J Korean Orthop Assoc.  1977 Sep;12(3):371-382. 10.4055/jkoa.1977.12.3.371.

Discrepancies in Myeolography

• Kim KY
• Cho DY
• Ko WS
• Park CI

• KMID: 2461783
• DOI: http://doi.org/10.4055/jkoa.1977.12.3.371

Abstract

Among 157 cases operated upon, under the diagnosis of herniated intervertebral disc, we experienced 34 cases of discrepancies between myelographic and operative findings. We analysed these cases in the respect of patterns, causes and clinical significance of these discrepancies and the results were as follow; 1. Thirty four cases (21.7%) among 157 cases operated upon showed discrepancies between myelographic and operative findings. 2. These 34 cases consisted of 17 cases of level discrepancies, 9 cases of false positive and 8 cases of false negative. 3. The main cases of level discrepancies was indentation due to bony spur with/without adhesion. 4. The main cause of false positive was degenerative changes of the spine. In the detection of this false positive, plain X-ray of lumbosacral spine give important clue. In false positive, explorative paitial laminectomy and removal of bony spur or adhesiolysis was indicated because the effect of the spur or adhesion was same as that of herniated disc. 5. The causes of false negative were giant canal, congenitally narrow cul de sac, high cul de sac and far laterally seated disc herniation. In false negative, plain X-ray of lumbosacral spine afforded little diagnostic aid. In case of being compatible to disc herniation at a certain level through clinical signs, normal myelographic finding has less meanings and exploration is to be performed according to the clinical signs.

MeSH Terms

Diagnosis
Intervertebral Disc
Intervertebral Disc Displacement
Laminectomy
Spine