Pantopaque Myelography: Diagnostic Errors and Review of Cases

Abstract

Numerous articles dealing with the use of Pantopaque in myelography have appeared in the medical literature in the past three years. While the more typical myelographic pictures due to rupture of the nucleus pulposus are easily recognizable, one occasionally encounters bizarre patterns whose interpretation is difficult. We wish to present some of these unusual patterns, to discuss common sources of error in diagnosis, and to review 215 Pantopaque myelograms. Of the 215 cases examined, 69 came to operation, and the myelographic findings will be compared with the preoperative diagnosis. Technic Site of Injection: In myelography for detection of a protruded disk in the lumbar region, the needle should not be introduced at the level of the suspected protrusion, since removal of the oil may be more difficult and defects due to the needle may resemble those due to a protruded disk. If we encounter a defect at the site of introduction of the needle, it is our practice to remove it, continue the fluoroscopic and ...