Current status of myelography in the evaluation of the thoracic spinal cord

The myelographic features in 35 patients with clinical thoracic spinal cord disease and normal plain radiographs were reviewed to re-evaluate the role of pre-operative myelography since the advent of computed tomography and magnetic resonance. The most frequent lesions were meningioma (9 cases), prolapsed intervertebral disc (9 cases), and metastases (8 cases). The extent and anatomical location of the lesion was demonstrated in all 19 patients without myelographic block. In 16 cases with complete block, the anatomical location was demonstrated in 14, and the extent of the lesion in four, using cervical puncture in two and CT myelography in one. Myelography remains a valuable method of assessment of the thoracic spinal cord and canal and is sufficient to allow the preoperative planning of surgical management in the absence of complete block. Additional investigation by computed tomography or magnetic resonance imaging is advised in the presence of complete block or an intramedullary lesion.