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At least 217 records · Page 12Linked to original sources
PubMed1977

[Side effect of metrizamide and meglumine iocarmate in lumbar myelography. A prospective, parallel, interview study (author's transl)].

Side effects of metrizamide (Amipaque) and meglumine iocarmate (Dimer-X) were compared in lumbar myelography of 161 patients by a prospective, parallel, interview study. Severe complications were not observed. The percentage pairs of smaller complications were mainly in favour of Dimer-X, but in 2 of the 54 pairs only the difference did raise to a significant level. In one pair there were less symptomless patients after Amipaque-myelography (p less than 0.05) and in another pair the men had more headache after Amipaque-myelography (p less than 0.01). It may be possible to show with larger comparative series, that Amipaque has a tendency to cause more central-subcortical or meningeal-side effects than Dimer-X.

Female↗
PubMed1987

[Computerized tomography and myelography findings following lumbar intervertebral disk surgery].

56 patients suspected of having suffered recurrent disc prolapse in the lumbar region were examined by CT and by myelography; the value of these examinations has been analysed. In 32 patients the findings were checked during surgery. There were difficulties in diagnosis, both for CT and myelography, where the findings were complex, i.e. in patients in whom there was postoperative fibrosis as well as disc prolapse and/or osseous spinal canal stenosis. As regards recurrence of prolapse, sensitivity for both methods was 83%. Postoperative scar formation can be clearly demonstrated by CT, but myelography produced a false positive diagnosis of recurrent prolapse in 17%. The changes were, in fact, caused by scar tissue formation.

Cicatrix↗
PubMed1986

[Nuclear magnetic resonance tomography of the spine and spinal cord compared with computed tomography and myelography].

In cases of syringomyelia MR is superior to CT and myelography in visualisation and delineation of the extent of the process. In diagnosing spinal tumours MR is a more sensitive method than CT and myelography. MR provides additional information on sagittal and frontal planes regarding the extent of the tumour. In diagnosis of disc prolapse MR seems to be as accurate as CT or myelography. We obtained additional information in diagnosis of degenerated disc tissue. Spinal stenosis is easily recognisable. CT was superior in differentiation of bony and disc protrusion. The results show that MR has opened up new possibilities in the diagnosis of spinal diseases and will result in a reorientation of the diagnostic approach.

Arteriovenous Fistula↗
PubMedDate not supplied

Double contrast myelography.

Myelography was performed with a combination of air and an aqueous myelographic contrast media. Excellent demonstration of the arachnoid sac and cord was possible with double contrast myelography in primates. A technique for double contrast myelography is described. Clinical applications are discussed.

Air↗
PubMedDate not supplied

Iohexol vs. iopamidol for myelography.

Three hundred sixty-three patients undergoing myelography were examined on a random basis with either iohexol (179) or iopamidol (184). All patients underwent neurologic or psychological assessment before and after the examination; 100 patients also submitted to cardiovascular and hematologic tests. Sixty patients were examined with electroencephalography before and after myelography. Incidence and severity of side effects were carefully evaluated in all patients and, wherever possible, by an independent observer, who was not told which contrast medium had been used. Radiographic quality was independently estimated and graded and was equally adequate with both media. Both iohexol and iopamidol will, in competent hands, provide myelograms of good radiographic quality without producing any permanent adverse sequelae. Incidence and severity of adverse side effects were slightly but significantly less with iohexol than with iopamidol. Three patients of the 25 examined with iopamidol showed EEG evidence of neuronal excitability following myelography. None of the 35 examined with iohexol showed this change.

Adolescent↗
PubMed2001

Clinical experience with iomeprol in myelography and myelo-CT: clinical pharmacology and double-blind comparisons with iopamidol, iohexol, and iotrolan.

RATIONALE AND OBJECTIVES: To evaluate iomeprol, a new nonionic iodinated contrast medium, as a contrast agent for myelography and to compare it with iopamidol, iohexol, and iotrolan. METHODS: An extensive clinical program was conducted on more than 600 patients to assess iomeprol's pharmacokinetics, tolerability, safety, and efficacy after intrathecal injection. RESULTS: Pharmacokinetics study results showed that after intrathecal administration iomeprol is completely absorbed from the cerebrospinal fluid compartment; once absorbed into the systemic circulation, it is rapidly excreted, unmetabolized, by glomerular filtration. Dose-finding studies showed that the opacification produced by iomeprol depends on the injected dose. Although a dose-dependent increase in efficacy was observed, no differences in neurotolerability and safety were detected between the doses tested. Doses of iomeprol greater than 3 g I did not cause a greater incidence of adverse events and produced significantly better contrast efficacy. Comparative clinical trials showed that iomeprol and iopamidol, iohexol, and iotrolan always provided adequate opacification of the subarachnoid space, both in conventional myelography and myelo-CT, with adequate delineation of normal structures and pathologic processes. No serious adverse events occurred up to a total dose of 4.5 g I. No differences between the agents with regard to tolerance, adverse events, and effects on vital signs, physical examination, and neurologic examination were observed. CONCLUSIONS: Iomeprol is safe and effective and can be recommended for myelography and myelo-CT.

Adult↗
PubMedDate not supplied

CT myelography in cervical nerve root avulsion.

Computed tomographic myelography (CTM) with metrizamide was performed in six patients to delineate the CTM appearance of avulsed cervical nerve roots. Twelve cervical nerve root avulsions were found and confirmed by cervical myelography and physical examination. The CTM findings in cervical nerve root avulsion closely matched those found myelographically: outpouchings of metrizamide extending ventrolaterally from the thecal sac into the neural foramen in an expanding or "mushroom-like" manner and separated from the thecal sac proximally by a 1-2 mm thick dural plane. This CTM appearance differs from that seen in such normal variants as dilated nerve root sleeves or root diverticula. We conclude that CTM is as sensitive as myelography. In addition, it can provide useful information regarding bony fragments or contiguous soft tissue injury.

Adolescent↗
PubMed1979

Gas myelography in spinal cord injury.

Using polytomographic techniques, gas myelography was performed in 162 patients with post-traumatic neurologic deficit. The type, extent, and location of lesions were easily demonstrated, allowing adequate preoperative surgical planning. In cases in which expected neurologic improvement did not follow surgery, postoperative myelography provided information so that remedial measures could be taken. No neurologic deterioration was noted in any of the patients and furthermore, arachnoiditis, which may accompany positive contrast myelography, has not been detected in any of the patients in the series reported.

Humans↗
PubMed2000

Predictive value of computed tomographic myelography in obstetrical brachial plexus palsy.

Preoperative radiologic studies to detect root avulsions of the brachial plexus caused by birth trauma are considered useful in assisting with surgical planning for reconstruction. In this study, the predictive value of computed tomographic (CT) myelography in detecting nerve root avulsions at our institution was determined. Sixty-three consecutive patients with an obstetrical brachial plexus palsy who had had both preoperative CT myelography and reconstructive surgery were selected. All CT myelograms were analyzed post hoc by a single neuroradiologist in a manner blind to the surgical findings. At each root level of the brachial plexus, the presence of a pseudomeningocele was noted along with the presence or absence of rootlets within each identified pseudomeningocele. Extraforaminal root avulsions later determined at surgery were reviewed by a single surgeon in a manner blind to the radiographic results. Surgical and radiographic findings were then compared at each corresponding root level. A total of 281 roots were examined. The sensitivity, specificity, positive predictive value, and likelihood ratio for root avulsions with pseudomeningoceles were 0.63, 0.85, 0.40, and 4.2, respectively. For pseudomeningoceles for which rootlets traversing the sac could not be identified, these values were 0.37, 0.98, 0.74, and 18.5, respectively. The presence of pseudomeningoceles with or without rootlets was not a sensitive indicator of root avulsions. Root avulsions were better predicted by identifying the absence of rootlets in a pseudomeningocele. This absence on CT myelography may be used to suggest an extraforaminal root avulsion due to its high specificity and high likelihood ratio.

Birth Injuries↗
PubMed1978

Arachnoiditis from experimental myelography with aqueous contrast media.

Myelography was performed on 80 monkeys to study postmyelographic arachnoiditis. Metrizamide myelography caused arachnoiditis when high concentrations were used, but not with the usual clinical concentrations. Arachnoiditis resulted after myelography with meglumine iocarmate; however, the risk of arachnoiditis was reduced by diluting the contrast medium. Prophylactic intrathecal methylprednisolone was not effective in preventing arachnoiditis. Blood in the cerebrospinal fluid did not affect the degree of arachnoiditis.

Animals↗
PubMedDate not supplied

Total myelography in the evaluation of lumbar discs. With the presentation of three cases of thoracic neoplasms simulating nerve root lesions.

It has been our practice to perform total myelography in all cases of lumbar disc disease including the various syndromes of spinal stenosis, because experience has indicated that myelographic abnormalities in the cervical and thoracic areas could have clinical importance despite the presence of gross changes in the lumbar region. Failure to establish a definite diagnosis by restricted lumbar myelography makes it mandatory to evaluate all levels of the spinal axis. Recently, 3 patients with thoracic spinal cord tumors presented with primary signs and symptoms of lumbar spine disorders. Evidence of spinal cord disease was minimal and could be readily overlooked. Total myelography disclosed varying degrees of lumbar spinal pathology, but also showed evidence of lesions in the thoracic region. One proved to be an intramedullary astrocytoma of the spinal cord, and two were schwannomas. The symptoms of low-back pain and lumbar radiculopathy improved after excision of the schwannomas and following x-ray therapy and chemotherapy in the patient with the intramedullary neoplasm.

Adult↗
PubMedDate not supplied

A comparison of sonography and myelography in clinically suspected spinal stenosis.

Anterio-posterior measurements of the subarachnoidal space of the lumbar spinal canal were obtained by myelography and by ultrasound. The correlation between the measurements is low and the distribution of the regression coefficient is considerable. The usefulness of diagnostic ultrasound as a screening procedure for patients with clinically suspected spinal stenosis, therefore, is limited. The noninvasive ultrasound method, nevertheless, has a certain value for selecting patients for myelography. An ultrasound measurement of 14 mm or more will exclude that the corresponding anterio-posterior measurement obtained at myelography is 8 mm or below.

Adolescent↗
PubMed1986

Inefficacy of routine laboratory analysis of CSF obtained during myelography for suspected disc disease.

The routine laboratory analysis of cerebrospinal fluid (CSF) obtained during myelography is performed in many institutions. The records of 100 consecutive patients who had myelography for suspected disc disease were reviewed retrospectively. The laboratory analysis of the CSF obtained during myelography did not benefit patient management in any instance. In one case, the CSF results adversely affected patient management. The CSF analysis did not add any information to the myelogram result. The CSF protein level did not correlate in a statistically significant way with the degree of disc protrusion seen myelographically.

Cerebrospinal Fluid↗
PubMed1988

Spinal imaging: will MRI replace myelography?

A retrospective study on the value of magnetic resonance imaging (MRI) in replacing contrast studies of the lumbar spine has been undertaken. Studying pre- and postoperative conditions, the authors attempted to answer the question, Will MRI replace myelography? In this retrospective study, comparison is made in 20 patients between MRI and myelography and with 12 intra-operative findings. The overall impression was that MRI is equally sensitive as the invasive myelogram in diagnosing both protruded lumbar discs and postoperative fibrosis. The practical conclusion was an almost complete abandonment of myelography.

Adult↗
PubMed1990

Magnetic resonance imaging of lumbar disc herniation. Comparison with myelography.

Fifty-three patients with surgically confirmed lumbar disc herniation at 55 levels were studied retrospectively to compare the diagnostic accuracy of high-field strength surface coil magnetic resonance imaging (MRI) with that of myelography. Disc herniation was classified into three groups according to MRI findings, namely, unilateral single-disc herniation, central single-disc herniation, and multilevel disc herniation. Magnetic resonance imaging diagnosis of unilateral single-disc herniation was extremely reliable, so myelography was considered to be unnecessary. Conversely, MRI findings of central single-disc herniation and multilevel disc herniation were less definite, in that myelography was necessary in locating the disc causing symptoms.

Adult↗
PubMed1996

Intraspinal cross-section areas measured on myelography--computed tomography. The relation to outcome in nonoperated lumbar disc herniation.

STUDY DESIGN: A prospective cohort study with computed tomographic-myelographic and clinical base registrations and follow-up by questionnaire 14 months after the onset of leg pain. OBJECTIVES: To detect predictive relations between intraspinal area measures and outcome in nonoperated lumbar disc herniation. SUMMARY OF BACKGROUND DATA: Myelography and computed tomography are qualitative methods ordinarily. The authors wanted to investigate the quantitative possibilities of computed tomographic technology in the pursuit of predictive measures. METHOD: Cross-section areas of the disc hernia, the dural sac, and the residual spinal canal were measured on computed tomography-myelography in 58 patients with lumbar disc herniation who did not undergo surgery. Pain, disability, and vocational status were asked for in a questionnaire after 8 months. RESULTS: After a median of 14 months from the onset of leg pain, 77% had returned to work, and only 7% were pain-free. The hernia size was not associated with the outcome measures. A high score for pain intensity and distal pain distribution was associated with a wide dural sac and a wide residual spinal canal. Disability and vocational status were not associated with any of the areas measured. Patients with the longest duration of leg pain had the narrowest spinal canals. CONCLUSIONS: Area measurements on computed tomography-myelography could not predict outcome in patients with lumbar disc herniation who were not operated on. There was an association between pain and a wide dural sac, which might underscore the sensory role of dura in protracted cases of sciatica.

Adult↗
PubMed2001

Dorsal root ganglia morphologic features in patients with herniation of the nucleus pulposus: assessment using magnetic resonance myelography and clinical correlation.

STUDY DESIGN: Morphologic features of the dorsal root ganglia were investigated in patients with herniation of the nucleus pulposus by means of magnetic resonance myelography. OBJECTIVES: This study was undertaken to assess morphologic changes of the dorsal root ganglia in patients with herniation of the nucleus pulposus and to determine the relations between the morphologic features of the dorsal root ganglia and clinical features. SUMMARY OF BACKGROUND DATA: It has recently been reported that application of the nucleus pulposus to a nerve root induces edema in the rat dorsal root ganglion. Edema in the human dorsal root ganglion resulting from lumbar disc herniation has not been discussed in the literature, to the authors' knowledge. METHODS: Eighty-three consecutive patients (average age 42.1 years; range 17 to 77 years) with monoradicular symptoms were examined. Dorsal root ganglion morphologic features, i.e., indentations and swelling, were evaluated by magnetic resonance myelography. The dorsal root ganglion swelling at each level was quantitatively expressed as a ratio of the dorsal root ganglion width on the involved side to that of the contralateral side and was termed dorsal root ganglion ratio. Eighty-three uninvolved levels were chosen as controls in a randomized manner. Factors possibly contributing to the morphologic changes in the dorsal root ganglion were investigated. Neurologic symptoms, evaluated by the Japan Orthopaedic Association scoring system, were correlated to the morphologic changes. The morphologic features were followed up for 1 year after treatment in a small group of patients. RESULTS: Dorsal root ganglion indentations were always found in the narrowed intervertebral foramens. The incidence of indentations was significantly higher at the involved nerve roots (10.8%) than at the uninvolved nerve roots (4.0%) (P = 0.026). Patients with dorsal root ganglion indentations were significantly older (P = 0.0008). Leg pain scores in patients with indentations were significantly poor (P = 0.007). The dorsal root ganglion ratios were significantly higher at the involved levels than at the uninvolved levels (P = 0.001); the means +/- SD were 1.19 +/- 0.25 and 1.08 +/- 0.13, respectively. Patients with lateral herniated nucleus pulposus had significantly higher dorsal root ganglion ratios than those with central herniated nucleus pulposus (P = 0.0001); the mean ratios +/- SD were 1.48 +/- 0.32 and 1.10 +/- 0.12, respectively. A moderate positive correlation was found between dorsal root ganglion ratio and age (Pearson's correlation coefficient = 0.313). There was moderate negative correlation between the dorsal root ganglion ratio and leg pain, gait, motor, and total Japan Orthopaedic Association score (correlation coefficients were = -0.385, -0.350, -0.422, and -0.358, respectively). The dorsal root ganglion ratios were significantly diminished at 1-year follow-up (P = 0.001); the means +/- SD were 1.22 +/- 0.22 and 1.09 +/- 0.07, respectively. Indentations observed before treatment disappeared after treatment. CONCLUSIONS: Swelling and impingement in the involved dorsal root ganglion were clearly visualized by magnetic resonance myelography. The swelling and indentations were well correlated with severity of leg pain. These findings have important value in understanding the pathophysiology of the nerve roots in herniated nucleus pulposus.

Adolescent↗
PubMedDate not supplied

The role of computerized tomography-myelography in a patient with spontaneous intracranial hypotension from multiple cerebrospinal fluid leaks.

OBJECTIVES: To describe a patient with spontaneous intracranial hypotension (SIH) secondary to multiple sites of cerebrospinal fluid (CSF) leaks, a rarely described phenomenon. To compare computerized tomography-myelography with radionuclide cisternography as confirmatory diagnostic aids in SIH. METHODS: A patient with SIH had transient or no response to 2 thoracic epidural blood patches. A computerized tomography-myelography showed bilateral CSF leaks at T11-T12 and T12-L1 levels and on the left side of T10-T11. RESULTS: A left paramedian epidural blood patch was performed at T12-L1 under fluoroscopy guidance. Injection of 1 mL dye showed confinement of the dye at the left T11-L1 epidural space. The patient had 90% to 95% relief of her headache and complete relief at 4 months. She was asymptomatic 1 year after the last epidural blood patch. CONCLUSIONS: In a patient with SIH, a computerized tomography-myelography should be performed if an initial epidural blood patch is ineffective. This is to show the vertebral level and site(s) of CSF leak and to guide the physician to the ideal vertebral level for the epidural blood patch.

Adult↗