Spinal Phlebography: Lumbar and Cervical Techniques

ISBN-13: 9783642953262 / Angielski / Miękka / 2012 / 168 str.

J. Theron; J. Moret; R. Djindjian

Opis

Spinal phlebography is an "indirect" radiologic technique for investigating verte bromedullary pathology. It is a harmless and almost painless technique that does not require the introduction of contrast medium into the subarachnoid spaces. Its interpretation is based on the modifications of the epidural veins which do not themselves have any proven pathology. The longitudinal epidural veins are situated in the anterolateral angles of the spinal canal between the nerve root and the intervertebral disc. They conse quently represent a major anatomic landmark in the investigation of disc pathol ogy because they are compressed by a disc herniation before the corresponding nerve root is reached. The improvement of the techniques of lumbar phlebography by catheterization of the lateral sacral veins and of cervical phlebography by catheterization of the vertebral veins now permits opacification of the epidural venous system along the total length of the lumbar and cervical spine. Spinal phlebography can consequently be used routinely, primarily in disc pathology but now also in other fields of vertebromedullary pathology such as myelopathy, tumors, or stenosis of the spinal canal, where it provides new information as compared to the other techniques of investigation. The techniq ue and results of spinal phlebography in these various conditions are presented in this monograph which is an attempt, with the collaboration of several authors, to summarize current knowledge in this field. Only lumbar and cervical phlebography will be discussed in this monograph."

Spis treści

1 The Physiologic Role of the Meningorachidian Plexus.- 1.1. Anastomotic Availability.- 1.2. Relationships with the Jugular System.- 1.3. The Meningorachidian Plexus (MRP) as a Main Pathway of Cerebral Venous Return.- 1.4. The Postural Phenomenon.- 1.5. The Postural Phenomenon at the Level of the Inferior Vena Cava.- 1.6. Increased Intrathoracic Pressure.- 1.7. Conclusions.- Figures 1–13.- 2 Lumbar Phlebography.- 2.1. Anatomic Radiology.- Figures 14–19.- 2.2. Technique, Pitfalls, Complications.- 2.2.1. Pitfalls.- 2.2.2. Complications.- Figures 20–29.- 2.3. Disc Herniations.- Figures 30–50.- 2.4. Lumbar Neuralgia.- Figures 51–56.- 2.5. Correlations Between Phlebography and Surgery.- 2.5.1. Results of Lumbar Phlebography as Compared to Other Techniques.- 2.5.2. New Information Provided by Phlebography.- 2.5.3. Advantages of Phlebography.- 2.5.4. Intraoperative Pattern of the Epidural Veins.- Figure 57.- 2.6. Megadural Lumbar Sac.- 2.6.1. Radiologic Diagnosis.- 2.6.2. Lumbar Disc Lesions and Megadural Sac.- Figures 58–60.- 2.7. Arachnoiditis, Epiduritis.- 2.7.1. Arachnoiditis.- 2.7.2. Epiduritis.- 2.7.3. Arachnoepiduritis.- Figures 61–63.- 2.8. Spondylolisthesis.- 2.8.1. Phlebographic Results.- Figures 64–68.- 2.9. Phlebography in Conjunction with Discography.- 2.9.1. Lumbar Phlebography.- 2.9.2. Discography.- 2.9.3. Combined Use of Phlebography and Discography.- 2.9.4. Techniques.- 2.9.5. Indications.- 2.9.6. Contraindications.- 2.9.7. Conclusion.- Figure 69.- 2.10. Tumors.- Figures 70–75.- 2.11. Stenosis of the Lumbar Canal.- Figures 76–85.- 3 Cervical Phlebography.- 3.1. Technique, Complications, Indications, Anatomic Radiology.- 3.1.1. Technique.- 3.1.2. Complications.- 3.1.3. Indications.- 3.1.4. Anatomic Radiology.- Figures 86–92.- 3.2. Cervicobrachial Neuralgia.- 3.2.1. Results.- 3.2.2. Discussion.- Figures 93–102.- 3.3. Tumors.- Figures 103–106.- 3.4. Cervical Myelopathy.- Figures 107–113.