MYELOGRAPHIC EVALUATION OF NON-TRAUMATIC SPINAL-CANAL OBSTRUCTION - NEW APPROACH

A new technique simplifies the evaluation of the spinal canal above obstructing lesions encountered during myelography via the lumbar route. After the demonstration of a block with 2-4 ml Pantopaque, a second injection of 2-4 ml Pantopaque is made through the lumbar needle with the patient in 45° Trendelenberg (or any degree necessary to keep the initial contrast bolus against the inferior margin of the obstruction). In all 10 cases in this series, the second injection easily displaced contrast around and above obstructions that could not be overcome by gravity thereby obviating a lateral cervical or cisternal puncture. No technical failures or complications were encountered. The method is not recommended in cases of traumatic spinal canal obstruction.