Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality
Background. Intraoperative myelography has been reported for decompression control in multilevel lumbar disease. Cervical myelography is technically more challenging. Modern 3D fluoroscopy may provide a new opportunity supplying multiplanar images. This study was performed to determine the feasibili...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Radiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/498936 |
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| author | Thomas Westermaier Stefan Koehler Thomas Linsenmann Michael Kiderlen Paul Pakos Ralf-Ingo Ernestus |
| author_facet | Thomas Westermaier Stefan Koehler Thomas Linsenmann Michael Kiderlen Paul Pakos Ralf-Ingo Ernestus |
| author_sort | Thomas Westermaier |
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| description | Background. Intraoperative myelography has been reported for decompression control in multilevel lumbar disease. Cervical myelography is technically more challenging. Modern 3D fluoroscopy may provide a new opportunity supplying multiplanar images. This study was performed to determine the feasibility and image quality of intraoperative cervical myelography using a 3D fluoroscope. Methods. The series included 9 patients with multilevel cervical stenosis. After decompression, 10 mL of water-soluble contrast agent was administered via a lumbar drainage and the operating table was tilted. Thereafter, a 3D fluoroscopy scan (O-Arm) was performed and visually evaluated. Findings. The quality of multiplanar images was sufficient to supply information about the presence of residual stenosis. After instrumentation, metal artifacts lowered image quality. In 3 cases, decompression was continued because myelography depicted residual stenosis. In one case, anterior corpectomy was not completed because myelography showed sufficient decompression after 2-level discectomy. Interpretation. Intraoperative myelography using 3D rotational fluoroscopy is useful for the control of surgical decompression in multilevel spinal stenosis providing images comparable to postmyelographic CT. The long duration of contrast delivery into the cervical spine may be solved by preoperative contrast administration. The method is susceptible to metal artifacts and, therefore, should be applied before metal implants are placed. |
| format | Article |
| id | doaj-art-376adf07b30d4bfaafff5e73f326b864 |
| institution | Kabale University |
| issn | 2090-1941 2090-195X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Radiology Research and Practice |
| spelling | doaj-art-376adf07b30d4bfaafff5e73f326b8642025-02-03T05:46:46ZengWileyRadiology Research and Practice2090-19412090-195X2015-01-01201510.1155/2015/498936498936Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image QualityThomas Westermaier0Stefan Koehler1Thomas Linsenmann2Michael Kiderlen3Paul Pakos4Ralf-Ingo Ernestus5Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyDepartment of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyDepartment of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyDepartment of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyDepartment of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyDepartment of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, GermanyBackground. Intraoperative myelography has been reported for decompression control in multilevel lumbar disease. Cervical myelography is technically more challenging. Modern 3D fluoroscopy may provide a new opportunity supplying multiplanar images. This study was performed to determine the feasibility and image quality of intraoperative cervical myelography using a 3D fluoroscope. Methods. The series included 9 patients with multilevel cervical stenosis. After decompression, 10 mL of water-soluble contrast agent was administered via a lumbar drainage and the operating table was tilted. Thereafter, a 3D fluoroscopy scan (O-Arm) was performed and visually evaluated. Findings. The quality of multiplanar images was sufficient to supply information about the presence of residual stenosis. After instrumentation, metal artifacts lowered image quality. In 3 cases, decompression was continued because myelography depicted residual stenosis. In one case, anterior corpectomy was not completed because myelography showed sufficient decompression after 2-level discectomy. Interpretation. Intraoperative myelography using 3D rotational fluoroscopy is useful for the control of surgical decompression in multilevel spinal stenosis providing images comparable to postmyelographic CT. The long duration of contrast delivery into the cervical spine may be solved by preoperative contrast administration. The method is susceptible to metal artifacts and, therefore, should be applied before metal implants are placed.http://dx.doi.org/10.1155/2015/498936 |
| spellingShingle | Thomas Westermaier Stefan Koehler Thomas Linsenmann Michael Kiderlen Paul Pakos Ralf-Ingo Ernestus Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality Radiology Research and Practice |
| title | Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality |
| title_full | Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality |
| title_fullStr | Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality |
| title_full_unstemmed | Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality |
| title_short | Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality |
| title_sort | intraoperative myelography in cervical multilevel stenosis using 3d rotational fluoroscopy assessment of feasibility and image quality |
| url | http://dx.doi.org/10.1155/2015/498936 |
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