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At least 883 records · Page 49Linked to original sources
PubMed2005

Narrowing of lumbar spinal canal predicts chronic low back pain more accurately than intervertebral disc degeneration: a magnetic resonance imaging study in young Finnish male conscripts.

The objective of this magnetic resonance imaging study was to evaluate the role of degenerative changes, developmental spinal stenosis, and compression of spinal nerve roots in chronic low back (CLBP) and radicular pain in Finnish conscripts. The degree of degeneration, protrusion, and herniation of the intervertebral discs and stenosis of the nerve root canals was evaluated, and the midsagittal diameter and cross-sectional area of the lumbar vertebrae canal were measured in 108 conscripts with CLBP and 90 asymptomatic controls. The midsagittal diameters at L1-L4 levels were significantly smaller in the patients with CLBP than in the controls. Moreover, degeneration of the L4/5 disc and protrusion or herniation of the L5/S1 disc and stenosis of the nerve root canals at level L5/S1 were more frequent among the CLBP patients. Multifactorial analysis of the magnetic resonance imaging findings provided a total explanatory rate of only 33%. Narrowing of the vertebral canal in the anteroposterior direction was more likely to produce CLBP and radiating pain than intervertebral disc degeneration or narrowing of the intervertebral nerve root canals.

Adolescent↗
PubMed2002

Microsurgical transdural discectomy with laminoplasty: New treatment for paracentral and paracentroforaminal cervical disc herniation associated with spinal canal stenosis.

STUDY DESIGN: A clinical study of the surgical procedure for cervical disc herniation was conducted. OBJECTIVES: To describe microsurgical transdural discectomy with laminoplasty, and to assess the clinical outcome of this surgical technique. SUMMARY OF BACKGROUND DATA: A posterior approach for cervical disc herniation has been considered risky, and few reports on a transdural approach to this disorder have appeared in the past decade. However, a transdural approach with recent innovations (a microsurgical technique, intraoperative spinal cord monitoring, and laminoplasty) has not been reported. METHODS: For this study, 30 patients with myelopathy or radiculomyelopathy accompanied by cervical disc herniation, aged 30 to 77 years (mean, 55 years), underwent microsurgical transdural discectomy with laminoplasty. Preoperative images showed multisegmental disc degeneration, developmental canal stenosis, or both for all the patients. The intraoperative evoked spinal cord potentials were recorded for neurophysiologic assessment. The follow-up period averaged 52 months (range, 24-118 months). RESULTS: The operative time averaged 239 minutes (range, 160-340 minutes), and the mean blood loss was 169 mL (range, 30-701 mL). The Japanese Orthopedic Association score improved from 3.5 to 15 (mean, 11.4) before surgery to 9 to 17 (mean, 15.2) after surgery. The intraoperative evoked spinal cord potentials indicated the affected spinal cord level and reflected the severity of myelopathy. Postoperative cerebrospinal fluid leakage, pseudomeningocele, and progression to cervical deformity were not observed. Transient palsy of the C5 nerve root was observed in two patients with C4-C5 central cervical disc herniation. CONCLUSIONS: Microsurgical transdural discectomy with laminoplasty can be performed safely as a selected surgical option for paracentral and paracentroforaminal cervical disc herniation with multisegmental canal stenosis.

Action Potentials↗
PubMed1992

Spinal canal metastases: a late complication of glioblastoma.

The case of a 41 year old woman with a cerebral glioblastoma is reported who developed paraplegia due to a pathologically confirmed spinal metastasis. This and 22 other case histories from the literature suggest that spinal seeding is a rather late complication of cerebral glioblastomas that can be diagnosed on clinical grounds with the help of myelography, CSF cytology and MR imaging.

Adult↗
PubMed1993

Myelography, CT, and MRI of the spinal canal in patients with myelopathy: a prospective study.

A prospective study including myelography, CT, and MRI was performed on 36 patients with clinical signs of myelopathy. Evoked potentials and spinal fluid examinations were also carried out. Based on our findings, the patients could be classified as suffering from cryptogenic myelopathy (n = 12), multiple sclerosis (n = 6), spinal stenosis (n = 6), or miscellaneous myelopathies (n = 12). The diameter of the spinal cord was normal in the 2 first groups of patients and of same magnitude evaluated by myelography and CT, while MRI constantly gave higher figures. In only four of the patients important new information was added by CT and MRI (syringomyelia, myelitis, lipomatosis) compared with myelography, although a more precise visualization was often provided. Further diagnostic progress in patients with myelopathy of undetermined etiology may be obtained by including supplementary MRI of the brain disclosing multiple sclerosis in several cases.

Adult↗