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.

Related Articles


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 October 23, 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 October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
More People Diagnosed With TB In 2013, But There's Good News

More People Diagnosed With TB In 2013, But There's Good News

Newsy (Oct. 22, 2014) The World Health Organizations says TB numbers rose in 2013, but it's partly due to better detection and more survivors. 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:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

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