PC (26) 70010 Myelography, Posterior Fossa, Radiological Supervision and Interpretation 336.45
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Post–Vertebral Augmentation Back Pain: ORIGINAL RESEARCH Evaluation and Management
Post–Vertebral Augmentation Back Pain: ORIGINAL RESEARCH Evaluation and Management S. Kamalian BACKGROUND AND PURPOSE: Vertebral augmentation is an established treatment for painful osteo- R. Bordia porotic vertebral fractures of the spine. Nevertheless, patients may continue to have significant back pain afterward. The purpose of this study was to assess the source of persistent or recurrent back pain A.O. Ortiz following vertebral augmentation. MATERIALS AND METHODS: Our institutional review board approved this study. We evaluated 124 consecutive patients who underwent vertebral augmentation for painful osteoporotic vertebral frac- tures. All patients were evaluated after 3 weeks, 3 months, and 1 year following their procedure. Patients with any type of back pain after their procedure were examined under fluoroscopy. RESULTS: Thirty-four of 124 (27%) patients were men, and 90/124 (73%) were women. Persistent or recurrent back pain, not due to a new fracture or a failed procedure, was present in 29/124 (23%) patients. The source of pain was most often attributed to the sacroiliac and/or lumbar facet joints (25/29 or 86%). Seventeen of 29 (59%) patients experienced immediate relief after facet joint injection of a mixture of steroid and local anesthetic agents. The remaining 12 (41%) had relief after additional injections. Ten (34%) patients ultimately required radio-frequency neurolysis for long-term relief. CONCLUSIONS: Back pain after vertebral augmentation may not be due to a failed procedure but rather to an old or a new pain generator, such as an irritated sacroiliac or lumbar facet joint. This is of importance not only for further pain management of these patients but also for designing trials to compare the efficacy of vertebral augmentation to other treatments. -
Introduction to Neuroimaging
Introduction to Neuroimaging Aaron S. Field, MD, PhD Assistant Professor of Radiology Neuroradiology Section University of Wisconsin–Madison Updated 7/17/07 Neuroimaging Modalities Radiography (X-Ray) Magnetic Resonance (MR) Fluoroscopy (guided procedures) • MR Angiography/Venography (MRA/MRV) • Angiography • Diffusion and Diffusion Tensor • Diagnostic MR • Interventional • Perfusion MR • Myelography • MR Spectroscopy (MRS) Ultrasound (US) • Functional MR (fMRI) • Gray-Scale Nuclear Medicine ―Duplex‖ • Color Doppler • Single Photon Emission Computed Tomography (SPECT) Computed Tomography (CT) • Positron Emission Tomography • CT Angiography (CTA) (PET) • Perfusion CT • CT Myelography Radiography (X-Ray) Radiography (X-Ray) Primarily used for spine: • Trauma • Degenerative Dz • Post-op Fluoroscopy (Real-Time X-Ray) Fluoro-guided procedures: • Angiography • Myelography Fluoroscopy (Real-Time X-Ray) Fluoroscopy (Real-Time X-Ray) Digital Subtraction Angiography Fluoroscopy (Real-Time X-Ray) Digital Subtraction Angiography Digital Subtraction Angiography Indications: • Aneurysms, vascular malformations and fistulae • Vessel stenosis, thrombosis, dissection, pseudoaneurysm • Stenting, embolization, thrombolysis (mechanical and pharmacologic) Advantages: • Ability to intervene • Time-resolved blood flow dynamics (arterial, capillary, venous phases) • High spatial and temporal resolution Disadvantages: • Invasive, risk of vascular injury and stroke • Iodinated contrast and ionizing radiation Fluoroscopy (Real-Time X-Ray) Myelography Lumbar or -
Myelography in the Assessment of Degenerative Lumbar Scoliosis And
https://doi.org/10.14245/kjs.2017.14.4.133 KJS Print ISSN 1738-2262 On-line ISSN 2093-6729 CLINICAL ARTICLE Korean J Spine 14(4):133-138, 2017 www.e-kjs.org Myelography in the Assessment of Degenerative Lumbar Scoliosis and Its Influence on Surgical Management George McKay, Objective: Myelography has been shown to highlight foraminal and lateral recess stenosis more Peter Alexander Torrie, readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the Wendy Bertram, advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine Priyan Landham, and is less invasive, however availability remains limited. This study evaluates the potential Stephen Morris, role of myelography and its impact upon surgical decision making. John Hutchinson, Methods: Of 270 patients undergoing myelography during 2006-2009, a period representing Roland Watura, peak utilisation of this imaging modality in our unit, we identified 21 patients with degenerative Ian Harding scoliosis who fulfilled our inclusion criteria. An operative plan was formulated by our senior author based initially on interpretation of an MRI scan. Subsequent myelogram and CT myelogram Department of Spinal Surgery, investigations were scrutinised, with any additional abnormalities noted and whether these im- Southmead Hospital, Bristol, United pacted upon the operative plan. Kingdom Results: From our 21 patients, 18 (85.7%) had myelographic findings not identified on MRI. Of Corresponding Author: note, in 4 patients, supine CT myelography yielded additional information when compared to George McKay supine MRI in the same patients. -
Procedure Codes
NEW YORK STATE MEDICAID PROGRAM ORDERED AMBULATORY PROCEDURE CODES Ordered Ambulatory Procedure Codes Table of Contents GENERAL INFORMATION ---------------------------------------------------------------------------------------------------------------2 LABORATORY SERVICES INFORMATION-----------------------------------------------------------------------------------------2 RADIOLOGY INFORMATION------------------------------------------------------------------------------------------------------------3 MMIS MODIFIERS --------------------------------------------------------------------------------------------------------------------------6 RADIOLOGY SERVICES------------------------------------------------------------------------------------------------------------------7 DIAGNOSTIC RADIOLOGY (DIAGNOSTIC IMAGING) ------------------------------------------------------------------------7 DIAGNOSTIC ULTRASOUND SERVICES- -------------------------------------------------------------------------------------- 20 RADIOLOGIC GUIDANCE....................................................................................................................................25 BREAST, MAMMOGRAPHY --------------------------------------------------------------------------------------------------------- 26 BONE/JOINT STUDIES --------------------------------------------------------------------------------------------------------------- 26 RADIATION ONCOLOGY SERVICES --------------------------------------------------------------------------------------------- 27 NUCLEAR -
Vertebral Augmentation ICD 9 Codes: Osteoporosis 733. 0, Vertebra
BRIGHAM AND WOMEN’S HOSPITAL Department of Rehabilitation Services Physical Therapy Standard of Care: Vertebral Augmentation ICD 9 Codes: Osteoporosis 733. 0, Vertebral Fracture closed 805.8, Pathological fracture of Vertebrae 733.13 Vertebral augmentation, known as vertebroplasty and kyphoplasty, is a minimally invasive procedure that is used to treat vertebral fractures. Vertebral fractures are the most common skeletal injury associated with osteoporosis, and it is estimated that more than 750,000 occur annually in the United States.1 Up to one quarter of people over 50 years of age will have at least one vertebral fracture in their life time secondary to osteoporosis.2 According to the World Health Organization (WHO), the operational definition of osteoporosis is a bone density measure >2.5 standard deviations (SD) below the mean of young healthy adults of similar race and gender.3 Primary osteoporosis is related to the changes in postmenopausal women secondary to reduction of estrogen levels and related to age-related loss of bone mass. Secondary osteoporosis is the loss of bone caused by an agent or disease process. 1,4 (See Osteoporosis SOC) The severity of vertebral fractures can be assessed by the Genat semiquantitative method. Commonly used by radiologists, this scale assesses the severity of the fracture visually and has been shown to be reliable.5 Genat Semiquantitive Grading System for Vertebral Deformity5 Grade 0- normal vertebral height Grade 1- minimal fracture- 20-25% height decrease Grade 2- moderate fracture- 25-40% height decrease Grade 3-severe- >40% height decrease Standard methods of diagnosing vertebral fractures are imaging, including the following: CT scan, MRI, and radiography. -
Screening for Postmenopausal Osteoporosis
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers— patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services. Systematic Evidence Review Number 17 Screening for Postmenopausal Osteoporosis Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 2101 East Jefferson Street Rockville, MD 20852 http://www.ahrq.gov Contract No. 290-97-0018 Task Order No. 2 Technical Support of the U.S. Preventive Services Task Force Prepared by: Oregon Health Sciences University Evidence-based Practice Center, Portland, Oregon Heidi D. Nelson, MD, MPH Mark Helfand, MD, MS September 2002 Preface The Agency for Healthcare Research and Quality (AHRQ) sponsors the development of Systematic Evidence Reviews (SERs) through its Evidence-based Practice Program. With ∗ guidance from the third U.S. Preventive Services Task Force (USPSTF) and input from Federal partners and primary care specialty societies, two Evidence-based Practice Centers—one at the Oregon Health Sciences University and the other at Research Triangle Institute-University of North Carolina—systematically review the evidence of the effectiveness of a wide range of clinical preventive services, including screening, counseling, immunizations, and chemoprevention, in the primary care setting. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
ICD~10~PCS Complete Code Set Procedural Coding System Sample
ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00 -
Musculoskeletal Program CPT Codes and Descriptions
Musculoskeletal Program CPT Codes and Descriptions Spine Surgery Procedure Codes CPT CODES DESCRIPTION Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition 20930 to code for primary procedure) 20931 Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar 20936 fragments) obtained from same incision (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial 20937 incision) (List separately in addition to code for primary procedure) Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate 20938 skin or fascial incision) (List separately in addition to code for primary procedure) 20974 Electrical stimulation to aid bone healing; noninvasive (nonoperative) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22206 body subtraction); thoracic Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22207 body subtraction); lumbar Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral 22208 body subtraction); each additional vertebral segment (List separately in addition to code for -
Effectiveness of Cementoplasty for Vertebral Augmentation in Multiple Myeloma: a Case Series
WCRJ 2017; 4 (2): e882 EFFECTIVENESS OF CEMENTOPLASTY FOR VERTEBRAL AUGMENTATION IN MULTIPLE MYELOMA: A CASE SERIES G. TESTA1, M. PRIVITERA1, T. FIDILIO1, G. DI STEFANO1, A. VESCIO1, G. D’ANGELO2, V. PAVONE1 1Department of Orthopedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy 2Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi” – Unit of Paediatrics, University of Messina, Messina, Italy Abstract – Objective: Multiple myeloma (MM) is a neoplasm characterized by the proliferation of somatically mutated plasma cells that tend to expand within the bone marrow and affect mul- tiple locations throughout the bone marrow. When it is located in vertebral areas it causes bone lesions with pain, kyphosis, walking impairments, and disability. Different types of treatments are available. The goal of this study is to report our experience regarding the treatment of vertebral fractures from multiple myeloma using cementoplasty. Patients and Methods: From January 2012 to December 2015, 38 patients with multiple mye- loma and multilevel vertebral fractures were treated. Seventeen patients underwent conservative treatment (group 1), and 21 patients underwent vertebral augmentation with percutaneous ce- mentoplasty (group 2). Both groups were clinically evaluated at 1, 6 and 12 months using a visual analogic scale (VAS) for pain, SF-36 and ODI Score Questionnaires. Radiographic evaluation was performed to verify the quality of cementoplasty and complications. Results: Mean follow-up was 23.7 months. Mean VAS score in group 1 decreased from 7.1 pre-operatively to 3.9 at final follow-up (p<0.05). In group 2, this score decreased from 7.3 pre-op- eratively to 2.3 at final follow-up (p<0.05). -
Assessment of Bronchiectasis by Computed Tomography
Thorax: first published as 10.1136/thx.40.12.920 on 1 December 1985. Downloaded from Thorax 1985;40:920-924 Assessment of bronchiectasis by computed tomography IM MOOTOOSAMY, RH REZNEK, J OSMAN, RSO REES, MALCOLM GREEN From the Departments of Diagnostic Radiology and Chest Medicine, St Bartholomew's Hospital, London ABSTRACT Computed tomography and bronchography were used to assess the distribution of bronchiectasis in 15 lungs from eight patients with clinical features of the disease. Of the 36 lobes adequately displayed by bronchography, 22 were found to have bronchiectasis and 14 were found to be normal by both techniques. Cystic disease was readily identified by computed tomography but the cylindrical and varicose types of bronchiectasis could not be distinguished. Segmental local- isation was less accurate, with agreement between computed tomography and bronchography in 116 out of 130 segments. It is concluded that with a modern high resolution scanner computed tom- ography provides a useful method of assessing lobar distribution in bronchiectasis. The incidence of bronchiectasis in the United King- placing bronchography in a substantial number, dom has decreased since the advent ofantibiotic treat- Muller et al found correspondence in only about half ment and the decline in severe respiratory disease in the lungs studied. childhood. Nevertheless, it still occurs as the result of The purpose of this study is to assess the place of severe pulmonary infections and in association with modern high resolution computed tomography scan-copyright. immune deficiency, cystic fibrosis, and other condi- ners in the clinical management ofpatients with bron- tions. chiectasis and to investigate the accuracy with which The disease is defined as irreversible abnormal di- lobar and segmental disease and the type of disease latation of the bronchi and has been classified by present can be predicted. -
Treatment of Spinal Cord Vascular Malformations by Surgical Excision
J. Neurosurg. / Volume 30 / April, 1969 Treatment of Spinal Cord Vascular Malformations by Surgical Excision H. KRAYENBOHL, M. G. YA~ARGIL, M.D., AND H. G. McCLINTOCK* Section v] Neurosurgery, Kantonsspital, The University o] Ziirich, Ziirich, Switzerland ECENT developments have now made called attention to an increase in symptoms direct surgical attack the treatment during pregnancy with subsidence after of choice for spinal cord vascular delivery, z~ Newman has stated that he be- malformations. We are reporting 17 cases lieves the increase in symptoms in such cases treated with surgical excision, the last 11 of may be due to "venous congestion" from the which were operated on under the operating distended uterus and interestingly suggests microscope. the possibility of some "hormonal factor act- There is much confusion in the literature ing on the vessel walls. ''22 Although none of concerning the histological nomenclature our cases was a child, several authors have used to describe varieties of spinal vascular reported the occurrence in children and even malformations. This confusion is partly the in infants?, ~, 10,22,23 result of the lack of opportunity for ade- quate microscopic study of the entire lesion. Clinical Picture We prefer to follow the classification of History. The clinical history is usually one Bergstrand, et al.2 who divided these malfor- of three types. There can be 1) a slow mations into: 1) angioma cavernosum, 2) progression of neurological symptoms and angioma racemosum, and 3) angioreticu- signs, 2) progression followed with regres- loma. Some vascular malformations will sion or a stationary period, or 3) a sudden show characteristics of more than one group, apoplectic onset.