Levine H L, Olmstead E J
AJR Am J Roentgenol. 1979 Oct;133(4):715-8. doi: 10.2214/ajr.133.4.715.
A new technique simplifies the evaluation of the spinal canal above obstructing lesions encountered during myelography via the lumbar route. After the demonstration of a block with 2--4 ml Pantopaque, a second injection of 2--4 ml Pantopaque is made through the lumbar needle with the patient in 45 degree Trendelenberg (or any degree necessary to keep the initial contast bolus against the inferior margin of the obstruction). In all 10 cases in this series, the second injection easily displaced contrast around and above obstructions that could not be overcome by gravity thereby obviating a lateral cervical or cisternal puncture. No technical failures of complications were encountered. The method is not recommended in cases of traumatic spinal canal obstruction.
一种新技术简化了通过腰椎途径在脊髓造影时对阻塞性病变上方椎管的评估。在用2 - 4毫升碘苯酯显示出阻塞后，让患者处于45度头低脚高位（或为使最初的造影剂团块抵住阻塞下缘所需的任何角度），通过腰椎穿刺针再注入2 - 4毫升碘苯酯。在本系列的所有10例病例中，第二次注射很容易使造影剂在重力无法克服的阻塞周围和上方移位，从而避免了颈椎侧方穿刺或小脑延髓池穿刺。未遇到技术失败或并发症。该方法不适用于外伤性椎管阻塞病例。
