[Lumbar phlebography. Contribution to the diagnosis of lumbo-sciatica of discal origin]

The authors wanted to define the diagnostic value of lumbar phlebography in the investigation of intervertebral disc lesions and to compare these results with those obtained from clinical examination and plain Y-rays. They conducted a retrospective study of 200 cases of patients hospitalised for sciatica who were investigated by lumbar phlebography using selective catheterisation, without any prior neuro-radiological examination. 104 of these cases were operated. The lumbar phlebography was interpretable in 99 p. cent of cases. Severe thrombo-embolic episodes occurred in two cases. In the 104 patients who went to operation, the surgical procedure confirmed the presence of a herniated disc (suspected on phlebography) in 96 p. cent of cases. Topographical agreement between the phlebographic data and the operative findings was observed in 81 p. cent of cases. Phlebography proved to be more reliable at L4-L5 than at L5-S1. In the patients in whom clinical examination and plain X-ray findings provided coherent information as to the site of the herniated disc, phlebography was considered to be of no use. In those patients for whom this examination did not provide coherent information, phlebography proved to be valuable in the topographical diagnosis of the herniated disc.