Diagnostic Significance of Myelo-Enhanced Computerized Tomography(MECT) in Spinal Stenosis

Kang, Seong Su

Abstract

Lumbar spinal stenosis may be defined as any type of narrowing of the spinal canal, nerve root canals or intervertebral foramina. It may be local, segmental or generalized and may be caused by the encroachment of bone or soft tissue. The narrowing may involve the bony canal alone or the dural sac or both. Myelo-enhanced computerized tomography(MECT) has been accepted as especially useful diagnostic method for spinal steonsis after its application in the orthopedic fields. The goal of this study was to analyze the diagnostic accuracy and sensitivity of MECT and to determine the prevalance of stenosis in various regions of lumbar spine. During the period of 3 years, from January 1991 to December 1993, 40 cases of lumbar spinal stenosis were analyzed, all of whom took myelography, computerized tomography and surgical treatment. The results of the study were as follows: 1. The myelographic findings were, respectively, hourglass bilateral defect 15(37.5%), complete block 14(35%) and the unilateral focal defect 5(12.5%). 2. The most prevalent from of spinal stenosis was the combined central-lateral-foraminal stenosis(47.5%) and the degenerative change in the lumbar spine was the principal etiologic factor(55%) by Arnoldi classification. 3. The involved levels were as follows:1 level 18(45%), 2 level 16(40%) and 3 level 6(15%). And among single level, the most frequent level was L5-S1 intervertebral space(30%). The diagnostic accuracies according to operative finding and above results were 83% by myelography and 97.5% by MECT. The MECT showed absolutely superior to myelography or CT and it was especially useful in lateral stenosis and multi-level stenosis.