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Der Orthopade Oct 2019
Topics: Constriction, Pathologic; Humans; Lumbar Vertebrae; Spinal Canal; Spinal Stenosis
PubMed: 31559468
DOI: 10.1007/s00132-019-03771-0 -
Orthopaedic Surgery Jul 2021This study is to introduce lift-open laminoplasty and verify the increase of the spinal canal area following this surgical technique according to the preoperative... (Review)
Review
OBJECTIVE
This study is to introduce lift-open laminoplasty and verify the increase of the spinal canal area following this surgical technique according to the preoperative anatomical measurement.
METHODS
There are 82 patients (43 male and 39 female) analyzed in our study from January 2019 to December 2020. The average age was 63.2 ± 3.21 years (from 41 to 84 years). All of them were treated with open-door laminoplasty, with a decompression segment range from C3 to C6. The increase of the spinal canal area after open-door laminoplasty was measured on postoperative CT images of the patients, and the distances between both lamina-facet junctions and lamina length was measured on preoperative CT images. Using the Pythagorean theorem for the equation of calculation area after the expansile open-door laminoplasty. Based on previous measurement parameters, spinous process length, lateral mass width, distance between osteotomy line and lamina-facet junctions line were additionally measured on preoperative CT images. Pythagorean theorem was used for calculating the area after the expansile lift-open laminoplasty. The results were recorded and a statistical analysis was undertaken. Then, there were six patients (five male and one female) treated with lift-open laminoplasty on C6, open-door on C3-C5, who suffer from cervical spondylotic myelopathy from December 2020 to January 2021. The average age was 60.3 ± 1.7 years (from 56 to 71 years). Operation time, blood loss, and Japanese Orthopaedic Association (JOA) score recovery rate were recorded. Intraoperative and postoperative complications were observed.
RESULTS
The increase of the spinal canal area after open-door laminoplasty measured on postoperative CT images was 123.01 ± 17.06 mm and the calculation of the increase of the spinal canal areausing the Pythagorean theorem after open-door laminoplasty was 122.86 ± 15.86 mm . A comparison of the actual value with calculative value showed no significant difference (T value = 0.057, P value = 0.955). The calculation of the increase of the spinal canal area after lift-open laminoplasty was 183.57 ± 62.99 mm , which was larger than that after open-door laminoplasty (T value = 8.462, P value < 0.001). Mean operation time was 153.3 min and operative blood loss was 600 mL of the six patients treated with lift-open laminoplasty. At 1 month follow-up, all patients had recovered well. JOA score recovery rate was 37.6% and no intraoperative and postoperative complications occurred.
CONCLUSION
Lift-open laminoplasty could preserve nearly 100% of extensor muscle, avoid damaging C7 paraspinal muscles and C6-7 posterior muscle-ligament complex, reconstruct the spinous process firmly in the midline, and expand adequate spinal canal area after operation. These advantages could reduce the incidence rate of complications and bring better clinical results than traditional laminoplasty.
Topics: Adult; Aged; Aged, 80 and over; Cervical Vertebrae; Female; Humans; Laminoplasty; Male; Middle Aged; Spinal Canal; Spinal Cord Diseases; Tomography, X-Ray Computed
PubMed: 34109741
DOI: 10.1111/os.13026 -
Journal of Orthopaedic Surgery and... Jun 2023The purpose of this study was to quantify the degree of lumbar spinal stenosis by assessing the anterior and posterior vertebral canal diameter and dural area, determine... (Review)
Review
Effect of the preoperative assessment of the anteroposterior diameters of the spinal canal and dural area on the efficacy of oblique lumbar interbody fusion in patients with lumbar spinal stenosis.
OBJECTIVE
The purpose of this study was to quantify the degree of lumbar spinal stenosis by assessing the anterior and posterior vertebral canal diameter and dural area, determine the sensitivity of the anterior and posterior spinal canal diameter, dural area and dural occupying rate in predicting the postoperative efficacy of oblique lumbar interbody fusion (OLIF) for patients with single-stage lumbar spinal stenosis, and identify the corresponding indicators suggesting that OLIF surgery should not be performed.
METHODS
In a retrospective analysis of patients who had previously undergone OLIF surgery in our hospital, we included a total of 104 patients with lumbar spinal stenosis who had previously undergone single-stage surgery in our hospital. Three independent observers were employed to measure the anterior and posterior diameter of the spinal canal (AD, mm), dural area (CSA, mm), the spinal canal area (SCA, mm), and the ratio of the dural area to the spinal canal area (DM, %) at the disc level with the most severe stenosis on MRI. According to the values of AD and CSA in preoperative MRI, patients were divided into three groups: A, B, and C (Group A: AD > 12 and 100 < CSA ≤ 130, group B: Except A and C, group C: AD ≤ 10 and CSA ≤ 75). Preoperative and postoperative clinical outcome scores (Japanese Orthopaedic Association [JOA] score, VAS score, modified Macnab standard) of 104 patients were statistically.
RESULTS
There were significant differences in the preoperative and postoperative clinical correlation scores among the mild, moderate and severe lumbar spinal stenosis groups. The improvement rate of the post treatment JOA score, the difference between the preoperative and postoperative VAS score, and the modified Macnab standard were compared pairwise. There was no statistical significance in the improvement rate of the post treatment JOA score, the difference between the preoperative and postoperative VAS score, and the modified Macnab standard between Group A and Group B (P = 0.125, P = 0.620, P = 0.803). There were statistically significant differences between Group A and Group C and between Group B and Group C in the improvement rate of the JOA score, the difference in the pre- and postoperative VAS score, and the modified Macnab standard. The anterior and posterior vertebral canal diameter and dural area are sensitive predictors of the postoperative efficacy of OLIF surgery for single-stage lumbar spinal stenosis. Moreover, when the anterior and posterior vertebral canal diameter was less than 6.545 mm and the dural area was less than 34.43 mm, the postoperative effect of OLIF surgery was poor.
CONCLUSIONS
All the patients with mild, moderate, and severe lumbar spinal stenosis achieved curative effects after OLIF surgery. Patients with mild and moderate lumbar spinal stenosis had better curative effects, and there was no significant difference between them, while patients with severe lumbar spinal stenosis had poor curative effects. Both the anteroposterior diameter of the spinal canal and the dural area of the spinal canal were sensitive in predicting the curative effect of OLIF surgery for single-stage lumbar spinal stenosis. When the anterior and posterior vertebral canal diameter was less than 6.545 mm and the dural area was less than 34.43 mm, the postoperative effect of OLIF surgery was poor.
Topics: Humans; Spinal Stenosis; Retrospective Studies; Treatment Outcome; Lumbar Vertebrae; Spinal Canal; Spinal Fusion
PubMed: 37337281
DOI: 10.1186/s13018-023-03913-3 -
Magnetic Resonance Imaging Clinics of... Aug 2016Spinal stenosis is common and presents in a variety of forms. Symptomatic lumbar stenosis occurs in approximately 10% of the population and cervical stenosis in 9% over... (Review)
Review
Spinal stenosis is common and presents in a variety of forms. Symptomatic lumbar stenosis occurs in approximately 10% of the population and cervical stenosis in 9% over age 70. Imaging is central to the management decision process and first-choice MR imaging may be substituted with CT and CT myelography. A review of the literature is presented with particular emphasis on the clinical-radiologic correlation in both neurogenic intermittent claudication and cervical spondylotic myelopathy. Advanced techniques promise improvements, particularly with radicular compressive lesions, but remain underutilized in routine clinical practice.
Topics: Humans; Magnetic Resonance Imaging; Neuroimaging; Spinal Canal; Spinal Stenosis; Tomography, X-Ray Computed
PubMed: 27417399
DOI: 10.1016/j.mric.2016.04.009 -
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 -
Annals of Vascular Surgery Mar 2022The insertion of a neck central venous catheter (CVC) is a common procedure in medical practice; however, malposition and complications frequently occur. A 66-year-old... (Review)
Review
The insertion of a neck central venous catheter (CVC) is a common procedure in medical practice; however, malposition and complications frequently occur. A 66-year-old woman had CVC inserted through the right internal jugular vein. CVC malposition was observed on chest radiography and computed tomography. The catheter was accidentally inserted via the vertebral vein and had entered the C6-C7 intervertebral foramen, penetrating the spinal canal with the tip at the T2 epidural space. We present this rare CVC complication to demonstrate the possibility of incorrect insertion of the catheter and penetration of the spinal canal, possibly causing neuronal damage.
Topics: Aged; Catheterization, Central Venous; Central Venous Catheters; Female; Humans; Magnetic Resonance Imaging; Medical Errors; Pneumorrhachis; Radiography, Thoracic; Spinal Canal; Thoracic Vertebrae; Tomography, X-Ray Computed
PubMed: 34780938
DOI: 10.1016/j.avsg.2021.09.027 -
Brain & Development Jan 2011Ultrasonography (US) remains the first method in the evaluation of fetal central nervous system (CNS) abnormalities but in case of the spinal canal and cord it is often... (Review)
Review
Ultrasonography (US) remains the first method in the evaluation of fetal central nervous system (CNS) abnormalities but in case of the spinal canal and cord it is often insufficient since the bony structures may obscure these structures. Prenatal magnetic resonance imaging (MRI) is therefore the final noninvasive tool for the assessment of these malformations allowing for correction of sonographic findings, revealing the full extent of complex lesions and choosing the candidates for in utero treatment. The authors present the most frequent anomalies of spinal canal and spinal cord in the consecutive phases of pregnancy, illustrated with their own MR images, with reference to the literature and own experience. In 58 out of 252 fetuses examined due to suspicion of CNS anomalies (23.0%) the spinal canal and spinal cord abnormalities were found on MRI. The cases of diastematomyelia, myelomeningocele, tethered cord, caudal regression syndrome, anterior meningocele, cystic sacrococcygeal teratoma and syringohydromyelia are demonstrated.
Topics: Central Nervous System; Female; Fetus; Humans; Magnetic Resonance Imaging; Nervous System Malformations; Pregnancy; Prenatal Diagnosis; Spinal Canal; Ultrasonography, Prenatal
PubMed: 20188501
DOI: 10.1016/j.braindev.2010.01.003 -
European Spine Journal : Official... Aug 2012The aims of this study were to review published data on pedicle dimensions and bony spinal canal diameters calculated from CT examinations of the cervical spine through... (Review)
Review
PURPOSE
The aims of this study were to review published data on pedicle dimensions and bony spinal canal diameters calculated from CT examinations of the cervical spine through the English-language literature and analyze these data for ethnic disparities and similarities.
MATERIALS AND METHODS
The authors reviewed the literature on "pedicle" and "spinal canal" by conducting a bibliographic search using PubMed, Ovid MEDLINE, and Science Direct from January 1985 to December 2010. After evaluating all of the selected abstracts, we ultimately selected 19 studies involving living subjects: 12 studies on pedicle dimensions and 7 on spinal canal diameters. The four parameters, pedicle width (PW), pedicle transverse angle (PTA), anterior-posterior diameter of the spinal canal (APD), and transverse diameter of the spinal canal (TD), were analyzed at the relevant levels from C3 to C7. In addition, the values for pedicle dimensions and spinal canal diameters in the European/American populations were compared using the data from Asian populations as a baseline.
RESULTS
The smallest mean PW was found at C4 in the male (5.1 mm) and female populations (4.1 mm); the largest mean PW was found at C7 in both male (7.7 mm) and female populations (7 mm). The PW in males was greater than in females at the majority of levels. The smallest mean PTA was found at C7 in both male (33.4°) and female populations (33°); the largest mean PTA was found at C4 in both male (53.2°) and female populations (52.1°). The overall PW, PTA, APD, and TD ratio of European/American to Asian populations was 91.4-98.8, 99.6-106.2, 110.7-122, and 100-108.3 %, respectively.
CONCLUSION
Although our cervical spine CT data were suggestive of possible ethnic differences in spinal canal morphology, our analysis failed to identify significant ethnic disparity in pedicle dimensions despite potential differences in physique between populations.
Topics: Cervical Vertebrae; Ethnicity; Female; Humans; Male; Spinal Canal; Tomography, X-Ray Computed
PubMed: 22526698
DOI: 10.1007/s00586-012-2295-y -
Medicine Dec 2023Accurate and detailed spinal canal diameter transverse foraminal morphometry measurements are essential for understanding spinal column-related diseases and surgical...
Accurate and detailed spinal canal diameter transverse foraminal morphometry measurements are essential for understanding spinal column-related diseases and surgical planning, especially for transpedicular screw fixation. This is especially because lateral cervical radiographs do not provide accurate measurements. This retrospective study was conducted to measure the dimensions of the transverse foramen sagittal and transverse diameter (TFD), spinal canal diameter, the distance of the spinal canal from the transverse foramina at the C1 to C7 cervical level, and the anteroposterior and TFDs in the Turkish population. A total of 150 patients who underwent cervical spine computed tomographic imaging with a 1:1 gender ratio were enrolled in the study. The sagittal and TFDs of the spinal canal, the distance of the spinal canal from the transverse foramen, and anteroposterior and TFDs in both right and left sides for all cervical levels C1 to C7. Foramina transversal diameters were measured using imaging tools of the imaging software in the radiology unit. The mean age of the study group was 47.99 ± 18.65 (range, 18-80) years. The majority of the distances of the spinal canal from the transverse foramen and antero-posterior (AP) & transverse (T) diameters for cervical vertebrae were significantly higher in male patients (P < .05). However, between age groups, a few measurements were found significantly different. Some of the distances of the spinal canal from the transverse foramen were significantly higher on the right side whereas all AP & T diameters were significantly higher on the left side in both male and female patients (P < .05). Almost all measurements were significantly higher on the left side for younger patients (<65 years) whereas only AP & T diameters were significantly higher on the left side for older patients (>65 years) (P < .05). Computed tomographic imaging is better than conventional radiographs for the preoperative evaluation of the cervical spine and for a better understanding of cervical spine morphometry. Care must be taken during transpedicular screw fixation, especially in female subjects, more so at the C2, C4, and C6 levels due to decreased distance of the spinal canal from the transverse foramina.
Topics: Humans; Male; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Sex Characteristics; Retrospective Studies; Cervical Vertebrae; Spinal Canal; Spinal Diseases; Tomography, X-Ray Computed
PubMed: 38065881
DOI: 10.1097/MD.0000000000036155 -
Acta Radiologica (Stockholm, Sweden :... May 2019The studies that described the dimensions of the normal fetal thoracic spinal canal and spinal cord on magnetic resonance imaging (MRI) are scarce.
BACKGROUND
The studies that described the dimensions of the normal fetal thoracic spinal canal and spinal cord on magnetic resonance imaging (MRI) are scarce.
PURPOSE
To determine the normal appearance of the fetal spinal canal and spinal cord at T12 across different gestational ages using 3.0-T MRI.
MATERIAL AND METHODS
The spines of 43 normal human fetuses, aged 15-40 weeks, were scanned by 3.0-T MRI. All specimens were scanned using a GE 3.0-T MRI scanner. Imaging of the T12 vertebrae was performed in the coronal, sagittal, and axial planes. The anterior-posterior (AP) diameter, width, and cross-sectional area of the spinal canal and spinal cord at T12 were measured. The influence of gestational age on these parameters was investigated with a scatter plot and linear regression analysis using Pearson correlation coefficient.
RESULTS
The normal morphology of the fetal vertebra at T12 can be clearly showed by MRI; the spinal canal appeared circular, while the spinal cord was ellipsoid. Linear regression analysis showed a significant positive correlation between the AP diameter, width, and cross-sectional area of the spinal canal at T12 and gestational age.
CONCLUSION
Postmortem MRI is a reliable method for understanding the growth dynamics of the spinal canal and spinal cord at T12. Findings from this study would benefit the prenatal diagnosis of congenital malformations by MRI.
Topics: Female; Humans; Magnetic Resonance Imaging; Male; Pregnancy; Prenatal Diagnosis; Reference Values; Spinal Canal; Spinal Cord
PubMed: 30142995
DOI: 10.1177/0284185118791197