Henry Ford Hospital Medical Journal


The water-soluble contrast medium lumbar myelogram is a very helpful tool in the diagnosis of herniated nucleus pulposus (EfNP) in patients who suffer unilateral root pain of mechanical course. One can often make the differential diagnosis between a ruptured disc and a protruding disc. Unless the disc fragment lies way out in the intervertebral foramen, the myelogram will show some kind of anomaly. Therefore, fewer exploratory operations will be performed on patients having normal myelograms. Metrisamide, a newcomer among the water-soluble contrast media, is nontoxic for the spinal cord. Therefore, if the usual myelogram is normal and one fears a lesion at the upper lumbar or lower thoracic level, the solution may be moved upwards in the spinal canal by tilting the x-ray table. All water-soluble contrast media are quickly absorbed from the cerebral spinal fluid into the serum. Metrisamide is 99% absorbed in a matter of three hours.