she began experiencing severe low-pressure headaches and lower back pain, bilateral lower extremity weakness, numbness, and pain, and urinary retention when upright. Spinal MRI demonstrated extensive epidural CSF collection posterior to the thecal sac extending from the cervicothoracic junction to the sacrum. After 48 h in the supine position and gradual mobilization, the patient had complete resolution of symptoms and no neurological sequelae. CONCLUSION: Patients usually recover without any neurological deficits after conservative treatment. Prone or lateral decubitus positioning immediately after lumbar puncture may decrease the incidence of this phenomenon.

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