The Journal of Bone and Joint Surgery, Vol 65, Issue 8 1144-1149, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
The indications for metrizamide myelography. Relationship with complications after myelography
HN Herkowitz, RL Romeyn and RH Rothman
To test the validity of our impression that in the absence of objective
clinical evidence of nerve-root impingement there is a disproportionately
high incidence of complications associated with myelography, the results in
248 patients were reviewed retrospectively and those in 110 were studied
prospectively. Of all 358 patients, 53 per cent had complications after
myelography with injection of metrizamide, of which headache and nausea and
vomiting were the most frequent. The incidence of complications in the 112
patients whose objective clinical and myelographic findings were consistent
was compared with that in the 180 patients who had only subjective
complaints and normal myelographic findings. The incidence of complications
was 30 per cent in the former group and 70 per cent in the latter group, an
almost twofold difference (p greater than 0.05). The 110 patients in the
prospective study were asked to grade the intensity of their headache after
myelography. Of the thirty-one patients with positive objective clinical
and myelographic findings, ten complained of headache, which was mild in
seven (70 per cent) and severe in three. Of the sixty patients with only
subjective complaints, thirty-eight complained of headache, which was mild
in twelve (32 per cent) and severe in twenty-six.
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