Functional cervical myelography with iohexol

Thirty patients underwent functional cervical myelography, i.e. radiographs in the lateral view were obtained in extension as well as in flexion of the neck. Sagittal tomography was performed in both positions. Widening of the subarachnoid space and decreased sagittal diameter of the spinal cord due to shortening were demonstrated in the lateral view in flexion. In some cases with advanced narrowing or spinal block in extension, such widening in flexion resulted in better diagnostic images by providing passage of the contrast medium caudally. Although iohexol (Omnipaque, Nyegaard & Co., Oslo) was regularly forced into the posterior cranial fossa by the movements, the frequency of side effects was approximately the same as in our former trials with iohexol in conventional cervical myelography. EEG changes occurred in two patients (7%). A sitting position for 3–4 min after the examination followed by an elevated head end of the bed was probably important for preventing side effects from the contrast medium. Specific questioning revealed twice as many subjective side effects as reported after general questions alone.