Biomedical subjects
Publications and source records attributed to P D de Villiers.
Iopamidol (Jopamiron 200) is a new water-soluble, non-ionic contrast medium for myelography, which recommends itself for reasons of safety, diagnostic effectiveness, economy and convenience. It has been used in a small series of 185 patients in doses of 10-15 ml and found to be highly satisfactory for myelography of the lumbosacral, thoracic and cervical regions.
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Metrizamide (Amipaque; Winthrop) has provided consistently reliable diagnostic results in a small series of 150 myelograms. It is an acceptable diagnostic alternative to Dimer-X for myelography of the lumbar, thoracic and cervical segments. It is also safer but expensive, and its use requires modification of technique. The distressing headache which often follows lumbar puncture appears to be unavoidable.
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Experience with Dimer-X myelography in 3000 patients provides some indication of the scope of examination of the lumbar, thoracic and cervical segments of the spinal canal with a water-soluble contrast medium. Myelography with any contrast medium should only be applied for serious indications, and never as an outpatient procedure, for the patient requires careful after-treatment. However, the routine use of myelography may offer the best insurance against the disappointment and embarrassment of surgery by trial and error. The application of a careful, standardized technique makes it possible to obtain accurate information about the whole spinal canal and to avoid the danger of the false results to which examination with oily media are liable at all levels. The development of ever safer contrast media may help to limit the problem of spinal fibrosis, which is not a rare complication of myelography and spinal surgery.
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