Avulsion of nerve rootlets with the Cuatico needle during Pantopaque removal after myelography

The role of MR imaging in evaluating metastatic spinal disease

“…Before MR , myelography was considered the procedure of choice for the diagnosis of spinal metastases and associated spinal cord compression [1). In addition to the well-known side effects of water-soluble contrast media and to the risk of exposing the patient to ionizing radiation , myelography carries other potential risks, including rapid neurologic deterioration after lumbar puncture [2] , nerve root avulsion [3], and puncture-site hematomas that occasionally lead to death [4][5][6][7][8][9][10]. Moreover, evaluation of the entire spinal canal with water-soluble contrast material may not be possible in a very ill patient with diffuse metastatic spinal disease.…”