A syringe for injecting lipiodol into the spinal canal

A SYRINGE FOR INJECTING LIPIODOL INTO THE SPINAL CANAL 0. A. NELSON, Urologist to Swedish Hospital;

SEATTLE,

Section, King County HospitaI

WASHINGTON

L

IPIODOL used in the spinal cana for a radio-opaque medium has in the past proved diffrcuIt to inject through the spina needle with the ordinary hand

FIG. 1. Worm-drive

M.D.

Head of a Urologica

the barre1, and in the center of the meta cap is an opening with coarse screw thread to match the screw thread on the stem of the pIunger.

syringe for injection of Iipiodol into the spinal canal.

syringe. A portion of the opaque medium is frequentIy lodged outside of the dura, making it impossibIe at times for the roentgenoIogist to visuaIize the actua1 condition of the spina canal. Furthermore, spiIIing of the Iipiodol outside of the dura is usuaIIy followed by severe pains, whereas a cIean injection is painless. A worm-drive syringe designed by us and constructed by our mechanic has worked so satisfactoriIy that we wish to describe its form and operation. It has a meta pIunger, the stem of which has a coarse screw thread. The gIass barre1 has a IO cc. capacity, with metal attachments at each end. These meta ends are heId secureIy by three truss rods alongside the barre1. The beak of the syringe has an adjustabre attachment so that it can be firmly connected to the spina needle. At the pIunger end of the syringe is a metal cap which screws onto

After removing the pIunger from the barre1, the syringe can be sterirized by boiIing. Loading with IipiodoI is best accompIished by pIacing a smaI1 hypodermic needIe on the beak of the syringe and pouring the IipiodoI into the barrel. The pIunger is now repIaced and excess air expelled. For the purpose of injection the IipiodoI need not be warmed but wiI1 run more readiIy from the ampuIe if pIaced in aIcoho1 of about body temperature before it is used. Having prepared the syringe and compIeted the spina puncture by a 19 or 20 gauge needle, the operator next attaches the syringe to the spina needle. CIockwise rotation of the pIunger drives the IipiodoI through the needIe. At the finish, the rotation should be reversed so as to suck the Iipiodol from the point of the needIe and not Ieave any of it in the tissue outside of the dura. 187