Myelographic Imaging of Spinal Cord Disorders

Myelographic imaging evaluates the spinal canal, nerve roots, and subarachnoid space using intrathecal contrast with fluoroscopy and computed tomography (CT), or noninvasively with MR-myelography. Although MR imaging has largely replaced conventional myelography owing to its superior soft tissue contrast and noninvasive nature, CT myelography remains essential when MR imaging is contraindicated, limited by artifact, or inconclusive. It is particularly valuable for assessing nerve root compression, spinal stenosis, cerebrospinal fluid leaks, postoperative anatomy, and complex lesions. Myelography helps localize pathology to extradural, intradural extramedullary, or intramedullary compartments, guiding diagnosis and surgical planning.