[False negative myelography in surgically confirmed lumbar intervertebral disk prolapse]

Area of Science:

• Radiology
• Neurosurgery
• Orthopedics

Background:

• Lumbar myelography is a diagnostic tool for prolapsed intervertebral disks.
• A significant percentage of myelograms may yield false-negative results despite technical quality.

Purpose of the Study:

• To investigate if anatomical variations or functional states of the subarachnoid space contribute to false-negative lumbar myelograms in patients with prolapsed disks.

Main Methods:

• Analysis of 821 consecutive lumbar myelograms in surgically treated prolapsed disk patients.
• Evaluation of clinical symptoms and radiological parameters including pedicle distances and subarachnoid space widths at L4, L5, and S1.
• Statistical correlation of measurements with false-negative myelogram findings.

Main Results:

• 5.7% of myelograms were false-negative despite excellent technical quality.
• No statistically significant correlation was found between measured anatomical variants (pedicle distances, subarachnoid space widths) and false-negative myelograms.
• Specific functional states of the subarachnoid space could not be definitively ruled out as a cause.

Conclusions:

• Anatomical variations of the lumbar subarachnoid space do not appear to be the cause of false-negative myelograms in prolapsed disk patients.
• The possibility of false-negative results due to unmeasured factors or functional states remains.
• Further research is needed to fully understand the reasons for false-negative lumbar myelograms.