Metrizamide myelography and postmyelographic computed tomography: comparative adequacy in the cervical spine

Metrizamide myelography and postmyelographic computed tomography (CT) were evaluated for relative efficacy when correlated with operative findings in a series of 30 patients. Fifty-seven levels were operated on in the 30 patients with 27 patients diagnosed as having diffuse cervical stenosis, hyperostotic spondylosis, or herniated nucleus pulposus. Metrizamide myelography and CT metrizamide myelography were equally useful in providing preoperative diagnostic information at 44 of 57 levels. Both radiographic techniques agreed with the degree of canal and neural forman stenosis found operatively at more than 80% of levels. This study indicates that either metrizamide myelography or CT myelography alone is sufficient, and that both should be performed only if one fails to answer the clinical question or if syringomyelia or cord tumors are suspected.