Featured Research

from universities, journals, and other organizations

Feared spinal X-ray found to be safe, study shows; Spinal angiography also rules out misdiagnosis of inflammation, transverse myelitis

Date:
September 15, 2011
Source:
Johns Hopkins Medical Institutions
Summary:
Medical imaging experts have reviewed the patient records of 302 men and women who had a much-needed X-ray of the blood vessels near the spinal cord and found that the procedure, often feared for possible complications of stroke and kidney damage, is safe and effective.

Medical imaging experts at Johns Hopkins have reviewed the patient records of 302 men and women who had a much-needed X-ray of the blood vessels near the spinal cord and found that the procedure, often feared for possible complications of stroke and kidney damage, is safe and effective.

Reporting in the journal Neurology online Sept. 14, the Johns Hopkins researchers found that none of the study participants, all of whom underwent a spinal digital subtraction angiography, or SpDSA, at The Johns Hopkins Hospital between 2000 and 2010, had suffered either a stroke or any kidney damage as a result of the procedure, considered the "gold standard" test for distinguishing among many types of vascular disorders near the spine. These include strokes, hematomas, aneurysms, fistulas and tumors.

"Patients and their physicians can now look with confidence to our study and see for themselves the real as opposed to perceived risks and complications from spinal angiography," says study senior investigator and interventional neuroradiologist Philippe Gailloud, M.D. "Advances in the procedure have made it much safer today than before, and neurologists and patients really should consider this valuable diagnostic tool based on the actual medical evidence and not on whatever unsubstantiated rumors they might hear secondhand or read on the Internet," adds Gailloud, an associate professor at the Johns Hopkins University School of Medicine.

Gailloud says reports of stroke and kidney damage had been rather high, in as many as 3 percent of people, in the 1970s when the procedure was first introduced. Then, preparing patients for testing and injecting a dye to make the blood vessels more visible often took hours instead of the routine half-hour it takes today, raising the chances that a clot could dislodge in the blood vessels and cause a stroke. The earlier process also used up more than twice as much of the potentially toxic contrast agent than is needed today.

Another key finding in the latest study was that spinal angiography could accurately rule out suspected cases of spinal inflammation, a condition known as transverse myelitis. Fourteen of 45 patients diagnosed and treated with steroids or other immune-suppressing drugs for transverse myelitis were later confirmed by SpDSA to have a vascular malformation instead. All of these patients were successfully treated for their actual spinal problem, and none of them suffered any complications as a result.

According to Gailloud, who is also director of interventional neuroradiology at Johns Hopkins, this shows physicians that anyone who is diagnosed with transverse myelitis and who does not show improvement after drug treatment but is still likely suffering from a spinal problem should consider having a SpDSA to either verify the original diagnosis or determine if it is actually a vascular malformation. Both conditions have similar symptoms, he says, with people often complaining of a weakening in the legs, even temporary paralysis, sudden and uncontrolled urination, and back pain.

Lead study investigator and Hopkins medical student James Chen, M.Sc., began the study with encouragement from experts at the Johns Hopkins Transverse Myelitis Center after noticing continued reluctance by other specialists and patients to use spinal angiography. They believed the procedure to be too dangerous, despite growing acceptance of its efficacy. "To counter medical rumor and historical perception, we simply had to put some current numbers on its safety and risk," says Chen, who is also a Doris Duke Charitable Foundation research fellow in interventional neuroradiology at Johns Hopkins.

Gailloud and Chen have already begun the next phase of their research, a prospective study to monitor people after they have had a SpDSA for any possible complications months or even years after the procedure. Initial results are expected in 2012.

In the SpDSA procedure, a catheter tube is inserted into the larger blood vessels near the groin and gently threaded, one by one, into each of the major arteries branching from the aorta to the spine. Dye is released into each artery to help form multiple images of each artery, as taken by X-ray. The test is usually performed to specifically identify the source of the vascular problem after an MRI has ruled out any other physical disorders to the spine.

Funding support for this study was provided by The Johns Hopkins Hospital.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Journal Reference:

  1. James Chen, Philippe Gailloud. Safety of spinal angiography: Complication rate analysis in 302 diagnostic angiograms. Neurology, 2011; DOI: 10.1212/WNL.0b013e3182302068

Cite This Page:

Johns Hopkins Medical Institutions. "Feared spinal X-ray found to be safe, study shows; Spinal angiography also rules out misdiagnosis of inflammation, transverse myelitis." ScienceDaily. ScienceDaily, 15 September 2011. <www.sciencedaily.com/releases/2011/09/110914161731.htm>.
Johns Hopkins Medical Institutions. (2011, September 15). Feared spinal X-ray found to be safe, study shows; Spinal angiography also rules out misdiagnosis of inflammation, transverse myelitis. ScienceDaily. Retrieved July 26, 2014 from www.sciencedaily.com/releases/2011/09/110914161731.htm
Johns Hopkins Medical Institutions. "Feared spinal X-ray found to be safe, study shows; Spinal angiography also rules out misdiagnosis of inflammation, transverse myelitis." ScienceDaily. www.sciencedaily.com/releases/2011/09/110914161731.htm (accessed July 26, 2014).

Share This




More Health & Medicine News

Saturday, July 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins