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KMID : 0376219820190040617
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Chonnam Medical Journal
1982 Volume.19 No. 4 p.617 ~ p.623
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Correlation of myelographic defects with operative findings in lumbar disc lesions.
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Abstract
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Myelography usually precedes surgery for lumbar disc lesion. Defects of the shape of the contrast material-filled lumbar thecal sac are common findings at myelography in patients with low back pain, but not all such deformities are due to disc lesions. An Over-all accuracy of myelography in the diagnosis of lumbar disc lesions ranges from 75% to 90%.
We attempted to find out some correlation between myelographic defects and operative findings by reviewing the size and shape of myelographic defects. The results of analysis of fifty-five patients whom we operated upon after lumbar myelography during the time interval from January, 1982 to December, 1982 were as follows
1. Lumbar discs occur predominantly in men (72.7%) between the age of twenties and forties, 75% at L4-5 level and 17.2% at L5-S1 level.
2. The size of myelographic defect, in general, was largest in case of axillary type of protruded disc and smallest in shoulder type of bulging disc.
3. Centrally located discs made blocking deformities in 72.7% of cases and hourglass defects less frequently.
4. Extruded or protruded discs produced wedge-shaped myelographic defects in 85.7% and 34.4% respectively but bulging discs appeared as smooth and round defects in 59% of cases.
5. Filling defects in A-P view of myelography were more accentuated by oblique views at the rate of 1.28 and it was more pronounced in case of small or no defect in A-P view.
6. False negative myelographic findings were noted in 5.5% of cases predominantly at L5-Sl level and false defects were produced in 11.1 %.
7. Configurations of affected root sleeves in A-P view of myelography were obliterated in 62. 2% of cases not related to the type of lumbar disc.
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KEYWORD
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