Computerized Tomography with Myelography:

This procedure is somewhat similar to a myelogram. (see Myelography below).   The CT imaging study is performed before and after the administration of a contrast agent (radio-opaque dye) into the subarachnoid space (spinal sac).  The contrast agent helps to provide a detailed view of the integrity of the spinal contents and nerve root sleeves.  The patient can be moved or positioned so that the flow of contrast reaches particular areas of interest.   This dynamic option provides a unique view of areas surrounding the spinal cord and nerve roots.  The administration of contrast consists of injecting a dye (radiographically opaque) into the sac, which surrounds the nerve roots.  The dye provides contrast around the nerve roots and therefore can be used to help assess whether there is physical compression or deviation of the nerve roots.

The corresponding CT scan helps assess whether there is bony compromise, which may be contributing to spinal cord or nerve root compression.  One of the more common side effects of the administration of a contrast agent into the spine is a severe headache.  Headaches tend to occur more frequently in individuals with a history of migraine headaches.  A persistent or progressive post-myelogram headache may occur if a cerebrospinal spinal fluid leak develops.  This refers to spinal fluid leaking out of the puncture site where the myelographic agent was administered.  A procedure called a blood patch may need to be performed to help stop the spinal fluid leak.

3D-CT scan: Computerized X-ray that provides detailed information about

bones and tissue in a three dimensional format.  A 3D-CT is a longer test than a

routine CT scan because more data (X-ray images) must be acquired in smaller sections at many different angles.  The technician uses a computer to remove select tissue

signals in order to render and recreate bones in a three dimensional format.  This

form of imaging can be particularly helpful for therapeutic planning, especially

surgery.

Current Perceptual Threshold Evaluation (CPT):

Current Perceptual Threshold (CPT) testing refers to the application of superficial conducting electrodes to a designated skin region that corresponds to an area innervated by the nerve.  The test is performed by select application of a current through electrodes.  The CPT study is performed to help quantify the threshold of sensation carried by a select nerve.  CPT studies can be a helpful tool in the screening and monitoring of polyneuropathy, peripheral nerve injury and peripheral nerve entrapment syndromes.  It tends to be less helpful in the evaluation of radiculopathy.

Cystourethrography:

Spinal cord and spinal nerve disorders can cause urinary bladder dysfunction.  Functional evaluation of the urinary bladder and related mechanisms can help differentiate whether urinary problems are related to spinal cord compromise or other neurological causes such as cauda equina syndrome, peripheral neuropathy, or problems with the bladder itself.  Electromyography of pelvic muscles and the activity of the internal and external sphincters can be performed during cystourethrography.