In myelography, the spinal puncture may be performed with the patient in which positions?

Myelography involves the injection of a contrast agent into the spinal canal to visualize the spinal cord and nerve roots using imaging techniques such as X-rays or MRI. The position of the patient during a spinal puncture is crucial for both safety and effectiveness.

By choosing the supine or flexed lateral position, it facilitates easier access to the lumbar region of the spine, which is typically the site for spinal puncture in myelography. In the supine position, the patient lies flat on their back, allowing for better stability and accessibility to the spine. The flexed lateral position, with the patient lying on their side and knees brought up towards the chest, provides optimal intervertebral spacing, making it easier to locate the intervertebral foramen where the puncture will occur. This positioning helps reduce the risk of complications and enhances the accuracy of the procedure.

The other positions suggested, while they may be used in different medical contexts, do not provide the same level of access or safety during a myelographic spinal puncture.