-
Scientific Reports Sep 2021A known prevalence of concurrent cervical and lumbar spinal stenosis was shown to be 5-25%, but there is a lack of evidence regarding direct relationships in canal...
A known prevalence of concurrent cervical and lumbar spinal stenosis was shown to be 5-25%, but there is a lack of evidence regarding direct relationships in canal dimension and canal-body ratio between cervical and lumbar spine. Total 247 patients (mean age: 61 years, male: 135) with cervical and lumbar computed tomography scans were retrospectively reviewed. Midsagittal vertebral body and canal diameters in reconstructed images were measured at all cervical and lumbar vertebrae, and canal-body ratios were calculated. The canal diameter and ratio were also compared according to the gender and age, and correlation analysis was performed for each value. There were significant correlations between cervical (C3-C7) and lumbar (L1-L5) canal dimension (p < 0.001). C5 canal diameter was most significantly correlated with L4 canal diameter (r = 0.435, p < 0.001). Cervical canal-body ratios (C3-C7) were also correlated with those of lumbar spine (L1-L5) (p < 0.001). The canal-body ratio of C3 was most highly correlated with L3 (r = 0.477, p < 0.001). Meanwhile, mean canal-body ratios of C3 and L3 were significantly smaller in male patients than female (p = 0.038 and p < 0.001) and patient's age was inversely correlated with C5 canal diameter (r = - 0.223, p < 0.001) and C3 canal-body ratio (r = - 0.224, p < 0.001). Spinal canal dimension and canal-body ratio have moderate degrees of correlations between cervical and lumbar spine and the elderly male patients show the tendency of small canal diameter and canal-body ratio. This relationship of cervical and lumbar spine can be an important evidence to explain to the patients.
Topics: Cervical Vertebrae; Female; Humans; Lumbar Vertebrae; Male; Middle Aged; Spinal Canal; Spinal Stenosis
PubMed: 34531481
DOI: 10.1038/s41598-021-98038-0 -
European Spine Journal : Official... May 2013To compare volume-occupying rate of cervical spinal canal between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and to investigate its...
PURPOSE
To compare volume-occupying rate of cervical spinal canal between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and to investigate its significance in cervical spine disease.
METHODS
Spiral computed tomography (CT) scan (C4-C6 cervical spine unit) was performed in 20 normal subjects and 36 cases of CSM at a neutral position, and data were transferred to the Advantage Workstation Version 4.2 for assessment. Bony canal area and fibrous canal area in each cross section, and sagittal diameters of cervical spinal canal and cervical spinal body were measured. Volume-occupying rate of cervical spinal canal was calculated using MATLAB. Cervical spinal canal ratio and effective cervical spinal canal ratio were calculated, and Japanese Orthopaedic Association score was used to assess cervical spinal cord function.
RESULTS
Volume-occupying rate of cervical spinal canal at a neutral position was significantly higher in CSM patients as compared to normal subjects (P < 0.01). There was no correlation between cervical spinal canal ratio and JOA score in CSM patients, with a Pearson's correlation coefficient of 0.171 (P > 0.05). However, sagittal diameter of secondary cervical spinal canal, effective cervical spinal canal ratio and volume-occupying rate of cervical spinal canal were significantly associated to JOA score, with Pearson's coefficient correlations of 0.439 (P < 0.05), 0.491 (P < 0.05) and -0.613 (P < 0.01), respectively.
CONCLUSIONS
Volume-occupying rate of cervical spinal canal is an objective reflection of compression on cervical spine and spinal cord, and it is associated with cervical spinal cord function. These suggest that it may play a significant role in predicting the development of CSM.
Topics: Adult; Cervical Vertebrae; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Organ Size; Spinal Canal; Spinal Cord Compression; Spondylosis
PubMed: 23291855
DOI: 10.1007/s00586-012-2622-3 -
Medicina 2023
Topics: Humans; Exostoses, Multiple Hereditary; Spinal Canal
PubMed: 37379552
DOI: No ID Found -
European Neurology 2010Lumbar puncture is a frequent procedure performed by physicians from several disciplines to help establish a diagnosis and treatment for several diseases. Post-lumbar... (Review)
Review
Lumbar puncture is a frequent procedure performed by physicians from several disciplines to help establish a diagnosis and treatment for several diseases. Post-lumbar puncture headache (PLPH) is a frequent complication that typically lasts for a couple of days and can be severe enough to immobilize the patient and to require therapy. There are several risk factors identified, pain characteristics, and characteristic findings on spinal and head magnetic resonance imaging. There are several procedural factors that have been identified to be of consequence in attenuating the PLPH incidence, specifically the needle type and size used for this procedure. Once PLPH occurs, the clinician should treat it conservatively with bed rest, analgesics and increased fluids intake, especially caffeine-containing beverages, as it can dramatically affect the patient's wellness. If the pain is severe and disabling and does not respond to conservative treatment, a blood patch should be considered at least 24-48 h following the LP. Epidural blood patch is a safe and rapidly effective treatment in experienced hands. Furthermore, patients who developed PLPH should be advised to contact the medical staff in case of changes in the characteristics of headaches. When a patient who was diagnosed with PLPH has a change in the pain character, or additional neurological manifestations appear, an urgent brain CT/head MRI should be performed to exclude rarer life-threatening intracranial complications.
Topics: Humans; Magnetic Resonance Imaging; Needles; Pain; Post-Dural Puncture Headache; Risk Factors; Spinal Canal; Spinal Cord; Spinal Puncture
PubMed: 20628255
DOI: 10.1159/000316774 -
Spinal Cord Series and Cases Aug 2020Gunshot wounds (GSW) to the cervical spine remain uncommon. Surgery often does not yield significant neurological improvement and the decision to utilize surgery depends... (Review)
Review
INTRODUCTION
Gunshot wounds (GSW) to the cervical spine remain uncommon. Surgery often does not yield significant neurological improvement and the decision to utilize surgery depends on a number of factors. We describe the case of a 28 year-old male suffering a complete spinal cord injury (SCI) secondary to a bullet lodged in the cervical spinal canal. We present the unique radiological findings and review the indications for and utility of spine surgery for cervical GSW.
CASE PRESENTATION
The patient was a 28 year-old male involved in a motor vehicle accident immediately after sustaining a gunshot wound to the cervical spine. Neurologic exam revealed a complete SCI at the C4 level. CT scan revealed a retained bullet in the spinal canal at the C4/5 level without vascular injury or unstable vertebral fracture. He was managed nonoperatively, however, he remained ventilator dependent and ultimately expired secondary to cardiac arrest from a suspected pulmonary embolism.
DISCUSSION
We present a case of complete SCI secondary to a retained bullet in the cervical spine. These cases can be managed both operatively and nonoperatively. Given the high risk of morbidity and overall poor neurological recovery after surgical intervention for SCI secondary to GSW, physicians must understand the appropriate indications for surgical intervention. These indications include, but are not limited to, progressive neurological deficit, cerebrospinal fluid leak, spinal instability, and acute lead toxicity.
Topics: Adult; Cervical Vertebrae; Decompression, Surgical; Humans; Male; Spinal Canal; Spinal Cord Injuries; Tomography, X-Ray Computed; Wounds, Gunshot
PubMed: 32826864
DOI: 10.1038/s41394-020-00326-w -
Journal of Orthopaedic Research :... Aug 2021Lumbar developmental spinal stenosis (DSS) refers to multilevel pre-existing narrowed spinal canals, which predispose to neural compromise. The objective of this study...
Lumbar developmental spinal stenosis (DSS) refers to multilevel pre-existing narrowed spinal canals, which predispose to neural compromise. The objective of this study is to identify any inheritance pattern of DSS by utilizing pedigree charts. This was a case series of 13 families with a total of 80 subjects having magnetic resonance imaging (MRI) from L1 to S1. Cases (subjects with DSS) or controls (subjects without DSS) were identified by measuring their anteroposterior (AP) vertebral canal diameters. Multilevel model analyses were also performed to evaluate whether there is substantial clustering of observations within the families, and the effect of multilevel DSS. The intraclass correlation coefficient (ICC) and Akaike information criteria (AIC) were compared between models. Correlations between subject demographics and AP vertebral canal diameter were statistically insignificant at all levels. Only vertebral canal cross-sectional area, and axial and sagittal vertebral canal diameter were found to be statistically different between cases and controls at all levels (all p < .05). Both males and females were affected by DSS and there was no skipping of generation, which highly suggested DSS followed an autosomal dominant inheritance pattern. After accounting for multilevel DSS, there was a drop of more than 10 in AIC and some variances were also explained within families. This is the first study that suggests multilevel lumbar DSS to have an autosomal dominant inheritance pattern. Within families with a background of DSS, subjects had a smaller canal size, contributed by shortened axial and sagittal AP vertebral canal diameter, and smaller canal cross-sectional area.
Topics: Female; Humans; Inheritance Patterns; Lumbar Vertebrae; Male; Pedigree; Spinal Canal; Spinal Stenosis
PubMed: 32902878
DOI: 10.1002/jor.24850 -
American Journal of Veterinary Research Jul 2016OBJECTIVE To evaluate the potential usefulness of epiduroscopy for clinical diagnosis and treatment of vertebral canal and spinal cord lesions in dogs. SAMPLE Cadavers...
OBJECTIVE To evaluate the potential usefulness of epiduroscopy for clinical diagnosis and treatment of vertebral canal and spinal cord lesions in dogs. SAMPLE Cadavers of 6 mixed-breed dogs. PROCEDURES Dogs were positioned in sternal recumbency, and an endoscope was introduced into the lumbosacral epidural space. A fiberscope (diameter, 0.9 mm; length, 30 cm) was used for 3 dogs, and a videoscope (diameter, 2.8 mm; length, 70 cm) was used for the other 3 dogs. Visibility and identities of anatomic structures were recorded, and maneuverability of the endoscopes was assessed. Extent of macroscopic tissue damage was evaluated by manual dissection of the vertebral canal at the end of the procedure. RESULTS Intermittent saline (0.9% NaCl) solution infusion, CO2 insufflation, and endoscope navigation improved visualization by separating the epidural fat from the anatomic structures of interest. Images obtained with the fiberscope were small and of poor quality, making identification of specific structures difficult. Maneuverability of the fiberscope was difficult, and target structures could not be reliably reached or identified. Maneuverability and image quality of the videoscope were superior, and spinal nerve roots, spinal dura mater, epidural fat, and blood vessels could be identified. Subsequent manual dissection of the vertebral canal revealed no gross damage in the spinal cord, nerve roots, or blood vessels. CONCLUSIONS AND CLINICAL RELEVANCE A 2.8-mm videoscope was successfully used to perform epiduroscopy through the lumbosacral space in canine cadavers. Additional refinement and evaluation of the technique in live dogs is necessary before its use can be recommended for clinical situations.
Topics: Animals; Cadaver; Dog Diseases; Dogs; Female; Lumbosacral Region; Male; Spinal Canal; Spinal Cord; Spinal Cord Diseases; Spinal Diseases
PubMed: 27347831
DOI: 10.2460/ajvr.77.7.766 -
Journal of Clinical Pathology Nov 1992The pathological findings of an intradural and extramedullary cyst in the mid cervical spinal canal are described in a 55 year old woman who presented with a short...
The pathological findings of an intradural and extramedullary cyst in the mid cervical spinal canal are described in a 55 year old woman who presented with a short history of pain and paraesthesia of the right arm. Intradural well defined solitary cystic lesions in the spinal canal are uncommon, their pathogenesis is poorly understood, and their nomenclature is confusing. In this case the cyst was a bronchogenic cyst; these are a rare form of such cysts and they are thought to be a malformation arising from a split notochordal syndrome and not a teratoma.
Topics: Bronchogenic Cyst; Female; Humans; Middle Aged; Myelography; Spinal Canal; Spinal Diseases
PubMed: 1452780
DOI: 10.1136/jcp.45.11.1032 -
European Spine Journal : Official... Jun 2010Transforaminal endoscopic techniques have become increasingly popular in surgery of patients with lumbar stenosis. The literature has not yet been systematically... (Meta-Analysis)
Meta-Analysis Review
Transforaminal endoscopic techniques have become increasingly popular in surgery of patients with lumbar stenosis. The literature has not yet been systematically reviewed. A comprehensive systematic literature review up to November 2009 to assess the effectiveness of transforaminal endoscopic surgery in patients with symptomatic lumbar stenosis was made. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality, and relevant data, including outcomes, were extracted by two reviewers independently. No randomized controlled trials were identified, but seven observational studies. The studies were of poor methodological quality and heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures. Overall, 69-83% reported the outcome as satisfactory and a complication rate of 0-8.3%. The reported re-operation rate varied from 0 to 20%. At present, there is no valid evidence from randomized controlled trials on the effectiveness of transforaminal endoscopic surgery for lumbar stenosis. Randomized controlled trials comparing transforaminal endoscopic surgery with other surgical techniques are direly needed.
Topics: Clinical Trials as Topic; Endoscopy; Humans; Lumbar Vertebrae; Outcome Assessment, Health Care; Radiography; Spinal Canal; Spinal Stenosis; Treatment Outcome
PubMed: 20087610
DOI: 10.1007/s00586-009-1272-6 -
European Spine Journal : Official... 1997It has been observed that after reduction of an unstable vertebral fracture, treated either conservatively or operatively, the encroachment of the spinal canal remaining... (Comparative Study)
Comparative Study
It has been observed that after reduction of an unstable vertebral fracture, treated either conservatively or operatively, the encroachment of the spinal canal remaining after reduction can decrease considerably with time. A series of 31 cases, each with a set of CT scans taken preoperatively, immediately after surgery and after implant removal respectively, was assessed using computer-aided planimetry. The mean initial narrowing of the spinal canal was 44.6%. Through surgery this was decreased by 20.4%, leaving a remaining deficit of 24.2%. After implant removal, 15 months after trauma and surgery, the area of the spinal canal increased a further 17.4%, leaving a remaining deficit of only 6.8%. Comparing the values of the spinal canal for T12-L5 directly after surgery and after implant removal, an almost identical degree of restoration for each level can be seen. This additional and gradual restoration of the spinal canal is termed remodeling. This study demonstrates that a residual postoperative narrowing of the spinal canal of up to 25% can be ignored, provided there is no initial neurologic damage.
Topics: Adolescent; Adult; Decision Making, Computer-Assisted; Female; Follow-Up Studies; Humans; Internal Fixators; Lumbar Vertebrae; Male; Middle Aged; Prostheses and Implants; Plastic Surgery Procedures; Spinal Canal; Spinal Fractures; Spinal Fusion; Spinal Stenosis; Thoracic Vertebrae; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 9455672
DOI: 10.1007/BF01834072