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To the Editor.
—We read with interest the article "Complications of Metrizamide Myelography" by Killebrew et al (Archives 1983;40:78-80). The group of neurosurgeons with whom we are associated perform approximately 40 myelograms per month, of which a growing segment are cervical metrizamide myelograms. We would like to share some of our treatment protocol that has brought our complication rate for lumbar myelography to less than 5% and that for cervical myelography to less than 15%.Standard metrizamide, in concentrations of 18 mL of 180 mg/dL for lumbar studies and 10 mL of 260 mg/ dL for cervical and complete myelographic studies, are used.All patients have nothing by mouth on the morning of myelographic examination. Preoperative medications given intramuscularly one hour prior to the procedure consist of 10 mg of diazepam, 100 mg of hydroxyzine hydrochloride, and 4 mg of dexamethasone sodium phosphate. Following myelography, the patient is placed in