PATIENT ATTITUDES TO MYELOGRAPHY, COMPUTED-TOMOGRAPHY AND MAGNETIC-RESONANCE-IMAGING WHEN EXAMINED FOR SUSPECTED LUMBAR DISC HERNIATION

In reports of diagnostic methods in disorders of the spine focus is ce ntred on diagnostic resolution, while psychological effects and patien ts' discomfort are often disregarded. To get a comprehensive picture o f the appropriateness of a new technology the latter factors need to b e explored and included in an assessment. In a prospective study, eigh t patients with signs of lumbar disc herniation underwent myelography, computed tomography and magnetic resonance imaging. A structured pati ent interview on attitudes to these technologies was carried out after all three examinations had been carried out. Myelography was most oft en reported painful and unpleasant among the three modalities. Discomf ort due to magnetic resonance imaging stem from the narrow calibre of the machine and the noise. In computed tomography immobilization was t he main reason for discomfort. Altogether most patients preferred comp uted tomography. In view of the fact that myelography must be consider ed as diagnostically inferior to the other two examinations, the repor ted discomfort from myelography indicates that computed tomography and magnetic resonance imaging should be the primary examinations for pat ients with lumbar disc herniation.