Myelography complications and current practice patterns.
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.


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.


CONCLUSIONS
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.
Sandow
Bruce A
BA
Department of Radiology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Donnal
John F
JF
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D006801:Humans; D009192:Myelography / Q000009:adverse effects* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States
D000894:Anti-Inflammatory Agents, Non-Steroidal