{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:37:01Z","timestamp":1792733821974,"version":"4.5.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Precise localization and understanding of the origin of spontaneous high-flow spinal CSF leaks is required prior to targeted treatment. This study demonstrates the utility of ultrafast dynamic CT myelography for the precise localization of high-flow CSF leaks caused by spiculated spinal osteophytes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This study reports a series of 14 patients with high-flow CSF leaks caused by spiculated spinal osteophytes who underwent ultrafast dynamic CT myelography between March 2009 and December 2010. There were 10 male and 4 female patients, with an average age of 49 years (range 37\u201374 years). The value of ultrafast dynamic CT myelography in depicting the CSF leak site was qualitatively assessed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In all 14 patients, ultrafast dynamic CT myelography was technically successful at precisely demonstrating the site of the CSF leak, the causative spiculated osteophyte piercing the dura, and the relationship of the implicated osteophyte to adjacent structures. Leak sites included 3 cervical, 11 thoracic, and 0 lumbar levels, with 86% of the leaks occurring from C-5 to T-7. Information obtained from the ultrafast dynamic CT myelogram was considered useful in all treated CSF leaks.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Spinal osteophytes piercing the dura are a more frequent cause of high-flow CSF leaks than previously recognized. Ultrafast dynamic CT myelography adds value beyond standard dynamic myelography or digital subtraction myelography in the diagnosis and anatomical characterization of high-flow spinal CSF leaks caused by these osteophytes. This information allows for appropriate planning for percutaneous or surgical treatment.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.spine14209","type":"journal-article","created":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T14:59:58Z","timestamp":1420210798000},"page":"324-331","source":"Crossref","is-referenced-by-count":98,"title":["Ultrafast dynamic computed tomography myelography for the precise identification of high-flow cerebrospinal fluid leaks caused by spiculated spinal osteophytes"],"prefix":"10.3171","volume":"22","author":[{"given":"Kent R.","family":"Thielen","sequence":"first","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Sillery","sequence":"additional","affiliation":[{"name":"Department of Radiology, Billings Clinic, Billings, Montana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Hoxworth","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix E.","family":"Diehn","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Wald","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Rosebrock","sequence":"additional","affiliation":[{"name":"High Plains Radiological Association, Amarillo, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick H.","family":"Luetmer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14209","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"535","DOI":"10.3174\/ajnr.A2815","article-title":"The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension","volume":"33","author":"Akbar","year":"2012"},{"key":"b2-spine14209","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"52","DOI":"10.3174\/ajnr.A2730","article-title":"Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade","volume":"33","author":"Brus-Ramer","year":"2012"},{"key":"b3-spine14209","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3174\/ajnr.A1294","article-title":"Localization of a rapid CSF leak with digital subtraction myelography","volume":"30","author":"Hoxworth","year":"2009"},{"key":"b4-spine14209","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/j.spinee.2005.12.026","article-title":"Intracranial hypotension with spinal pathology","volume":"6","author":"Inamasu","year":"2006"},{"key":"b5-spine14209","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1212\/01.wnl.0000172345.05810.14","article-title":"Role of dynamic CT myelography in identifying the etiology of superficial siderosis","volume":"65","author":"Kumar","year":"2005"},{"key":"b6-spine14209","series-title":"AJNR Am J Neuroradiol","first-page":"1711","article-title":"Dynamic CT myelography: a technique for localizing high-flow spinal cerebrospinal fluid leaks","volume":"24","author":"Luetmer","year":"2003"},{"key":"b7-spine14209","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"690","DOI":"10.3174\/ajnr.A2849","article-title":"When should I do dynamic CT myelography? 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