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Year : 1978  |  Volume : 12  |  Issue : 2  |  Page : 152-160

LumbosacraI Radiculography With Water Soluble Contrast Medium (Conray 280) In Lumbar Disc Prolapse Syndrome

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R. K Airon

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Lesions of lumbosacral region causing, “ Sciatica” are not uncommon in orthopaedic practice. The most common cause of sciatica and low back pain is herniation of an intervertebral disc. It is generally agreed that pre-operative localization of the ruptured disc cannot always be made with accuracy from clinical examination alone. Radiographic localization of the site of disc prolapse is a useful adjunct to the pre-operative assessment of these cases as it helps the surgeon in planning the treatment and minimizes the number of negative explorations. Several radiological diagnostic methods have been introduced to arrive at a correct diagnosis. Myelography was first done by Dandy in 1919 using air as contrast medium. Pantopaque has very good tolerance but the nerve roots, nerve sheaths and minor disc protrusions are missed because of high viscorsity of the contrast medium. Water soluble contrast media, because of their low viscosity give a more complete view of root pockets. Although these were first used in 1931, studies were limited because of highly irritant effects of contrast media. The introduction of sodium free contrast medium, Conray 280, has provided a nonirritant, water soluble contrast medium for radiculography of lumbosacral region. Its use was first reported by Campbell et al. (1964). Since then lumbosacral radiculogrphy has been successfully practiced by many workers without spinal anaesthesia (Praestholm and Lester 1970). Studies involving the use of Conray 280 in lumbar radiculogrphy have also been undertaken in our country (Rao and Dinakar 1971, Jankharia et al. 1973, Patel et al. 1974, Sharma et al. 1975), and the authors reported satisfactory visualization of the nerve roots and sheaths. The present study was undertaken with a view to assess its value in arriving at a correct pre-operative localization of herniation of an intervertebral disc, and also to obtatin a working experience with a water soluble contrast agent (Conray 280) for lumbosacral radiculography.

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