Injections of Pantopaque into nerve roots are valuable as a method for evaluating sciatica, particularly in those patients with recurrent sciatica following multiple diagnostic procedures (myelograms, discograms, and electromyograms), following multiple operations on the back, or when the etiology of the sciactica cannot be determined by standard methods. Successful localization of the involved nerve root is accomplished by introduction of a needle into a nerve-root sleeve under roentgenographic control, after which 1 per cent lidocaine (Xylocaine) is used as a nerve block. If the Xylocaine injection eliminates the sciatica, surgical exploration of the nerve root is then carried out. In a series of twenty-two patients with complicated back problems who were seen with sciatica as the major symptom, evaluation by this method permitted precise diagnosis of the level and side of the lesion in eighteen patients, and appropriate surgical treatment in sixteen.
From the Department of Orthopaedic Surgery, Akron General Medical Center, Akron