Myelography

Abstract

In 1919 air myelography was introduced by Dandy as a radiologic diagnostic procedure (see p. 183). Initially, the results were unsatisfactory, considering the state of X-ray technology at this time. It was thought that the deficiencies of air myelography might be overcome with the help of a positive contrast agent and indeed Sicand and Forestier, who had developed Lipiodol — an iodized poppy seed oil — for bronchoscopy, used it in 1922 to carry out the first positive contrast myelogram. After the injection of the contrast medium into the cisterna magna in quantities up to 2 ml, information about the spinal canal could be obtained by allowing the oil to flow through it. Smaller pathological processes, which did not completely block the flow of the oil, generally went unrecognized. A further disadvantage came from the fact that the Lipiodol was not resorbed and sometimes led to foreign body granulomas or to chronic adhesive arachnoiditis. Similar problems accompanied the use of Iodipin, an iodized sesame seed oil.