Paul Teng

Spinal Arachnoid Diverticula

The spinal arachnoid diverticula are formed by the partial seclusion of the subarachnoid space. They occurred more frequently in the dorsal than the cervical spinal canal. Smaller diverticula are frequently found in Pantopaque myelography. The large ones produce symptoms by gravitational traction upon the spinal cord. Twelve patients have been studied during the last six years, and five have been surgically treated. Microscopic examination of the excised arachnoidea including the wall of the diverticula showed no evidence of adhesive arachnoiditis. The technique used in myelography for the visualisation of the spinal arachnoid diverticula has been described. Sacral perineurial cysts are frequent concomitant findings in spinal arachnoid diverticula.

Myelographic Findings in Adhesive Spinal Arachnoiditis (With a Brief Surgical Note)

Abstract Spinal adhesive arachnoiditis may produce various types of myelographic defects. Streaks and droplets are characteristic of arachnoiditis which does not obliterate the sub-arachnoid space. In obstructive type of arachnoiditis it may create the following forms of defects. (1) An oval or circular defect resembles that of an extra-medullary tumour. It differentiates from the latter by the absence of displacement of the spinal cord and enlargement of the subarachnoid space. These changes provide a three-dimensional effect on myelography in an intradural and extramedullary tumour. (2) A paint-brush defect often simulates an epidural compressing lesion. In arachnoiditis, there is no deviation of the head of the Pantopaque column, whereas in epidural tumours, it may be lifted, depressed or pushed to one side. (3) Scalloping defects are produced by multiple obliterations of the subarachnoid space. (4) Defects like “flower-petal” arrangement lining the circumference of the spinal canal are the result of m...

Myelographic Appearance of Vascular Anomalies of the Spinal Cord

Fifteen cases of vascular anomalies of the spinal cord are classified as venous, arterial, arteriovenous and telangiectatic anomalies. In myelography, large amounts of Pantopaque provide a better visualisation of the anomalies than the small quantity usually employed. Because of their posterior location, predominently in the dorsal spinal cord, supine examination permits a full view of the posterior compartment of the dorsal spinal canal. Upright films are sometimes informative.

Myelographic Findings in Spondylosis of the Lumbar Spine

Lumbar spondylosis can produce nerve root or cauda equina compression. The hypertrophic facet joints, laminal processes and osteophytes of spondylosis may produce defects both at the anterior, posterior and lateral margins of the Pantopaque column in myelography. Multiple constrictions of the oil column in upright lumbar myelography are characteristic features of spondylosis. Differentiating myelographic features of spondylosis from herniation of intervertebral disc are discussed, and 11 illustrated cases are presented. In lumbar spondylosis, the most frequently involved areas, in order of their sequence, are L4–5, L3–4 and L2–3; whereas in herniation of the nucleus pulposus they are L4–5 and L5–S1.