Observation of spinal canal and cisternae with the newly developed small-diameter, flexible fiberscopes.

Small-diameter (0.5-, 0.9-, and 1.4-mm) flexible fiberscopes were developed for visual diagnosis of spinal canal diseases. The fiberscopes were introduced via a Tuohy needle into the subarachnoid and epidural spaces of ten patients with various pain syndromes. Clear visualization of the subarachnoid space was achieved using the fiberscopes. The epidural space could be visualized only during withdrawal of the fiberscope. In five cases, the fiberscope could be advanced up to the level of the cisternae without causing the patient any discomfort. A slight headache and transient fever were noted after the examination in five and two cases, respectively, but no other complications occurred. Interestingly, preexisting pain diminished (two cases) or disappeared (one case) after the myeloscopy in three of five cases in which the myeloscopy revealed aseptic adhesive arachnoiditis. Further studies should be carried out to evaluate the usefulness of this technique.