Cervical computerized tomographic myelography (CTM) has been performed in 99 patients who were suspected as having various diseases in the cervical portion. After making a comparison between the results of CTM with those of water-soluble myelography and neurologic examination, the author could have the conclusion as follows:
1. Because bones and soft tissues of both shoulders make artifacts on cervical plain CT, the clearance of image is low and the diagnostic value is very poor, especially in the lower cervical portion.
2. Metrizamide, iopamidol and iohexol were used as water-soluble contrast media, but the side effects such as headache and nausea were less in iopamidol and iohexol.
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3. C1C2 puncture showed clear image with less amount of contrast media than lumbar route as the route of administration of contrast media for cervical myelography and CTM.
4. The author experienced that no or inadequate amount of cerebrospinal fluid was observed although C1C2 puncture was correctly performed. In such a case, cervical myelography should be done via lumbar route in stead of C1C2 puncture in
s the conviction that tumor mass or adhesive arachnoiditis was placed near C1C2 portion.
5. Recently, CTM is recognized as the best method to diagnose the cervical cord diseases except nuclear magnetic imaging. And the diagnostic accuracy is more increased if cervical myelography and CTM are complementally used.
6. C1C2 puncture can be easily performed if flouroscopic image intensifier is used. In spite of upper cervical portion the C1C2 puncture was safe and there were no complications in all 65 cases.
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