Myelography in spinal disorders - experience of 1400 cases

ABSTRACT

To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with clinical presentation of the patients. Patients selected for myelography had presented with history of various spinal disorders such as low backache, neurogenic claudication, paraparesis or paraplegia, quadriparesis or quadriplegia, trauma to spinal region and infective spondylitis. Patients excluded were those with history of allergies to iodinated contrast agents, seizures coagulopathy and pregnant women. Contrast agent was water soluble non ionic agent - Iohexol. Spinal Needles used were of 20,22 and 25 gauge. X-Ray machine with tilltable table was used for myelography. There were 1400 patients of whom 935 were males and 465 females with male to female ratio of 2.1. Age range was 8 to 65 years. Spinal disorders diagnosed on myelography were lumbar disc prolapse 866 [60%] cases, lumbar canal stenosis 113 [8%], thoracic disc protrusions 15 [1%], infective spondylitis 53 [4%] cases, spinal tumors 36 [2.5%], spinal dysraphism 28 [2%] and traumatic spine in 85 [6%] cases. Free flow of contrast agent with no block was found in 149 [10.64%] cases. These were subjected for MRI scan which revealed significant pathological lesion of surgical importance in 23 cases [1.64%] only. Myelography is the least expensive valuable diagnostic test in spinal disorders specially in lumbar disc prolapses and lumbar canal stenosis