Positive and negative contrast myelography in spinal trauma

The myelograms of 60 acutely injured patients were reviewed. Positive contrast material (Pantopaque) was preferred in cervical and thoracic trauma manifesting bony deformity, in cervical trauma without bony deformity (in the prone position), in delineating the thoracic spinal cord in the frontal projection, and in lumbar spinal injuries. Negative contrast material (air) was preferred in cervical trauma without bony deformity, to delineate the thoracic spinal cord in the lateral projection and in chronic trauma to demonstrate cord atrophy. An experimental, water-soluble positive contrast material (Amipaque) may show the spinal cord advantageously in both the anteroposterior and lateral projections and may be more extensively used. A protocol has been devised, based on the analysis of the myelographic findings.