Potential complications in myelography: I. Technical considerations.

Scanning electron microscopy demonstrated starch powder contamination on the stylet tip from a spinal needle after it was lightly touched with nonwashed surgical gloves. A sterile solution of Pantopaque was injected through the spinal needle after the stylet was withdrawn and carried particulate contaminants to a 0.2 micrometer millipore filter. Using both scanning electron microscopy and energy dispersive x-ray analysis, particles of various sized (mostly 5-10 microns) and variable compositions, including starch, talc, and other elements, were identified. Also, glass particles from the Pantopaque vial and plastic particles from the plastic syringe and tubing used in drawing up the Pantopaque were seen. These observations indicate that strict attention to proper technique in myelography is essential in order to eliminate potential cerebrospinal fluid contamination.