-
European Spine Journal : Official... Aug 2015To clarify the relationship between the laminoplasty opening size (LOS), the laminoplasty opening angle (LOA) and the increase in sagittal canal diameter (SCD) and to...
Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty.
OBJECTIVE
To clarify the relationship between the laminoplasty opening size (LOS), the laminoplasty opening angle (LOA) and the increase in sagittal canal diameter (SCD) and to predict the amount of canal enlargement during open-door cervical laminoplasty (ODCL).
METHODS
Formula describing the relationship between LOS and LOA, the increase in SCD was deduced. The parameters of pre- and postoperative computed tomography scans of 36 patients who had undergone laminoplasty surgery were measured by picture archiving and communication system (PACS) software, and the amount of canal enlargement of these patients was predicted when the opening size of laminoplasty was 8, 10, 12, 14 and 16 mm according to the formula.
RESULTS
For equivalent LOS, the amount of canal enlargement with each opening size differed throughout the cervical region. When the C3-C7 LOS was 10 mm the SCD increased >4.1 mm, and the canal area increased in C3-C6 >88 mm(2), and the canal area increased in C7 > 80 mm(2). When the C3-C7 LOS was 12 mm, the SCD increased >5.2 mm, and the canal area increased in C3-C6 >104 mm(2), and the canal area increased in C7 > 94 mm(2).
CONCLUSION
Formula accurately showed the relationship between the LOS and the increase in SCD achieved by ODCL. The amount of canal enlargement following ODCL could be predicted by the formula. LOS of 10-12 mm at C3-C7 might be optimal during ODCL.
Topics: Adult; Aged; Cervical Vertebrae; Decision Support Techniques; Female; Humans; Laminoplasty; Male; Middle Aged; Outcome Assessment, Health Care; Spinal Canal; Tomography, X-Ray Computed
PubMed: 25628021
DOI: 10.1007/s00586-015-3779-3 -
Spine Jul 1988
Review
Topics: Biomechanical Phenomena; Humans; Neck; Spinal Canal; Spinal Cord Diseases; Spinal Cord Injuries; Spinal Diseases; Stress, Mechanical
PubMed: 3057648
DOI: 10.1097/00007632-198807000-00024 -
The Journal of Bone and Joint Surgery.... Sep 2014Questions remain as to the effect of pedicle screws on spinal canal development in young children. The purpose of this study was to determine the effects of unilateral... (Comparative Study)
Comparative Study
BACKGROUND
Questions remain as to the effect of pedicle screws on spinal canal development in young children. The purpose of this study was to determine the effects of unilateral placement of dual screws across the neurocentral synchondrosis on spinal canal development as assessed with histological analysis and measurement of the canal dimensions in an immature pig model.
METHOD
Twenty-seven one-month-old pigs were assigned to two groups on the basis of the surgical approach used to place unilateral double screws that did or did not cross the neurocentral synchondrosis. In one group, sixteen pigs underwent a posterior approach from T7 to T14 and were divided into four subgroups: no screws (without screw fixation), short screws (dual pedicle screws that did not cross the neurocentral synchondrosis), long screws (dual pedicle screws that crossed the neurocentral synchondrosis), and screw removal (long dual pedicle screws that were removed at six weeks postoperatively). In the other group, eleven pigs underwent an anterior approach, with double vertebral body screws placed via thoracotomy. These animals were divided into two subgroups: short screws (dual vertebral body screws that did not cross the neurocentral synchondrosis) and long screws (dual vertebral screws that crossed the neurocentral synchondrosis). All animals were killed at seventeen weeks. The total area, width, and depth of the spinal canal were measured on axial computed tomography (CT) images. Quantitative histological analysis was performed to measure the rate of neurocentral synchondrosis closure.
RESULTS
Use of unilateral double pedicle screws across the neurocentral synchondrosis through a posterior approach resulted in 97% neurocentral synchondrosis closure with a 20% decrease in the canal area and a 15% decrease in the canal depth. Use of unilateral double vertebral body screws across the neurocentral synchondrosis through an anterior approach resulted in 71% neurocentral synchondrosis closure with a 15% decrease in the canal area and an 8% decrease in the canal width.
CONCLUSIONS
Unilateral double pedicle screws crossing the neurocentral synchondrosis adversely affected spinal canal growth in immature pigs.
CLINICAL RELEVANCE
Pedicle screws should be used with caution in very young children, and a delay in surgical treatment until they are older should be considered.
Topics: Analysis of Variance; Animals; Animals, Newborn; Bone Screws; Disease Models, Animal; Equipment Design; Equipment Safety; Immunohistochemistry; Orthopedic Procedures; Random Allocation; Spinal Canal; Swine; Thoracic Vertebrae; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 25187590
DOI: 10.2106/JBJS.M.01365 -
Spine 1980This paper records measurement of the lumbar spinal canal by diagnostic ultrasound in more than 700 subjects from early infancy until the age of 65 years. It... (Comparative Study)
Comparative Study
This paper records measurement of the lumbar spinal canal by diagnostic ultrasound in more than 700 subjects from early infancy until the age of 65 years. It demonstrates the range of canal size in a South Yorkshire population. The canal is relatively wide in children, reaches a maximum diameter in the late teens, and reduces slightly by late adult life. This does not appear to be related to occupation. Comparisons are made with more than 700 patients with symptoms of back pain, especially patients with disabling disc symptoms, root entrapment syndrome, and neurogenic claudication. The size of the central canal is particularly significant in patients who have neurogenic claudication and disc symptoms. It is less significant in root entrapment syndrome.
Topics: Adolescent; Adult; Aged; Back Pain; Child; Child, Preschool; Female; Humans; Intermittent Claudication; Intervertebral Disc Displacement; Leg; Male; Middle Aged; Nerve Compression Syndromes; Occupational Medicine; Spinal Canal; Spinal Nerve Roots; Ultrasonography
PubMed: 6446166
DOI: 10.1097/00007632-198003000-00003 -
Radiology Nov 1976The value of computed tomography (CT) in cases of spinal dysraphism, spinal canal narrowing and widening, and spinal bony abnormalities is discussed. With further...
The value of computed tomography (CT) in cases of spinal dysraphism, spinal canal narrowing and widening, and spinal bony abnormalities is discussed. With further experience, CT may become a valuable modality for the diagnosis of spinal diseases.
Topics: Humans; Spinal Canal; Spinal Diseases; Tomography, X-Ray Computed
PubMed: 981614
DOI: 10.1148/121.2.361 -
Neurosurgery Aug 1986The authors present seven cases of spinal trauma at the T-12--L-1 level with severe spinal canal stenosis secondary to compressive, anterior discocorporeal lesions....
The authors present seven cases of spinal trauma at the T-12--L-1 level with severe spinal canal stenosis secondary to compressive, anterior discocorporeal lesions. Associated neurological disorders were of varying severity. Six cases were investigated by computed tomography, which enabled the degree of thoracolumbar spinal canal stenosis to be determined. In all cases, the surgical procedure involved rectification of spinal deformity, with an initial unilateral posterolateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of ejected disc fragments. The stabilization was in all cases achieved by complimentary bilateral plates using Roy-Camille material, associated with posterolateral arthrodesis by grafting with reconstruction of the articulopedicular structure. The functional spinal result was excellent in all cases, and recalibration was verified by tomography. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis. The application of this posterolateral approach for severe lesions of the thoracolumbar junction seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods, which present widely recognized difficulties at the thoracoabdominal junction.
Topics: Adult; Evaluation Studies as Topic; Female; Humans; Lumbosacral Region; Male; Spinal Canal; Spinal Injuries; Spinal Stenosis; Thorax; Tomography, X-Ray Computed
PubMed: 3748349
DOI: 10.1227/00006123-198608000-00007 -
Harefuah Apr 1981
Topics: Humans; Spinal Canal
PubMed: 7274813
DOI: No ID Found -
Neurocirugia (English Edition) 2023A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged...
A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients.
Topics: Male; Humans; Child; Wounds, Gunshot; Paraplegia; Spinal Cord Injuries; Neurosurgical Procedures; Spinal Canal
PubMed: 36623892
DOI: 10.1016/j.neucie.2022.11.016 -
The Spine Journal : Official Journal of... Jun 2024The optimal treatment for osteoporotic vertebral burst fracture (OVBF) without neurological symptoms is still a matter of debate.
Is there a risk of further displacement of the fractured fragment into the spinal canal in osteoporotic vertebral burst fractures after unilateral PKP? A prospective study.
BACKGROUND CONTEXT
The optimal treatment for osteoporotic vertebral burst fracture (OVBF) without neurological symptoms is still a matter of debate.
PURPOSE
To evaluate the safety and efficacy of percutaneous kyphoplasty (PKP) for OVBF.
STUDY DESIGN
The study is a prospective study and is registered in the China Clinical Trials Registry with the registration number ChiCTR-OOC-17013227.
PATIENT SAMPLE
The study involved 119 patients with 137 fractured vertebrae who underwent unilateral PKP for OVBF.
OUTCOME MEASURES
The measurements were carried out independently by two physicians and measured with picture archiving and communication system (PACS) and ImageJ software (National Institutes of Health, Bethesda, MD, USA).
METHODS
The change in the spinal canal area and posterior wall protrusions (PWP) were measured before and after surgery via three-dimensional computed tomographic imaging (CT). Preoperative, postoperative, and final follow-up standing X-rays were used to measure the height of the anterior wall (HAW), height of the posterior wall (HPW), and local kyphotic angle (LKA). Additionally, visual analogue scale (VAS) and the Oswestry Disability Index (ODI) were also determined.
RESULTS
Among the 137 vertebrae assessed, 79 exhibited an increased postoperative canal area, while 57 showed a decrease, with mean values of 8.28±6.871 mm² and -9.04±5.991 mm², respectively. Notably, no significant change in postoperative canal area was identified on the entire dataset (p>.01). There was a significant decrease between median preoperative (3.9 [IQ1-IQ3=3.3-4.8] mm) and postoperative (3.7 [IQ1-IQ3=3.0-4.4] mm) PWP (p<.01). Preoperative and postoperative HAW measurements were 19.4±6.1 mm and 23.2±5.2 mm, respectively (p<.01). However, at the final follow-up, the HAW was lower than the postoperative value. The HPW was also significantly improved after surgery (p<.01), but at the final follow-up, it was significantly decreased compared with the postoperative measurement. Following surgery, KA was significantly corrected (p<.01); however, at the final follow-up, relapse was detected (average KA: 18.4±10.3°). At the final follow-up, both VAS and ODI were significantly improved compared with the preoperative period (p<.01). As for complications, 50 patients experienced cement leakage, and 16 patients experienced vertebral refracture. All patients did not develop neurological symptoms during the follow-up.
CONCLUSIONS
OVBF without neurological deficits showed significant improvement in symptoms during the postoperative period after PKP. There was no notable alteration in the spinal canal area, but a significant decrease in PWP was observed. Consequently, we posit that PKP stands as a secure and efficacious surgical intervention for treating OVBF cases devoid of neurological symptoms.
Topics: Humans; Spinal Fractures; Female; Male; Osteoporotic Fractures; Aged; Middle Aged; Kyphoplasty; Spinal Canal; Prospective Studies; Aged, 80 and over; Treatment Outcome
PubMed: 38110090
DOI: 10.1016/j.spinee.2023.12.005 -
Medical Science Monitor : International... Feb 2018BACKGROUND This study aimed to explore the feasibility and efficacy of bone cement-augmented short-segmental pedicle screw fixation in treating Kümmell disease....
BACKGROUND This study aimed to explore the feasibility and efficacy of bone cement-augmented short-segmental pedicle screw fixation in treating Kümmell disease. MATERIAL AND METHODS From June 2012 to June 2015, 18 patients with Kümmell disease with spinal canal stenosis were enrolled in this study. Each patient was treated with bone cement-augmented short-segment fixation and posterolateral bone grafting, and posterior decompression was performed when needed. All patients were followed up for 12-36 months. We retrospectively reviewed outcomes, including the Oswestry disability index (ODI), visual analog scale (VAS) score, anterior and posterior heights of fractured vertebrae, kyphotic Cobb angle, and neurological function by Frankel classification. RESULTS The VAS grades, ODI scores, anterior heights of affected vertebrae, and kyphotic Cobb angles showed statistically significant differences between pre- and postoperative and between preoperative and final follow-up values (P<0.05), whereas the differences between postoperative and final follow-up values were not statistically significant (P>0.05). The differences between posterior vertebral heights at each time point were not statistically significant (P>0.05). Improved neurological function was observed in 12 cases at final follow-up. Three cases had complications, including asymptomatic cement leakage in 2 patients and delayed wound infection in 1 patient. CONCLUSIONS Bone cement-augmented short-segment pedicle screw fixation is safe and effective for treating Kümmell disease, and can achieve satisfactory correction of kyphosis and vertebral height, with pain relief and improvement in neurological function, with few complications.
Topics: Aged; Aged, 80 and over; Bone Cements; Constriction, Pathologic; Decompression, Surgical; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Male; Middle Aged; Pedicle Screws; Postoperative Care; Spinal Canal; Spinal Fractures; Tomography, X-Ray Computed
PubMed: 29443957
DOI: 10.12659/msm.905804