metrizamide and Spinal-Diseases

The sensitivity of magnetic resonance imaging (MRI) to tissue alterations is particularly useful in spinal cord imaging. In addition to excellent anatomic display of this compact and complex area, syrinx cavities, tumors, and degenerating disks can be identified before they cause the anatomic distortion often necessary for detection by conventional means.

Topics: Astrocytoma; Bone Marrow Diseases; Brain Diseases; Ependymoma; Humans; Intervertebral Disc Displacement; Lipoma; Magnetic Resonance Spectroscopy; Meningeal Neoplasms; Metrizamide; Myelography; Neurofibroma; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases; Spinal Injuries; Spine; Syringomyelia; Tomography, X-Ray Computed

Topics: Adult; Aged; Arteriovenous Malformations; Cervical Vertebrae; Female; Humans; Joint Dislocations; Ligaments; Male; Metrizamide; Microsurgery; Middle Aged; Myelography; Ossification, Heterotopic; Spinal Cord; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases; Syringomyelia; Tomography, X-Ray Computed

Topics: Humans; Injections, Spinal; Metrizamide; Myelography; Radiographic Image Enhancement; Spinal Cord; Spinal Cord Diseases; Spinal Diseases; Spine; Tomography, X-Ray Computed

Topics: Arteriovenous Malformations; Child; Child, Preschool; Contrast Media; Histiocytosis, Langerhans-Cell; Humans; Infant; Metrizamide; Neural Tube Defects; Neuroblastoma; Rhabdomyosarcoma; Spinal Cord; Spinal Diseases; Spinal Injuries; Spine; Tomography, X-Ray Computed

A randomized double blind study with iohexol (Omnipaque) and metrizamide (Amipaque) in cervical myelography was performed in 50 patients, 29 with iohexol and 21 with metrizamide. The myelographies were performed either with lumbar or with C1-C2 puncture in about equal groups, using 300 mg I/ml and 240 mg I/ml of the contrast media respectively. The image quality was equal with both contrast media, excellent in about 4/5 and good in 1/5 of the examinations. Subjective side effects were twice as frequent with metrizamide as with iohexol. The most frequent side effect was headache, occurring in 34% with iohexol and in 67% with metrizamide. Altogether 24% or the patients had EEG changes after iohexol as compared to 47% after metrizamide. All EEG changes were slight dysrythmia-except in three patients with spike activity after metrizamide. These were the only ones with mental reactions as well. It can be concluded that in this trial iohexol was better suited for cervical myelography than metrizamide.

Topics: Adult; Aged; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Electroencephalography; Female; Humans; Iodobenzoates; Iohexol; Male; Metrizamide; Middle Aged; Myelography; Spinal Diseases; Triiodobenzoic Acids

Recognizing that not all patients with low back pain have lumbar disc disease, the authors began to inject facet joints in June 1982 and have experience now with 21 patients, each injected under fluoroscopic control with a mixture of local anesthetic and steroid. One technical problem occurred when large osteophytes blocked access to the facet joints. Otherwise, there were no complications and minimal morbidity. Most patients (15 of 20; 75%) had an initial response, but a much smaller number (six of 18 followed more than three months; 33%) had a lasting response. Repeat injections, when done, always led to temporary improvement but rarely to lasting relief (one of five; 20%). Three factors characterized the patients: a negative screening examination for other causes of back pain or sciatica; back pain with tenderness localized over one or more facet joints; and radiologic changes of degenerative joint disease within the facet joints. Facet joint disease may be a significant cause of low back pain. The above three criteria are useful in clinical identification of patients with this problem. Facet joint injections play an important role in the diagnosis and treatment of low back pain.

Topics: Adult; Aged; Back Pain; Female; Follow-Up Studies; Humans; Injections, Intra-Articular; Lidocaine; Male; Metrizamide; Middle Aged; Radiography; Spinal Diseases

Outpatient metrizamide cervical and lumbar myelography complimented by CT scanning is a safe and effective method of assessing the contents of the neural canal. By minimizing the dose of metrizamide and using a small needle, the incidence of side effects is reduced. The techniques of needle insertion metrizamide injection and radiography as well as pre- and post procedure care are described in detail.

Topics: Adult; Aged; Ambulatory Care; Evaluation Studies as Topic; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Diseases; Tomography, X-Ray Computed

CT has become the imaging modality of choice for diagnosing the specific cause of low back pain syndrome. This article describes and illustrates those abnormalities commonly associated with low back pain: disk herniation, spinal stenoses, facet joint abnormalities, spondylosis, inflammatory conditions of the lumbar spine, and sacroiliitis.

Topics: Adolescent; Aged; Back Pain; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Metrizamide; Sacroiliac Joint; Spinal Diseases; Spinal Stenosis; Spondylolisthesis; Spondylolysis; Tomography, X-Ray Computed

A rare case of intrasacral perineurial cyst is presented. Findings on metrizamide myelography and computed tomography scan are described, and their usefulness in the diagnosis of this rare condition is emphasized. The literature is reviewed, and the clinical and pathological features of the 17 reported cases including our own are summarized. Indication for operation and surgical approach are briefly discussed.

Topics: Adult; Cysts; Female; Humans; Laminectomy; Metrizamide; Myelography; Sacrococcygeal Region; Spinal Diseases; Spinal Nerve Roots; Tomography, X-Ray Computed

Computed tomography is an extremely valuable adjunct to the evaluation of the cervical spine and spinal cord. When combined with intrathecal metrizamide enhancement and with computer reformatted images in sagittal and coronal planes, CT is a thorough diagnostic modality that can be applied to congenital/developmental, degenerative, and trauma-induced abnormalities. Its major deficiency is the potential to miss defects that are oriented in the transverse plane because of partial volume averaging of adjacent surrounding bone. CT scanning of the cervical spine has been used sparingly to date, probably because available scanners are used for higher-priority demands. However, anecdotal information in the literature document the value of CT in evaluations of the cervical spine, intervertebral disks, neural foramina, and spinal cord. In the future, magnetic resonance scanners may shift some of the imaging burden away from x-ray CT. More widespread use of CT for evaluation of cervical radiculopathies and myelopathy may then occur.

Topics: Adult; Cervical Vertebrae; Child; Fractures, Bone; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Spinal Diseases; Spinal Stenosis; Tomography, X-Ray Computed

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.

Topics: Aged; Brain; Humans; Iodobenzenes; Iophendylate; Iothalamic Acid; Male; Meglumine; Meningitis; Metrizamide; Middle Aged; Myelitis; Myelography; Sorbitol; Spinal Cord; Spinal Diseases

The paper presents a method of carrying out cervical myelography by lateral C1/C2-puncture (LCP) using a conventional fluoroscopic device with an image-intensifying TV-chain. The patient is deposited on a specially designed transverse table. The amount of time and picture-quality are equale to those for costly special apparatus.

Topics: Cervical Vertebrae; Fluoroscopy; Humans; Metrizamide; Myelography; Radiographic Image Enhancement; Spinal Diseases; Spinal Stenosis

Five cases of intradural arachnoid cysts were reported. Two rare cases were in cervical region, other three cases in thoracic region. Clinical and radiological findings were discussed in 67 cases including ours. All our cases with chronic clinical course except one showing spastic para- or tetraparese, sensory disturbance and gait disturbances were not much different to other reported cases in neurological findings. Plain radiography, tomography and intravenous enhanced CT were not effective. In all of the cases spinal CT was performed following metrizamide myelography. Only one cyst failed to detect during metrizamide myelography, but a metrizamide CT revealed the intradural arachnoid cyst even in this case. Vonofakos says that metrizamide myelogram failed to found the arachnoid cysts, however, we could confirm them by performing metrizamide CT about 3 hours after conventional myelography. Moreover reconstruction technique was very effective in ascertaining the shape and the extention of the tumors. Especially it is recommended to do delayed metrizamide CT with ReView technique in order to show the detailed relation between the cyst and the spinal cord. In conclusion, we emphasize the accurate neurological examination, the importance of total myelography and the improvement of fluoroscopic technique in myelography and CT scanning.

Topics: Adult; Aged; Arachnoid; Cysts; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Diseases; Tomography, X-Ray Computed

The specificity of the intraarticular facet block as a diagnostic test for facet joint disease is currently unknown. Capsular rupture with epidural and periarticular diffusion is probably responsible for many false positive findings. We found a comparatively low success rate of the procedure in 25 patients in whom maximal volumes were strictly controlled to avoid extravasation.

Topics: Adolescent; Adult; Aged; Female; Humans; Intervertebral Disc; Joint Diseases; Lidocaine; Lumbar Vertebrae; Male; Metrizamide; Middle Aged; Nerve Block; Radiography; Spinal Diseases

Topics: Adolescent; Adult; Aged; Female; Humans; Intervertebral Disc; Lumbar Vertebrae; Male; Metrizamide; Middle Aged; Myelography; Nerve Compression Syndromes; Spinal Diseases

Topics: Brain Diseases; Confusion; Electroencephalography; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Diseases

Topics: Humans; Metrizamide; Myelography; Posture; Spinal Diseases; Spinal Stenosis

Topics: Adolescent; Adult; Aged; Cervical Vertebrae; Contrast Media; Female; Humans; Iopamidol; Iothalamic Acid; Male; Metrizamide; Middle Aged; Myelography; Neck; Spinal Cord Diseases; Spinal Diseases

The diagnostic value of plain film metrizamide myelography (PFMM) was compared with computed tomographic metrizamide myelography (CTMM) in a study of 106 individuals who had undergone high-resolution computed tomographic scanning of the spine. CTMM provided more significant information than PFMM in 42 of 106 cases (40%), but showed no advantage over PFMM in 63 of 106 cases (59%). In 19 of the 42 cases (45%), PFMM was useful in directing the CT analysis to the appropriate region of pathology. In one patient, PFMM revealed a mobile herniated disc that had not been visualized with CTMM. In 30 of 106 cases in which plain CT scans of the spine were also obtained, the addition of intrathecal metrizamide demonstrated additional pathology in ten individuals. In general, CTMM was useful in the delineation of a variety of pathologic entities, especially neoplasms and congenital abnormalities. Low-dose CTMM (3 ml of a 150 ml/mg concentration) was performed as an outpatient procedure and found to be a useful adjunct to plain CT in two patients. A schema for the radiological evaluation of pathology of the spine is presented.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Intervertebral Disc Displacement; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Diseases; Spinal Diseases; Tomography, X-Ray Computed

Arthrography was performed during steroid injection in 14 patients (22 joints) with noninflammatory conditions of the cervical facet joints. Two isolated spines were also studied. The capsular recesses were found to be quite large, especially near the intervertebral foramen. Though the appearance of the arthrogram was not clinically useful, it was helpful in positioning the needle for the steroid injection and confirming that the joint in question was abnormal. Distension of the capsule provoked pain in about 50% of cases; rupture of the distended capsule was rare but could account for leakage into the epidural space or foramen. Nine patients had significant relief of pain for three days to thirteen months.

Topics: Adult; Arthrography; Cervical Vertebrae; Diatrizoate Meglumine; Female; Humans; Male; Metrizamide; Middle Aged; Pain; Spinal Diseases

Topics: Adult; Arnold-Chiari Malformation; Child; Humans; Male; Metrizamide; Neck; Spinal Diseases; Spinal Injuries; Syringomyelia; Tomography, X-Ray Computed

Topical diagnostic problems in cases of chronic cervical myelopathy in correlation with cervical spinal stenosis are pointed out. The importance for technically perfect myelography with Amipaque in order to enable thorough and most precise diagnosis is stressed.

Topics: Cervical Vertebrae; Constriction, Pathologic; Humans; Metrizamide; Myelography; Spinal Cord Compression; Spinal Diseases

Topics: Aged; Arachnoiditis; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Diseases; Spinal Puncture

Topics: Adult; Aged; Calcinosis; Female; Humans; Iophendylate; Ligaments; Male; Metrizamide; Middle Aged; Myelography; Polyradiculoneuropathy; Spinal Diseases; Thoracic Vertebrae; Tomography, X-Ray Computed

Reportedly, ossification of the posterior longitudinal ligament (OPLL) usually involves the cervical spine and often accompanies other ligamentous ossification such as diffuse idiopathic skeletal hyperostosis (DISH). It is considered serious because it sometimes causes severe radiculomyelopathy; however, the present study, based on a fixed population sample, revealed that OPLL of the thoracic spine is nearly always asymptomatic. The prevalence of thoracic OPLL was 0.6%, with three times as many women as men being affected, compared with cervical OPLL which occurs predominantly among men. No marked radiculomyelopathy was observed, nor definite evidence of neurological involvement due to thoracic OPLL. DISH was rare, especially among women.

Topics: Adult; Aged; Calcinosis; Female; Follow-Up Studies; Humans; Japan; Ligaments; Male; Metrizamide; Middle Aged; Myelography; Nuclear Warfare; Radiation Injuries; Spinal Diseases; Thoracic Vertebrae; Tomography, X-Ray Computed

Topics: Contrast Media; Ependymoma; Humans; Iopamidol; Iothalamic Acid; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Spinal Cord Diseases; Spinal Cord Neoplasms; Spinal Diseases

Total myelography with metrizamide at a concentration of 270 mgI/ml was carried out via lumbar puncture in 170 consecutive patients. Good opacification and/or diagnostic value was obtained in the lumbar, thoracic and cervical region at 88.8%, 77.6% and 72.4% respectively. Unsatisfactory results were mostly due to the poor technique of physicians and x-ray technicians. Also it was inadequate to perform this study in some lesions, such as ruptured arterio-venous malformation and occification of posterior longitudinal ligament. Several cases with previous oil myelography showed poor results, because the remaining of Myodil disturbed a good spreading of the newly injected media. It was requested to evacuate oily contrast media prior to metrizamide myelography. One of the most important clues to a successful myleography was to make dilusion of contrast media as little as possible, and the use of high concentration of metrizamide (250-270 mgI/ml) seemed to be tolerated. It was also important to avoid excessive movement of the patient and the rapid transit of the contrast media to the level of interest. It was recommended to study the entire spinal subarachnoid space as a whole. In sixty-three patients out of 170, one or more abnormal myelographical findings were detected at unexpected level. Immediately after the examination the patients were encouraged to drink a large quantity of diuretic beverages such as tee, juice or coffee for the purpose of reducing side effects. As Potts and coworkers and Eldevik and associates reported, it was recognized that the overhydration could reduce the severe side effects after the metrizamide myelography.

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Diseases; Spinal Diseases

Topics: Cervical Vertebrae; Humans; Metrizamide; Myelography; Spinal Cord Diseases; Spinal Diseases; Technology, Radiologic

A double-blind study was performed on 20 patients comparing the safety and efficacy of Iopamidol and Metrizamide in cervical myelography. The radiographic qualities of the Iopamidol and Metrizamide examinations were equivalent when using the same volume (12 to 13 ml), concentration (200 mg I/ml), and a C1-2 route of administration. The performance of a CT scan on selected patients in specified areas of interest provided additional diagnostic information in some patients (e.g syringomyelia, degenerative spondylosis). The adverse reactions were mild in the Iopamidol group with 4 of the 10 patients experiencing no adverse reactions. The more severe reactions, including disorientation, agitation, dysarthria, asterixis, hyperreflexia and EEG abnormalities were limited to the Metrizamide group with one or more occurring in 2 of the 10 patients studied. Only one Metrizamide patient experienced no adverse reactions. In this study containing a limited number of patients, Iopamidol was shown to be a diagnostically effective and safer contrast medium for performing cervical myelography.

Topics: Chemical Phenomena; Chemistry; Double-Blind Method; Humans; Iopamidol; Iothalamic Acid; Metrizamide; Myelography; Spinal Cord Diseases; Spinal Diseases

Ten symptomatic patients with skeletal abnormalities of varying etiology at the craniovertebral junction were studied with gas or metrizamide myelography. The type of compressive pathology was accurately delineated by these techniques. The surgical approach was determined by the findings on the myelograms.

Topics: Adolescent; Adult; Aged; Cervical Vertebrae; Child; Female; Humans; Hypophosphatemia, Familial; Male; Metrizamide; Middle Aged; Mucopolysaccharidosis IV; Myelography; Spinal Cord Compression; Spinal Diseases

Topics: Adult; Aged; Cervical Vertebrae; Coma; Confusion; Epilepsy, Tonic-Clonic; Female; Hemiplegia; Humans; Intervertebral Disc Displacement; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Diseases; Spinal Diseases

The non-ionic water-soluble contrast medium Amipaque (metrizamide) shows a lowered neurotoxicity, and therefore it may be used in the entire spinal canal. The better visibility of fine structures compared with oily and gaseous contrast media allows an excellent diagnostic approach to all spinal affections. Our technique of myelography is described and typical examples are given.

Topics: Adolescent; Atrophy; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Meningomyelocele; Metrizamide; Myelography; Spina Bifida Occulta; Spinal Cord; Spinal Cord Neoplasms; Spinal Diseases

Either EMT Head Scanner, CT 1010 (slice thickness 10mm) or EMI Body Scanner, CT 5005 (slice thickness 13mm) was used. The concentration of metrizamide was 170-250 mgI/microliter and the amount was 7-10 microliters. Either lumbar puncture or lateral C puncture was made.. 26 cases were included in this study. 1) disc disease: 11 cases, 2) spinal cord tumor: 6 cases, 3) Arnold-Chiari malformation: 3 cases, 4) atlantoaxial dislocation: 3 cases, 5) ossification of the posterior longitudinal ligament (associated with ossification of the ligamentum flavum): 2 cases (1 case), 6) spinal foreign body (acupuncture needle): 1 case.. 1) CT metrizamide myelography visualizes the subarachnoid space and makes it possible to know the lesion in the spinal canal in relation to the spinal cord in transverse plane. 2) It is difficult to determine the exact level of the lesion in axial plane. 3) The present technique does not allow to visualize the root sleeves. 4) It is difficult to delineate a compression of the subarachnoid space by small localized lesions (esp., disc diseases) due to overlapping the patent adjacent subarachnoid space within a slice 10 mm to 13 mm thick.

Topics: Astrocytoma; Humans; Meningeal Neoplasms; Meningioma; Metrizamide; Myelography; Neurilemmoma; Spinal Cord Neoplasms; Spinal Diseases; Tomography, X-Ray Computed

Amipaque (Metrizamide) when injected intrathecally, acts as a drug which may cause side effects and even complications. The adverse effects depend on the amount and concentration of the medium which reach the surface of the brain. The examination of the cervical area carries a risk that undiluted contrast material escapes into the cranial cavity. Knowledge of physical, physiological and pathophysiological properties of the medium is mandatory for proper management of the examination. Careful evaluation of the patient and the diagnostic problem and correct technique of cervical myelography gives perfect diagnostic information, minimal side-effects and no risk of serious complications.

Topics: Contrast Media; Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Neurilemmoma; Osteoarthritis; Retrospective Studies; Spinal Cord Neoplasms; Spinal Diseases; Syringomyelia

Topics: Adult; Aged; Humans; Metrizamide; Middle Aged; Myelography; Spinal Diseases; Subarachnoid Space

Topics: Adult; Epilepsies, Myoclonic; Female; Humans; Metrizamide; Myelography; Seizures; Spinal Diseases

Topics: Bone Diseases; Chondrocalcinosis; Humans; Metrizamide; Muscular Diseases; Spinal Diseases; Tomography, X-Ray Computed

The authors present a function myelography with Amipaque (Metrizamide) as a basic condition for an optimum radiologic-morphological analysis of spondylogenous cervical syndromes. This permits a systematic use of the actual operative possibilities (modified ventral fusion procedures, dorsal compression-lowering interventions).

Topics: Humans; Intervertebral Disc Displacement; Metrizamide; Myelography; Spinal Diseases; Spinal Osteophytosis

The results of 65 consecutive lumbar epidurograms obtained with metrizamide are reviewed. A pure Seldinger technique with a caudal approach through the sacral notch and selective nerve root sheath injection affords the best technical results. Lumbar epidurography serves as an important radiographic procedure in the evaluation of patients with equivocal myelography and/or confusing or nondiagnostic physical findings. It is particularly valuable in patients with a wide ventral epidural space secondary to previous surgery, arachnoiditis or congenital condition. This situation occurs most commonly at the L5-S1 disk space.

Topics: Epidural Space; Humans; Intervertebral Disc; Intervertebral Disc Displacement; Methods; Metrizamide; Radiography; Spinal Canal; Spinal Diseases

Topics: Humans; Intervertebral Disc; Metrizamide; Myelography; Spinal Diseases; Spinal Neoplasms; Spinal Nerve Roots

Topics: Arachnoiditis; Chronic Disease; Edetic Acid; Humans; Metrizamide; Spinal Diseases

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.

Topics: Animals; Arachnoiditis; Disease Models, Animal; Haplorhini; Iothalamate Meglumine; Methylprednisolone; Metrizamide; Myelography; Spinal Diseases

Cervical myelography by means of lumbar application of metrizamide was performed on 110 patients. The exploration technique, the results, the quality of the myelograms, and the side effects observed are discussed. The most frequent complaint was headache. There were also cases of vertigo, vomitus, pain in the back and legs, and one case of tachycardia. Complications of a more serious nature, in particular epileptic seizures, did not occur.

Topics: Adolescent; Adult; Aged; Female; Humans; Lumbosacral Region; Male; Metrizamide; Middle Aged; Myelography; Neck; Spinal Diseases

We have taken myelograms of six patients with grave post-tuberculous thoracic gibbus of the spine and gross deformity of the thoracic cage. Two of these patients suffered violent convulsions and fracture of the neck of the femur. In one patient the myelogram was taken with Conray Meglumine and in another with Dimer X. We suggest that a grave deformity of the thoracic cage is a relative contraindication for lumbar myelography with these water-soluble contrast media. We assume that the reduced tissue oxygenation in these patients results in a lower threshold for convulsions.

Topics: Femoral Neck Fractures; Humans; Iothalamate Meglumine; Metrizamide; Myelography; Seizures; Spinal Diseases; Spine