CPT® Code 70010

Myelography, specifically posterior fossa myelography, is a specialized diagnostic imaging procedure primarily utilized to assess the cerebellopontine angles, particularly when there is a suspicion of an acoustic neuroma. This procedure involves the use of contrast material, which is injected into the subarachnoid space surrounding the spinal cord and nerve roots. The injection is performed through a lumbar puncture, allowing for the visualization of the central nervous system structures. The imaging is conducted using real-time fluoroscopic x-ray technology, which provides dynamic visualization of the contrast flow. During the procedure, the patient is positioned on their side, with their legs secured to a footboard to maintain stability. The table is then tilted, and the patient's head is flexed and extended to facilitate the movement of the contrast material into the upper cervical canal. As the contrast flows through the foramen magnum, it accumulates in the dependent cerebellopontine cistern and the internal auditory canal, enabling detailed imaging of these critical areas. Once the contrast has adequately filled the target regions, the table is returned to a horizontal position, and the patient's head is carefully adjusted to align the petrous ridge parallel to the top of the imaging film, allowing for the acquisition of high-quality images necessary for accurate diagnosis and evaluation.