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Unusal Myelogpaphic Appearances of the Lumbosacral Radicular Sheaths

Lumbosacral pain syndromes may arise from causes other than disc herniation, among which congenital cysts of the spinal membranes play an important role. Their clinical signs and radiologic diagnosis should present no real difficulties. A number of unusual appearances in the lumbosacral region during myelographies for disc lesions or congential cysts of the lumbosacral root sheaths led to an investigation to establish their possible nature. The literature seems to contain no record of similar work; the possibility of the appearances being due to artefacts caused by technical errors has been eliminated. The records of 9 patients who had had a lumbosacral pain syndrome or mild motor impairment of the lower limbs were analysed. All the patients underwent myelographic examination with the positive contrast medium Lipiodol ultrafluide injected into the spinal canal through an atraumatic lumbar puncture, the average amount injected being 10 ml. The examination was performed with TV fluoroscopy on a tilting table with the patient prone, at its conclusion most of the contrast medium was removed by means of a further tap. None of the patients had had previous lumbar puncture; spinal fluid was always withdrawn at the time of the examination for analytic purpose and before the injection of the contrast medium.