When should I order a CTmyelogram

For many complex spinal problems, high-quality MRI and CT scans may be used as complementary studies to define the clinical problem. Nevertheless, in certain situations, a CT-myelogram remains the test of choice. Some of these situations include:

• Evaluation of the neural elements in a postoperative patient with stainless steel spinal implants

• Patients with significant symptoms and equivocal MRI findings

• Patients with cervical or lumbar spinal stenosis problems in whom MRI is contraindicated

• Preoperative planning for surgery in patients with symptomatic spinal stenosis and severe lumbar scoliosis

• Preoperative planning for revision spinal stenosis surgery, especially if symptoms suggest a relation to postural change

• Preoperative planning for surgical treatment of specific complex spinal deformities

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