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PubMed2006

[Modified percutaneous balloon kyphoplasty at osteolysis of 11th thoracic vertebra and communication with the spinal canal. Case report and review of the literature].

This paper presents the case report of a 67-year-old man who came to our hospital suffering from severe osteolysis of the 11th thoracic vertebral body. The patient has been suffering from renal cell carcinoma for 2 years. During a routine control the above-mentioned lesion was found by chance. A few days later pain started in the thoracolumbar region. Treatment was intended to be palliative. Therefore, we looked for an option to stabilize the vertebral body as minimally invasive as possible. Because of a destroyed trailing edge of the vertebra, "normal" kyphoplasty was not possible. For this reason, we performed a modification, using one filled balloon as a kind of curtain between the vertebral body and spinal canal. With this technique we achieved an optimal filling of the destroyed vertebral body with cement, without any leakage. Two days postoperatively, the patient could leave our hospital without any pain symptoms.

Catheterization↗

PubMed1983

[Morphofunctional changes in the spinal cord, its meninges and epidural structures in experimental obturation of the epidural veins of the spinal canal].

When the blood flow in the epidural veins of the spinal cord canal is stopped (performed in 24 dogs) by means of paraffin emboli, it results, at early stages, in distrophic and hypoxic changes in neurons and glial cells of the spinal cord. In 2-4 weeks these changes are substituted by certain restorative processes and in 3 months normal structure and function are restored.

Animals↗

PubMedDate not supplied

Radiographic versus direct measurements of the spinal canal at lumbar vertebrae L3-L5 and their relations to age and body stature.

The role of the narrow lumbar spinal canal in back and sciatic pain is well established. The accuracy of measurements obtained from lumbar radiographs was therefore analyzed in lumbar spine specimens taken from 132 male cadavers. After removal of soft tissues, the same distances were measured on the bones of 80 specimens. Comparisons were made after correction for magnification, the radiographic measurements of interpedicular distances being, on average, 2 mm greater at L3 than the osteologic ones and 4 mm greater at L5. Interarticular distances, midsagittal diameters, and pedicular lengths were, on average, 1 mm greater and foraminal anteroposterior measurements 1 mm less than the osteologic ones. Body stature correlated with interpedicular and interarticular distances, pedicular length, and foraminal anteroposterior measurements. In older age groups, the midsagittal diameter tended to be reduced. A number of correlations were found between the five measurements, e.g. between the anteroposterior diameter of the intervertebral foramen and the pedicular length. Measurements in the transverse plane were independent of those in the anteroposterior plane. These results confirm and amplify preliminary observations and indicate the potential value of simple measurements on lumbar spine films as an alternative to more sophisticated and expensive radiologic investigations.

Adult↗

PubMed1993

A computed tomographic analysis of changes in the spinal canal after anterior lumbar interbody fusion.

Thirteen patients with spondylolisthesis (six isthmic type and seven degenerative type) and ten patients with intervertebral disk herniation were treated by anterior lumbar interbody fusion. Preoperative and postoperative computed tomography (CT) scans were performed for each patient, and changes in anteroposterior (AP) diameter and lateral diameter of the dural sac, the area of the dural sac, and the amount of disk bulging were measured. The periodic tomogram was done in all patients postoperatively, and one- and two-year fusion rates were calculated. The calculations were compared with the early and late clinical results. The early clinical results after operation were excellent in 26.1%, good in 56.5%, and fair in 17.4%. The late clinical results were similar to early results. The early clinical results correlated with the changes in the spinal canal, such as an increase in AP diameter of the dural sac and a decrease in amount of disk bulging after anterior interbody fusion. There was statistical correlation between the early clinical results and the change in AP diameter of the dural sac. But the late clinical results were influenced by multiple factors including solid bony fusion.

Adult↗

PubMed1987

Intermittent priapism in spinal canal stenosis.

A case of spontaneous intermittent priapism in a patient with spinal canal stenosis is presented. Erection, as well as intermittent neurogenic claudication and urinary incontinence were provoked by physical exertion, mainly walking. The symptoms completely resolved after decompressive lumbar laminectomy.

Aged↗

PubMed1995

Spontaneous remodeling of the spinal canal after burst fractures of the low thoracic and lumbar region.

A retrospective study was done on five adult patients in whom burst fractures of the low thoracic and lumbar spine were associated with intracanalar displacement of a large bony fragment. In one case two vertebrae were involved. Three of these patients presented with neurologic damage of different degrees. All but one underwent operative posterior stabilization by Harrington rods and bone autografts. Although no surgical decompression was performed, they showed gradual neurologic recovery at the follow-up, which is still incomplete in only one, initially paraplegic patient. In comparing the initial computed tomography scans of the five patients with those taken 1 1/2-5 years later at the same level, it was found that a process of total or subtotal resorption of the retropulsed fragment had occurred in all patients, with spontaneous remodeling of the spinal canal. These findings agree with the recent reports of other authors and provide the orthopedic surgeon with a new argument in favor of the possible conservative treatment of these severe, potentially unstable fractures. In most of the cases, and especially in those without neurological compromise, surgical reduction or surgical removal of the intraspinal fragment is not necessary. We believe that loss of mechanical loading and rhythmic respiratory oscillations in cerebrospinal fluid pressure are both important factors in the mechanism of bone resorption.

Adolescent↗

PubMedDate not supplied

[Spinal contusion after trauma to the cervical spine--relevance of the sagittal diameter of the spinal canal].

PURPOSE: The purpose of this study was to analyze the relationship between spinal stenosis and cervical myelopathy. Furthermore it was to investigate whether there is a correlation between spinal stenosis and progression of neurologic symptoms? PATIENTS AND METHODS: Using the Pavlov ratio method, we compared 14 patients with a contusio spinalis with 14 patients who suffered from a distortion of the cervical spine. This ratio is calculated by the sagittal diameter of the spinal canal with the anteroposterior width of the vertebral body. RESULTS: In eight patients with a contusio spinalis, there was a spinal stenosis, while there was none in the distortion group. The remaining patients with a contusio had severe degenerative changes in routine roentgenograms of the cervical spine. The Pavlov ratio was statistically significant reduced in the contusio group. After 8.5 days there was a complete regression of neurologic symptoms, whereas in 4 patients there was no full recovery. CONCLUSION: To conclude we demonstrated that a spinal stenosis promotes a contusio spinalis but there is no evidence that the Pavlov ratio allows statements concerning the progression of the injury.

Adolescent↗

PubMed1984

Malum perforans pedis caused by spinal canal stenosis and spondylolisthesis.

A case of malum perforans pedis caused by spinal canal stenosis with spondylolisthesis in a 76-year-old female is reported with a brief review of literature. In our case, orthopedic and neurological evaluations were indispensable for correct diagnosis and treatment of the condition.

Aged↗

PubMed1990

[An evaluation of cervical spinal canal stenosis--a correlation with cerebrospinal fluid pressure using a semiconductor and its coefficients].

This study was conducted to determine whether the cerebrospinal fluid pressure (CSFP) obtained by the lumbar puncture technique is capable of evaluating the pathological state of the cervical spinal canal stenosis (CSCS). A method was developed in which the CSFP was measured with a small piezoelectric semiconductor in combination with the lumbar puncture technique. The data thus obtained were quantitatively analysed using a personal computer. Using this method, we studied patients with cervical myelopathy due to vertebral canal stenosis. The CSFP wave form obtained by compression of the cervical region was converted into a regression curve using the computer. In order to estimate the vertebral canal stenosis ratio (spinal cord/dural tube) of patients with CSCS by CSFP, multiple regression analysis was performed to obtain a multiple regression with respective parameters as expository variables. Descending curve coefficients (CND, CFD and CED) were found to be useful as parameters estimating the state of CSCS by means of CSFP analysis. On the basis of these parameters, CND, the coefficient of a descending curve obtained at the neutral cervical position, and CED, the coefficient of a descending curve obtained at the extended position, patients with CSCS were able to distinguish from normal subjects. The multiple regression equation (Y = 73.2-3890 CNA-4740 CND + 3620 CFD-10470 CEA-802 CED-0.119 NPP) was statistically significant at P = 0.01, therefore, useful in estimating the vertebral canal stenosis ratio. On the contrary, the values calculated from the multiple regression equation were not well correlated with either the JOA (Japanese Orthopedic Association) scores evaluated in accordance with the JOA Criteria or with the spinal compression ratio (anterior-to-posterior diameter/right-to-left diameter).

Aged↗

PubMed2003

[Claudicatio intermittens. Narrow spinal canal].

Degenerative changes in the vertebrae can lead to narrowing of the spinal canal. This is most often the cause of back pain and radiating pain in the legs, which in turn can cause problems with mobility. The diagnosis can be verified through radiological evidence. When conservative treatment and injections do not improve the condition or when there is evidence of paraethesia the best course of treatment is operative decompression procedure. Through this procedure results of a quick regression of pain and improved mobility are experienced. The operation has no risk, a quick recovery period and can be carried out in old patients.

Back Pain↗

PubMed1980

Multiple meningiomas in the spinal canal.

Previous experimental and clinical observations suggest that radiation is a causative factor in the development of meningiomas. We report a rare case of three spinal meningiomas in a patient who had prior irradiation in the spinal region. The myelographic technique to evaluate multiple spinal canal tumors is outlined.

Adult↗

PubMed1957