-
Deutsche Medizinische Wochenschrift... May 1989
Review
Topics: Diagnosis, Differential; Humans; Spinal Canal; Spinal Stenosis; Tomography, X-Ray Computed
PubMed: 2653768
DOI: 10.1055/s-2008-1066669 -
Spine Oct 1984This study investigated the relationship between cervical spine sagittal canal diameter and neurologic injury in cases of spinal fracture-dislocation. A group of 98...
This study investigated the relationship between cervical spine sagittal canal diameter and neurologic injury in cases of spinal fracture-dislocation. A group of 98 patients with such injuries was reviewed; 45 had no neurologic deficits, 39 had incomplete quadriplegia, and 14 had complete quadriplegia. Spinal canal sagittal diameter was measured in all, and large diameter and small canals were defined. Small diameter canals were correlated significantly with neurologic injury, while large diameter canals allowed protection from neurologic injury in cervical fracture dislocation.
Topics: Adult; Aged; Cervical Vertebrae; Fractures, Bone; Humans; Joint Dislocations; Middle Aged; Quadriplegia; Radiography; Retrospective Studies; Spinal Canal
PubMed: 6505832
DOI: 10.1097/00007632-198410000-00001 -
European Journal of Radiology May 1981The sagittal diameter of the lumbar spinal canal has been measured on the radiographs of 100 children in age groups from three to fourteen years, both ages included....
The sagittal diameter of the lumbar spinal canal has been measured on the radiographs of 100 children in age groups from three to fourteen years, both ages included. Corrections have been made for the factors of magnification, leading to the conclusion that the diameter does not vary significantly in the different age groups. The values correspond well to those given in previous anatomical investigations based upon adult skeletal material. The belief that the sagittal diameter increases in childhood appears to be due to disregard of the radiological enlargement. An hour-glass like shape of the lumbar spinal canal with narrowing at the third and fourth lumbar levels is present already from the age of 3.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Radiography; Spinal Canal; Spinal Diseases
PubMed: 7338242
DOI: No ID Found -
European Spine Journal : Official... Feb 2001Bone fragments in the spinal canal after thoracolumbar spine injuries causing spinal canal narrowing is a frequent phenomenon. Efforts to remove such fragments are often...
Bone fragments in the spinal canal after thoracolumbar spine injuries causing spinal canal narrowing is a frequent phenomenon. Efforts to remove such fragments are often considered. The purpose of the present study was to evaluate the effects of surgery on spinal canal dimensions, as well as the subsequent effect of natural remodelling, previously described by other authors. A base material of 157 patients operated consecutively for unstable thoracolumbar spine fractures at Sahlgrenska University Hospital in Gothenburg during the years 1980-1988 were evaluated, with a minimum of 5-years follow-up. Of these, 115 had suffered burst fractures. Usually the Harrington distraction rod system was employed. Patients underwent computed tomography (CT) preoperatively, postoperatively and at follow-up. From digitized CT scans, cross-sectional area (CSA) and mid-sagittal diameter (MSD) of the spinal canal at the level of injury were determined. The results showed that the preoperative CSA of the spinal canal was reduced to 1.4 cm2 or 49% of normal, after injury. Postoperatively it was widened to 2.0 cm2 or 72% of normal. At the time of follow-up, the CSA had improved further, to 2.6 cm2 or 87%. The extent of widening by surgery depended on the extent of initial narrowing, but not on fragment removal. Remodelling was dependent on the amount of bone left after surgery. The study shows that canal enlargement during surgery is caused by indirect effects when the spine is distracted and put into lordosis. Remodelling will occur if there is residual narrowing. Acute intervention into the spinal canal, as well as subsequent surgery because of residual bone, should be avoided.
Topics: Follow-Up Studies; Humans; Internal Fixators; Lumbar Vertebrae; Spinal Canal; Spinal Fractures; Spinal Stenosis; Thoracic Vertebrae; Time Factors; Tomography, X-Ray Computed
PubMed: 11276837
DOI: 10.1007/s005860000194 -
The Spine Journal : Official Journal of... Feb 2011Traumatic pneumorrhachis (PR) is a rare entity, consisting of air within the spinal canal. It can be classified as epidural or subarachnoid, identifying the anatomical... (Review)
Review
BACKGROUND CONTEXT
Traumatic pneumorrhachis (PR) is a rare entity, consisting of air within the spinal canal. It can be classified as epidural or subarachnoid, identifying the anatomical space where the air is located, and is associated with different etiologies, pathology, and treatments.
PURPOSE
To conduct a systematic review of the scientific literature focused on the etiology, pathomechanism, diagnosis, and treatment of PR, and to report a case of an asymptomatic epidural type.
STUDY DESIGN
International medical literature has been reviewed systematically for the term "traumatic pneumorrhachis" and appropriate related subject headings, such as traumatic intraspinal air, traumatic intraspinal pneumocele, traumatic spinal pneumatosis, traumatic spinal emphysema, traumatic aerorachia, traumatic pneumosaccus, and traumatic air myelogram. All cases that were identified were evaluated concerning their etiology, pathomechanism, and possible complications.
SAMPLES
Studies that included one of the aforementioned terms in their titles.
METHODS
A systematic review was performed to identify, evaluate, and summarize the literature related to the term "traumatic pneumorrhachis" and related headings. Furthermore, we report a rare case of an asymptomatic epidural PR extending to the cervical and thoracic spinal canal. We present the current data regarding the etiology, pathomechanism, diagnosis, and treatment modalities of patients with PR.
RESULTS
The literature review included 37 related articles that reported 44 cases of traumatic PR. Only isolated case reports and series of no more than three cases were found. In 21 cases, the air was located in the epidural space, and in 23 cases, it was in the subarachnoid space. Most of the cases were localized to a specific spinal region. However, eight cases extending to more than one spinal region have been reported.
CONCLUSIONS
Traumatic PR is an asymptomatic rare clinical entity and often is underdiagnosed. It usually resolves by itself without specific treatment. We stress the significance of this information to trauma specialists, so that they may better differentiate between epidural and subarachnoid PR. This is of great significance because subarachnoid PR is a marker of severe injury. The management of traumatic PR has to be individualized and frequently requires multidisciplinary treatment, involving head, chest, and/or abdomen intervention.
Topics: Emphysema; Epidural Space; Humans; Radiography; Spinal Canal; Spinal Diseases; Subarachnoid Space
PubMed: 21296300
DOI: 10.1016/j.spinee.2010.12.010 -
Preoperative spinal canal investigation in adolescent idiopathic scoliosis curves > or = 70 degrees.Spine Jul 1994This is a prospective evaluation of a consecutive series of patients with adolescent idiopathic scoliosis (AIS) with curves > or = 70 degrees.
STUDY DESIGN
This is a prospective evaluation of a consecutive series of patients with adolescent idiopathic scoliosis (AIS) with curves > or = 70 degrees.
OBJECTIVE
The authors investigated the possibility that large curve size may constitute an atypical presentation of idiopathic scoliosis suggestive of underlying neurologic pathology, which would warrant preoperative investigation.
SUMMARY OF BACKGROUND DATA
The potential for intraspinal pathology to cause scoliosis is well accepted. The incidence of spinal canal abnormalities in congenital or atypical scoliosis may be as high as 30-60%. Identification of clinical neurologic deficits, congenital abnormalities, or atypical features of scoliosis are often helpful in identifying the subpopulation of scoliosis patients at risk for spinal canal pathology.
METHODS
Thirty-three consecutive patients with large (> or = 70 degrees) adolescent idiopathic scoliosis (AIS) and without evidence of neurologic or congenital abnormalities, were evaluated with either computed tomography/myelogram (n = 3) or magnetic resonance imaging (n = 30) to assess the entire spinal canal.
RESULTS
None of the studies revealed any pathology of the neuraxis, and all 33 patients were treated with surgery without any neurologic sequelae.
CONCLUSIONS
Preoperative investigation of the central neuraxis is not mandatory in large (> or = 70 degrees) but otherwise typical AIS curves. These large curves do not appear to suggest associated spinal canal anomalies.
Topics: Adolescent; Central Nervous System; Child; Female; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Preoperative Care; Prospective Studies; Risk Factors; Scoliosis; Spinal Canal; Spinal Fusion; Thoracic Vertebrae; Tomography, X-Ray Computed
PubMed: 7939997
DOI: 10.1097/00007632-199407001-00009 -
Neurologia I Neurochirurgia Polska 2016The authors present the anterior approach to cervical spine, which enabled complete resection of tumor located in the anterior part of the spinal canal. Considering...
The authors present the anterior approach to cervical spine, which enabled complete resection of tumor located in the anterior part of the spinal canal. Considering there are not many reports in the literature, the authors present a case of a meningioma at the level C5-C6 resected with good result through anterolateral approach.
Topics: Adult; Cervical Vertebrae; Female; Humans; Meningeal Neoplasms; Meningioma; Microsurgery; Neurosurgical Procedures; Orthopedic Procedures; Spinal Canal
PubMed: 27154454
DOI: 10.1016/j.pjnns.2016.02.006 -
Radiology May 2008To prospectively evaluate the safety of radiofrequency (RF) ablation for vertebral lesions by monitoring the temperature in swine vertebral models with and without a...
PURPOSE
To prospectively evaluate the safety of radiofrequency (RF) ablation for vertebral lesions by monitoring the temperature in swine vertebral models with and without a cortical bone defect.
MATERIALS AND METHODS
The institutional animal care and use committee approved the animal studies. In vivo and ex vivo studies were performed. In the in vivo study, 20 lumbar vertebrae from six swine were locally heated by using 1- or 2-cm active-tip internally cooled electrodes. In the ex vivo study, 12 fresh pig cadaver lumbar vertebrae were extracted from four swine, and spinal tumor models with or without cortical bone defect were created by stuffing a cavity with muscle tissue and locally heated by using a 1-cm active-tip internally cooled electrode. The temperature was monitored in the spinal canal and around the vertebral body during ablation. Mann-Whitney U test was used to indicate a significant difference between groups by using 1- and 2-cm active tip in the in vivo study and between groups with and without cortical defect in the ex vivo study.
RESULTS
In the in vivo study in which 1- and 2-cm active-tip needles were used, the temperature in the spinal canal rose to 38.2 degrees C +/- 2.7 (standard deviation) and 45.5 degrees C +/- 6.2, respectively. The latter was significantly higher than the former (P < .001). In the ex vivo study in which tumor models with or without a cortical bone defect were used, the temperature in the spinal canal rose to 48.4 degrees C +/- 6.2 and 31.3 degrees C +/- 3.4, respectively. The former was significantly higher than the latter (P < .001).
CONCLUSION
For in vivo cases with a 2-cm active tip and ex vivo cases with a vertebral posterior bone defect, the temperature rose to over 45 degrees C, potentially injuring the spinal cord and peripheral nerves.
Topics: Animals; Catheter Ablation; Hot Temperature; Prospective Studies; Radiography, Interventional; Spinal Canal; Statistics, Nonparametric; Swine
PubMed: 18430872
DOI: 10.1148/radiol.2472070808 -
Spine Sep 2014Anatomic study.
STUDY DESIGN
Anatomic study.
OBJECTIVE
To determine whether the thoracic spinal canal diameter decreases when the pedicle is allowed to expand with increasing screw diameter. To observe whether osseous breach occurs medially or laterally.
SUMMARY OF BACKGROUND DATA
Insertion of a pedicle screw that is larger in diameter than that of the native pedicle has been shown to expand the pedicle and increase biomechanical fixation strength. With this technique, there is concern for medial expansion of the pedicle causing decrease in spinal canal diameter, especially in the concavity of scoliosis, resulting in spinal cord compression. Also, large pedicle screws that are inserted correctly may still cause undetected medial bony breach during surgery.
METHODS
A total of 162 pedicles from 81 thoracic vertebrae (T1-T12) of 7 fresh-frozen adult cadavers were analyzed. After undertapping the pedicle by 1 mm, pedicle screws were inserted in increasing diameter (range, 4.0-9.5 mm) bilaterally until there was an osseous breach in the pedicle. A total of 938 screws were used. Transverse spinal canal diameter and pedicle circumference were measured (in millimeters) before and after each pedicle screw placement. Photographs and fluoroscopic images of representative specimens were obtained for visual assessment.
RESULTS
The average transverse spinal canal diameter was 17.7 mm. The average transverse canal diameter with the largest screw inserted before bony breach was detected was 17.6 mm (P = 0.92). The average diameter of the largest screw inserted before breach was 6.9 mm. Pedicle circumference increased from 41.8 mm before screw placement to 43.4 mm at maximal expansion before bony breach with the next sized screw. Twenty-eight pedicles did not break with 9.5-mm-diameter screws. There were 133 lateral and 1 medial breaches.
CONCLUSION
Increasing pedicle screw size caused pedicle expansion laterally but did not significantly alter transverse spinal canal dimensions. When there was an osseous breach, most were lateral (99.3%).
LEVEL OF EVIDENCE
N/A.
Topics: Humans; Orthopedic Procedures; Pedicle Screws; Spinal Canal; Thoracic Vertebrae
PubMed: 25010092
DOI: 10.1097/BRS.0000000000000514 -
Skeletal Radiology Aug 2016Periosteal chondroma is a very unusual cartilaginous neoplasm of the spinal canal. We herein report a case of periosteal chondroma in a 41-year-old male who presented...
Periosteal chondroma is a very unusual cartilaginous neoplasm of the spinal canal. We herein report a case of periosteal chondroma in a 41-year-old male who presented with gait disturbance and paresthesia of both lower extremities. Magnetic resonance (MR) images showed an extradural mass which caused compression of the spinal cord at the T5/6 level. The mass showed iso-signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and nodular and peripheral rim enhancement on post-contrast T1-weighted images. Computed tomography (CT) images showed a mass with punctate calcifications and extension into the left T5/6 neural foramen. MR and CT images showed extrinsic cortical bone erosion of the posterior inferior body of T5 and superior pedicle of T6, bone remodeling with overhanging margins, and sclerosis adjacent to the tumor. The patient underwent a complete excision of the mass by left T5/6 hemi-laminectomy and exhibited complete resolution of his symptoms. Histopathologic examination revealed periosteal chondroma. Tumor recurrence was not recorded during the 18-month follow-up period.
Topics: Adult; Chondroma; Humans; Magnetic Resonance Imaging; Male; Spinal Canal; Spinal Cord Compression; Tomography, X-Ray Computed
PubMed: 27179652
DOI: 10.1007/s00256-016-2406-7