Sandow Bruce A, Donnal John F
Department of Radiology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
AJR Am J Roentgenol. 2005 Sep;185(3):768-71. doi: 10.2214/ajr.185.3.01850768.
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.
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.
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.
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.
关于脊髓造影术后并发症的文献资料相对较少。此外，对于是否有必要筛查脊髓造影患者使用潜在致癫痫药物、二甲双胍、阿司匹林或其他非甾体抗炎药（NSAIDs），或常规检查凝血酶原时间（PT）和部分凝血活酶时间（PTT），目前尚无共识。我们设计了一项基于网络的调查，以获取有关脊髓造影并发症及当前实践模式的信息。
向美国神经放射学会（ASNR）的2296名成员发送电子邮件，邀请他们参与调查，共收到351份回复（15%）。调查包括关于脊髓造影检查的数量以及在脊髓造影患者中观察到的癫痫发作和其他并发症数量的问题；关于筛查潜在致癫痫药物、二甲双胍、阿司匹林或其他NSAIDs的问题；以及关于检查PT和PTT的问题。
大多数回复的ASNR成员（88%）报告在脊髓造影术后未出现癫痫发作，82%的成员在过去5年中未观察到其他严重并发症。大多数从业者（63%）会筛查患者是否使用潜在致癫痫药物，63%的受访者不建议患者在脊髓造影术后停用二甲双胍，58%的受访者不建议患者停用阿司匹林或其他NSAIDs，73%的受访者不常规检查PT和PTT。
脊髓造影总体上是安全的，癫痫发作、造影剂反应和其他严重并发症的风险较低。本研究结果表明，大多数从业者会筛查患者是否使用潜在致癫痫药物，但大多数人并不要求患者停用二甲双胍和阿司匹林或其他NSAIDs，也不在术前常规检查PT和PTT。这些常见的实践模式被认为适合脊髓造影的安全有效实施。
