Outpatient Lumbar Myelography

Over a 2-year period, 92 patients were submitted as outpatients to lumbar myelography using lopamidol, a new nonionic water-soluble contrast medium. The incidence and severity of adverse reactions associated with myelography in these cases were compared with those in 116 patients who underwent lopamidol myelography as inpatients. The hospitalized patients received 10 ml, and the outpatients 8 or 10 ml of contrast medium (300 mg l/ml). The severity of complications was graded as very mild, mild, moderate, or severe. The complication rate was 37% in the hospitalized patients and 40% in the outpatients. Adverse reactions, mostly in the form of headache, were very mild in approximately two thirds of cases in each group, and moderate or severe in 15% of the inpatients and 24% of the outpatients presenting complications. The incidence of moderate or severe reactions was lower in the outpatients receiving 8 ml of contrast medium compared with those given 10 ml. lopamidol lumbar myelography performed on an outpatient basis is a safe procedure. The outpatient regimen considerably reduces the cost of myelography and indirectly increases the availability of beds in orthopaedic and neurologic units.