metrizamide and Sciatica

Topics: Arthritis, Rheumatoid; Back Pain; Female; Humans; Joints; Metrizamide; Middle Aged; Myelography; Sciatica; Synovial Cyst; Tomography, Emission-Computed; Tomography, X-Ray Computed

Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L5 or/and S1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively, Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occurred in 47 L5 roots and 11 S1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases (75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Nerve Compression Syndromes; Sciatic Nerve; Sciatica; Tomography, X-Ray Computed

One hundred patients with symptoms of lumbo-sacral root compression were prospectively and consecutively assigned to operation based alone on clinical findings. A preoperative myelogram was performed in all patients and described without a knowledge of the clinical features. All patients were explored for the clinically and myelographically relevant disc. When the myelogram was normal (16 patients) both lower lumbar interspaces were exposed. In 58 patients a herniated disc was revealed at surgery. Only "myelographic herniation" with indentation of the contrast column was accompanied by a high frequency of disc herniation at surgery (73-87%). In cases with normal myelograms only 5% had a disc herniation. The severity of the myelographic finding was clearly correlated to the frequency of positive surgical findings and good outcomes. The preoperative radiculogram gives a high degree of certainty in the preoperative evaluation whether a surgical lesion is present or not and reveals a precise prediction of the outcome of surgery.

Topics: Back Pain; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Prognosis; Prospective Studies; Sciatica; Spinal Nerve Roots

The long history of sciatica is recalled from the 18th century observations through the contributions of Lasègue (a philosopher who worked with Claude Bernard), Valleix, Brissaud, Dejerine, Sicard, Forestier, Alajouanine and Petit-Dutaillis. Two papers by professor de Sèze on the significance of herniations of lumbar disks were published in December 1939 and June 1940, a most unfavourable period in France. Since then many advances are to be recorded among which the use of metrizamide instead of the old lipiodol and, most of all, the advent of CT Scan.

Topics: France; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Intervertebral Disc; Intervertebral Disc Displacement; Iodized Oil; Italy; Lumbar Vertebrae; Metrizamide; Radiculopathy; Sciatica; Tomography, X-Ray Computed

In patients with lumbago-sciatica levomepromazine is a potent supplement to analgetics in pain treatment. The hypothesis that neuroleptics increase the risk of epileptic seizures after metrizamide myelography was not confirmed in a series of 77 patients, 26 with and 51 without levomepromazine medication, before and after lumbar metrizamide myelography. No differences existed between the groups with regard to the appearance of EEG abnormalities such as slow waves or spikes. Mild side effects were more frequent in the levomepromazine group, except nausea and vomiting. Lumbar metrizamide epidurography in 30 patients did not cause any abnormal EEG.

Topics: Drug Interactions; Electroencephalography; Headache; Humans; Methotrimeprazine; Metrizamide; Myelography; Nausea; Sciatica; Seizures; Time Factors

Topics: Absorption; Adolescent; Adult; Cerebrovascular Circulation; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Postmortem Changes; Sciatica; Subarachnoid Space

Topics: Back Pain; Humans; Lumbosacral Region; Metrizamide; Myelography; Sciatica

The development of metrizamide, a recent hydrosoluble contrast medium, has opened up the possibility of dynamic lumbosacral radicolugraphy, but in the opinion of the authors only the upright position is adequate to accentuate or reveal new pathological appearances. This was the case in 68 out of 100 consecutive radiculographies performed.

Topics: Back Pain; Humans; Lumbosacral Region; Metrizamide; Middle Aged; Radiography; Sciatica

Topics: Adult; Diagnosis, Differential; Female; Humans; Intervertebral Disc Displacement; Male; Metrizamide; Middle Aged; Myelography; Sciatica; Spinal Nerve Roots

This study of 75 anatomical specimens and their comparison with contrast metrizamide radiography of the terminal dural sac reveals the exact topography, height, volume and morphology of the dural sheath and for the nerve roots their disposition in the terminal sac, the level of the root emergence and anatomical and radiological views of the foramina above and below the emerging roots.

Topics: Cauda Equina; Dura Mater; Humans; Methods; Metrizamide; Radiography; Sciatica; Spinal Nerve Roots