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Diagnosing the cause of back pain

Radiological testing: Myelography

What it is:

It consists of injecting a substance into the spinal canal. This substance ("contrast media") hinders the passage of X-rays. Upon injection of the contrast, conventional X-rays are taken, and the spinal canal is then viewed because it is filled with the contrast. This cannot be seen by conventional X-rays. If a lesion -disc herniation- is invading the spinal canal, the image shows that the liquid is not filling this space.

What it allows:

It allows visualization of the space occupied by the spinal cord and the nerve roots. This enables diagnosis, for example, of spinal stenosis or disc herniations. It was formerly the only test to observe the space which contains the spinal cord ("spinal canal"), but nowadays, MRI allows a better imaging.

Risks:

Myelography is painful and carries a small risk of allergy to the contrast media, and infection.

Indications:

Due to the risks and pain involved, its use is not indicated. MRI should rather be the choice. The existing recommendations based on scientific evidence do not advise myelography.



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