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At least 73 records · Page 4Linked to original sources
PubMed1996

Large vertebral body, in addition to narrow spinal canal, are risk factors for cervical myelopathy.

It is well known that a narrow spinal canal is frequently associated with cervical spondylotic myelopathy. However, few investigators have studied the relationship between the size of the cervical spinal canal and that of the cervical spinal cord. Moreover, no studies mention the correlation between the size of the vertebral body and that of the spinal canal in the pathogenesis of cervical myelopathy. In the present study, we used computed tomographic myelography to measure the size of the vertebral body, spinal canal, and spinal cord in patients who had classic cervical myelopathy and in control subjects. We found that patients with cervical spondylotic had a narrow spinal canal as well as a slender spinal cord in the cervical region. Moreover, the vertebral body is significantly larger in the myelopathy group than in controls. A large vertebral body is thought to be associated with a large osteophyte and large disc protrusion. We conclude that a large vertebral body is another risk factor for cervical myelopathy, along with a narrow spinal canal.

Adult↗
PubMed1995

Morphometric study of the lumbar spinal canal in the Korean population.

STUDY DESIGN: The anatomic dimensions of the vertebral body and spinal canal of the lumbar spine were analyzed in Koreans. OBJECTIVES: To determine the normal dimension of the lumbar spinal canal in Koreans, to determine whether there are any racial differences in the morphometry of the lumbar spinal canal, and to provide criteria for diagnosing spinal stenosis in the Far Eastern Asian. SUMMARY OF BACKGROUND DATA: Some radiologic and anatomic studies have been conducted regarding the size of the lumbar spinal canal of whites and blacks in western and African countries. METHODS: One-thousand-eight-hundred measurements were performed on the transverse and sagittal diameters of vertebral bodies and spinal canals using complete sets of 90 lumbar vertebrae. RESULTS: The mean mid-sagittal diameter of the lumbar spinal canal in the Korean population was less than that measured in white and African populations, but there was no significant differences between the Korean, white, and African populations regarding the transverse diameter of the lumbar spinal canal. CONCLUSION: The mid-sagittal diameter of the lumbar spinal canal is narrowest in the Far Eastern Asian population; the radiologic criteria of spinal stenosis should be reconsidered for these people.

Adult↗
PubMed1989

[Transesophageal ultrasonography of the spinal canal].

Transoesophageal ultrasound imaging of the spinal canal through an intervertebral disc was successfully achieved in 44 of 50 adults (18 women and 32 men; mean age 56 years, range 22-79) who, for cardiological indications had transoesophageal echocardiography. On average, five (range 1-11), usually sequential, segments were visualized. In 37 patients pulse-synchronous sagittal displacement of the spinal cord was noted, presumably caused by cerebrospinal fluid pulsation. In one woman, with known syringomyelia, the spinal cord cavity was well shown. Real-time demonstration of dynamic events in the spinal canal opens up new possibilities for the diagnosis and follow-up monitoring of spinal diseases.

Adult↗
PubMed1984

[Morphological changes of the cervical spinal canal and cord due to aging].

UNLABELLED: Cervical spondylotic myelopathy is a condition in which degenerative changes of the cervical vertebral bodies and the intervertebral discs cause disturbances to the spinal cord either by direct mechanical compression or by disturbing the blood supply. There have been a number of studies on roentgenological measurements of the anteroposterior (AP) diameter of the cervical spinal canal relating to the disorder. However, there are only a few reports concerning the shape and the size of the spinal canal and the spinal cord. Murone reported that the cervical spinal canal of Japanese was significantly smaller than those of Europeans on roentgenograms. However, whether the size of the spinal cord of Japanese is proportionally smaller or not remains to be studied. The aim of the present study is to perform various measurements of the human cervical spine specimens to find any influence of the age on them and to see relative correlation of the spinal cord size to the corresponding spinal canal size. METHODS: Seventy-seven human cervical spinal columns taken én bloc from C3 to C7 at post-mortem examination were used for the study. After taking AP and lateral roentgenograms, the specimen was horizontally transsected at the middle of each vertebral body and at the level of each intervertebral disc. The reason why the middle of the vertebral body was selected is to exclude modifications by osteophyte formation at the upper and the lower ends of the body and to see possible genuine appearance and change of the spinal canal. The measured items were AP diameter of the vertebral body (A), AP diameter of the spinal canal (B), area of the spinal canal (C), AP diameter of the spinal cord (beta) and area of the spinal cord (gamma). In five untreated specimens, CT-scan was performed prior to the horizontal section, and the CT-scan findings were compared to those by direct measurements. Lateral cervical roentgenograms of 249 patients of various ages were used as a comparison. RESULTS: The AP diameter of the vertebral body (A) and the AP diameter of the spinal canal (B) showed some correlation with the age. The former became larger whereas the latter became smaller with the age. The area of the spinal canal (C) did not show correlation with the age. The AP diameter of the spinal cord (beta) showed correlation with the age, whereas the area of the spinal cord (gamma) failed to show the correlation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1988

Anatomy of the lumbar spinal canal.

1. In the lumbar spinal canal of the achondroplast there is decreased cross-sectional area. In addition the intervertebral foramina are narrow. These changes result in reduced area for the dural sac and exiting spinal nerves. 2. There is associated thoracolumbar kyphosis and a lumbosacral hyperlordosis. These sagittal plane changes result in increased tension on the dural sac and nerves. 3. With aging there is disc degeneration with disc space narrowing and osteophyte formation. In addition facet hypertrophy with osteophyte formation are common. These degenerative changes further reduce the size of an already compromised spinal canal and intervertebral foramina. The above understanding of the normal spinal and anatomy in the achondroplast, and the added effects of aging allow the surgeon to plan a logical treatment regimen for neurological problems in the achondroplast.

Achondroplasia↗
PubMed1989

The effect of flexion-extension motion of the lumbar spine on the capacity of the spinal canal. An experimental study.

The symptoms of lumbar spinal stenosis are often posture-dependent, and it is generally accepted that the capacity of the spinal canal is affected by flexion-extension motions of the lumbar spine. A study of spinal capacity in flexion-extension of ten cadaver specimens on the lumbar spine was done and measurements were obtained from the flexion-extension lateral myelograms. There proved to be a larger capacity of dural sac of 3.5 to 6.0 ml (4.85 +/- 0.75 ml) in flexion than in extension, and the differences were highly significant (P less than 0.001). In addition, the sagittal diameter of the dural sac and the length of the spinal canal increased from extension to flexion. Because of the effect of flexion-extension motion of the lumbar spine on the spinal capacity, we suggest that maintaining the lumbar spine in flexion is more suitable since spinal canal capacity is enlarged and symptoms may be mitigated.

Adult↗
PubMed1998

Spontaneous remodeling of the spinal canal after conservative management of thoracolumbar burst fractures.

STUDY DESIGN: Forty-two conservatively treated patients with a burst fracture of the thoracic, thoracolumbar, or lumbar spine with more than 25% stenosis of the spinal canal were reviewed more than 1 year after injury to investigate spontaneous remodeling of the spinal canal. OBJECTIVES: To investigate the natural development of the changes in the spinal canal after thoracolumbar burst fractures. SUMMARY OF THE BACKGROUND DATA: Surgical removal of bony fragments from the spinal canal may restore the shape of the spinal canal after burst fractures. However, it was reported that restoration of the spinal canal does not affect the extent of neurologic recovery. METHODS: Using computerized tomography, the authors compared the least sagittal diameter of the spinal canal at the time of injury with the least sagittal diameter at the follow-up examination. RESULTS: Remodeling and reconstitution of the spinal canal takes place within the first 12 months after injury. The mean percentage of the sagittal diameter of the spinal canal was 50% of the normal diameter (50% stenosis) at the time of the fracture and 75% of the normal diameter (25% stenosis) at the follow-up examination. The correlation was positive between the increase in the sagittal diameter of the spinal canal and the initial percentage stenosis. There was a negative correlation between the increase in the sagittal diameter of the spinal canal and age at time of injury. Remodeling of the spinal canal was not influenced by the presence of a neurologic deficit. CONCLUSION: Conservative management of thoracolumbar burst fractures is followed by a marked degree of spontaneous redevelopment of the deformed spinal canal. Therefore, this study provides a new argument in favor of the conservative management of thoracolumbar burst fractures.

Adolescent↗
PubMed2002

Ultrasound-guided decompression of the spinal canal in traumatic stenosis.

The purpose of this study was to examine the efficacy of ultrasound (US)-guided decompression of the myelon in the surgical treatment of spinal fractures. Intraoperative ultrasonography was performed in 22 patients with traumatic stenosis of the spinal canal during spinal cord surgery with removal of retropulsed bony fragments. US imaging requires a posterior approach and an enlarged foramen interarcuale. The posterior vertebral facet and the myelon can accurately be distinguished from small bony fragments by ultrasonography. Pre- and postoperative computed tomography was compared with intraoperative US imaging. Complete decompression of the spinal canal was controlled by US imaging of the restored ventral epidural space, as seen after repositioning of displaced fragments. Thus, the required extent of the surgical procedure was determined by intraoperative ultrasonography. We conclude that intraoperative US imaging is an important tool to monitor the restoration of the spinal canal and decompression of the spinal cord in case of fracture. The repositioning of stenosing bony fragments using surgical instruments can be monitored. US imaging as a real-time method intraoperatively provides the surgeon with additional information and significantly influences treatment options.

Decompression, Surgical↗
PubMedDate not supplied

Measurements of the lumbar spinal canal in 2 racial groups.

Direct measurements of 1,340 lumbar vertebrae in 275 skeletons in two racial groups are reported. The average figure, and the upper and lower limits of normal are reported for the anteroposterior diameter of the canal and for Spinal Index. Radiological studies have established a technique for defining the posterior margin of the spinal canal on plain X-ray films. It is formed by a line joining the apex of the superior to the inverted apex of the inferior articular facet. The Spinal Index is not a reliable factor. The anteroposterior diameter alone is the essential parameter in assessing spinal stenosis. The negroid canal is marginally less spatial than that of the caucasoid.

Black People↗
PubMed2005

Correlation between neurological deficit and spinal canal compromise in 198 patients with thoracolumbar and lumbar fractures.

STUDY DESIGN: Review the correlation between loss of spinal canal diameter and neurological deficits in patients with thoracolumbar and lumbar burst fractures. OBJECTIVES: To try to establish a correlation between neurological deficits and the degree of narrowing of the spinal canal. SUMMARY OF BACKGROUND DATA: The correlation between the degree of protrusion of the bone fragments into the spinal canal and the incidence of neurological deficits in thoracolumbar and lumbar burst fractures has not been well established, raising a lot of controversies in the literature. METHODS: Manual measurements of axial-computed tomography scan films using a millimetric ruler were made from the spinal canal of 198 patients admitted to the hospital with thoracolumbar and lumbar burst fractures, from 1989 to 2000. RESULTS: The probability of neurological deficit in a patient with 25, 50, and 75% narrowing of the thoracolumbar spinal canal was found to be 12, 41, and 78%, and in the lumbar spinal canal it was 8, 30, and 68%, respectively. CONCLUSIONS: The narrowing of the spinal canal proved to be a predictive factor in establishing early neurological deficits in thoracolumbar and lumbar burst fractures, showing a positive correlation between narrowing of the spinal canal and the severity of the incomplete neurological deficit by the Frankel classification. Patients with complete spinal cord injuries (Frankel A) did not show this correlation.

Adolescent↗
PubMed1998

Spinal canal capacity in simulated displacements of the atlantoaxial segment: a skeletal study.

In normal, physiological circumstances there is ample room in the spinal canal to accommodate the spinal cord. Our study aimed to identify the degree of compromise of the spinal canal which could be anticipated in various atlantoaxial pathological states. We examined paired atlas and axis vertebrae using high-definition radiography and simultaneous photography in both normal and simulated pathological orientations in order to measure the resultant dimension of the spinal canal and its percentage occlusion. At the extreme of physiological axial rotation (47 degrees) the spinal canal is reduced to 61% of its cross-sectional area in neutral rotation. The spinal cord is thus safe from compromise. Atlantoaxial subluxation of up to 9 mm reduces the area of the spinal canal, in neutral rotation, to 60% with no cord compromise. Any rotation is, however, likely to cause cord compression. The mechanism of fixation in atlantoaxial rotatory subluxation could be explained by bony interlocking of the facet joint, reproducible in dry bones.

Atlanto-Axial Joint↗
PubMed1986

Epidermoid tumor: an unusual cause of ossification within the spinal canal.

Epidermoid tumors of the spinal canal are rare. We report two patients with intraspinal lesions and radiographically evident calcification. One proved to have an epidermoid tumor. Although the tissue diagnosis in the second was not definitive, it suggested an epidermoid tumor as well. Radiographically visible ossification or calcification has not been reported before in intraspinal epidermoids.

Calcinosis↗
PubMed1981

[Examination of spinal canal by computerized tomography (author's transl)].

CT of the spinal canal as a method of neuroradiological examination has increasingly gained significance. So far, it has been used in addition to conventional Xray of the spine and to myelography; however special indications have been established to make it the method of choice in certain instances. Besides invasive secondary or primary CT myelography, noninvasive CT is applied in tumor diagnosis and traumatology; also in order to demonstrate dysraphic formative anomalies, degenerative changes as well as conditions which obstruct the spinal canal and compress spinal cord and nerve roots. CT has the advantage of better soft- tissue-visualization while the spinal canal is equally well outlined; it has no disadvantages. With even more efficient scanners available, especially primary CT diagnosis of the spine will gain further significance.

Evaluation Studies as Topic↗
PubMed2000

Increase in spinal canal area after inverse laminoplasty: an anatomical study.

STUDY DESIGN: In vitro measurement of the area of the spinal canal in the rostral and caudal portions of lumbar vertebrae before and after application of a new technique called "inverse laminoplasty." OBJECTIVES: To quantify the normal area of the spinal canal in the rostral and caudal portions of lumbar vertebrae and the amount of enlargement gained after inverse laminoplasty. SUMMARY AND BACKGROUND DATA: Other types of laminoplasty have been proven to increase the area of the spinal canal. Inverse laminoplasty has been performed in 10 patients but has not been evaluated in vitro. METHODS: The transverse and anteroposterior diameter of the spinal canal was measured in 34 vertebrae from seven cadavers using digital calipers. In each vertebra, the laminae and spinous process were removed en bloc using a high-speed drill. The removed piece was inverted and reattached with titanium mini-plates. The area of the spinal canal was again measured and compared with the prelaminoplasty measurements using paired Student's t tests. RESULTS: The anteroposterior diameter and area of the spinal canal were significantly smaller before surgery in the rostral than in the caudal part of the vertebrae (P <10(-3)). The rostral and caudal areas of the spinal canal increased by 61% and 17%, respectively, after the laminae were inverted (P <10(-3)). CONCLUSION: Because inverse laminoplasty is simple and increases the area of the spinal canal, it may prove to be a useful surgical technique for the treatment of lumbar spinal stenosis. Further studies are needed to determine whether the technique is biomechanically sound and whether it helps prevent perineural scarring.

Adult↗
PubMed1991

Magnetic resonance imaging evaluation of the spinal canal following arthrodesis and removal of sublaminar wires.

Seven patients who underwent posterior spinal fusion with Harrington instrumentation and sublaminar wires, and subsequently had these implants removed, were evaluated for evidence of spinal canal compromise with magnetic resonance imaging (MRI) at the sites of the sublaminar wires. All fusions were solid. The sites of 33 wires (27 levels) were evaluated with MRI. The average time the wires were in the spinal canal was 24.6 months. The average time following wire removal at the time of MRI was 61.7 months. Twenty-eight of 33 (85%) wire sites had no evidence of spinal canal compromise. Five sites had minimal (less than 15%) spinal canal compromise. The permanent structural changes in the spinal canal attributable to sublaminar wires appears to be quite modest.

Adolescent↗
PubMed2002

Burst fractures of the thoracolumbar spine: changes of the spinal canal during operative treatment and follow-up.

Although multiple studies have concluded operative decompression of a traumatically narrowed spinal canal is not indicated because of spontaneous remodeling, instrumental decompression is frequently used as part of the operative treatment of spinal fractures. To investigate the process of remodeling, we studied the diameter of the spinal canal in 95 patients with burst fractures at the thoracolumbar junction (T9-L2). To measure and compare the spinal canal's diameter we used either computed tomography (CT) scans or radiographs, made preoperatively, postoperatively, after 9 months and after 24 months. In lateral plain radiographs we found that the initial percentage of cases with bony canal narrowing preoperatively of 76.5 was reduced to 18.4% postoperatively, to 8.2% at 9 months, and to 2.4% at 24 months. In CT scans in a selection of patients, the mean residual diameter of the spinal canal was 53% preoperatively and 78% at 24 months. The posterior segmental height increases during operation and decreases in the respective periods after operation. So ligamentotaxis can only play a role in the perioperative period. We conclude that a significant spontaneous remodeling of the spinal canal follows the initial surgical reduction. Two years after operation, bony narrowing of the spinal canal is only recognizable in 2.4% of the patients on plain lateral radiographs. The remodeling of the spinal canal can be seen on plain radiographs, although not as accurately as on CT scans.

Bone Remodeling↗
PubMedDate not supplied

Multiple spinal canal meningiomas.

Three cases of multiple spinal canal meningiomas are presented, bringing the total number of documented cases in the American literature to nine. While the exact incidence of multiple spinal meningiomas is difficult to determine, their possible occurrence warrants careful myelographic examination of the whole spinal canal, particularly if multiple clinical levels are present. When a complete block to the contrast agent is encountered, myelography should also be carried out via an upper cervical puncture. The radiograhic appearances of multiple meningiomas are nonspecific.

Aged↗