[Side effects of spinal nerve root radiography. How to reduce them?]

Contrastographic techniques with intrathecal injections (SRG, Myelo-CT) are widely employed in the diagnostic approach to lumbar pathologic conditions. These techniques allow pathologic changes to be demonstrated and the information they yield helps plan the correct surgical approach. However, these invasive examinations are seldom employed for the high incidence of side-effects. The latter are related to various causes, the identification of which can help reduce the side-effects themselves. The authors analyzed a study population of 522 patients subjected to radiculography, using needles of different gauges (18-23 G), and injected non-ionic contrast medium in doses ranging 5-10 ml. The incidence of side-effects was significantly higher in the patients suffering from usual headache (79/237 = 33%), in those under 40 (87/238 = 37%), and in female patients (86/221 = 39%). The incidence of side-effects was lower with fine needles (41/139 = 17%) and contrast medium in doses less than 8 ml (80/337 = 24%). The patients were divided into 4 subgroups according to the different doses of contrast medium administered and to needle gauges: the above parameters exhibited a percentage decrease (21/161 = 14%) with 21-23 G needles and 8 ml of contrast medium. The authors believe it possible to reduce side-effects by using fine needles and smaller doses of contrast medium.