Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SPINAL CANAL”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Backache and the lumbar spinal canal.

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.

Adolescent↗
PubMed2005

The effect of pedicle screw placement with or without application of compression across the neurocentral cartilage on the morphology of the spinal canal and pedicle in immature pigs.

STUDY DESIGN: Experimental study. OBJECTIVES: To investigate the effects of pedicle screw insertion on spinal canal and pedicle morphology in immature pigs, and, if transpedicular fixation has an effect, to document whether this occurs because of the inhabitance of the screw inside the growth plate (neurocentral cartilage [NCC]) or because of compression applied across the NCC. SUMMARY OF BACKGROUND DATA: Transpedicular fixation has been less commonly applied to the pediatric population, especially because of the risk of damage to the NCC. METHODS: Twelve newborn pigs (4-6 weeks of age) were operated on. Left sided pedicles from L1-L5 were studied, while right sides served as controls. Pigs were randomly assigned into 3 groups: (1) pedicles were probed only; (2) screws were inserted; and (3) after screw insertion, a washer and a nut were engaged at the pedicle entry point so that gradual compression across the NCC was achieved. After 4 months, spiral computerized tomography was used to measure the pedicle lengths and size of the halves of the spinal canal. RESULTS: In group 1, the operated hemi-canal area was not statistically different from the nonoperated side (P = 0.159). Pedicle screw insertion either with (P = 0.007) or without (P = 0.005) compression resulted in smaller hemi-canal area and shorter pedicles at the operated side, respectively (P = 0.008, P = 0.021). Approximately 4% to 9% shortening of the pedicle lengths and 20% to 26% narrowing of the hemi-canal areas on the instrumented side occurred with transpedicular instrumentation (groups 2, 3). CONCLUSION: Even without compression, pedicle screws passing through the NCC in immature pigs disturb spinal canal growth significantly. Clinical relevance for young children should be studied further.

Animals↗
PubMed1978

Hemangiopericytoma of the spinal canal. Report of three cases.

Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.

Adult↗
PubMed1979

Myelographic evaluation of nontraumatic spinal canal obstruction: a new approach.

A new technique simplifies the evaluation of the spinal canal above obstructing lesions encountered during myelography via the lumbar route. After the demonstration of a block with 2--4 ml Pantopaque, a second injection of 2--4 ml Pantopaque is made through the lumbar needle with the patient in 45 degree Trendelenberg (or any degree necessary to keep the initial contast bolus against the inferior margin of the obstruction). In all 10 cases in this series, the second injection easily displaced contrast around and above obstructions that could not be overcome by gravity thereby obviating a lateral cervical or cisternal puncture. No technical failures of complications were encountered. The method is not recommended in cases of traumatic spinal canal obstruction.

Adult↗
PubMed1977

[Radiological diagnosis of the narrow lumbar spinal canal syndrome (author's transl)].

31 myelograms of patients with the syndrome of lumbar spinal canal constriction were analysed. Two forms can be distinguished - a primary form with hypoplasia of the lumbar section of the spinal canal, and a secondary form with circumscribed constriction through olisthy or spondylosis deformans. The characteristics symptoms of the primary form (n = 21) are: difficult lumbar puncture, the ascent of the contrast medium in the thoracic section of the vertebral canal, multiple protrusions of the intervertebral discs, reduced sagittal diameter of the dural area which is marked by additional signs of spondylosis. In this connection, the alterations were so characteristic that it was possible to diagnose the condition even before the operation. The myelogram with water-soluble contrast-medium is considered to be markedly superior to other methods of radiological examination.

Adult↗
PubMed1997

Mobile tumours in the lumbar spinal canal: a diagnostic problem.

In two cases of mobile tumours in the lumbar spinal canal there was difficulty and delay in clinical and radiologic diagnosis because the early symptoms did not correspond to any particular dermatome. Myelography and computed tomography (CT) are the initial diagnostic procedures used in most institutions, even where magnetic resonance imaging (MRI) is available. The purpose of these 2 case reports is to remind clinicians that it is possible for certain tumours attached to the roots in the lumbar spinal canal to migrate, because the roots tend to be redundant or tax. Multilevel search is essential in neuroradiologic studies for early diagnostic confirmation of mobile tumours.

Aged↗
PubMed2001

[Measurement of CSF flow in the spinal canal using MRI with an optimized MRI protocol: experimental and clinical studies].

PURPOSE: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. METHODS: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm2), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 different power levels were measured at the stenosis and at a distance of 70 cm. RESULTS: A total of 226 dynamic measurements have been performed--so far 76 in the first part (62 = 81.5% evaluable) and 150 in the second part--using the optimized sequence and optimal flow velocities. A flow-encoding sequence of 12 cm/s was found best in the CSC and one of 6 cm/s in the TSC and LSC. The maximum velocity in the CSC was 0.95 cm/s with the flow being directed caudal and 0.38 cm/s with the flow being directed cranial. In the TSC the values were 4.7 cm/s and 1.65 cm/s and in the LSC 0.96 cm/s and 0.59 cm/s. The highest velocities were found at the TSC, which has the smallest diameter compared to the CSC and LSC. In the 4 patients with PTS, the maximum velocities were between 0.09 cm/s and 0.97 cm/s with the flow being directed cranial and between 0.04 cm/s and 1.03 cm/s with the flow being directed caudal. The stroke volumina in the CSC were between 0.1 and 1.23 ml/s (mean: 0.48 ml/s) and 0.2 and 2.45 ml/s (mean: 0.66 ml/s) in the TSC and in the LSC 0.08 ml/s and 0.67 ml/s (mean: 0.29 ml/s). The results of the flow model studies showed an increase of velocity between 2.06 and 4.94 cm/s (mean: 3.31 cm/s) at the stenosis and 1.1 and 1.33 cm/s (mean: 1.23 cm/s) at a distance of 70 cm. CONCLUSION: Quantitative measurement of the oscillating CSF flow in the entire spinal canal (SC) is possible using an optimized MRI protocol as well as to detect stenosis induced velocity changes. Due to the high interindividual variability in the data of spinal CSF dynamics, further studies are necessary to collect normal data. The detection of movement of CSF in a post-traumatic spinal cord lesion may alter the therapeutic management.

Adult↗
PubMed1996

[Reconstruction of open width of the spinal canal by internal fixator instrumentation and remodeling].

In 106 cases of unstable vertebral fractures treated with the ASIF internal fixator, the degree of restoration of the spinal canal could be studied in detail. Computer-aided planimetry was used to measure the area of the spinal canal. Three series could be studied, where the postoperative CT scans had been performed at different times. The first series of 58 cases had the CT scans taken immediately after surgery; the initial mean traumatic narrowing of the spinal canal had been 42.8%, but after surgery it was only 25.2%. The second series consisted of 74 CT scans performed after implant removal. At this time, a residual defect of only 3.7% was observed. In a third series 31 cases could be analysed where CT scans obtained both directly after surgery and after implant removal were available. This confirmed the first two series insofar as it demonstrated the existence of a further mechanism, i.e. remodeling, that served to increase the degree of restoration of the spinal canal. This biological-functional process operates to approximately the same degree at each fracture level, demonstrated by the almost parallel course of the graph showing reduction plus internal fixation and remodeling. In summary, the remaining deficit of 25% after surgery is restored almost to normal through remodeling and can be neglected, provided there is no neurologic damage.

Adolescent↗
PubMed1994

Geometric changes in the cervical spinal canal during impact.

SUMMARY OF BACKGROUND DATA: Although the extent of injury after cervical spine fracture can be visualized by imaging, the deformations that occur in the spinal canal during injury are unknown. STUDY DESIGN: This study compared spinal canal occlusion and axial length changes occurring during a simulated compressive burst fracture with the residual deformations after the injury. METHODS: Canal occlusion was measured from changes in pressure in a flexible tube with fluid flowing through it, placed in the canal space after removal of the cord in cadaver specimens. To measure canal axial length, cables were fixed in C1 and led through the foramen transversarium from C2-T1, then out through the base, where they were connected to the core rods of linearly variable differential transformers (LVDT). Axial compressive burst fractures were created in each of ten cadaveric cervical spine specimens using a drop-weight, while force, distraction, and occlusion were monitored throughout the injury event. Pre- and post-injury radiographs and computed tomography scans compared transient and post-injury spinal canal geometry changes. RESULTS: In all cases, severe compressive injuries were produced. Three had an extension component in addition to compression of the vertebra and retropulsion of bone into the canal. The mean post-injury axial height loss measured from radiographs was only 35% of that measured transiently (3.1 mm post-injury, compared with 8.9 mm measured transiently), indicating significant recovery of axial height after impact. Post-injury and transient height loss were not significantly correlated (r2 = 0.230, P = 0.16) demonstrating that it is not a good measure of the extent of injury. Similarly, mean post injury canal area was 139% of the minimum area measured during impact, indicating recovery of canal space, and post-injury and transient values were not significantly correlated (r2 = 0.272, P = 0.12). Mean post-injury midsagittal diameter was 269% of the minimum transient diameter and showed a weak but significant correlation (r2 = 0.481, P = 0.03). CONCLUSIONS: Two potential spinal cord injury-causing mechanisms in axial bursting injuries of the cervical spine are occlusion and shortening of the canal. Post-injury radiographic measurements significantly underestimate the actual transient injury that occurs during impact.

Biomechanical Phenomena↗
PubMed1975

Congenital narrowing of the cervical spinal canal.

The clinical and laboratory findings in six patients with congenital narrowing of the cervical spinal canal and neurological symptoms are described. A variable age of onset and an entirely male occurrence were found. Signs and symptoms of spinal cord dysfunction predominated in all but one patient. Symptoms were produced in five patients by increased physical activity alone. Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes. The clinical features may be distinguishable from those found in cervical spondylosis without congenital narrowing. Intermittent claudication of the cervical spinal cord appears to be an important feature of this syndrome. Surgery improved four out of five people.

Adolescent↗
PubMed1992

Distribution of hypobaric tetracaine within cerebrospinal fluid in a spinal canal model.

We studied the distribution of hypobaric tetracaine within cerebrospinal fluid (CSF) using a spinal canal model to examine the spread of a hypobaric anesthetic solution during spinal anesthesia. In our study, 0.2% tetracaine colored with methylene blue was observed to migrate upwards rapidly and spread horizontally in the upper portion of the model placed horizontally and filled with CSF which was collected from several neurosurgical patients. The boundary between the hypobaric solution and CSF could be clearly identified. These results suggest that the hypobaric tetracaine will distribute in the upper portion of the spinal canal during spinal anesthesia. It can be used to produce unilateral spinal blockade in the lateral decubitus position despite a small difference in specific gravity between the hypobaric anesthetic and CSF. In addition, the fact that the hypobaric solution showed a rapid horizontal spread suggests that correct positioning both during and following administration of the anesthetic is important to control the level of anesthesia.

Journal Article↗
PubMed2002

MRI diagnosis of embryonal tumors in the spinal canal: analysis of 6 cases.

OBJECTIVE: To evaluate the magnetic resonance imaging (MRI) features characterizing embryonal tumors in the spinal canal. METHODS: Retrospective analyses of the MR images were conducted in 6 patients with surgically and pathologically confirmed embryonal tumors in the spinal canal. RESULTS: Epidermoid cysts in 3 cases displayed a variety of non-characteristic signal intensity patterns on T1- and T2-weighted images (T1WI and T2WI). Lipomas in 2 cases showed high signal intensity on T1WI and attenuated to intermediate signal intensity on T2WI. An intramedullary neurenteric cyst in 1 case was illustrated as low signal intensity on T1WI and high signal intensity on T2WI. CONCLUSION: The MRI presentation of embryonal tumors in the spinal canal with the exception of lipomas is devoid of typical features, and their MRI diagnosis should be complemented by history of developmental anomaly and pathological and etiological findings.

Adolescent↗
PubMed1994

[Voiding dysfunctions in patients with lumbar spinal canal stenosis].

We studied on subjective and objective findings of 69 patients with lumbar spinal canal stenosis. Of the patients 51 (73.9%) had not only orthopedical symptoms but also urological complaints of mostly emptying disorders such as protracted and retardated dysuria and urinary retention, 14 (20.3%) no urological symptom and four (5.8%) urological complaint alone. Cystometrographic findings investigated from all of the patients revealed normoactive detrusor in 34 (49.3%) of them, underactive or acontractile detrusor in 28 (40.6%) and overactive detrusor 7 (10.1%). Eighteen of the patients underwent a surgical treatment for the lumbar spinal canal stenosis. All of seven patients with normoactive detrusor had a good micturition and four of nine with underactive or acontractile detrusor and one of two with overactive detrusor required clean intermittent catheterization (CIC) even after the surgeries. Pre and post surgical urodynamic studies demonstrated that the seven patients resulted in normoactive in four and overactive in three, the nine underactive in six and overactive in three and the two overactive and underactive in one, respectively. It was suggested from the results that the bladder of a patient with limbar spinal canal stenosis could become more irritable state after the surgery than before the therapy.

Adult↗
PubMed1981

The lumbar spinal canal in children. Part I: The sagittal diameter.

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.

Adolescent↗
PubMed1998

Microdecompression and uninstrumented single-level fusion for spinal canal stenosis with degenerative spondylolisthesis.

STUDY DESIGN: A retrospective review was completed on 21 patients who had a "least invasive" (one or two level) microdecompression and uninstrumented single-segment lumbar fusion for spinal canal stenosis with degenerative spondylolisthesis. OBJECTIVE: To determine whether a "least invasive" approach to lumbar spinal canal stenosis and degenerative spondylolisthesis would yield acceptable results. SUMMARY OF BACKGROUND DATA: The prevailing surgical technique for symptomatic spinal canal stenosis with degenerative spondylolisthesis is a wide midline decompression and instrumented fusion. METHODS: On an average of 38 months postoperatively, 21 patients were personally assessed on four scores: 1) their overall satisfaction with the outcome of surgery, 2) an analog back and leg pain scale, 3) a functional evaluation scale, and 4) Ferguson (upshot) anterior-posterior lumbosacral and lateral flexion-extension radiographs. RESULTS: The overall satisfactory outcome on all four scales was 16 (76%) of 21. Twenty of twenty-one patients had relief of their claudicant leg pain; the overall fusion rate was 18 (86%) of 21. Two of three patients with a pseudarthrosis had a successful outcome on the patient-oriented outcome (1, 2, and 3) scales (excluding the radiograph scale), and one was a failure. One patient with a solid fusion was a failure because of continuing back pain. One patient with a solid fusion was a failure because of continuing leg pain. The overall satisfactory outcome on the nonradiographic scales was 18 of 21, for an 86% patient satisfaction rate. CONCLUSIONS: In this retrospective study, a "least invasive" surgical approach to lumbar degenerative spondylolisthesis with spinal canal stenosis causing claudicant leg pain produced acceptable results.

Decompression, Surgical↗
PubMed2005

Anterior dual rod instrumentation in idiopathic thoracic scoliosis: a computed tomography analysis of screw placement relative to the aorta and the spinal canal.

STUDY DESIGN: Axial computed tomography scans (CT) in 20 consecutive patients with idiopathic right thoracic scoliosis and anterior correction and fusion with a dual rod dual screw system. OBJECTIVES: CT evaluation of screw position in anterior dual rod instrumentation relative to the aorta and the spinal canal. SUMMARY OF BACKGROUND DATA: In anterior scoliosis surgery, bicortical screw purchase is used to increase pullout strength. However, impingement of the aorta due to excessive contralateral screw penetration has been reported, especially after endoscopic instrumentation. Data on the accuracy of dual screw instrumentation in thoracic scoliosis are missing. METHODS: All 20 patients underwent an identical anterior surgical technique with double thoracotomy approach and dual rod instrumentation of the primary curve. Postoperative sequential CT scans were analyzed with respect to following parameters: vertebral body width and depth, diameter of the aorta, distance from the aorta to the closest point of the vertebral body cortex, distance between the tip of the screws and the aorta, distance between the screw and the spinal canal, and the amount of contralateral screw penetration. A total amount of 226 screws were evaluated. RESULTS: All screws were placed correctly without any critical proximity to the aorta or spinal canal. A total of 198 of 226 screws (88%) had a bicortical purchase. Thirteen screw tips (5.8%) were within 1 to 3 mm proximity to the aorta. All other screws were more than 3 mm distant from the aorta. The closest proximity of the screw tips to the thoracic aorta was found at the upper end vertebrae (T5, T6, or T7). There were no screws perforating the spinal canal. CONCLUSION: Anterior instrumentation and correction of thoracic scoliosis with a dual rod dual screw system enable a correct and safe screw placement using a standard open approach. Excessive bicortical screw perforation should be avoided in order not to endanger the thoracic aorta.

Adolescent↗
PubMed1995

Reduction of bone retropulsed into the spinal canal in thoracolumbar vertebral body compression burst fractures. A prospective randomized comparative study between Harrington rods and two transpedicular devices.

STUDY DESIGN: This was a prospective, randomized study. OBJECTIVE: To compare the ability of three methods of internal fixation (Harrington rods, AO internal fixator, posterior segmental fixator) to obtain reduction of intracanal fragments in thoracolumbar vertebral compression burst fractures. SUMMARY OF BACKGROUND DATA: Sixty-seven acute thoracolumbar compression burst fractures of T12 or L1 were randomized into three groups that were treated using one of the three methods. Reduction was accomplished indirectly by distraction applied using the fixation device. METHODS: The spinal canal encroachment was calculated as a percentage of the estimated pre-injury value from serial transverse computed tomographic scans obtained on admission and immediately after surgery. RESULTS: The median preoperative sagittal encroachment of the spinal canal was 37% (range, 0-90%) of the normal diameter. All three methods of internal fixation produced a spinal canal clearance provided that the patient was operated on within 4 days after trauma. The median postoperative encroachment varied from 13% (range, 0-37%) to 22% (range, 0-37%), the best reduction being attained using Harrington rods and the poorest with the posterior segmental fixator. There was a suggestive statistical significance between these two. CONCLUSION: The differences in postoperative spinal canal encroachment and ability to obtain spinal canal clearance observed between the devices studied were small. There seems to be no reason to base the choice of the operative method in thoracolumbar fractures on any hypothetical differences in reductive power between Harrington rods and the AO internal fixator.

Adolescent↗