0:00

So this is a patient who had both a conventional myelogram in the past and had a

0:05

pressure augmented myelogram with us. Um,

0:07

and you can see basically they had a suspicious looking perineural cyst at T

0:11

nine. Um, but which one of these is the one that's leaking?

0:14

It is really difficult to tell. In this case, after pressure augmentation,

0:17

we could see that it was clearly, um, the one here on the right that is leaking.

0:21

So pretty straightforward to see, um, on the pressure augmented gram,

0:25

whereas a conventional myelogram, we could not see it at all.

0:27

And without kind of having the, the, um,

0:30

the m r i beforehand to show us where the perineural cysts were, we,

0:33

we didn't even know where to focus. So, but this is really,

0:35

really helpful and I,

0:36

I can kind of show you some more of these lateral decubitus images as well, um,

0:40

as we go on. But th that was the,

0:42

that was the final result after doing a D SS m. Um,

0:46

this is a patient with a type four C S F leak.

0:48

So you can see basically we've got contrast all along this, uh,

0:51

T one nerve root extending, um, into the intercostal space.

0:54

So very similar situation.

0:56

Both of these patients actually just underwent blood patches, uh,

1:00

foraminal blood patches and did fine, didn't have any more symptoms of,

1:04

of C Ss f leak. Um, but without doing these more specialized, uh,

1:08

pressure augmented myelograms, I would not have seen these C S F leaks.