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Kelanjutannya dari
medulla oblongata
Memanjang dari
brain hingga sekitar
L2
Terhubung ke 31
pasang syaraf tulang
belakang
Meninges
Bagian-bagian membran
brain and spinal cord
Contrast is generally
water-soluble,
nonionic, iodinated
medium
OMNIPAQUE
http://www.ismp.org/newsletters/acutecare/
articles/20031127.asp
ISOVUE
Contrast Precautions
Verify it is the correct contrast
Non-ionic iodinated contrast
○ Omnipaque or Isovue
Correct concentration
○ 180 and 300 common
Arterio-venous malformations
Spinal
Needles
(covered)
Prone
Pillow under abdomen
for flexion of spine
Lateral flexion
Widens interspace for
easier introduction of
needle
Prosedur Pemeriksaan
Anestesi lokal daerah yg
akan dilakukan Lumbal
Puncture (LP) dengan
Lidocaine and sodium
bicarbonate
Masukkan Spinal needle
dimonitor dg fluoroscopy
hingga keluar cairan
CSF
Tampung cairan CSF ke
dalam botol laborat yg
steril, kurang lebih 10 cc
Injeksikan media kontras
kurang lebih 9-12 cc.
Dimonitor dg fluoroscopy
Cabut spinal dan tutup
kain kassa bethadine
Prosedur Pemeriksaan
Lumbar puncture
needle inserted
under fluoroscopic
guidance until fluid
appears
PA Lateral
MYELOGRAM WITH CONTRAST
Myelography accuracy rate
MRI – 96%
Myelography – 81%
CT – 57%
CT and Myelography together - 84%
Cervical
Myelogram
Set-Up for Lateral Cervical Film
Cervical Radiographs
Overheads
PA
PA Oblique projections
Cross-table lateral films
Myelography
Pusing Kepala
Hypotension
Convulsions (Kejang)
Confusion/hallucinations
Possible Complications from Myelography
Vomiting Spinal Headache