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At least 253 records · Page 14Linked to original sources
PubMed2006

Morphometric determinants of the sagittal dimensions of the cervical spinal canal in achondroplasia: an analysis of the reliability of the Torg ratio.

This study was undertaken to evaluate the accuracy of the Torg ratio for predicting the spinal canal stenosis in achondroplasia, by trying to establish its correlation with the corresponding effective sagittal canal diameter (ESCD) and dural sac ratio (DSR) on the MRI of the cervical spine. Lateral radiographs and the sagittal and axial MRI study of the cervical spine from C3 to C7 level were carried out in 18 asymptomatic achondroplasia subjects. A total of 90 levels were evaluated on the lateral radiographs and on the mid sagittal T2 MR images. On statistic analysis, the highest correlation coefficient for the Torg ratio compared with the ESCD was 0.74 at C6 level and the least was 0.45 at the C5 level. The highest correlation coefficient between the Torg ratio and the DSR was 0.79 at C3 level and the least was 0.42 at the C5 level. The highest coefficient of determination for the ESCD was 54% at C6 which translates into a poor correlation. The highest coefficient of determination for the DSR was 62 at C3 level, indicating a variable correlation. These results clearly show that the Torg ratio is of limited value in the assessment of the true sagittal spinal canal diameter in achondroplasia and its reliability as an indicator of severe cervical canal stenosis is questionable.

Achondroplasia↗
PubMed2001

Migration of a lumboperitoneal shunt catheter into the spinal canal--case report.

A 50-year-old female suffered upward migration of a lumboperitoneal (LP) shunt catheter into the spinal canal, manifesting as disturbance of short-term memory. Revision of the shunt confirmed that the tube had migrated into the spinal canal. The tube was pulled back into the peritoneal cavity and attached firmly to the fascia with a new anchoring device. LP shunts have the advantages of technical simplicity and extracranial procedure, but firm fixation is recommended since movements of the spine may cause proximal tube migration.

Female↗
PubMed1994

[Spontaneous "regeneration" of the spinal canal in traumatic bone fragments after fractures of the thoraco-lumbar transition and the lumbar spine].

This is a report about four patients in whom spontaneous remodelling of the spinal canal was observed after thoracolumbar fractures with intraspinal bone fragments leading to narrowing by 33-93%. One of the patients was female and three male; two patients had partial neurologic deficits and two had none. The ages of the patients were 33, 16, 65 and 16 years, and the fractures were localized in one case in segment T-12 in two in L-1 and in one in L-4. Active functional treatment was performed with no repositioning or plastering. The changes in spinal canal narrowing and the bone union were monitored by means of CT scans. The follow-up is 9-27 months. The intraspinal bone fragments gradually disappeared in all cases, while the partial neurologic deficits regressed. All patients are now free of troublesome complaints. We would therefore like to point out that thoracolumbar fractures without complete neurologic deficit that are associated with intraspinal bone fragments, whatever their size, should not immediately be treated by surgery, because conservative active functional treatment with spontaneous remodelling of the spinal canal gives results as good as those of operative treatment with far less risk.

Adolescent↗
PubMed1996

[Radiology of lumbar spinal canal stenosis].

Lumbar spinal stenosis is a frequent cause of low back pain. In this paper we discuss both the pathophysiology and clinical symptomatology of the disease. We also discuss advantages and limitations of plain film radiography, myelography, CT and MRI in its diagnosis. Following an analysis of the pertinent literature we try to determine the relative merit of the various radiologic procedures as to their true representation of clinical and intraoperative findings and faithful rendition of postoperative results. Until sufficient statistically valid data regarding the clinical significance of radiological findings have accumulated, surgery of lumbar spinal stenosis can only be performed after critical evaluation of the individual case.

Diagnostic Imaging↗
PubMed1990

[Correlations in the development of the spinal cord, dura mater and spinal canal in humans].

The spinal cord axial structures (AS) (its dura mater and vertebral canal) demonstrate the greatest growth rate during the intrauterine period and on the 18th month. After birth for the dura mater this age is 3 years, and for the spinal cord and the vertebral canal--7 years of age. The pubertal jump in growth of these formations is noted during the adolescent age (17-21 years). During the first two decades AS demonstrate asymptotic type of growth. In AS development the following periods in common have been revealed: a) intensive growth in children up to 7 years of age; b) growth stabilization (from 8 up to 16 years of age); c) period of a relative morphological stability (22-35 years); d) period of unstable compensatory-adaptive rearrangements (36-60 years); e) period of involutive changes (61-90 years).

Adult↗
PubMed1984

The relationship between spinal canal diameter and back pain in coal miners. Ultrasonic measurement as a screening test?

Back pain is the commonest cause of absence among coal miners. However, the degree of morbidity is variable. To determine whether the susceptible individual can be identified, ultrasound was used to measure the spinal canal diameters of 204 miners. The results show that those men with the longest histories and the longest times off work and those who had to leave the coalface or who left the industry--i.e., those with the greatest morbidity--had significantly narrower canals. Ultrasonic measurement of the spinal canal diameter is safe and noninvasive. Its use should be further evaluated as part of a preemployment screening procedure for back pain.

Age Factors↗
PubMed2001

Correction method for determining anteroposterior diameter of the cervical spinal canal on lateral radiographs.

SUMMARY: Measurement of the anteroposterior diameter of the cervical spinal canal may prove unreliable because of the rotatory effect of degenerative disease. Nevertheless, this measuring error may be corrected by performing dual midpoint measurements between the posterior vertebral body and spinolaminar line when less than 10 degrees of rotation is present.

Analysis of Variance↗
PubMedDate not supplied

Spinal cord injury with a narrow spinal canal: utilizing Torg's ratio method of analyzing cervical spine radiographs.

A 65-year-old inebriated man crashed his car and presented with spinal shock and neurogenic shock from a cervical spinal cord injury without cervical spine fracture or dislocation. The lateral cervical spine radiography was initially read as normal, except for degenerative disk disease; however, Torg's ratio method of analyzing cervical spinal canal sagittal width indicated the spinal canal was congenitally narrow. Magnetic resonance imaging confirmed this and showed bulging and herniation of multiple invertebral disks between C2 and C7. This case illustrates the value of using Torg's ratio method of analyzing lateral cervical spine radiographs. Although Torg's method has not been prospectively validated, it may be useful to identify patients at risk for cervical spinal cord injuries without fractures or dislocations. An abnormal Torg's ratio may be the only clue to the fact that the patient is at higher risk of spinal cord injury when the patient's history or examination is questionable because of head injury, drug intoxication, or therapeutic sedation and paralysis.

Accidents, Traffic↗
PubMed1999

Paragangliomas of the spinal canal.

We report the clinical MRI and histopathological features of five consecutive cases of spinal paraganglioma. Three intradural tumours were found in the typical location (two at the L4, one at the S2 level); one intradural extramedullary tumour arose at an unusual level, from the ventral C2 root, and one extradural tumour growing along the L5 nerve root sheath had an aggressive growth pattern with early, local paraspinal recurrence and, eventually, intradural metastatic spread. This type of growth pattern has not been described previously. Paragangliomas of the spinal canal are more common than previously thought and can be located anywhere along the spine, although the lumbosacral level is the most common. Their appearance on MRI can not distinguish them from other tumours in the spinal canal. Even though paragangliomas in general are benign and slowly growing their growth pattern can vary and be more aggressive, to the point of metastatic spread.

Adult↗
PubMed2005

An extreme lateral access for the surgery of lumbar disc herniations inside the spinal canal using the full-endoscopic uniportal transforaminal approach-technique and prospective results of 463 patients.

STUDY DESIGN: Prospective study of patients with lumbar disc herniations who were operated on with a full-endoscopic uniportal transforaminal approach using an extreme lateral access. OBJECTIVES: To examine the technical possibilities of an extreme lateral access for full-endoscopic uniportal transforaminal surgery of lumbar disc herniations within the spinal canal. Also, to assess sufficient decompression, and the advantages and disadvantages of the minimally invasive procedure. SUMMARY OF BACKGROUND DATA: Conventional prolapsed disc operations can result in consecutive damage as a result of traumatization. The usual transforaminal access is posterolateral, and is associated with problems in reaching the epidural space directly with unhindered vision and, thus, with problems of sufficient decompression in lumbar disc herniations within the spinal canal. METHODS: A total of 463 patients were observed for 1 year. In addition to general and specific parameters, the following measuring instruments were used: visual analog scale, German version North American Spine Society Instrumentarium, Oswestry low back pain disability questionnaire. RESULTS: There were no complications. Of the patients, 81% reported no longer having leg pain, and 14% had occasional pain. There was no worsening. The results were constant and are equal to those of conventional procedures. No patients presented with neural scarring; 7% had recurrence of the prolapse. The extreme lateral access was necessary to reach the sequestered material. CONCLUSIONS: The technique presented is an adequate and safe alternative to conventional procedures, and has the advantages of a truly minimally invasive procedure. The extreme lateral access is required for the indications described. There are clear limitations outside these indications. The possibility of selecting an access from posterolateral to extreme lateral now enables surgery of lumbar disc herniations inside and outside the spinal canal.

Adolescent↗
PubMed1997

Remodeling of the spinal canal deformed by trauma.

Computed tomography (CT) examinations and functional scores were evaluated in 28 patients with thoracolumbar fractures with intraspinal fragments, of whom 20 underwent operation. The cross-sectional area and the sagittal and frontal diameters of the spinal canal were measured after the injury, postoperatively, and at follow-up (mean, 6 years). The operative reduction significantly increased both diameter and area of the spinal canal. During follow-up, a further significant increase of the sagittal diameter and the area was noted, in both surgically and conservatively treated patients. There was no difference in remodeling between the groups. Six patients in the surgically treated group had neurologic deficits at admission, five had improved, and one remained unchanged at follow-up. The presence or absence of intraspinal fragments should not influence the treatment strategy per se in cases without neurologic signs.

Adolescent↗
PubMedDate not supplied

Clear-cell meningioma: CT and MR imaging findings in two cases involving the spinal canal and cerebellopontine angle.

Clear-cell meningioma is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes. We report two cases of clear-cell meningioma, one in the thoracolumbar spinal canal and the other in the cerebellopontine angle. Though the CT and MR imaging findings were not different from those of ordinary meningioma, after surgical removal the condition recurred repeatedly in the patient with spinal canal involvement.

Adolescent↗
PubMed1997

[MR myelography in spinal canal stenosis].

PURPOSE: The purpose of this prospective study was to evaluate the clinical value of 3D-MR-myelography (3D-MRM) in comparison to myelography and intra-operative findings. MATERIAL AND METHODS: 25 patients with suspected lumbar spinal canal stenosis were studied via myelography and 3D-MRM (volume-data set, 3D-FISP sequence, TR 73 ms, TE 21 ms, flip angle 7 degrees, sagittal slices) besides the routinely acquired sagittal and axial T1- and T2-weighted images. Diagnoses were made by two radiologists and one neurosurgeon without knowing the clinical history and symptoms, in two separate sessions. Results were compared to intraoperative findings. RESULTS: 3D-MRM has the same diagnostic sensitivity (25/25 = 100%) as conventional X-ray myelography (25/25 = 100%) compared to intraoperative findings, but is not invasive and shows more diagnostic details than myelography. Especially in cases of high-grade spinal canal stenosis there is often a lack of intrathecal contrast medium distally of the stenosis. CONCLUSION: 3D-MRM is as good as conventional myelography in predicting intraoperative findings in patients with lumbar spinal canal stenosis. This new method is non-invasive and can be performed routinely on an outpatient basis.

Adult↗
PubMed1988

Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression.

The lateral region of the lumbar spinal canal is subject to pathologic alterations which encroach upon the neural structures located within. In order to further understanding and facilitate communication among specialists in diverse disciplines, a subdivision of the lateral region is proposed to comprise three zones: entrance zone, mid-zone and exit zone. The anatomical boundaries of these zones are defined and the pathologic conditions of each are described, and serve as the basis for techniques of surgical decompression when clinically required.

Humans↗
PubMed1989

Multiple meningiomas of the spinal canal and posterior fossa--case report.

The majority of multiple meningiomas are associated with von Recklinghausen's disease, and those that are not, i.e., true multiple meningiomas, particularly with simultaneous development in the posterior fossa and spinal canal, are very rare. We recently encountered a case of true multiple meningiomas in which the lesions were found simultaneously in the left posterior fossa and the upper thoracic spinal canal. The spinal meningioma consisted mainly of meningotheliomatous components, and that in the posterior fossa of fibroblastic components. Both tumors were surgically removed. The cause of the multiplicity in cases of true multiple meningiomas is unknown. Incidental multiplicity is a consideration when the number of tumors is relatively small. Spinal meningiomas are often undetected in the absence of neurological symptoms. However, even if von Recklinghausen's disease is not present, and particularly when more than two meningiomas have been discovered, the patient must be carefully examined for other tumors.

Aged↗
PubMed1982

CT examination of the spine and the spinal canal.

Analogous to its other fields of application, CT of the spine and the spinal canal has also already achieved a permanent place among the diagnostic methods. Numerically, CT studies of the cervical, thoracic and lumbar spine for our patient population with a total of 460 examinations are in the ratio 2: 1: 4.5. The essential advantages are improved differential diagnosis for many processes, the exact breakdown of the degree of extraspinal and intraspinal involvement in the change, the increasing limitation of myelography and last but not least the possibility of reducing cost.

Adolescent↗