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At least 289 records · Page 16Linked to original sources
PubMed1985

[Complications following myelography with positive contrast media (Pantopaque, Amipaque). Pathomorphologic findings in 2 fatal cases].

It is reported on three patients which suffered from severe side effects after cervical myelography using Amipaque (cases 1 and 3) and Pantopaque (case 2). In 2 cases death occurred after 13 days (case 2) respectively 17 days (case 3). Worsening of the clinical symptoms appeared in all cases within four days after myelography. In the first 2 cases inflammatory alterations prevailed whereas in the third case complications probably based on mechanical irritations of nerval and vascular structures. In the 2 lethal cases autopsy offered a prostatic cancer with vertebral and intraspinal metastases respectively syringobulbia and cervical syringomyelia beside an ependymoma of the cervical spinal cord as incurrable complaints. The various side effects and complications after myelography using positive contrast media as well as their causes are discussed.

Aged↗
PubMed1978

[Cervical myelography using metrizamide via a lateral approach at C1-C2 (author's transl)].

Metrizamide is a new hydrosoluble contrast medium of an entirely original conception which for first time makes it possible to explore the whole cord and its spaces. The technique of latero-cervical puncture between C1 and C2 was used in 45 cases of cervical cord compression, cervico-brachial neuralgia or brachial plexus paralysis. This technique of myelography has proved to be simple and reliable. It has a number of advantages: it is far more rapid, less painful and offers good visualisation of the nerve roots as compared with air myelography; unlike myelography with iodine-based oils, it is not necessary to remove the contrast medium after the examination since Metrizamide is spontaneously resorbable. Tolerance in general is remarkably good.

Adolescent↗
PubMedDate not supplied

Iohexol in lumbar myelography: preliminary results from an open, noncomparative multicenter clinical study.

This is a preliminary report of the first clinical trials using iohexol as a contrast agent in lumbar myelography. The study was noncomparative and involved 82 adult patients in four centers. Iohexol doses of 10-15 ml (180 mg I/ml) were administered and clinical and laboratory tests were performed before and at intervals during 48 hr after myelography. Side effects were noted in 29 (35%) of 82 patients. Spinal repuncture 6 or 24 hr after myelography was performed in 51 patients. No significant increases in cerebrospinal fluid parameters were seen. No seizures or spikes on electroencephalography were seen.

Adult↗
PubMedDate not supplied

Discrepancy between metrizamide CT and myelography in diagnosis of cervical disk protrusions.

With the advent of the relatively safe water-soluble contrast medium metrizamide, cervical myelography followed by metrizamide computed tomography (CT) can be performed easily. Sixteen patients with cervical disk protrusions (eight central and eight posterolateral) were studied by both procedures to evaluate the diagnostic value of each. In 75% of the posterolateral disk protrusions, myelography was as diagnostic as metrizamide CT. Metrizamide CT was definitely superior to myelography in 75% of the central disk protrusions with delineation of compressed cord. Information provided by metrizamide CT is detailed enough to allow the selection of a definitive anterior approach without delay.

Cervical Vertebrae↗
PubMedDate not supplied

Iohexol lumbar myelography: clinical study.

Forty-three patients underwent lumbar myelography with the new, nonionic contrast medium iohexol. Multiple laboratory examinations, neurologic examinations, and electrocardiograms showed no significant alterations after intrathecal injection of the contrast agent. Mild electroencephalographic changes were seen in one patient. Nineteen adverse reactions occurred in 13 patients; only one of them was considered severe. No patient experienced a seizure, auditory or visual hallucination, or similar neuropsychologic reaction. This is a distinct improvement over the side effects described for previous water-soluble contrast agents. The adverse reactions occurring with iohexol myelography are fewer in number and less severe than with metrizamide myelography, and radiographic visualization obtained with iohexol is equal to that obtained with metrizamide. With iohexol, it appears that the most disturbing and disabling neuropsychologic reactions have been reduced to an acceptable minimum.

Adult↗
PubMedDate not supplied

Metrizamide myelography for disk disease: continuing need for epidural venography.

Metrizamide is largely replacing iophendylate (Pantopaque) for routine lumbar myelography. Better visualization of the nerve root sheaths should make metrizamide myelography more sensitive in detecting laterally herniated disks, such that epidural venography might be required less often. However, that expectation has not been realized. In over 800 consecutive myelograms, one-half obtained with iophendylate and one-half obtained with metrizamide, 60 patients still required epidural venography. Nearly as many had metrizamide as had iophendylate (28 versus 32). Further, the number of positive epidural venograms with herniated disks confirmed at surgery was not significantly different (12 versus 11). Epidural venography is still indicated after negative or equivocal metrizamide myelography if strong clinical suspicion of herniated disk persists.

Epidural Space↗
PubMed1982

Computed tomography versus myelography in diagnosis of lumbar disc herniation.

Analysis of computed tomography (CT) of the lumbar spine and myelography in 48 of 52 consecutive patients with the clinical diagnosis of disc herniation, confirmed at surgery, showed CT to be superior to myelography in diagnosis. We suggest that CT should replace myelography in assessing most patients with possible disc herniation.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Diagnostic value of dimerix myelography in postoperative patients].

Myelography with dimerix was performed and postoperative changes were studied in 88 cases after operations on the intervertebral disks in the lumbar region. The informative value of myelography in recurrence of Schmorl's body is discussed. The use of myelography with a water-soluble contrast medium is indicated in aggravation after the operation. It is not always possible to make a differential diagnosis between a recurrent prolapse of the disk and a postoperative scar formed at the site of the operation.

Adult↗
PubMed1994

[Why still use myelography in neurosurgery?].

Recently CT scan and NMR imaging have become diagnostic routine methods for spine lesions, while myelography is no longer the method of choice in most cases. From the experience of our clinic, however, there remain some neurosurgical indications, which will be the contents of this publication. We would like to give a review of the present literature. Still remaining indications are: 1. Traumatic nerve root lesions 2. Anomalies of lumbosacral nerve roots 3. Cervical disc herniation: anterior disc excision vs. posterior operation. 4. Stenosis of the spinal canal in more than 2 levels 5. Neurological deficit after trauma of the spine 6. Functional Myelography 7. Spinal arteriovenous malformations 3 Patients are presented in the crucial phase of diagnostic evaluation. Based on their outcome, the indications of myelography are discussed.

Diagnosis, Differential↗
PubMed1994

[Ambulatory lumbar myelography].

Out-patient lumbar myelography was carried out on 74 consecutive patients, and adverse reactions were registered by the patients themselves. Twenty-four percent experienced moderate or severe headache; 62% experienced increasing back pain of a moderate or severe degree; 40% experienced increasing leg pain of a moderate or severe degree; 15% experienced nausea/general symptoms to a moderate or severe degree. Twenty-nine percent experienced the myelography as unpleasant in a moderate or severe degree. Fourty-seven percent had some kind of adverse reaction for > or = four days. Eleven patients (16%) were admitted to hospital because of severe adverse reactions, mostly headache, and nine of them were treated with a blood patch. Twenty-five percent were referred for operation for their back disease. Generally, out-patient lumbar myelography is well tolerated, but a large proportion of the patients experience temporary adverse reactions to a moderate or severe degree, perhaps in part because of immobilisation in connection with photographing procedures.

Adolescent↗
PubMed1994

A prospective comparison of iotrolan and iohexol in lumbar myelography.

In a double-blind study 238 patients were examined with lumbar myelography using iotrolan or iohexol in randomized sequence in order to evaluate the image quality, the safety and tolerance of iotrolan by monitoring the adverse effects with special attention to late reactions. There were no serious complications. On the first day 28 patients (24%) had headache after iotrolan and 41 (34%) after iohexol. This difference was not significant, and these frequencies are similar to those found after spinal puncture alone. The second most frequent side effect was neck pain; the duration of neck pain were significantly longer after myelography with iohexol than with iotrolan. There was a significantly higher frequency of adverse effects in females the first 24 hours, but during examination and on days 2 to 4 there were no differences between males and females. Anamnestic information or myelographic diagnosis could not predict which patients would have side effects. The image quality was excellent or good in all examinations but one. It is concluded that iotrolan is a safe contrast medium well suited for lumbar myelography.

Adult↗
PubMed1993

[Anamnesis and myelography in the preoperative assessment of lumbar spinal stenosis. Results of a postoperative follow-up study].

Between 1987 and 1991, 33 patients with spinal stenosis of the lumbar spine were treated by decompression (33 patients) and posterior fusion (30 patients). Indication for decompression was based on case history and lumbar myelography with flexion/extension views. At follow-up 1-5.5 years later, 28 patients were happy with the results of the treatment and would be willing to be operated on again in a similar situation. Two other patients also presented objectively good results, but were dissatisfied for reasons not related to the operation. Our study shows that myelography and case history are adequate investigations for determination of the level of pathology and for making a decision about operative decompression in spinal stenosis of the lumbar spine. CT or MRI are only needed if the symptoms of the patient are not explained by the myelogram. Although MRI is advocated as the investigation of first choice for lumbar spinal stenosis, we still prefer the myelography, which is easier to interpret during the operation. Our study also shows that operative treatment of spinal stenosis is very rewarding, since 9 out of 10 patients will have good results. We usually combine decompression and fusion. Decompression alone is only performed in patients without any back pain and with stable motion segments after adequate decompression.

Adult↗
PubMed1977

[Lumbar myelography with metrizamid (author's transl)].

A series of lumbar myelographies -- 105 in 98 patients - was carried out with water-soluble Metrizamid (Amipaque R) in a concentration of 170 mg I/ml and showed side-effects in 32% and a quality of contrast similar to that of other water-soluble contrast media used before. The side effects were mild, of short duration and needed no treatment. There were no epileptic fits, tonic or clonic carried out 1 - 12 months later showed no signs of arachnoiditis. Dangers of more serious complications appeared to increase, the higher the level of injection into the spinal canal. A short survey of contrast media used in myelography and earlier experience of experimental or clinical side effects caused by Medtrizamid in myelography follows.

Adult↗
PubMed1996

[Diagnostic imaging in suspected lumbar disk prolapse. A controlled comparison of myelography, CT and magnetic resonance imaging].

Eighty patients with monoradicular sciatica were examined by myelography, computed tomography (CT) and magnetic resonance imaging (MRI) and all had subsequent surgery. The images were evaluated by a decision-analytic regret function. The largest amount of diagnostic information was gained from CT followed by MRI and myelography. Myelography was not significantly informative. The results suggest that CT or MRI should be the first choice examination in patients with suspected lumbar disc herniation.

Adult↗
PubMed1997

[Secret information provided by lumbosacral myelography].

The authors emphasize the misleading images of lumbar myelography encountered in common vertebral diseases: disk disease, posterior interapophyseal joint diseases, degenerative and narrow spinal canal, in which dynamic views in the upright position represent the most original contribution of lumbosacral myelography as compared to new techniques. The authors also describe the postoperative appearances observed on lumbosacral myelography and some rarer diseases which must not be missed, such as epidural arachnoid cysts and epidural lipomatosis.

Angiography↗
PubMed1976

[Side reaction after lumbar myelography with dimer-x (author's transl)].

The existence of several very impressive spinal paroxysms after lumbar myelography with Dimer-X1 caused us to make a retrospective investigation of 327 patients with 355 myelographies. In 7.1% of the investigations we have found partly heavy, but mostly reversible neurological complications. The latter cannot be classified, contrary to prevailing statements, in spinal, meningeal or cerebral reactions, since mostly all 3 anatomical structures are being concerned. Corresponding casuistical information are being presented and with their neurological symptomatic discussed. The spinal paroxysms appeared approximately 6 hours after the myelography and lasted over 8-10 hours, in spite of intensive therapeutical efforts. The pathogenesis points to a multifactorial occurrence caused by the coincidence of an increased dosage of the contrast media, too bed rest time, rising of the contrast media in the spinal cord zone and disturbed liquor fluid circulation and contrast media resorption. Pathophysiologically is in connection with spinal cramps an epileptic mechanism probable. Additional spinal reflexive components could be an explanation for the little therapeutical effect of Diacepam (Valium), which is contrary to the statement in the literature. We have seen a better effect in particular cases with Phenothiazine. With strict observance of specific precautionary measures, the Dimer-X seems to be a good media for the presentation of the lumbar subarachnoid space. A further development in this field is desirable.

Adolescent↗
PubMed1989

Traumatic lumbosacral nerve root meningoceles. The value of myelography, CT and MRI in the assessment of nerve root continuity.

A case of traumatic lumbar meningoceles at four levels in combination with total and partial nerve root avulsion and with preservation of a nerve root is reported. Several diagnostic imaging techniques (myelography, CT, myelo-CT and MRI) are compared and their value in demonstrating the continuity of the nerve roots is discussed. MRI could assess the continuity of a nerve root in a traumatic meningocele, not demonstrable by myelography or myelo-CT. The combination of myelography, myelo-CT and MRI is likely to provide a complete diagnostic evaluation of nerve root lesions.

Adult↗
PubMed1987

[RARE-MR myelography in routine clinical practice. Experience with 175 cases].

In 1984 Henning, Nauerth, Friedburg and Ratzel described a new MRI data acquisition technique called RARE (Rapid Acquisition with Relaxation Enhancement). Several clinical applications have been published. A modification developed in the meantime, called "RARE hydrography", yields T2-weighted aqueous fluid specific images within a few seconds. As a nontomographic rapid approach to MR-myelography ("RARE-myelography") this technique is routinely applied at the beginning of all examinations of the spine. On the basis of 175 cases current potentials and limitations are discussed. Future applications of 3D-RARE myelography are mentioned.

Evaluation Studies as Topic↗