Summary
Five- and ten-millimeter-thick transverse axial computed tomography (CT) scans were obtained at lumbar disc spaces in 81 patients with suspected lumbar disc disease. Scans were obtained following metrizamide myelography. CT and myelography findings were compared and correlated with clinical and surgical findings. Postmyelography CT scan was superior to myelography in 68% since it was able to demonstrate even small herniations. It was especially valuable in the L5-S1 space where the wide epidural space can hide the disc herniation without it being demonstrated by myelography. Also other kinds of pathology which may simulate or complicate disc herniation were readily evaluated by postmyelography CT. Although noncontrast CT scans are usually diagnostic and sufficient, the improved anatomical details obtained by postcontrast CT scans, increase the diagnostic accuracy, and selected, complicated cases may need the CT study with intrathecal metrizamide.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gurdjian ES, Webster JE, Ostrowski AZ, Hardy WG, Lindmer GW, Thomas LM (1961) Herniated lumbar intervertebral dises. An analysis of 1117 cases. J Trauma 1:158–194
Tchang SPK, Howie JL, Kirkaldy-Willis WH, Paine KWE, Moola D (1982) Computed tomography versus myelography in diagnosis of lumbar disc herniation. J Canad Assoc Radiol 33:15–20
Di Chiro G, Schellinger D (1976) Computed tomography and spinal cord after lumbar intrathecal introduction of metrizamide (computer assisted myelography). Radiology 120: 101–104
Coin CG, Chan YS, Keranen V, Pennink M (1977) Computer assisted myelography in disc disease. J Comput Assist Tomogr 1:398–404
Arii H, Takahashi M, Tamakawa Y, Suzuki M, Shindo M (1980) Metrizamide spinal computed tomography following myelography. Comput Tomogr 4:117–125
Federle MP, Moss AA, Margolin FR (1980) Role of computed tomography in patients with “sciatica”. J Comput Assist Tomogr 4:335–341
Houghton V, Syvertsen A, Williams AL (1980) Soft tissue anatomy within the spinal canal as seen on computed tomography. Radiology 134:649–655
Braun IF, Lin JP, George AE, Kricheff II, Hoffmann JC (1984) Pitfalls in the computed tomographic evaluation of the lumbar spine in disc disease. Neuroradiology 26:15–20
Robersson GH, Taveras JM, Tadmore R, Kleefeld J, Ellis G (1977) Computed tomography in metrizamide cisternography. Importance of coronal and axial views. J Comput Assist Tomogr 1:241–245
Coin CG, Coin JT (1981) Computed tomography of cervical disc disease. Technical considerations with representative case reports. J Comput Assist Tomogr 5:275–280
Williams AL, Houghton VM, Syvertsen A (1980) Computed tomography in the diagnosis of herniated nucleus pulposus. Radiology 135:95–99
Lansche WE, Ford LT (1960) Correlation of the myelogram with clinical and operative findings in lumbar disc lesions. J Bone Joint Surg 42:193–206
Oliver L (1963) Multiple lumbar disc protrusions. Proc R Soc Med 56:807–809
Hudgins WR (1970) The predictive value of myelography in the diagnosis of ruptured lumbar discs. J Neurosurg 42: 152–162
Hintselberger WE, Witten RM (1968) Abnormal myelogram in asymptomatik patients. J Neurosurg 28:204–206
Ghormley RK (1933) Low back pain with special reference to the articular facets with presentation of an operative procedure. JAMA 101:1773–1777
Badgley CE (1941) Articular facets in relation to low back pain and sciatic radiation. J Bone Joint Surg 23:481–496
Mooney V, Robertson J (1976) The facet syndrome. Clin Orthop 115:149–156
Carrera GF, Houghton VM, Syvertsen A, Williams AL (1980) Computed tomography of the facet joints. Radiology 134: 145–148
Meyes GA, Houghton VM, Williams A (1979) Diagnosis of herniated lumbar disc with computed tomography. N Engl J Med 301:1166–1167
Burton C (1979) Computed tomographic scanning and the lumbar spine. Spine 4:355–363
Glenn WV Jr, Rhodes ML, Altschuler EM, Wiltse LL, Kostanke C, Kuo YM (1979) Multiplanar display computerized body tomography applications in the lumbar spine. Spine 4: 282–359
Houghton VM, Eldevik OP, Magnaes B, Amundsen P (1982) A prospective comparison of computed tomography and myelography in the diagnosis of herniated lumbar disc. Radiology 142:103–110
Nebel G, Dihlman W, Lingg G, Hering L (1981) Computed tomography in the diagnosis of prolapsed intervertebral disc. Eur J Radiol 1:158–162
Dublin AB, McGahan JP, Reid MH (1983) The value of computed tomographic metrizamide myelography in the neuroradiological evaluation of the spine. Radiology 146:79–86
Gyldensted C, Ketonen L (1981) Lumbar disc disease evaluated by myelography and spinal computed tomography. Paper presented at the Annual Meeting of the Scandinavian Society of Neuroradiology, Turku, Finland, August 11–12
Fries JW, Abodeely DA, Vijungco JG, Yeager VL, Gaffey WR (1982) Computed tomography of herniated and extruded nucleus pulposus. J Comput Assist Tomogr 6:874–887
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ketonen, L., Gyldensted, C. Lumbar disc disease evaluated by myelography and postmyelography spinal computed tomography. Neuroradiology 28, 144–149 (1986). https://doi.org/10.1007/BF00327887
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00327887