[Radiological diagnosis of iatrogenic stenosis of the lumbar spine in patients after surgical treatment of intervertebral disk displacement]. / Diagnostyka radiologiczna jatrogennych zwezen ledzwiowego odcinka kanalu kregowego u chorych po przebytych operacjach przepuklin jadra miazdzystego.

Iatrogenic stenosis of the vertebral canal arises as a result of inflammatory changes of the arachnoid with formation of adhesions following irritation of the meninges with chemicals, such as drugs and contrast media, or extension of the intracranial scar tissue, usually after operations. This stenosis is a serious diagnostic and therapeutic problem being often the cause of lacking improvement or recurrence of radicular pains after operations for herniated nucleus pulposus. On the basis of a literature review and own experiences the authors discuss the aetiology, pathogenesis, radiological diagnostic methods and methods of treatment in cases of iatrogenic postoperative stenosis of the lumbar vertebral canal.

[Value of computerized tomography in the diagnosis of discopathy in the L4-L5-S1 segment]. / Wartosc tomografii komputerowej w rozpoznaniu dyskopatii w odcinku L4-L5-S1.

The aim of this analysis was demonstration of the usefulness of CT in the diagnosis of lumbar discopathy. In 110 patients with backache, CT of the L4-L5-S1 part of the spine was done. The observed abnormalities were analysed, including presence of nucleus pulposus herniation, pathological changes of osseous structures of the spine, width of the vertebral canal and lateral recesses, and presence of other lesions there. Comparing the results of (CT) and myelography with intraoperative observations it was possible to confirm the high usefulness and value of CT in such cases. CT may be an important diagnostic method preoperatively in patients with iodine hypersensitivity and those with vertebral canal stenosis.

[Surgically treated epidural hematoma of the spinal cord at the Th1-Th2 levels associated with arachnoid cyst]. / Krwiak nadtwardówkowy rdzenia kregowego na poziomie Th1-Th2 skojarzony z torbiela pajeczynówki, leczony operacyjnie.

In a man aged 28 clinical picture, myelography and computerized myelotomography demonstrated epidural haematoma at the level of Th1-Th2 vertebrae with associated arachnoidal cyst. Owing to initially erroneous diagnosis of transverse myelitis the haematoma was diagnosed only after 7 days and removed surgically with simultaneous evacuation of the cyst. The therapeutic result was minimal.

[Value of myeloscintigraphy in the evaluation of patency of the spinal canal]. / Wartosc mieloscyntygrafii w ocenie droznosci kanalu kregowego.

The authors carried out 66 myeloscintigraphies in 66 patients suspected of having compressing lesions of the spinal cord. In 32 cases the obtained results agreed with the results of contrast myelography which was carried out in 38 patients, and in 22 cases these results were confirmed by operations. In the remaining cases contrast myelography was abandoned in view of unequivocal results of myeloscintigraphy and conservative treatment was started. On the basis of a comparative analysis the authors stated that myeloscintigraphy is safer than contrast myelography, less troublesome for the patient and eliminates the risk connected with contrast medium remaining in the subarachnoideal space. There are practically no contraindications to its use even in outpatients, and it could even be used for screening patients with suspected spinal cord compression. Myeloscintigraphy makes possible the diagnosis of spinal tumours, arachnoideal adhesions and meningocele. In cases of nucleus pulposus prolapse the method is less reliable and less useful. For determination of the character of the pathological lesion and its relation to the spinal cord, and also in cases with doubtful results of myeloscintigraphy contrast myelography should be done.

[Case of spinal cord hemangioma simulating the clinical course of multiple sclerosis]. / Przypadek naczyniaka rdzenia kregowego nasladujacy przebiegiem stwardnienie rozsiane.

The authors report a case of haemangioma of the thoracic spine in a man aged 50 years in whom the clinical course of the disease resembled that of multiple sclerosis. The monofocal character of the clinical symptoms and signs, the course of the disease with steady progression without intermittent improvement suggested a slowly developing expanding lesion in the lower thoracic part of the spinal canal. The correct diagnosis was reached after myelography and spinal arteriography. Three months after surgical closure of the afferent vessels the patient died died from septicaemia originating from extensive refractory decubitus ulcers.