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At least 235 records · Page 13Linked to original sources
PubMed1989

Outpatient myelography with iohexol and iopamidol; pilot study and contrast trial.

50 patients underwent myelography on an outpatient basis; the incidence and severity of side effects were compared, in a prospective study, with 180 inpatient examinations over the same period. In addition, in the initial 200 myelograms (36 outpatients and 164 inpatient) iohexol and iopamidol were compared in a double blind trial. Headache was the most common side effect in both patient groups, recorded in 50% of outpatients and 25% of inpatients. Other side effects were of comparable incidence. 84% of outpatients undergoing myelography found it "acceptable", and did not consider a night in hospital necessary after the procedure. No difference in side effects was demonstrated between the two contrast media. This pilot study suggests that outpatient myelography is practical and safe, with considerable cost saving implications.

Adolescent↗
PubMed1993

Myelography, CT, and MRI of the spinal canal in patients with myelopathy: a prospective study.

A prospective study including myelography, CT, and MRI was performed on 36 patients with clinical signs of myelopathy. Evoked potentials and spinal fluid examinations were also carried out. Based on our findings, the patients could be classified as suffering from cryptogenic myelopathy (n = 12), multiple sclerosis (n = 6), spinal stenosis (n = 6), or miscellaneous myelopathies (n = 12). The diameter of the spinal cord was normal in the 2 first groups of patients and of same magnitude evaluated by myelography and CT, while MRI constantly gave higher figures. In only four of the patients important new information was added by CT and MRI (syringomyelia, myelitis, lipomatosis) compared with myelography, although a more precise visualization was often provided. Further diagnostic progress in patients with myelopathy of undetermined etiology may be obtained by including supplementary MRI of the brain disclosing multiple sclerosis in several cases.

Adult↗
PubMed1998

Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia.

OBJECTIVES: This study was conducted to investigate complications after dural puncture. MATERIAL AND METHODS: A 15 months' prospective observation study of routine clinical practice with dural puncture at a university hospital was conducted. Quincke spinal needles 0.90 to 1.0 mm O.D. (20-19 g) were used for diagnostic lumbar puncture, 0.70 mm O.D. (22 g) for myelography and 0.40 to 0.50 mm O.D. (27-25 g) for spinal anaesthesia. A questionnaire about post-puncture discomfort was given to the patients, to be returned after 1 week. RESULTS: Of 679 questionnaires 537 (79.1%) were returned. Discomfort was experienced by 53.8% of the patients, most often after diagnostic lumbar puncture and myelography. The difference in incidence of headache after diagnostic lumbar puncture and myelography compared with spinal anaesthesia were 27.9% (95% CI: 18.6 to 37.2) and 18.3% (95% CI: 9.1 to 27.5). CONCLUSION: Small diameter and atraumatic spinal needles will reduce patients' discomfort after dural puncture.

Adult↗
PubMedDate not supplied

A prospective clinical trial comparing metrizamide and iohexol for equine myelography.

A prospective clinical trial comparing adverse postmyelographic effects and myelographic quality of metrizamide and iohexol was conducted. Using a predetermined, randomized assignment, 24 horses exhibiting neurologic signs were administered either metrizamide (180 mgl/ml) or iohexol (180 mgl/ml) via cerebellomedullary puncture. Each horse was evaluated postmyelographically for adverse effects. Myelographic quality was assessed by a numerical scoring method. Adverse effects were observed more frequently with metrizamide (21) compared with iohexol (6) myelography (p < 0.05). Seizures, intensification of preexisting neurologic signs and prolonged anesthetic recovery were the most common complications after myelography. There was no difference in myelographic quality (p > 0.05). We conclude that iohexol is safer than metrizamide for equine myelography and that quality myelograms can be obtained with either contrast medium.

Anesthesia Recovery Period↗
PubMedDate not supplied

Ultrasound-guided atlanto-occipital puncture for myelography in the horse.

Complications of cervical myelography arising from the puncture of the subarachnoid space to collect the cerebrospinal fluid and to inject the contrast medium have been described in humans and animals. In this study, 2 ultrasound-guided procedures were developed for puncture of the atlanto-occipital subarachnoid space, collection of cerebrospinal fluid, and injection of contrast medium. Myelography was performed on 6 ataxic horses using these procedures. The first attempt to puncture the subarachnoid space was successful in 5 horses and in one horse, a second attempt was necessary. Collection of cerebrospinal fluid and injection of contrast medium were achieved without difficulty. Ultrasound-guided myelography allowed reduction of potential complications associated with blind percutaneous puncture of the subarachnoid space. Methods described in this study should be tried-at least initially in an experimental setting--to collect cerebrospinal fluid from the atlanto-occipital site in standing horses where it may represent an alternative method when lumbosacral cerebrospinal fluid collection has been unsuccessful or contaminated with blood.

Animals↗
PubMed2006

Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt.

A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postulated that extension and flexion of the neck during myelography resulted in movement of the endotracheal tube cuff, causing the tracheal lesion and predisposing the colt to pleuropneumonia. Severe tracheal lesions and pleuropneumonia have not been reported as sequela of equine myelography, and should be considered as possible complications following repeated cervical manipulation during myelography in the horse.

Anesthesia, General↗
PubMed1988

Use of iohexol for myelography in the horse.

The use of iohexol as a contrast agent for myelography is reported in two groups of horses. Group 1 (n = 6) were used only for myelography and to assess the clinical and pathological effects of intrathecal administration of iohexol. A volume of 20 ml at a concentration of 300 or 350 mg iodine/ml gave satisfactory myelographic detail with no serious clinical or neurological side effects. Only a minimal inflammatory response could be demonstrated in cerebrospinal fluid at four and 14 days after injection. At post mortem examination 14 days after myelography there was no evidence of meningitis nor was any other pathological change detected. Group 2 (n = 19) comprised a series of clinical cases of suspected cervical vertebral malformation. The only untoward sequelae recorded involved two horses in which iohexol was diluted with sterile water prior in intrathecal injection. A progressive necrotising meningitis developed in both cases which necessitated euthanasia. It was concluded that the major advantages of iohexol for use in the horse were its diagnostic quality, safety and low cost.

Animals↗
PubMed1992

Contrast-enhanced computed tomography and myelography in six horses with cervical stenotic myelopathy.

The cervical spines of 6 horses with cervical stenotic myelopathy (CSM) were examined using myelography and contrast-enhanced computed tomography (CECT). Histopathology of the spinal cord of these horses identified 10 neurologically significant compressive lesions. Myelography and CECT were both able to demonstrate all 10 spinal cord compressive lesions, but myelography falsely identified 2 sites and CECT falsely identified 1 site as compressive lesions of the spinal cord which were not supported by histopathology. Additional qualitative information was obtained by CECT regarding the source, severity and location of spinal cord compression. Computed tomography identified stenosis of the vertebral canal with circumferential loss of contrast agent and documented lateral compressive lesions of the spinal cord due to malformed articular facets. Compression of the peripheral nerve roots by malformed articular facets encroaching on the intervertebral foramen was easily identified by CECT in the axial plane. No compressive lesions were identified in 3 unaffected horses by either method. Minimum sagittal diameter (MSD) values obtained from CECT images were strongly correlated with necropsy measurements, validating CECT as an accurate method of obtaining MSD values. The MSD values in the CSM-affected horses were significantly narrowed (P less than 0.05) from C3C6 regardless of the site of spinal cord compression, when compared with the unaffected controls. This finding supports previous reports suggesting that generalised stenosis of the vertebral canal is an important feature in the pathogenesis of cervical stenotic myelopathy.

Animals↗
PubMed1975

Myelography in patients with medulloblastoma.

Unsuspected metastatic medulloblastoma involving the spinal cord was detected by myelography in 2 of 3 patients with newly diagnosed medulloblastoma. Myelography revealed unsuspected spinal cord metastases in an additional patient with recurrent medulloblastoma in the posterior fossa. The authors suggest that myelography be performed prior to radiotherapy in all patients with either primary medulloblastoma or recurrence in the posterior fossa.

Adolescent↗
PubMed1977

Respiratory arrest--a fatal complication of myelography.

Respiratory arrest occurred in a patient undergoing cervical myelography in the Trendelenberg position. Autopsy revealed infiltration of the phrenic nerves by metastatic breast cancer resulting in diaphragmatic paralysis. Though this is a very rare complication of myelography, it is suggested that more attention be paid to the respiratory function of patients with neurological conditions prior to myelography.

Female↗
PubMed1978

The effect of hydration on the acute and chronic complications of aqueous myelography. An experimental study.

The effect of hydration on the incidence of complications from myelography with aqueous media was studied. Myelography was performed with methylglucamine iocarmate in dehydrated and vigorously hydrated monkeys. The incidence of seizures and the severity of arachnoiditis were significantly greater in the dehydrated animals. The authors suggest that patients be permitted fluids ad lib. prior to myelography with aqueous media, or in some cases be given fluids intravenously.

Acute Disease↗
PubMed1983

Metrizamide myelography: blood and cerebrospinal fluid response.

Cerebrospinal fluid and blood were examined for immunologic factors before and after metrizamide myelography in 13 patients who underwent lumbar myelography and seven patients who underwent thoracic myelography. Clinical symptoms were also recorded. The results were consistent with a toxic reaction to the contrast medium, rather than an immunologic one.

Adolescent↗
PubMed1987

High-dose iohexol myelography.

Lumbar myelography was performed with high volumes of iohexol (15-24 ml) at a concentration of 180 mgI/ml (average dose, 20 ml) in 48 patients. In 44 patients receiving more than the currently recommended upper dose limit of 17 ml, the frequency of headache (41%), nausea (14%), and vomiting (9%) was comparable to results for routine-dose lumbar metrizamide myelography. Overall, adverse reactions were more frequent, particularly at the highest dose levels, than reported for conventional-dose iohexol myelography. However, there were no occurrences of neuropsychiatric disorder, encephalopathy, or seizure. High-dose technique allows superior visualization of upper lumbar and conus detail and may be advantageous in patients with large subarachnoid spaces and in multi-level examinations. This study supports the results of previous trials that suggested the relative safety of iohexol as a contrast agent and extends those observations to a higher dose range. Because of the increased rate of adverse reactions at the highest dose levels (despite the absence of major adverse reactions), iohexol should continue to be used conservatively, with doses carefully tailored to each examination.

Adult↗
PubMed1998

Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography.

PURPOSE: To compare measurements of the sagittal diameter of the lumbar dural sac obtained at positional magnetic resonance (MR) imaging and at functional myelography and to assess the influence of various body positions on the dural sac and the intervertebral foramina. MATERIALS AND METHODS: Thirty consecutive patients referred for lumbar myelography were examined with an open 0.5-T MR imager, Sagittal T2-weighted fast spin-echo images were acquired with patients in the supine, upright flexion, and upright extension positions. The midsagittal diameter of the dural sac was measured at the level of the disks on MR images and myelograms. Foraminal sizes on the MR images were scored independently by two observers. RESULTS: Correlation between MR imaging and myelographic measurements was high (r = .81-.97). A small but statistically significant positional dependence of the dural sac diameter was found in the lower lumbar spine. Position-dependent differences in foraminal scores were uncommon. CONCLUSION: Quantitative assessment of sagittal dural sac diameters is comparable between lumbar myelography and positional MR imaging. In a selected patient population, only small changes in the sagittal diameter of the dural sac and foraminal size can be expected between various body positions, and the information gained in addition to that from standard MR imaging is limited [corrected].

Adult↗
PubMed1975

Side effects after lumbar myelography with dimeglumine iocarmate (Dimer-X). Further experiences.

Lumbar myelography with dimeglumine iocarmate was performed in 90 cases premedicated with diazepam (Valium). EEG was performed before, as well as 3 and 24 hours after myelography. The use of diazepam interfered to some extent with the interpretation of the EEG. In 3 cases EEG abnormalities occurred 3 hours after myelography, most probably ascribable to Dimer-X. No further changes were found in the 24-hour recording. Immediate side effects were few and mild and seizures did not appear. The EEG abnormalities were equally distributed among patients with and without side effects.

Adolescent↗
PubMed1983

Functional lumbar myelography with iohexol.

The results of 25 functional lumbar myelographies with iohexol are reported. The image quality was good or excellent in all. The side effects were mostly mild and showed the same frequency as reported in lumbar and thoracic myelographies with metrizamide. A slight increase in the frequency of side effects was found in 13 patients with spinal repuncture 6 or 24 hours after the myelography. Vacuolized monocytes in ultracentrifuged CSF following repuncture was found in 5 patients. No EEG changes or serious complications were found. Iohexol is considered safe in intrathecal use.

Adult↗
PubMed1983

First clinical trial with iohexol in myelography.

This is a report of the first clinical trial with iohexol in lumbar myelography. The investigation was carried out as an open, non-comparative study in 30 patients and was part of a multicentre trial. Iohexol doses of 10 to 15 ml (180 mg I/ml) were used and clinical and laboratory tests were performed before and during 48 h after myelography. Spinal repuncture 6 or 24 h after myelography was done in all patients. Only minor side effects of temporary duration were recorded in 8 patients. No seizures or spikes on EEG were seen. There was no significant increase in CSF parameters such as white cell counts, protein or IgG.

Cerebrospinal Fluid Proteins↗
PubMed1983

Clinical trial of iohexol in lumbar myelography.

Iohexol containing 180 mg I/ml was used in 20 patients for lumbar myelography. By using an adequate volume up to a maximum of 15 ml, satisfactory films were obtained in all cases. Minor or moderate adverse effects occurred in 4 patients. There were no changes in vital signs or neurologic examination related to the examinations. No patient had difficulty with concentration, personality changes or seizures. Later encephalographies performed in all patients before and during 24 h after the iohexol injections, showed no seizure or abnormal activity or any significant change. Repeated lumbar puncture was performed in 9 patients 24 h after the injection of iohexol. One of these, a patient with symptoms due to disc prolapse, whose CSF was abnormal before the myelography, had a slightly increased cellular response. There was no significant change in any of the other patients. Iohexol is a very satisfactory contrast medium for myelography and compared favorably with other non-ionic contrast media.

Adult↗