Decompressive laminectomies with clinical improvement but persistent myelographic blocks.

Surgical decompression for spinal cord compression secondary to metastatic epidural neoplasms is a common procedure. Preoperative myelography is nearly always done, and clinical improvement postoperatively is assumed to be correlated with relief of the radiologically demonstrated subarachnoid block. Three cases with postoperative clinical improvement but persistent subarachnoid blocks are reported. The recognition of this is important to avoid unnecessary secondary surgery.