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Der Radiologe Mar 2021Numerous vascular, inflammatory, degenerative and tumorous lesions of the spinal canal can cause paraplegic symptoms. In addition to the neurological examination and the... (Review)
Review
Numerous vascular, inflammatory, degenerative and tumorous lesions of the spinal canal can cause paraplegic symptoms. In addition to the neurological examination and the leading symptoms, the first topographical classification of the (suspected) disease is essential for further diagnostics. Hence, high-resolution magnet resonance imaging (MRI) is the gold standard for the majority of questions. To avoid diagnostic and therapeutic mistakes, differentiation of intraspinal tumors from tumor-like (nonneoplastic) lesions is indispensable, which is often only possible after follow-up imaging or surgical exploration.
Topics: Humans; Magnetic Resonance Imaging; Spinal Canal; Spinal Cord; Spinal Cord Diseases; Spinal Neoplasms
PubMed: 33566131
DOI: 10.1007/s00117-021-00829-z -
International Journal of Rheumatic... Oct 2023
Topics: Humans; Arthritis, Gouty; Spinal Canal; Thoracic Vertebrae
PubMed: 37243307
DOI: 10.1111/1756-185X.14747 -
World Neurosurgery 2014Acrodysostosis is a rare syndrome characterized by peripheral dysostosis, nasal hypoplasia, and frequently mental retardation. Only two adult cases of acrodysostosis... (Review)
Review
BACKGROUND
Acrodysostosis is a rare syndrome characterized by peripheral dysostosis, nasal hypoplasia, and frequently mental retardation. Only two adult cases of acrodysostosis have been reported to have neurological symptoms.
CASE DESCRIPTION
We report one additional adult case that presented with signs of spinal cord compression from spinal stenosis, and make the first histologic description in the literature of the bony anomalies seen in acrodysostosis. The patient had a T3 to T5 laminectomy and experienced a complete recovery.
CONCLUSIONS
Special attention should be given to these patients to detect signs of spinal stenosis, as early decompression can lead to neurological recovery.
Topics: Decompression, Surgical; Dysostoses; Female; Humans; Intellectual Disability; Laminectomy; Neurologic Examination; Neurosurgical Procedures; Osteochondrodysplasias; Recovery of Function; Spinal Canal; Spinal Cord Compression; Spinal Diseases; Spinal Stenosis; Treatment Outcome; Young Adult
PubMed: 23548849
DOI: 10.1016/j.wneu.2013.03.071 -
Seminars in Ultrasound, CT, and MR Dec 2014Ultrasound of the spine in the neonate is widely used as the initial modality to evaluate spinal canal anatomy, anatomical variants, and congenital malformations. The... (Review)
Review
Ultrasound of the spine in the neonate is widely used as the initial modality to evaluate spinal canal anatomy, anatomical variants, and congenital malformations. The spinal canal and its contents are best visualized in the newborn and young infant owing to incomplete ossification of the posterior vertebral elements.
Topics: Humans; Infant, Newborn; Lumbosacral Region; Meningocele; Neural Tube Defects; Sacrococcygeal Region; Spinal Canal; Spine; Teratoma; Ultrasonography
PubMed: 25454057
DOI: 10.1053/j.sult.2014.08.001 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Oct 2023To review the clinical research progress of spinal epidural lipomatosis (SEL). (Review)
Review
OBJECTIVE
To review the clinical research progress of spinal epidural lipomatosis (SEL).
METHODS
The clinical studies on SEL at home and abroad in recent years were extensively reviewed, and the pathogenesis, clinical and imaging manifestations, and treatment status of SEL were summarized and analyzed.
RESULTS
SEL is a disease characterized by compression of the spinal cord and nerve roots due to abnormal accumulation of epidural adipose tissue in the spinal canal. Its prevalence and diagnosis rate are low and the pathogenesis is not fully understood. MRI is the most sensitive and specific diagnostic test for SEL. Surgical decompression and removal of excess adipose tissue are the only options for patients with acute SEL or those who have failed conservative management, and conservative management should be considered for other patients.
CONCLUSION
SEL is a rare disease and related research still needs to be improved. In the future, high-quality, multi-center and large-sample studies will be of great significance for evaluating the choice of treatment methods and effectiveness of SEL patients.
Topics: Humans; Decompression, Surgical; Epidural Space; Lipomatosis; Magnetic Resonance Imaging; Spinal Cord Diseases
PubMed: 37848326
DOI: 10.7507/1002-1892.202305071 -
World Neurosurgery Mar 2018Syringomyelia is considered as a fluid-filled cavitation inside the spinal cord. However, there is no agreement whether a dilated central canal should be included under...
OBJECTIVE
Syringomyelia is considered as a fluid-filled cavitation inside the spinal cord. However, there is no agreement whether a dilated central canal should be included under this heading or how glioependymal cysts, myelomalacias, or cystic tumors should be distinguished from syringomyelia. This article provides a definition of syringomyelia and guidelines for its diagnosis.
METHODS
Between 1991 and 2015, of 3206 patients with spinal cord pathologies 2276 demonstrated cystic features. All patients underwent magnetic resonance imaging. Syringomyelia was differentiated from cystic intramedullary tumors, glioependymal cysts, myelomalacias, and dilatations of the central canal by clinical and radiologic criteria.
RESULTS
A total of 1535 patients were diagnosed with syringomyelia, 635 with dilatations of the central canal, 52 with glioependymal cysts, 52 with mylomalacias, and 2 with cystic intramedullary spinal cord tumors. Additional neuroradiologic studies revealed the causes of syringomyelia. As a result 604 patients showed pathologies at the craniocervical junction leading to disturbances of cerebrospinal fluid (CSF) flow. The commonest was a Chiari I malformation in 543 patients. Nine hundred thirty-one patients presented with pathologies in the spinal canal. The commonest causes were spinal arachnopathies, leading to CSF flow obstructions in 533 patients, intramedullary tumors in 152 patients, and tethered cord syndromes in 69 patients.
CONCLUSIONS
The diagnosis of syringomyelia should be reserved for patients with a fluid-filled cavity in the spinal cord related to either a disturbance of CSF flow, spinal cord tethering, or an intramedullary tumor. For patients in whom such a relation cannot be established, the diagnosis of syringomyelia should be withheld.
Topics: Adult; Arachnoid; Arnold-Chiari Malformation; Cysts; Diagnosis, Differential; Female; Guidelines as Topic; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Canal; Spinal Cord Neoplasms; Syringomyelia; Terminology as Topic
PubMed: 29317358
DOI: 10.1016/j.wneu.2017.12.156 -
British Journal of Neurosurgery Dec 2018This is a narrative overview of the pathophysiology, investigation and management of Degenerative Cervical Myelopathy (DCM). This review article also takes a look ahead... (Review)
Review
This is a narrative overview of the pathophysiology, investigation and management of Degenerative Cervical Myelopathy (DCM). This review article also takes a look ahead to the impact high resolution MRI may have on treatment. DCM is the most common cause of spinal dysfunction and yet it remains poorly understood. It is becoming increasingly common in our ageing population. Disc and facet joint abnormalities, osteophytes, spondylothisthesis and ligamentous hypertrophy all act together to produce spinal canal and neuronal foramina stenosis which in turn causes neural compromise. Its impact on the quality of life of this patient group and the wider economy is vast. Some patients with overt cord compression and MRI signal change in their cervical cord may only have subtle clinical signs whilst others with less striking imaging may be profoundly myelopathic. Who to operate on and when remains a neurosurgical dilemma in this group of patients. A number of articles with a broad variation in methodology were reviewed and referenced during the production of this paper. This paper is a narrative review. The results presented in all the referenced articles were considered. The process of developing new imaging techniques will give a greater understanding of the causes of the symptoms of DCM and in a wider context facilitate further surgical and medical strategies that are more cost effective and beneficial to patients. The advent of 7T MRI or further optimisation of safer 3T MRI sequences may soon provide this opportunity and the diagnostic gap in spinal cord imaging can begin to close.
Topics: Cervical Cord; Cervical Vertebrae; Humans; Magnetic Resonance Imaging; Neck; Quality of Life; Spinal Canal; Spinal Cord Compression
PubMed: 29688066
DOI: 10.1080/02688697.2018.1467371 -
BMC Musculoskeletal Disorders Nov 2023Unilateral laminotomy with bilateral spinal canal decompression has gained popularity recently.
BACKGROUND
Unilateral laminotomy with bilateral spinal canal decompression has gained popularity recently.
AIM
To systematically review the literature of unilateral laminotomy with bilateral spinal canal decompression for lumbar spinal stenosis (LSS) aiming to assess outcomes and complications of the different techniques described in literature.
METHODS
On August 7, 2022, Pubmed and EMBASE were searched by 2 reviewers independently, and all the relevant studies published up to date were considered based on predetermined inclusion and exclusion criteria. The subject headings "unilateral laminotomy", "bilateral decompression" and their related key terms were used. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement was used to screen the articles.
RESULTS
A total of seven studies including 371 patients were included. The mean age of the patients was 69.0 years (range: 55-83 years). The follow up duration ranged from 1 to 3 years. Rate of postoperative pain and functional improvement was favorable based on VAS, JOA, JOABPEQ, RMDW, ODI and SF-36, for example improved from a range of 4.2-7.5 preoperatively on the VAS score to a range of 1.4-3.0 postoperatively at the final follow up. Insufficient decompression was noted in 3% of the reported cases. The overall complication rate was reported at 18-20%, with dural tear at 3.6-9% and hematoma at 0-4%.
CONCLUSION
Unilateral laminotomy with bilateral decompression has favorable short- and mid-term pain and functional outcomes with low recurrence and complication rates. This, however, needs to be further confirmed in larger, long-term follow-up, prospective, comparative studies between open, and minimally invasive techniques.
Topics: Aged; Aged, 80 and over; Humans; Middle Aged; Decompression, Surgical; Laminectomy; Lumbar Vertebrae; Prospective Studies; Retrospective Studies; Spinal Canal; Spinal Stenosis; Treatment Outcome
PubMed: 37990183
DOI: 10.1186/s12891-023-07033-1 -
Indian Pediatrics Nov 2023To provide a gestation age- and weight-specific mathematical formula for predicting the optimal depth of spinal needle insertion.
OBJECTIVE
To provide a gestation age- and weight-specific mathematical formula for predicting the optimal depth of spinal needle insertion.
METHODS
The study included 127 neonates between 28 and 40 weeks of gestation and weighing 700 to 4000 grams, and a total of 202 ultrasound examinations were performed. Anterior and posterior borders were delineated using ultrasound and measured as spinal canal depth in lateral decubitus position at L3- L4 vertebral interspace. The mid-spinal canal depth (MSCD) was calculated.
RESULTS
Spinal canal dimensions showed an increasing trend with an increase in weight and post-menstrual age of the babies. The best correlation was found between weight and MSCD with an r2 of 0.85, which is given by the formula MSCD (cm) = 0.2 X weight in kg + 0.45.
CONCLUSION
Knowledge of the spinal canal depth using the formula may facilitate accurate needle placement, thereby decreasing traumatic lumbar puncture.
Topics: Infant, Newborn; Infant; Humans; Spinal Canal; Ultrasonography
PubMed: 37950466
DOI: No ID Found -
International Journal of Molecular... Dec 2022Although rodents have been widely used for experimental models of spinal cord diseases, the details of the growth curves of their spinal canal and spinal cord, as well...
Although rodents have been widely used for experimental models of spinal cord diseases, the details of the growth curves of their spinal canal and spinal cord, as well as the molecular mechanism of the growth of adult rat spinal cords remain unavailable. They are particularly important when conducting the experiments of cervical spondylotic myelopathy (CSM), since the disease condition depends on the size of the spinal canal and the spinal cord. Thus, the purposes of the present study were to obtain accurate growth curves for the spinal canal and spinal cord in rats; to define the appropriate age in weeks for their use as a CSM model; and to propose a molecular mechanism of the growth of the adult spinal cord in rats. CT myelography was performed on Lewis rats from 4 weeks to 40 weeks of age. The vertical growth of the spinal canal at C5 reached a plateau after 20 and 12 weeks, and at T8 after 20 and 16 weeks, in males and females, respectively. The vertical growth of the C5 and T8 spinal cord reached a plateau after 24 weeks in both sexes. The vertical space available for the cord (SAC) of C5 and T8 did not significantly change after 8 weeks in either sex. Western blot analyses showed that VEGFA, FGF2, and BDNF were highly expressed in the cervical spinal cords of 4-week-old rats, and that the expression of these growth factors declined as rats grew. These findings indicate that the spinal canal and the spinal cord in rats continue to grow even after sexual maturation and that rats need to be at least 8 weeks of age for use in experimental models of CSM. The present study, in conjunction with recent evidence, proposes the hypothetical model that the growth of rat spinal cord after the postnatal period is mediated at least in part by differentiation of neural progenitor cells and that their differentiation potency is maintained by VEGFA, FGF2, and BDNF.
Topics: Animals; Female; Male; Rats; Brain-Derived Neurotrophic Factor; Fibroblast Growth Factor 2; Magnetic Resonance Imaging; Rats, Inbred Lew; Sexual Maturation; Spinal Canal; Spinal Cord; Spinal Cord Compression; Spinal Cord Diseases
PubMed: 36555713
DOI: 10.3390/ijms232416076