Related Experiment Videos
The indications for metrizamide myelography. Relationship with complications after myelography
Abstract:
To test the validity of our impression that in the absence of objective clinical evidence of nerve-root impingement there is a disproportionately high incidence of complications associated with myelography, the results in 248 patients were reviewed retrospectively and those in 110 were studied prospectively. Of all 358 patients, 53 per cent had complications after myelography with injection of metrizamide, of which headache and nausea and vomiting were the most frequent. The incidence of complications in the 112 patients whose objective clinical and myelographic findings were consistent was compared with that in the 180 patients who had only subjective complaints and normal myelographic findings. The incidence of complications was 30 per cent in the former group and 70 per cent in the latter group, an almost twofold difference (p greater than 0.05). The 110 patients in the prospective study were asked to grade the intensity of their headache after myelography. Of the thirty-one patients with positive objective clinical and myelographic findings, ten complained of headache, which was mild in seven (70 per cent) and severe in three. Of the sixty patients with only subjective complaints, thirty-eight complained of headache, which was mild in twelve (32 per cent) and severe in twenty-six.
Insights
Myelography complications are more common in patients with subjective symptoms and normal findings. Objective evidence of nerve-root impingement reduces complication rates, highlighting the importance of clinical correlation in myelography.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Myelography is a diagnostic imaging procedure.
- Complications following myelography can occur.
- The incidence of complications may be related to clinical findings.
Purpose of the Study:
- To evaluate the relationship between clinical findings and myelography complications.
- To determine if objective evidence of nerve-root impingement affects complication rates.
Main Methods:
- Retrospective review of 248 patients and prospective study of 110 patients (total 358).
- Analysis of complications following myelography with metrizamide.
- Comparison of complication rates between patients with consistent objective findings and those with subjective complaints only.
Main Results:
- 53% of all patients experienced complications, most frequently headache and nausea/vomiting.
- Patients with subjective complaints and normal myelographic findings had a 70% complication rate, compared to 30% in those with consistent objective findings.
- Headache severity was greater in patients with subjective complaints only.
Conclusions:
- The absence of objective clinical evidence of nerve-root impingement is associated with a higher incidence of myelography complications.
- Clinical correlation is crucial for interpreting myelography results and managing patient expectations regarding potential complications.