[The value of postoperative dimer-X myelography]

Area of Science:

• Neurosurgery
• Radiology
• Spinal Surgery

Background:

• Lumbar intervertebral disc operations can lead to complications.
• Post-operative myelography is used to assess outcomes.
• Dimer-X and Pantopaque are contrast agents used in myelography.

Purpose of the Study:

• To evaluate the diagnostic utility of Dimer-X myelography following lumbar intervertebral disc surgery.
• To identify common post-operative findings and their implications.
• To assess the risks associated with Pantopaque myelography.

Main Methods:

• 88 patients underwent Dimer-X myelography after lumbar intervertebral disc surgery.
• Examinations included static and functional imaging (lying, sitting, standing positions).
• Findings were analyzed for abnormalities and compared to pre-operative conditions.

Main Results:

• Only 3 out of 88 cases showed unremarkable X-ray findings.
• Common findings included prolapses at other levels (12), scars (5), osteophytosis (1), reticulitis (2), meningoceles (2), and neurinoma (1).
• Scarring mimicked the typical contrast band narrowing seen in disc prolapses on repeat myelography.

Conclusions:

• Dimer-X myelography frequently reveals post-operative abnormalities after lumbar disc surgery.
• Scarring can be misdiagnosed as disc prolapse on myelography.
• Pantopaque myelography is cautioned against due to the risk of arachnoidal adhesions.
• Surgical techniques should minimize tissue damage, scarring, and adhesions.