Robertson H J, Smith R D
Department of Radiology, Louisiana State University Medical Center, New Orleans 70112.
Radiology. 1990 Jan;174(1):79-83. doi: 10.1148/radiology.174.1.2294575.
A total of 68 major complications of cervical myelography were reported by 220 neuroradiologists in a mail survey. Two-thirds of the complications were attributed to cervical spine hyperextension and one-third to lateral C1-2 puncture. Narrow sagittal diameter of the spinal canal and severe cervical spondylosis were frequent contributing factors to hyperextension injury of the cervical spinal cord. Clinical and radiographic premyelography screening is suggested, with magnetic resonance imaging performed first in patients with spinal canal stenosis, severe spondylosis, and/or myelopathy of any cause. Neck extension should be minimal during myelography. All C1-2 punctures should be monitored with lateral fluoroscopy for accurate needle positioning and prevention of contrast medium injection into the spinal cord.
在一项邮件调查中，220名神经放射科医生共报告了68例颈椎脊髓造影的主要并发症。三分之二的并发症归因于颈椎过度伸展，三分之一归因于C1-2外侧穿刺。椎管矢状径狭窄和严重颈椎病是颈椎脊髓过度伸展损伤的常见促成因素。建议进行临床和影像学脊髓造影前筛查，对于有椎管狭窄、严重颈椎病和/或任何原因引起的脊髓病的患者，首先进行磁共振成像检查。脊髓造影期间颈部伸展应尽量小。所有C1-2穿刺均应通过侧位透视监测，以准确进行针定位并防止造影剂注入脊髓。
