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At least 325 records · Page 18Linked to original sources
PubMed1996

Spinal canal remodeling in burst fractures of the thoracolumbar spine: a computerized tomographic comparison between operative and nonoperative treatment.

Operative and nonoperative treatment methods of burst fractures were compared regarding canal remodeling. The entire series consisted of 18 patients, with seven in the operative treatment group and 11 in the nonoperative treatment group. All fractures were studied with computed tomography (CT) at the postoperative (operative treatment group) or postinjury (nonoperative treatment group) and the latest follow-up. All patients were followed up for > or = 18 months. There was no statistical difference between postoperative and postinjury canal areas (p = 0.0859). However, a significant difference was found between the rates of remodeling (p = 0.0059). Although spinal canal remodeling occurred in both groups, the resorption of retropulsed fragments was less favorable in nonoperative treatment group.

Adult↗
PubMed1992

Transpedicular bone grafts misplaced into the spinal canal.

After open reduction of a burst fracture of L1, transpedicular bone grafting of the fractured vertebral body was performed. Bone grafts accidentally slipped into the spinal canal through the damaged medial wall of the pedicle. No adverse effects were noted clinically, but this case illustrates that transpedicular bone grafting is a potentially dangerous procedure. Computed tomography after 1 year showed complete resorption of the intraspinal bone grafts.

Bone Transplantation↗
PubMed1990

Transverse diameter of the lumbar spinal canal in normal adult Saudis.

Pathological changes in the diameters of the lumbar spinal canal may be associated with low back pain. The assessment of the size of the canal is therefore an important diagnostic procedure. Evidence suggests that there are ethnic differences in the dimensions of the canal. A radiogrammetric study was therefore undertaken to establish norms of the transverse diameter for the Saudi population. The results show that the transverse diameter of the canal in Saudis differ from that of other populations, but the shape is similar to those of earlier reports. Intersegmental differences which are useful for the detection of isolated segmental anomalies were also calculated. The significance of the findings is discussed.

Adult↗
PubMed1981

The lumbar spinal canal in children. Part II: the interpedicular distance and its relation to the sagittal diameter and transverse pedicular width.

The lumbar interpedicular distance in 100 children aged 3-15 years have been determined radiologically before and after correction for magnification in the different age groups. The increase by age was approximately 2,5 mm in the upper four lumbar levels and 3,3 mm in L5. The difference between the vertebral levels was almost similar in the different age groups. A rather weak correlation between the interpedicular distance and the sagittal diameter of the spinal canal was found, strongest at the fourth lumbar level. No correlation was found between the interpedicular distance and the size of the pedicles. The results are discussed with reference to the pertinent embryology and with emphasis on the implications with regards to stenosis of the lumbar spinal canal.

Adolescent↗
PubMed1994

Correlative study on findings of dynamic myelography and surgical operation in non-bony lumbar spinal canal stenosis.

The authors performed dynamic lumbar myelography with Omnipaque on 110 patients from 1990 to 1992, of them, 33 cases were diagnosed as non-bony lumbar spinal canal stenosis according to contrast medium defect seen on the lateral view of the myelogram. All such cases were operated on and their dynamic pathological findings during the operation were recorded to compare with the abnormal findings observed on the myelograms, there was a high coincidence rate of 88.7%. The authors believe that the fibrous degenerative changes make up the basis of dural sac compression and the dynamic compression in the spinal canal plays a very important role in causing the severity of the stenosis. As the dynamic pathological findings on the myelograms can not be well demonstrated on CT scanning and MR imaging, the dynamic lumbar myelography should be the method of choice for use in some cases.

Adult↗
PubMed2001

Muscle sympathetic nerve activity in patients with lumbar spinal canal stenosis.

The present study aimed to measure sensory nerve conduction velocity (SNCV) and muscle sympathetic nerve activity (MSA) in both normal subjects and patients with lumbar spinal canal stenosis (LSCS), and to determine what sensory and sympathetic nerve systems relate to the development of abnormal sensation in the lower limbs of the patients. The study population was 12 patients and 10 age-matched healthy control subjects. A statistical difference in the mean MSA intervals was found between the LSCS patients and the normal subjects. There was a fairly large difference between them in the values of the standard deviations as one of the parameters to determine the degree of fluctuation of MSA. These results suggest the LSCS patients have shorter MSA intervals and narrower fluctuations of MSA than normal subjects. As for the range of fluctuation of the MSA intervals and SNCV, the faster the SNCV, the wider the range of fluctuation of MSA intervals in the normal subjects. Many patients with LSCS seem to maintain a correlation between SNCV and MSA intervals. This suggests that even in cases of LSCS, human homeostasis works to keep the relationship between sympathetic nerve function and somato sensory nerve function to some extent. A few LSCS patients showed no correlation between MSA and SNCV. These patients were rather old, suffered spinal stenosis in the relatively higher levels of the spinal canal, and had suffered from the disease for longer than the mean period of all the patients. When the peripheral nerves or cauda epuina are chronically compressed, the nerve systems can not maintain the relationship between them, which finally results in failure. It is suggested that the disrupted coordination between sympathetic nerve function and somato sensory nerve function is one of the reasons why abnormal sensations occur in the lower extremities of LSCS patients.

Aged↗
PubMed1976

Morphogenesis of the spinal canal, normal and stenotic.

The closest formative developmental dependence of the axial skeleton upon the morphogenesis of the intraspinal nervous structures is reflected in the roentgen features of the individual vertebrae as well as of the vertebral column in its entirety. The vertebroneural developmental events are characterized by a steady relative decrease in size of the nervous structures (the first to be laid down and huge in the embryonic period) under a corresponding increase in size of the skeletogenic tissues. There exists experimental evidence that the maintenance of the necessary developmental balance between the two tissues, the bony and the skeletogenic, is a function of the nervous substance. The tight spinal canal appears to result from a failure of the latter neural function leading to overgrowth of the bony structures, viz., to massive vertebrae and laminae encroaching upon the neural contents. Morphogenesis of the normal and tight lumbar spinal canal is discussed with special reference to the developmental interrelations between the cauda equina complex and the lumbar vertebrae.

Constriction↗
PubMed1993

Biomechanics of indirect reduction of bone retropulsed into the spinal canal in vertebral fracture.

The biomechanics of indirect reduction of bone fragments retropulsed into the spinal canal in a burst fracture were investigated. In this model, tunnels were created in vertebrae L1 and C5 oriented anterior-to-posterior, allowing access to the posterior longitudinal ligament. A probe containing a load-sensing tip was passed through the tunnel. Both the location of the tip and the load acting on it by posterior deflection of the posterior longitudinal ligament were measured. In the lumbar spine, distraction was applied by spinal instrumentation that also permitted independent kyphotic-lordotic alignment of the vertebrae. In the cervical spine, axial traction was applied through direct loading. Several clinically relevant observations were made. It was not possible to produce an anteriorly directed force in the posterior longitudinal ligament at less than 35% canal occlusion, partly because the posterior longitudinal ligament stands away from the midbody of the vertebra. Distractive forces of up to 150 N were applied in the lumbar spine, which were nearly equal to the tensile breaking strength of the isolated posterior longitudinal ligament. Regardless of the relative sagittal plane angulation of the vertebrae, distraction was the governing factor in generating force in the posterior longitudinal ligament. Because positioning the vertebrae in lordosis before applying distraction significantly slackens the posterior longitudinal ligament, it is suggested that distraction be applied before angular positioning of the vertebrae is performed.

Biomechanical Phenomena↗
PubMed1991

Observation of spinal canal and cisternae with the newly developed small-diameter, flexible fiberscopes.

Small-diameter (0.5-, 0.9-, and 1.4-mm) flexible fiberscopes were developed for visual diagnosis of spinal canal diseases. The fiberscopes were introduced via a Tuohy needle into the subarachnoid and epidural spaces of ten patients with various pain syndromes. Clear visualization of the subarachnoid space was achieved using the fiberscopes. The epidural space could be visualized only during withdrawal of the fiberscope. In five cases, the fiberscope could be advanced up to the level of the cisternae without causing the patient any discomfort. A slight headache and transient fever were noted after the examination in five and two cases, respectively, but no other complications occurred. Interestingly, preexisting pain diminished (two cases) or disappeared (one case) after the myeloscopy in three of five cases in which the myeloscopy revealed aseptic adhesive arachnoiditis. Further studies should be carried out to evaluate the usefulness of this technique.

Adult↗
PubMed1995

Early cystic thoracic cord cavity complicating decompressive surgery for spondylotic spinal canal stenosis. Case report.

This is a report of a patient who developed thoracic cystic myelopathy immediately following an otherwise successful decompression operation for spondylotic stenosis secondary to osteophyte formation of the thoracic spinal canal. As this case shows, thoracic laminectomy is not without risks, and cystic myelopathy is a potential complication that should be borne in mind when surgery for spondylosis is being planned. Cavitation of the spinal cord may be associated with trauma secondary to extramedullary cord compression.

Humans↗
PubMed1978

Congenital stenosis of lumbar spinal canal: comparison of results of surgical treatment for this and other causes of lumbar syndrome.

The operative results in 37 consecutive patients suffering from developmental stenosis of the lumbar spinal canal, compared with those in spondylosis and disc herniations, are discussed. The diagnostic certainty of stenosis, suspected on the bases of clinical and radiographic data, is reached only at the operating table. To judge the usefulness of the operation we have considered not only the patients' verdicts, but also the improvements in neurological signs and the appearance of new deficits. Satisfactory results are around 80%, slightly less good with stenosis than with the other causes of lumbar syndrome. Radiographic study with contrast medium is mandatory. Dimer-X has been used with very clear radiographic findings and very few complications. Operating technique is also described: a wide laminectomy with facetectomy is advised. The great importance of early physiotherapy is emphasized.

Adolescent↗
PubMed1991

Does the angle of the computed tomographic scan change spinal canal measurements?

Computed tomographic scanning at 0 degrees, 10 degrees, and 20 degrees was used on two human cadaver cervical spines to determine whether altering the scan angle affects spinal canal measurement. Maximum anteroposterior diameter, cross-sectional area, and transverse diameter were determined by digitization of the scans. Both spines exhibited a regular sinusoidal pattern of variation in anteroposterior diameter and cross-sectional area, with less of a pattern for transverse diameter. The maximum values occurred around the discs in the normal spine, moving to just below the pedicle in the spondylotic spine. Minimum values were at the pedicle in the normal spine and near the discs in the spondylotic spine. Changing the computed tomographic scan angle to 10 degrees in either a cephalad or caudad direction had a negligible effect on the pattern or absolute values for any dimension in either spine. Changing the angle to 20 degrees in either direction significantly and irregularly altered both the pattern and values of anteroposterior diameter and cross-sectional area in both spines. There was little effect on transverse diameter. It was concluded that comparison of different scans should be interpreted with caution unless the change in angulation is 10 degrees or less.

Biomechanical Phenomena↗