Pantopaque (ethyl iodophenyl undecylate) intravasation during myelography

Summary Pantopaque has been used for myelography all over the world since 1944. Twenty-four cases of intravasation of the dye have been reported in the literature. We have recently encountered this complication in a young man.     

CT平扫诊断颈椎间盘膨出或突出症的局限性（附72例分析）

目的 探讨ＣＴ平扫诊断颈椎间盘膨、突出症的限度。方法 收集７２例做颈椎间盘ＣＴ平扫的病例，根据诊断结果进行分析。结果 ＣＴ平扫诊断颈椎间盘膨、突出症阳性率仅为４．２％（３／７２）。诊断骨质增生４７．２％（３４／７２），阴性占４８．６％（３５／７２）。结论 当ＣＴ平扫异常或诊断与临床表现不相符时，ＣＴＭ能提高正确诊断率。     

Extra dural arachnoid cyst: case report

Extradural arachnoid cysts are uncommon expanding lesions in the spinal canal, which may communicate with the subarachnoid space. Usually located in the lower thoracic spine, they may cause symptoms by compressing the spinal cord or nerve roots. We report a case of an extradural thoracic arachnoid cyst revealed by progressive spinal cord compression. CT myelography and MRI enabled diagnosis. Rapid neurological improvement was observed after surgical resection.     

Preoperative localization of herniated thoracic discs using myelo-CT guided transpleural puncture: technical note

Objective In recent years, video-assisted thoracoscopic microdiscectomy has gained acceptance as a minimally invasive, safe, and efficient technique suited for herniated thoracic discs from T4T5 until T11T12. However, correct localization is difficult and wrong level exploration is an ever-present threat. We present a reliable and time-efficient localizing technique.Materials and methods In 86 consecutive cases, 1 day preoperatively intrathecal contrast was administered and a computed tomography (CT) scan was performed in prone position. Using local anesthesia, a hollow needle was advanced above the corresponding rib and through the pleura. The inner wire and corresponding pathological level were easily identified endoscopically.Conclusion Myelo-CT provides detailed anatomical information, which is often helpful in determining the side of operative approach and the extent of bone removal needed. Needle localization obviates fluoroscopy, saves OR time, and allows the surgeon to focus on the technically demanding procedure. Furthermore, it is a relatively simple and safe technique.     

不同类型退变性腰椎管狭窄症的手术治疗

目的 通过对不同类型退变性腰椎管狭窄症手术方法的选择，提高手术治疗的疗效。方法回顾性分析2001年9月～2004年1月收治退变性腰椎管狭窄症患者96例，其中男85例，女11例。年龄39～71岁，平均54岁。病程3个月～7年。根据患者临床症状、体征及脊髓造影检查，分为5组，A组：1个节段椎间管狭窄，39例，行椎板间开窗椎间管（侧隐窝、神经根管）潜行扩大术；B组：1个节段中央椎管狭窄，21例，行椎板间开窗椎间盘摘除，椎间管潜行扩大术；C组：1个节段退行性脊柱滑脱，18例，行两侧椎板间开窗减压潜行扩大椎管后椎弓根钉系统内固定（AF、RF等）并横突间、小关节间植骨；D组：2个以上节段混合型椎管狭窄，ll例，行病变节段两侧开窗潜行扩大椎管，切除黄韧带，摘除椎间盘，松解神经根；E组：退行性脊柱侧突，7例，综合以上减压措施行椎弓根钉棒系统矫形内固定后外侧植骨。随访并评价其疗效。结果96例患者获随访6～36个月，平均12．2个月，未出现手术并发症。JOA评分优85例、良9例、中1例、差1例；X线片复查无椎弓根钉误置、断钉、拔出等。结论退变性腰椎管狭窄症的治疗采取有限化手术、有效化减压原则可减少并发症，提高疗效。脊髓造影对退变性腰椎管狭窄症的手术方式选择有重要价值。     

脊髓造影对腰骶神经根管狭窄的诊断意义

本文报告23例退行性腰骶神经根管狭窄的病例，应用脊髓造影作定位诊断。本组23例腰椎CT均无发现明显椎间盘突出和中央椎管狭窄。行脊髓造影检查显示不同程度腰骶神经根受压，受累节段的神经根管狭窄程度经手术证实。造影与手术发现的符合率为％％％。结论：脊髓造影可显示腰骶神经根在整个神经根管的形态特点，是对腰骶神经根管狭窄有效而经济的诊断方法。     

Spinal lesions simulating hip joint disorders

Summary In three patients pain in the groin and thigh which was initially attributed to either a malfunctioning hip prosthesis or osteoarthritic hip, was shown to arise in the spine. All patients had positive myelograms and one had electromyographic evidence of nerve root compression. Referred pain from the spine must always be considered in the differential diagnosis of pain thought to be arising from a hip replacement.     

Application of multi-detector row helical scanning to postmyelographic CT

The advent of a multi-detector row helical CT has made it possible to attain images over a broader area with good spatial resolution. We assessed whether postmyelographic CT scans obtained using this system provided more information than conventional imaging techniques. Postmyelographic CT scans were preoperatively obtained in 46 patients using a multi-detector row helical CT system. Reconstructed images in the sagittal and coronal planes in all patients and curved reformation images along the dural sac in 37 patients were compared with myelograms and conventional postmyelographic CT scans. In 34 patients comparison was also made with MR images. The multi-detector row CT images demonstrated deformities of the dural sac more clearly than the other modalities in 39 of the 46 patients. They also provided the best visualization of nerve root abnormalities in 24 of the 46 patients and clearly revealed the presence of spurs in all 22 patients with spinal canal stenosis. Postmyelographic CT scans made using a multi-detector row helical CT system provide more information on the dural sac, nerve sleeves, and their contents than other imaging techniques. Electronic Publication