脊椎・脊髄疾患における脊髄造影後CTの必要性に関する検討

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objective : We report on the utility and necessity of myelography and CT myelography in diagnosing spinal disease. methods : The study population consisted of 150 patients who had undergone spinal surgery in our institution within the past one year ; cervical disease was involved in 42 cases, thoracic in 4 cases and lumbar in 104 cases. The utility of these procedures was evaluated according to 3 stages : 1.) necessity, 2.) usefulness and 3.) non-necessity. Moreover, to enable evaluation according to disease distribution, the disease was further classified into four (4) types based on location : lateral disease (group A), medial- (group B), stenotic- (group C) and others (group D). results : The myelography and CTM necessity cases comprised 18 (42.9%) cases of cervical disease and 30 (28.8%) cases of lumbar disease. The: non-necessity cases 14 (33.3%) cases of cervical disease, all thoracic and 65 (62.5%) cases of lumbar disease, and the other cases were categorized by their usefulness. In lateral disease (group A), the necessity cases were mede up of 15 (75.0%) cases of cervical disease and 13 (56.5%) cases of lumbar disease. In medial cases and stenotic cases, the non-necessity cases accounted for 3 (25.0%) and none 0% of cervical disease, and 1 (16.7%) and 16 (25.8%) of lumbar cases. At any rate, all reoperation cases were classified as CTM necessity and usefulness cases. conclusions : Myelography and CTM are necessary in those cases where MRI is unusable and post operation. They are useful procedures in cases which have instability and/or lateral disease, and which are not definable from the responsibility point of view from several neurological studies. On the other hand, these procedures lack the necessity in cases involving thoracic region, clear disc herniation and cases with severe stenosis.
日本脊髄外科学会の論文
2008-06-01

脊椎・脊髄疾患における脊髄造影後CTの必要性に関する検討

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