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Potential complications in myelography: I. Technical considerations
Abstract:
Scanning electron microscopy demonstrated starch powder contamination on the stylet tip from a spinal needle after it was lightly touched with nonwashed surgical gloves. A sterile solution of Pantopaque was injected through the spinal needle after the stylet was withdrawn and carried particulate contaminants to a 0.2 micrometer millipore filter. Using both scanning electron microscopy and energy dispersive x-ray analysis, particles of various sized (mostly 5-10 microns) and variable compositions, including starch, talc, and other elements, were identified. Also, glass particles from the Pantopaque vial and plastic particles from the plastic syringe and tubing used in drawing up the Pantopaque were seen. These observations indicate that strict attention to proper technique in myelography is essential in order to eliminate potential cerebrospinal fluid contamination.
Insights
Contaminated surgical gloves introduced starch powder into spinal needles, leading to particulate contamination during myelography. Proper sterile technique is crucial to prevent cerebrospinal fluid contamination.
Area of Science:
- Medical Devices
- Materials Science
- Analytical Chemistry
Background:
- Spinal needles are used for cerebrospinal fluid access during myelography.
- Particulate contamination can pose risks during invasive procedures.
Purpose of the Study:
- To investigate potential sources of particulate contamination during myelography.
- To identify contaminants introduced via spinal needles and associated materials.
Main Methods:
- Scanning electron microscopy (SEM) was used to examine spinal needle stylets.
- Energy dispersive X-ray analysis (EDX) identified particle composition.
- Millipore filters were used to capture particulates from injected solutions.
Main Results:
- Starch powder from non-washed surgical gloves contaminated the spinal needle stylet.
- SEM and EDX identified starch, talc, glass, and plastic particles (5-10 microns).
- Contaminants were transferred to a 0.2 micrometer filter during simulated injection.
Conclusions:
- Non-sterile surgical gloves are a significant source of particulate contamination.
- Myelography procedures risk introducing diverse contaminants into the cerebrospinal fluid.
- Strict adherence to sterile techniques is essential to prevent patient harm.