CT myelography with intramedullary enhancement in cervical spondylosis

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✓ The authors describe seven cases of cervical spondylosis in which small high-density areas were detected in the spinal cord on delayed computerized tomographic (CT) myelography. These high-density areas are believed to represent cavities or areas of cystic necrosis. In all seven cases the cervical spinal canal was narrow, and the spondylosis was located at multiple levels, causing a so-called “pincer effect.” On the CT scans the high-density areas resembled fried eggs in the gray matter. These areas were localized near the abnormal cervical discs. In two cases in which the Brown-Séquard syndrome was noted, the symptoms could be attributed to the morphology of the high-density area on the affected side of the cord. Following decompressive surgery, most of the symptoms improved except for numbness of the upper extremities and motor weakness of hands.

Article Information

Address reprint requests to: Yoshinobu Iwasaki, M.D., Department of Neurosurgery, Hokkaido University School of Medicine, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060, Japan.

© AANS, except where prohibited by US copyright law.

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    Case 1. Left: Preoperative delayed computerized tomography (CT) myelogram demonstrating two small high-density areas within the medulla at the C-5 level. Right: Postoperative CT with a longer delay after metrizamide instillation showing cord atrophy and the same high-density areas as in the preoperative scan.

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    Case 3. Preoperative computerized tomography myelogram compression at the C-6 level of the anterior spinal cord by an osteophyte and two-high density areas within the cord. The high-density area on the left side occupies most of that side of the cord.

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