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PubMed1990

CT and MRI of symptomatic spinal involvement by extramedullary haemopoiesis.

Five cases of tumour-like extramedullary haemopoiesis (EH) causing spinal cord compression or back pain are reported. Three patients were suffering from thalassaemia major, one from sickle cell anaemia and one from thalassaemia intermedia. CT findings included soft tissue masses in the epidural space of the spinal canal, spinal cord displacement and involvement of the underlying bone. MRI studies showed masses compressing the spinal cord. On T1-weighted images there was a signal of slightly higher intensity compared to that of the adjacent marrow. CT suggested the diagnosis in four cases (in the fifth it was not performed), while MRI was positive in all five. There was good correlation between the MRI findings and the CT appearance of the EH masses. Our results suggest that MRI may eliminate the need for other diagnostic examinations in the investigation of patients with EH.

Adult↗
PubMedDate not supplied

A review of biomechanics of the central nervous system--Part III: spinal cord stresses from postural loads and their neurologic effects.

OBJECTIVE: To review literature pertaining to neurologic disorders stemming from abnormal postures of the spine. DATA COLLECTION: A hand search of available reference texts and a computer search of literature from Index Medicus sources was performed, with special emphasis placed on spinal cord stresses and strains caused by various postural rotations and translations of the skull, thorax, and pelvis. RESULTS: Spinal postures will often deform the neural elements within the spinal canal. Spinal postures can be broken down into four types of loading: axial, pure bending, torsion, and transverse, which cause normal and shear stresses and strains in the neural tissues and blood vessels. Prolonged stresses and strains in the neural elements cause a multitude of disease processes. CONCLUSION: Four types of postural loads create a variety of stresses and strains in the neural tissue, depending on the exact magnitude and direction of the forces. Transverse loading is the most complex load. The stresses and strains in the neural elements and vascular supply are directly related to the function of the sensory, motor, and autonomic nervous systems. The literature indicates that prolonged loading of the neural tissue may lead to a wide variety of degenerative disorders or symptoms. The most offensive postural loading of the central nervous system and related structures occurs in any procedure or position requiring spinal flexion. Thus flexion traction, rehabilitation positions, exercises, spinal manipulation, and surgical fusions in any position other than lordosis for the cervical and lumbar spines should be questioned.

Biomechanical Phenomena↗
PubMed1990

Experience with a spinal cord unit in Brasilia, Brazil.

We have analysed our experiences in a Spinal Cord Unit in Brasilia, Brazil in the last 5 years (1982-1986). There were 738 outpatients and 243 inpatients. One hundred and six patients were operated on by the neurosurgical staff, and the indications for operation are discussed. Some patients showed neurological recovery with surgery and some without surgery. Patients with a complete neurological deficit on admission did not show any improvement, and those with a severe but incomplete deficit showed improvement with surgery (18%), which was better than those without an operation. We conclude that a surgical procedure seems to be indicated in those with a comminuted, or with an unstable fracture, if there is an incomplete neurological deficit with an unreduced spinal deformity. There was a possibility of recovery of some nerve root function. The goal of surgical treatment is to restore and maintain the anatomical relationships between the spinal canal, spinal cord and nerve roots with the simplest possible surgical procedure, returning the patient as soon as possible to his functional capacity and social life.

Activities of Daily Living↗
PubMed1985

Evaluation of acute nonpenetrating cervical spinal cord injuries with CT metrizamide myelography.

Computerized tomography metrizamide myelography was performed in 46 patients with acute, nonpenetrating cervical spinal cord injuries. By visualizing the spinal canal, spinal cord, and any compressive lesion, the study proved valuable in the decision as to whether surgical decompression was indicated and what approach should be used. Eleven patients were found to have significant spinal cord compression, 10 of whom were treated surgically. The technique, results, and complications resulting from the study are discussed.

Adolescent↗
PubMed2002

Management of low back pain.

A sizeable section of world's population develop back pain sometime in their lives and the specific causes cannot be identified. Various clinical conditions like trauma, infection (tuberculous, pyogenic, etc), malignancy, rheumatological diseases, neurological disorders and degenerative diseases produce back pain, and also some systemic illnesses cause the same. Radiological studies are very important for the diagnosis of back pain. Plain radiographs, myelography, computed tomography, magnetic resonance imaging and bone scintigraphy are various radiological procedures often selected for diagnosis. Treatment modality comprises non-surgical and surgical methods. Non-surgical treatment consists of rest, pharmacological therapy, physical therapy and injection therapy. Disc surgery, widening of spinal canal, spinal fusion using bone grafts, removal of tumour or sequestrated disc are carried out when surgical intervention is needed.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1981

[The pathologico-anatomic study of the metastatic tumor of the spine (author's transl)].

The radiological and histological studies were performed on the three spinal column obtained at autopsy from cases with metastatic tumors to the spine with complete paralysis treated surgically. These three cases consisted of a maxillary carcinoma with metastasis to the cervical spine, a seminoma with metastasis to the thoracic spine and a metastasized renal cell carcinoma to the thoracic spine. All patients died without recovery from the paralysis, in spite of the immediate tumor resection and spinal fusion were done immediately after the appearance of complete paralysis. The histological examination of cross section of these spinal column showed that tumor cells infiltrated in the vertebral body and spinal canal, and spinal cord was remarkably compressed by the tumor. Therefore, various degrees of degeneration were seen in the spinal cord. In addition, many tumor-cell emboli were seen in veins of vertebral body and spinal canal in two cases, and also tumor cell infiltration to an intradural space and marked deformity of the spinal cord were seen in one case. These above findings would suggest that tumor cells, which metastasized to vertebral body through venous plexus from the primary lesion, infiltrated into the spinal canal, compressed spinal cord and caused paralysis.

Female↗
PubMed2006

A cadaveric examination of pediatric cervical pedicle morphology.

STUDY DESIGN: A retrospective radiographic analysis of 47 intact cadaver pediatric cervical spines at the Hamann-Todd Osteology Collection in Cleveland, Ohio. OBJECTIVES: Evaluate the morphology of the pediatric cervical spine pedicle, the feasibility of surgical pedicle screw instrumentation, and examine the contribution of growth to the pedicle axis. SUMMARY OF BACKGROUND DATA: The adult cervical spine has been studied extensively and the morphology of the pedicles well documented. The morphology of the pediatric cervical, thoracic, and thoracolumbar spine has been studied radiographically, but, to our knowledge, no study has specifically examined the cervical spine pedicle, pedicle axis, and their changes with growth. METHODS: A total of 47 pediatric human cadaver spines with a mean age of 13 years (range 3-18 years at death) from the Hamann-Todd Osteology Collection at the Cleveland Museum of Natural History were analyzed radiographically. There were 25 females and 22 males. The C3-C7 vertebrae were used in this study. The 228 vertebral specimens were evaluated in the axial and sagittal planes. The radiographs were subsequently digitized and measured for 5 parameters on the axial view: pedicle axis length, pedicle length, pedicle width, cervical spinal canal anteroposterior spinal canal diameter, and interpedicular distance. RESULTS: The pedicle axis length increased with advancing age. The pedicle length remained relatively constant throughout growth, and the pedicle diameter showed a statistically significant increase with growth. Mean pedicle diameter width was 3.0 mm at C3 and 4.2 mm at C7 in the 3-5 year-old group compared to 4.3 mm and 6.1 mm, respectively, at C3 and C7 at 18 years of age. The anteroposterior spinal canal diameter remained relatively constant with increasing age. The interpedicular distance achieved 80% of its adult size by 3-5 years of age. Regarding pedicle axis growth, the 3 components of the pedicle axis (i.e., vertebral body, pedicle, and lateral mass) were analyzed with regards to their contribution to growth. The vertebral body contributed an increasing percentage to overall pedicle axis growth with age, while the pedicle itself contributed a progressively smaller percentage. CONCLUSIONS: Our results showed an overall increase in the pedicle axis and pedicle width but no significant change in pedicle length. The data in this study indicate that pedicle screws may not be safe for use in the pediatric cervical spine, particularly younger children. The use of lateral mass screws was not specifically addressed in this study. As in the thoracolumbar spine, growth of the pedicles in relation to the spinal canal is lateral to the canal. The vertebral body itself appears to contribute most to overall pedicle axis growth, while the pedicle itself contributes a progressively smaller percentage over time.

Adolescent↗
PubMed2004

Necrotizing soft tissue infection from decubitus ulcer after spinal cord injury.

STUDY DESIGN: A case of necrotizing soft tissue infection in a patient with spinal cord injury with extension of infection into the spinal canal and spinal cord is presented. OBJECTIVE: To review the history, risk factors, pathophysiology, diagnosis, treatment, and morbidity and mortality regarding necrotizing soft tissue infection as they relate to spinal cord injury. SUMMARY OF BACKGROUND DATA: Necrotizing soft tissue infection related to decubitus ulcers is rare. To our knowledge, this is the first report of this disease related to a sacral decubitus ulcer with extension of the necrotizing infection into the spinal canal. METHODS: The clinical, radiographic, and pathologic features associated with necrotizing soft tissue infection are presented. The patient presented with a late-stage necrotizing soft tissue infection requiring extensive de-bridement of necrotic tissue, which the patient underwent on admission. RESULTS: The patent died of refractory septic shock and multiple-organ failure after surgery. CONCLUSION: Necrotizing soft tissue infections from decubitus ulcers are rare and unpredictable, and ultimately have a progressively aggressive course. The case reported herein is the first report of necrotizing soft tissue infection from a decubitus ulcer in a patient with spinal cord injury with extension into the spinal canal and spinal cord.

Abdomen↗
PubMed1996

Does the cervical canal to body ratio predict spinal stenosis?

The exact size of the bony cervical spinal canal and the vertebral body was measured in 368 cadaveric adult male vertebrae. A comparison of radiographic and direct measurements was also undertaken. The mean sagittal diameter of the spinal canal for C3-C7 was close to 14 mm (14.07 +/- 1.63 mm; N = 272). The mean ratio of the sagittal canal diameter to the vertebral body diameter (canal to body ratio) was 86.68 +/- 13.70 mm. Thirty-one percent of subaxial vertebrae would be diagnosed as having spinal stenosis if a canal to body ratio of less than 80% was considered abnormal. Measurements from plain radiographs overestimate the canal diameter. The average diameter for the lower cervical spinal canal is about 14 mm. The canal to body ratio is independent of radiographic magnification, but may produce misleading results.

Adult↗
PubMed1983

Lumbar spinal stenosis and pseudostenosis. Definition and classification of pathology.

The concept of lumbar stenosis is defined and a classification of the diverse types is proposed. This is based on a correlation of the findings at operation with those of radiographs and axial tomography in patients with spinal stenosis or with disc hernia in a narrow spinal canal. The spinal canal can only be considered stenosed if the osseous canal is narrowed to the point at which it causes compression of the dural sac with or without nerve root involvement. Lumbar spinal stenosis can be divided into: Stenosis of the spinal canal, stenosis of the root canal, and stenosis of the intervertebral foramen.

Humans↗
PubMed1998

Traumatic pneumomyelography. A marker of spinal column injury in the face of innocuous spine fractures: two case reports.

STUDY DESIGN: A report of two cases of spinal column injury. OBJECT: To document the presence of air within the spinal canal following spinal fractures. SUMMARY OF BACKGROUND DATA: Only two previous cases of air in the spinal canal have been reported in the English literature. This report emphasizes that even with innocuous-appearing fractures of the thoracic spine, a similar phenomenon can occur. METHODS: The author reports on the medical records and radiographic investigations related to these two cases. RESULTS: Air within the cervical, thoracic, and lumbar spine was identified in what appeared to be minor spinal fractures of the thoracic spine. CONCLUSIONS: In cases of relatively undisplaced fractures of the thoracic spine associated with air in the spinal canal, one should be alert to the possibility of more unstable injuries that may have undergone significant displacement at the time of the fracture.

Adult↗
PubMed1988

Neurologic return versus cross-sectional canal area in incomplete thoracolumbar spinal cord injuries.

Twenty-four patients with incomplete spinal cord injuries secondary to burst fractures of the thoracolumbar spine were reviewed an average of 26 months after their injury. No patient had had a specific attempt to decompress neural elements but the majority had posterior instrumentation and fusion for spine realignment and stabilization. The amount of neurologic recovery in each patient was compared to the final area of the spinal canal as determined by CT scan. It was concluded that there was no correlation between neurologic improvement and the amount of spinal canal encroachment. In addition, posterior instrumentation to realign the spine will usually restore canal patency to greater than 50% of normal.

Adult↗
PubMedDate not supplied

Migration of luque rods through a laminectomy defect causing spinal cord compression.

Internal fixation of traumatic spinal injuries has been associated with spinal canal stenosis, spinal cord compression, and nerve root impingement. We present a case of spinal cord/cauda equina compression due to migration of intact, anchored thoracolumbar Luque rods into the spinal canal through a laminectomy defect, leading to neurologic complications 10 years after the original operation.

Adult↗
PubMed2006

Specializations in the lumbosacral vertebral canal and spinal cord of birds: evidence of a function as a sense organ which is involved in the control of walking.

Birds are bipedal animals with a center of gravity rostral to the insertion of the hindlimbs. This imposes special demands on keeping balance when moving on the ground. Recently, specializations in the lumbosacral region have been suggested to function as a sense organ of equilibrium which is involved in the control of walking. Morphological, electrophysiological, behavioral and embryological evidence for such a function is reviewed. Birds have two nearly independent kinds of locomotion and it is suggested that two different sense organs play an important role in their respective control: the vestibular organ during flight and the lumbosacral system during walking.

Animals↗
PubMed1983

[Biometry of the thoracic spine using scanography].

Biometry was performed on CT scan of a human thoracic spine. The entire spine was removed from the fresh corpse of an adult man. Horizontal cross-sections were performed, every 6 mm from C7 to L1. Measurements involved the main diameters of the vertebrae, spinal canal and spinal cord, muscular depth and punctures. Several density measurements were noted.

Aged↗
PubMedDate not supplied

Computed tomography of the upper cervical spine in Down syndrome.

Axial CT of the upper cervical spine was performed on 25 Down syndrome patients. Measurements of the degree of atlantoaxial displacement, the sagittal diameters of the spinal canal and spinal cord, thickness of the transverse ligament, and the ratio of sagittal diameter of spinal cord to canal were made. Thirty-six percent of the group showed evidence of cord compression. These patients demonstrated a significant decrease in the anteroposterior diameter of the spinal canal and the cord with an increase in the degree of subluxation and the cord:canal ratio when compared with the remainder.

Adult↗