Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care?
GROUND AND PURPOSE: Recently, the performance of C1–2 punctures for cervical myelography was challenged in a medicolegal proceeding as being below the standard of care. We sought to examine current neuroradiologic practices and opinions on the technique. MATERIALS AND METHODS: An 11-question survey was sent to 120 program directors of neuroradiology via e-mail links regarding cervical myelography using a C1–2 puncture. Reminders were sent during a 2-month period before data were finalized. RESULTS: Eighty-five of 120 (71%) surveys were returned. In the previous year, 14.3% (12/85) of institutions had not performed a C1–2 puncture. Thirty-eight percent (32/85) had performed 6 in the same period. Seventy-nine percent (54/68 responding) favored a lumbar approach to cervical myelography, with 6% (4/68) having a predilection for a C1–2 puncture. Ninety-five percent (76/80 responding) thought that performing a C1–2 puncture for cervical myelography reflected the standard of care. Every insti
