Neurosurgery

presence of a kyphotic or scoliotic deformity, is best seen with plain X-rays. These caveats can be helpful in determining a requirement for stabilization or corrective procedures.

CT scanning of an involved area is also often warranted. The sensitivity of CT scanning is higher than that of plain films, although this modality is used most commonly to further define the degree of bony involvement and/or destruction. The detail of bony anatomy is useful in surgical planning, especially if instrumentation will be used for stabilizing the spine. Finally, in patients in which MRI is not an option, such as those with known metal fragments in their body or incompatible devices such as pacemakers, CT scanning with the administration of intrathecal contrast can help to define the degree of epidural extension

Recently, MRI has become the gold standard for radiological diagnosis of spinal metastasis. The ability of MRI to clearly visualize both the soft tissue, extradural and intradural contents in multiple planes makes this modality unique. Further, pending any contraindications to MRI, it enables the surgeon to evaluate the neural elements, with little or no risk to the patient. As MRI technology advances and as MRI-incompatible devices and hardware become less common, the utility of invasive tests such as myelography is sure to become more limited.

Another screening test that is commonly used in patients thought to have bony metastasis is isotope Tc99m bone scan. Often, bone scans are used as an adjuvant to standard screening examinations for patients with cancer. While these tests are useful in detecting bony lesions in patients with metastatic disease, the specificity of them is poor, as patients with degenerative processes or infectious processes can have lesions that are similarly bright on bone scan [2,14-23].

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

Get My Free Ebook


Post a comment