Myelography In Oblique Diagnostic Value Of Lumbar Disc Herniation Discussed

Objective: The purpose of this study was using different angle myelogrphy(DAM)observation to explore the insignificance on the diagnosis of disc herniation and to evaluate the best angle's scope of DAM oblique projection . Method: The image materials of 106 cases in recent 6 years were viewed and compared with their operative findings individually.30 cases of DAM, including 300, 400, 45 0 500 and 600 oblique projection, had been performed before operation in advance. At L4..5 and L5-S1 level, length of nerve root and degrees of root-sac angle were measured and analyzed by statistical method. Result: In retrospective materials, the sensitivities of right, lateral and oblique position had achieved 86.4%, 83.3% and 91.2% and the specificities were 66.7%, 17.24% and 80% respectively. According to localizing herniation direction in the middle of 73 lateral protrusion cases, the accuracy of right position was 41% and oblique position was 84.9%. In prospective materials, there is not obvious difference on diagnosing disc herniation of L4.5 and L5-S1 level during the scope from 300 to 45 , oblique. The oblique from 300 to 45 do not have obvious difference at the length of nerve root and degrees of root-sac angle. Conclusion: (1) Oblique projection may be the most valuable index on the diagnosis of lateral protrusion for myelography.(2) The oblique of myelography should be performed at the scope from 300 to 450...