Summary
In reports of diagnostic methods in disorders of the spine focus is centred on diagnostic resolution, while psychological effects and patients' discomfort are often disregarded. To get a comprehensive picture of the appropriateness of a new technology the latter factors need to be explored and included in an assessment.
In a prospective study, eight patients with signs of lumbar disc herniation underwent myelography, computed tomography and magnetic resonance imaging. A structured patient interview on attitudes to these technologies was carried out after all three examinations had been carried out.
Myelography was most often reported painful and unpleasant among the three modalities. Discomfort due to magnetic resonance imaging stem from the narrow calibre of the machine and the noise. In computed tomography immobilization was the main reason for discomfort. Altogether most patients preferred computed tomography.
In view of the fact that myelography must be considered as diagnostically inferior to the other two examinations, the reported discomfort from myelography indicates that computed tomography and magnetic resonance imaging should be the primary examinations for patients with lumbar disc herniation.
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References
Assessing Medical Technologies, Washington DC (1985) National Academy Press
Albeck MJ, Hilden J, Kjaer L, Hollås S, Praestholm J, Henriksen O, Gjerris F (1995): A controlled comparison of myelography, computed tomography and magnetic resonance imaging in clinically suspected lumbar disc herniation. In press
Brody DS (1980) The patient's role in clinical decision-making. Ann Int Med 93: 718–722
Hauge O, Falkenberg H (1982) Neuropsychologic reactions and other side effects after metrizamide myelography. AJNR 3: 229–232
Herkowitz HN, Romeyn RL, Rothman RH (1983) The indications for metrizamide myelography. Relationship with complications after myelography. J Bone Joint Surg Am 65: 1144–1149
Hopper KD, Houts PS, McCauslin MA, Matthews YL, Sefczek RJ (1992) Patients' attitude toward informed consent for intravenous contrast media. Invest Radiol 27: 362–366
Hudgins WR (1970) The predictive value of myelography in the diagnosis of ruptured lumbar discs. J Neurosurg 32: 152–162
Jackson RP, Cain JE Jr, Jacobs RR, Cooper BR, McManus GE (1989) The neuroradiographic diagnosis of lumbar herniated nucleus pulposus: II. A comparison of computed tomography (CT), myelography, CT-myelography, and magnetic resonance imaging. Spine 14: 1362–1367
Maravilla KR, Lesh P, Weinreb JC, Selby DK, Mooney V (1985) Magnetic resonance imaging of the lumbar spine with CT correlation. AJNR 6: 237–245
Mixter WJ, Barr JS (1934) Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 211: 210–215
Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell C (1986) Lumbar herniated disk disease and canal stenosis: prospective evaluation by surface coil MR. CT, and myelography. AJR 147: 757–765
Sand T (1989) Which factors affect reported headache incidences after lumbar myelography. A statistical analysis of publications in the literature. Neuroradiology 31: 55–59
Seigel RS, Williams AG, Waterman RE (1982) Potential complications in myelography. I. Technical considerations. AJNR 3: 65–68
Sensky T, Catalan J (1992) Asking patients about their treatment. Editorial. BMJ 305: 1109–1110
Skalpe IO, Amundsen P (1975) Lumbar radiculography with metrizamide. Radiology 115: 91–95
Skalpe IO, Thorbergsen T, Amundsen P, Presthus J (1973) Lumbar myelography with metrizamide. Acta Radiol [Suppl] 335: 367–379
Stevenson GW, Norman G, Frost R, Somers S (1991) Barium meal or endoscopy? A prospective randomized study of patients preference and physician decision making. Clinical Radiology 44: 317–321
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This study is supported by the Vigo and Katrine Skovgaard Foundation, and the Danish Hospital Foundation, Region of Copenhagen, Greenland and the Faroe Islands.
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Albeck, M.J., Danneskiold-Samsøe, B. Patient attitudes to myelography, computed tomography and magnetic resonance imaging when examined for suspected lumbar disc herniation. Acta neurochir 133, 3–6 (1995). https://doi.org/10.1007/BF01404939
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DOI: https://doi.org/10.1007/BF01404939