metrizamide and Peripheral-Nervous-System-Diseases

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Bupivacaine; Cranial Nerve Diseases; Female; Humans; Leg; Metrizamide; Middle Aged; Motor Neurons; Nervous System Diseases; Peripheral Nervous System Diseases; Pregnancy; Respiration; Sensation; Spinal Cord; Trigeminal Nerve

To correlate the accuracy of electromyography in diagnosing the correct root involved in cervical radiculopathy, 20 patients with cervical radiculopathy, diagnosed by electromyography using strict inclusion and exclusion criteria, were studied. Metrizamide myelography/computerized tomography were evaluated in all 20 patients independently, and the involved root was defined. The root involved, using the EMG examination and the myotome chart of the Medical Research Council, was C5 in 3 patients, C6 in 6, C7 in 9 patients, and C8 in 2 patients. The overall correlation with myelography/CT was 65% (33.3, 66.6, 77.7, and 50% for C5, C6, C7, and C8, respectively). EMG done properly has a good correlation of myelography/CT. This correlation is higher (73.3%) for the commonly occurring cervical radiculopathies (C6 and C7).

Topics: Action Potentials; Adult; Aged; Arm; Electromyography; Female; Humans; Male; Metrizamide; Middle Aged; Muscles; Myelography; Peripheral Nervous System Diseases; Spinal Nerve Roots; Tomography, X-Ray Computed

Sixty-nine patients with cervical spondylotic myelopathy (CSM), radiculopathy (CSR), or both (CSMR) were studied with computed tomography (CT). Computer-assisted myelography (CAM) accurately determines the site and nature of spondylotic protrusions and provides good visualisation of the subarachnoid space and cord deformities even in areas with dilute metrizamide. However, excessive vertebral movement and bulging ligamenta flava with their effects on cord deformity, so easily visualised in myelograms, are completely or partially missed. In the assessment of CSM, metrizamide myelography (MM) followed by CAM should be performed, particularly when the myelographic images are unsatisfactory due to contrast dilution or blockage, when cord compression cannot be ascertained with MM and when cord atrophy is suspected. In CSR, the diagnostic information from MM and CAM is comparable. The diagnostic criteria in CAM are, however, less direct and since MM is adequate in uncomplicated cases, CAM is generally not necessary. The APD, APD/TD ratio, area and circularity are sensitive indices of cord deformity and the first two should be used more often to assist visual assessment of cord deformity. The relation between cord parameters and treatment response is better reflected in CSM cases managed conservatively and the results suggest that the degree of cord deformity is helpful in determining the outcome and hence the choice between surgical and conservative treatment. In plain CT, the osteophytes and calcified discs are adequately visualised and canal dimensions measured with accuracy, but the cervical cord and roots cannot be properly assessed and the diagnosis of CSM or CSR cannot be ascertained. At present, its role in cervical spondylosis is therefore limited.

Topics: Humans; Metrizamide; Myelography; Peripheral Nervous System Diseases; Spinal Cord Diseases; Spinal Nerve Roots; Spinal Osteophytosis; Tomography, X-Ray Computed

Conventional myelography, metrizamide computed tomographic (CT) myelography, and surgical findings were correlated in 30 patients with cervical radiculopathy and/or myelopathy. In 60% of patients, metrizamide CT myelography provided significant additional information including better characterization of the abnormality, lateralization if the conventional myelogram was indeterminate, more definitive demonstration of cord atrophy, foraminal narrowing not appreciated on myelography, and demonstration of abnormalities distal to a myelographic block. In no case was a myelographic abnormality not detected on metrizamide CT myelography. In patients with cervical myelopathy, a cross-sectional diameter of the cord equaling less than 50% of the subarachnoid space is predictive of poor patient response to surgical intervention.

Topics: Adult; Aged; Cervical Vertebrae; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Peripheral Nervous System Diseases; Spinal Cord Diseases; Spinal Nerves; Tomography, X-Ray Computed

Nine patients with redundant lumbar nerve root syndrome were identified using positive-contrast myelography, seven with metrizamide and two with iophendylate. Serpiginous intradural filling defects occurred in conjunction with a complete or partial extradural block and spinal stenosis. These redundant nerve roots were seen on the cephalic side of the block. Eight of the nine patients had pseudoclaudication. One case was found incidentally during a cervical myelogram. This series is presented to demonstrate the characteristic myelographic pattern that should be recognized and differentiated from tortuous intradural blood vessels. Possible causes are discussed.

Topics: Adult; Aged; Female; Humans; Iophendylate; Male; Metrizamide; Middle Aged; Myelography; Peripheral Nervous System Diseases; Spinal Canal; Spinal Nerve Roots; Syndrome

Topics: Adult; Diagnosis, Differential; Female; Foot Diseases; Humans; Metrizamide; Neural Tube Defects; Peripheral Nervous System Diseases; Skin Ulcer; Spina Bifida Occulta; Tomography, X-Ray Computed