Related Experiment Video
Updated: Aug 16, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Myelography complications and current practice patterns
Bruce A Sandow1, John F Donnal
1Department of Radiology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Objective:
Relatively few data are available in the literature on postmyelography complications. Also, no consensus exists on the need to screen myelography patients for use of potentially epileptogenic drugs, metformin, and aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) or to routinely check prothrombin time (PT) and partial thromboplastin time (PTT). We designed a Web-based survey to obtain information on myelography complications and current practice patterns.
Materials And Methods:
An e-mailing was sent to 2,296 members of the American Society of Neuroradiology (ASNR), requesting their participation in a survey, and 351 responses (15%) were received. The survey included questions on the number of myelography examinations performed and the number of seizures and other complications observed in myelography patients; questions on screening for potentially epileptogenic drugs, metformin, and aspirin or other NSAIDs; and a question on checking PT and PTT.
Results:
Most responding ASNR members (88%) reported no postmyelography seizures, and 82% observed no other significant complications in the past 5 years. A majority of practitioners (63%) screens patients for potentially epileptogenic drugs, 63% of respondents do not advise patients to discontinue metformin use after myelography, 58% do not advise patients to discontinue aspirin or other NSAIDs, and 73% do not routinely check PT and PTT.
Conclusion:
Myelography is generally safe, with a low risk of seizures, contrast reactions, and other significant complications. The results of this study show that a majority of practitioners screens patients for use of potentially epileptogenic drugs, but a majority does not require patients to discontinue use of metformin and aspirin or other NSAIDs, nor do they routinely check PT and PTT before the procedure. These common practice patterns are considered to be appropriate for the safe and efficient performance of myelography.
Insights
Myelography is generally safe with few complications. Most practitioners screen for certain drugs but do not require discontinuation of metformin or NSAIDs, nor routinely check coagulation times.
Area of Science:
- Neuroradiology
- Medical Imaging Safety
Background:
- Limited data exist on postmyelography complications.
- No consensus on pre-procedure screening for epileptogenic drugs, metformin, aspirin/NSAIDs, or coagulation tests (PT/PTT).
Purpose of the Study:
- To survey current practice patterns regarding myelography complications.
- To gather data on screening protocols and complication rates.
Main Methods:
- A web-based survey was emailed to 2,296 American Society of Neuroradiology members.
- 351 responses (15% participation rate) were analyzed.
Main Results:
- 88% reported no postmyelography seizures; 82% observed no other significant complications.
- 63% screen for epileptogenic drugs; a majority do not stop metformin or NSAIDs.
- 73% do not routinely check PT and PTT.
Conclusions:
- Myelography demonstrates a low risk of seizures and other significant complications.
- Current practices of screening for some drugs but not routinely stopping others or checking coagulation are deemed appropriate.
- Established practice patterns support safe and efficient myelography.
Related Concept Videos
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography