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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 -
British Medical Journal (Clinical... May 1982
Topics: Constriction, Pathologic; Humans; Lumbosacral Region; Spinal Canal; Spinal Diseases
PubMed: 6805616
DOI: 10.1136/bmj.284.6329.1588-a -
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 -
Internal Medicine (Tokyo, Japan) Jul 2023A 60-year-old Japanese man diagnosed with acromegaly at 28 years old had difficulty walking due to worsening back pain. He had been treated with somatostatin analog... (Review)
Review
A 60-year-old Japanese man diagnosed with acromegaly at 28 years old had difficulty walking due to worsening back pain. He had been treated with somatostatin analog since 57 years old, but his pain and numbness continued to worsen. Lumbar magnetic resonance imaging showed disc bulging at L3/4 and L4/5, and he was diagnosed with lumbar spinal canal stenosis due to hypertrophy of the yellow ligament. Patients with acromegaly may complain of osteoarthropathy, so we must pay attention to the symptoms of spinal canal stenosis in collaboration with orthopedic specialists.
Topics: Male; Humans; Adult; Middle Aged; Acromegaly; Constriction, Pathologic; Lumbar Vertebrae; Spinal Stenosis; Back Pain; Magnetic Resonance Imaging; Spinal Canal
PubMed: 36476548
DOI: 10.2169/internalmedicine.0763-22 -
European Spine Journal : Official... Dec 2009
Topics: Aged; Decompression, Surgical; Humans; Intervertebral Disc; Intervertebral Disc Degeneration; Laminectomy; Lumbar Vertebrae; Male; Minimally Invasive Surgical Procedures; Osteotomy; Postoperative Complications; Spinal Canal; Spinal Nerve Roots; Spinal Stenosis; Spondylosis; Surgical Instruments; Treatment Outcome; Zygapophyseal Joint
PubMed: 19936802
DOI: 10.1007/s00586-009-1223-2 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jun 2022The aim of the study was to investigate the relationship between the interpedicular distance increase ratio and the ratio of canal compromise in thoracolumbar burst...
BACKGROUND
The aim of the study was to investigate the relationship between the interpedicular distance increase ratio and the ratio of canal compromise in thoracolumbar burst fractures.
METHODS
Thirty-one patients (18 male and 13 female) with an average age of 30.8 (14-57) who had been treated for thoraco-lumbar burst fractures in the Department of Orthopaedics and Traumatology were included in the study. The initial anteroposterior radiographs of the patients were used to calculate the increase ratio of interpedicular distance (both from medial-to-medial and from center-to-center). The area measurements from the computerized tomography or magnetic resonans images were used to calculate the canal compromise. The relationship between the increase ratio of interpedicular distance and the ratio of canal compromise was investigated by correlation and linear regression analysis.
RESULTS
There was a 'very good' correlation between the from medial-to-medial and from center-to-center measurements of interpedicular distance (Pearson correlation coefficient: 0.89, p<0.001). The correlation between the ratio of canal compromise and from medial-to-medial and from center-to-center measurements of interpedicular distance was 'good' with Pearson correlation coef-ficients of 0.60 and 0.63, respectively (p<0.001). No statistically significant relationships were found between the fracture levels, types, neurologic status of the patients, and the increase ratio of interpedicular distance or the ratio of canal compromise.
CONCLUSION
Depending on the correlation coefficients which were obtained in this study: To predict the canal compromise from the ratio of interpedicular distance increase is not a reliable method for all of the patients.
Topics: Adult; Female; Fractures, Comminuted; Humans; Lumbar Vertebrae; Male; Spinal Canal; Spinal Fractures; Thoracic Vertebrae
PubMed: 35652885
DOI: 10.14744/tjtes.2021.99560 -
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 -
Korean Journal of Anesthesiology Aug 2022If the proportion of the spinal cord in the epidural space can be determined under C-arm fluoroscopy during cervical epidural block, a safe entry point for the epidural...
Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients.
BACKGROUND
If the proportion of the spinal cord in the epidural space can be determined under C-arm fluoroscopy during cervical epidural block, a safe entry point for the epidural needle can be established. The aim of this study was the measurement of the cord to canal transverse diameter ratio of each cervical spines.
METHODS
We retrospectively evaluated the imaging data of 100 patients who underwent both cervical computed tomography (CT) and cervical magnetic resonance imaging (MRI) at our hospital. We measured the diameters of the spinal canal and spinal cord from the 3rd cervical vertebra to the 1st thoracic vertebra (T1) at each level by using the patients' cervical CT and MRI images. The spinal cord and spinal canal diameters were measured in the transverse plane of the cervical MRI and CT images, respectively.
RESULTS
The spinal cord to spinal canal diameter ratio was the highest at the 4th and 5th cervical vertebrae (0.64 ± 0.07) and the lowest at T1 (0.55 ± 0.06, 99% CI [0.535, 0.565].
CONCLUSIONS
Our findings suggest that the cord to canal transverse diameter ratio could be used as a reference to reduce direct spinal cord injuries during cervical epidural block under C-arm fluoroscopy. In the C-arm fluoroscopic image, if an imaginary line connecting the left and right innermost lines of the pedicles of T1 is drawn and if the needle is inserted into the outer one-fifth of the left and right sides, the risk of puncturing the spinal cord would be relatively reduced.
Topics: Humans; Magnetic Resonance Imaging; Republic of Korea; Retrospective Studies; Spinal Canal; Spinal Cord; Spinal Puncture; Tomography, X-Ray Computed
PubMed: 35272447
DOI: 10.4097/kja.22006 -
Neurology India 2023There have been reports on the significant canal cross-sectional area (CSA) expansion difference between pre- and post-operation, but no comparison of CSA expansion...
BACKGROUND
There have been reports on the significant canal cross-sectional area (CSA) expansion difference between pre- and post-operation, but no comparison of CSA expansion between the hinge-side area (Area H) and the open-side area (Area O) has been reported. This study aimed to measure the spinal CSA expansion between Area H and Area O retrospectively after open-door laminoplasty using new titanium spacers and evaluated this common decompression procedure's effectiveness.
MATERIALS AND METHODS
This study included 27 patients diagnosed with cervical spondylotic radiculopathy or myelopathy, ossification of the posterior longitudinal ligament, and developmental canal stenosis from February 2021 to October 2022. The CSA difference between pre- and post-cervical laminoplasty (C4-C6 levels) was measured with cervical transverse computed tomography scan images. The CSA difference in Area H and Area O between pre- and post-laminoplasty was similarly calculated.
RESULTS
The spinal canal areas of each segment after open-door laminoplasty were significantly enlarged (P < 0.05). Area O was also significantly enlarged compared to that of Area H (P < 0.05).
CONCLUSION
Area O was more enlarged than Area H, and both sides were statistically enlarged after open-door laminoplasty.
Topics: Humans; Laminoplasty; Retrospective Studies; Spinal Cord Compression; Cervical Vertebrae; Spinal Canal; Laminectomy; Spondylosis; Treatment Outcome
PubMed: 37635499
DOI: 10.4103/0028-3886.383874 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2021A peridural membranous layer exists between the bony wall of the spinal canal and the dura mater, but reports on the anatomy of this structure have been inconsistent....
A peridural membranous layer exists between the bony wall of the spinal canal and the dura mater, but reports on the anatomy of this structure have been inconsistent. The objective of this study is to give a precise description of the peridural membrane (PDM) and to define it unambiguously as a distinct and unique anatomical entity. Thirty-four cadaveric sections of human thoraco-lumbar spines were dissected. On gross examination, the PDM appears as a smooth hollow tube that covers the bony wall of the spinal canal. An evagination of this tube into the neural foramen contains the exiting spinal nerve. The entire epidural venous plexus, including its extension into the neural foramina, is contained in the body of the PDM. Histological examination of the PDM shows a variable distribution of veins arteries, lymphatics, and nerves embedded in a continuous sheath of fibrous, areolar, and adipose tissue. The posterior longitudinal ligament may be considered a dense condensation of fibrous tissue within the membrane. Thus, the PDM is a unique, continuous, and complete anatomical structure. In the spinal canal, the PDM is adjacent to the periosteum. In the neural foramen, suprapedicular PDM and pedicular periosteum separate anatomically to form a suprapedicular compartment, bounded anteriorly by the intervertebral disc and posteriorly by the facet joint. Trauma or degeneration of the disc or facet joint may lead to inflammation and pain sensitization of PDM. This protective mechanism may be of considerable importance for the functioning of the spine under conditions of strain.
Topics: Cadaver; Dura Mater; Epidural Space; Humans; Spinal Nerves; Spine
PubMed: 32562360
DOI: 10.1002/ar.24476