Summary
Nine patients with severe and prolonged signs and symptoms due to cervical spondylosis had myelography followed by a CT Scan using the same injection of intrathecal contrast. All patients had radiographic changes of cervical spine degeneration and were being considered for exploration and fusion of the anterior cervical spine. All patients had a full clinical evaluation, EMG studies and plain radiographs taken prior to their CT Scan. EMG readings showed several levels of compression in three patients but did not indicate a single level in any. Plain radiography showed multiple level involvement in every patient. Myelography indicated significant indentation in three of five patients with clinical signs but did not demonstrate root cut off in any case. CT Myelography indicated the degree of Lushka and facet joint involvement, indentation, exit foramen encroachment, and the degree of spinal stenosis at the involved segment. In three patients, the findings at operation correlated closely with the CT Scans. Myelography failed to indicate the presence of significant osteophytes in these two cases.
Résumé
Neuf cas d'arthrose cervicale, à l'origine de symptômes sévères et prolongés, ont été étudiés par myélographie couplée à un examen tomodensitométrique en utilisant la même injection de produit de contraste. Dans tous les cas existaient des signes radiologiques de cervicarthrose et les patients étaient programmés pour un abord antérieur du rachis cervical en vue d'une arthrodèse intersomatique. Tous avaient un bilan clinique, électromyographique et radiographique complet avant l'examen tomodensitométrique. L'examen électromyographique a permis dans trois cas de mettre en évidence l'atteinte de plusieurs étages. De même l'examen radiographique a toujours montré une atteinte pluriétagée. La myélographie a visualisé une compression du sac dural dans trois cas sur cinq mais sans jamais révéler l'absence d'injection d'une racine nerveuse. Lorsque la myélographie était couplée à un examen tomodensitométrique les renseignements étaient plus précis: atteinte des articulations de Lushka et interapophysaires, existence d'une compression centrale et/ou latérale. Dans trois cas les constatations opératoires ont confirmé les données de la tomodensitométrie alors que la myélographie seule n'avait pas montré la présence d'importants ostéophytes.
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Boot, D.A., Khan, R.H., Sellar, R.J. et al. Computed tomogram myelography in cervical spondylosis. International Orthopaedics 11, 249–254 (1987). https://doi.org/10.1007/BF00271457
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DOI: https://doi.org/10.1007/BF00271457