The various special diagnostic procedures have been used for the cervical cord injuries. The author describes a new technique of pantopaque cervical myelography based on the lateral C1-2 puncture.
Iophendylate* ; Myelography* ; Punctures*

Metrizamide lumbar myelography were performed in 150 patients with suspected herniated lumbar disc. The examination is easier to perform than with gas or iophendylate. The advantage of metrizamide over gas or iophendylate are the improved root sleeve visualization and examination of small structure such as root, root pocket and blood vessel. And then this is a higher percentage of diagnostic accuracy than can be obtained with other myelogram. Most of adverse reactions during and after myelography are mild and transitory, and no serious adverse reactions occured. It probably has a lower neurotoxicity than any other water soluble contrast agent.
Blood Vessels ; Humans ; Iophendylate ; Metrizamide* ; Myelography* ; Water

With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.
Decompression ; Dislocations* ; Iophendylate ; Myelography ; Rehabilitation ; Spinal Cord

Traction injuries of the brachial plexus have recognized since the classic descriptions of Duchenne, Erb and Klumpke. The original cases resulted from birth injuries, presumably from traction forces. In recent years, automobile accidents have resulted in and increase in traction or closed injuries to the brachial plexus. This paper reviews our experiences with 3 cases of injuries characteristically demonstrated by Pantopaque myelography.
Automobiles ; Birth Injuries ; Brachial Plexus ; Iophendylate ; Myelography ; Traction*

Foramen magnum tumors are uncommon. We experienced two cases of foramen magnum tumor. One case was meningioma, the other neurinoma. Metrizamide computerized tomography scanning and pantopaque myelography have been the radiographic test most commonly used to evaluate the foramen magnum. Moth cases underwent suboccipital craniectomy and total laminectomy in C1 & C2 with total removal of tumor mass. Postoperatively, both cases showed improvement without neurological sequelae. Both cases are discussed, and a review of literature is presented.
Foramen Magnum* ; Iophendylate ; Laminectomy ; Meningioma ; Metrizamide ; Moths ; Myelography ; Neurilemmoma

The virtues of the pantopaque myelography in the study of the herniated intervertebral disc have been generally accepted. As expected, it shows the presence of ruptured disc in the accuracy over 80%. But it is open to discussion whether the myelographic defects can indicate the exact location and type of herniated discs or not. In this article, we attempted to find out some correlation between the myelographic defect and the operative finding in viewing the size and shape of myelographic defects. This consideration may be helpful to make a clear cut diagnosis in the lumbar disc disease. One hundred and sixtytwo operative cases undergoing pantopaque myelography were subjected. Some obtained results will be presented.
Diagnosis ; Intervertebral Disc ; Intervertebral Disc Displacement ; Iophendylate ; Myelography ; Virtues

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

The first myelography with air was carried out by Walter Dandy in 1919, and the myelography with positive contrast medium was done by Sicard and Forestier in 1922. Since Pantopaque was adopted as a contrast material by University of Rochester group in 1944, it has been rapidly popularized. Although higher diagnostic accuracy has been made with a development of the diagnostic aids such as electromyography, discography, epidural venography and computerized tomography, myelography has been popularized in our country with electromyography. The authars have seen and studied 107 cases of herniated lumbar disc with respect to the diagnostic accuracy of myelographic examination from January, 1976 to December, 1981 at the department of Orthopedic Surgery, Yonsei University College of Medicine. The results were as follows: l. Of the 107 cases, 59 were found in the age of 20 to 40 years and the ratio of male and female was 2:l. 2. Fifty eight cases (54.2%) had no history of back injury, but 40 cases (37.4%) had sprain of the back and 9 cases had direct trauma history. 3. In all cases, plain X-ray and myelogram were taken. Among them 55 cases showed narrowing of intervertebral space in plain film, and 100 cases showed positive myelographic findings such as lateral indentation of dural sac (41 cases), hour-glass defect (30 cases), root sleeve defect (12 cases), block defect (10 cases) and combined defects (7 cases). 4. Sixty one cases which confirmed by operation, the most frequent level of disc herniation was in L4-5 space. Clinical diagnosis was correct in 57.4%, and myelographic accuracy was coincided with operative finding in 80.3%. 5. Twelve (19.7%) of the 61 cases showed discrepancy between myelographic and operative findings, and these 12 cases consisted of 5 cases of level discrepancy, 3 cases of false positive and 4 cases of false negative.
Back Injuries ; Clinical Study ; Diagnosis ; Electromyography ; Female ; Humans ; Iophendylate ; Male ; Myelography ; Orthopedics ; Phlebography ; Sprains and Strains

A rare case of intramedullary neurilemmoma of the spinal cord has been reported. A 23-year-old woman was admitted to our hospital, on 4th July, 1982, because of weakness of legs and difficulty of urination. Neurological examination revealed motor weakness of the both lower extremities with muscle atrophy. Sensory examination showed hypesthesia below the level of L3 dermatome of the right side and of L4 dermatome of the left. All deep tendon reflexes of the lower extremities were abolishes and Lasehue's sign was not appeared. Manometric Queckenstedt's test showed a complete block, with CSF protein of 460 mg/dl. Pantopaque myelogram demonstrated a complete block at the midportion of L1 spine. Total removal of the intramedullary tumor which was located in the dorsal column of the thoracolumbar segment was performed. The tumor was 4.0x1.5x1.0 cm in size and it proved to be an Antoni-A type neurilemmoma histologically. Only 20 similar cases have been published so far and summarized on Table 1, including our case. The relevant literature was reviewed.
Female ; Humans ; Hypesthesia ; Iophendylate ; Leg ; Lower Extremity ; Muscular Atrophy ; Neurilemmoma* ; Neurologic Examination ; Reflex, Stretch ; Spinal Cord ; Spine ; Urination ; Young Adult