Helical CT myelogram: The Ibadan initial experience

Abstract

To evaluate our initial experience with Helical Computed Tomography (CT) Myelogram in the investigation of spinal abnormalities. As late as 1980, CT was still regarded as unreliable compared with myelography however, the advent of slip-ring technology in the 1990s, in association with the use of more powerful computers and higher energy exactly tubes allowed a process known as Helical CT. This revolutionized CT scanning allowing achievement of thinner slices in a single breath-hold. Helical CT myelogram is one of the recent applications with the potential of improving clinical diagnosis in patients with spinal disorders. This is a descriptive study of 56 patients who had a CT myelogram in the first 15 months of operation of a helical CT scanner at Ibadan (January 2004 -March 2005). Axial scans were done after a lumbar puncture with injection of 8-10mls of contrast (iopamidol). Demographic, clinical data and CT findings were analyzed. Patient age s ranged from 3 to 75 years. The highest age frequency was seen in the 4th and 5th decade. 37 (66%) of these patients were males and 19(34%) were females. The majority of scans, 22 (39.2%) were in the thoracic and thoracolumbar regions. Low back pain was the most common indication 26(32.1%) followed by paraplegia 24(29.6%). Spinal cord compression and spondylosis represented 34% and 20% of the CT findings respectively. Helical CT myelogram is a valuable investigative tool which demonstrates spinal abnormalities well by providing a good silhouette image of the spinal cord.