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At least 109 records · Page 6Linked to original sources
PubMed1998

Dimensions of the lumbar spinal canal: variations and correlations with somatometric parameters using CT.

The aim of this study was to investigate the correlation of vertebral dimensions with somatometric parameters in patients without clinical symptoms and radiological signs of central lumbar spinal stenosis. One hundred patients presenting with low back pain or sciatica were studied with CT. In each of the L3, L4 and L5 vertebra three slices were taken with the following measurements: 1. Slice through the intervertebral disc: (a) spinal canal area; (b) interarticular diameter; (c) interligamentous diameter. 2. Slice below the vertebral arcus: (a) dural sac area; (b) vertebral body area. 3. Pediculolaminar level: (a) anteroposterior diameter and interpedicular diameter of the spinal canal; (b) spinal canal area; (c) width of the lateral recesses. The Jones-Thomson index was also estimated. The results of the present study showed that there is a statistically significant correlation of height, weight and age with various vertebral indices. The conventional, widely accepted, anteroposterior diameter of 11.5 mm of the lumbar spinal canal is independent of somatometric parameters, and it is the only constant measurement for the estimation of lumbar spinal stenosis with a single value. The present study suggests that there are variations of the dimensions of the lumbar spinal canal and correlations with height, weight and age of the patient.

Adult↗
PubMed1988

Clinical results following enlargement of the cervical spinal canal by means of laminoplasty.

Since 1978, cervical spinal canal laminoplasty has been performed on 75 patients in our hospital with cervical radiculomyelopathy and followed with studies of from 6 months to 8 years (average 4 years and 6 months). Overall results: the pre-operative score, using the Japanese Orthopaedic Association Scoring System, was 7.4 and the post-operative score was 15.2; the improvement was 81.0%. In congenital spinal stenosis, the average pre-operative score was 6.3 while the post-operative score was 14.2; the improvement was 66.9%. The pre-operative score of multiple disc lesions was 7.9 and the post-operative score was 15.2; the improvement was 82.8%. And the pre-operative score of OPLL was 7.3 and the post-operative score was 15.3; the improvement was 81.9%. Improvement may be due not only to the degree of enlargement of the spinal canal, but also to improvement in the circulation within the spinal cord and nerve roots. No case worsened after the surgery.

Female↗
PubMed2004

Spinal canal size in ossification of the posterior longitudinal ligament of the cervical spine.

BACKGROUND: The size of the spinal canal is a factor that contributes to the neurologic deficits associated with cervical ossification of the posterior longitudinal ligament (OPLL). METHODS: Bone-window computed tomography (CT) examinations of the cervical spine in 64 patients with cervical OPLL were reviewed. Forty-two patients underwent surgical treatment (anterior decompression: 16 patients, posterior decompression: 26 patients). The remaining 22 patients were managed conservatively. Selection of the surgical approach, anterior or posterior, was based on the longitudinal extent of cord compression. RESULTS: The mean developmental size of the spinal canal in the posterior decompression group (10.7 mm at C4) was significantly smaller than the other 2 groups. The spinal canal was narrowed by OPLL to 2.9 to 10.0 mm. The proportion of the patients showing motor deficits of the lower extremities significantly increased when the sagittal canal diameter was narrowed to less than 8 mm. CONCLUSIONS: This study demonstrates critical values of CT-determined spinal canal stenosis. Developmental size of the spinal canal and the residual anterior-posterior canal diameters resulting from OPLL spinal cord compression are important factors influencing clinical management and the neurologic state.

Adult↗
PubMed1995

Production of chronic compression of the cauda equina in rats for use in studies of lumbar spinal canal stenosis.

STUDY DESIGN: The pathophysiology of lumbar spinal canal stenosis was analyzed with a new model in rats. OBJECTIVES: To produce chronic compression of the cauda equina in rats for analysis of the pathophysiology of lumbar spinal canal stenosis. SUMMARY OF BACKGROUND DATA: Models of compression to date have involved acute or subacute compression. A model of chronic compression has not been available. METHODS: A stainless steel wire fastened around the spine at L5 in 3-week-old rats, with a plate inserted against the ventral aspect of the vertebra to protect it from the wire. as the rats grew, the wire cut into the spinal canal. One year after the operation, canal stenosis was present without paralysis of the back limbs. RESULTS: Stenosis seen in sagittal sections, as a percentage of the original width, was 51.6 +/- 6.2% (mean +/- standard deviation). In histologic analysis of the region near the wire, findings included axonal degeneration, demyelination, vacuolar degeneration of the nerve fibers, and narrowing the intradural blood vessels with a decrease in their number. Cephalad and caudad to the wire, congested intradural blood vessels, degenerative foci near these congested vessels, fibrosis around these foci, congested epidural vessels, and fibrosis around these vessels were observed. During electrophysiologic analysis (six rats with stenosis), the conduction velocity of the cauda equina was found to be delayed. CONCLUSIONS: The histologic and electrophysiologic findings in this animal model were similar to findings in human subjects, so rats prepared in this way should be useful for study of chronic compression of the cauda equina.

Animals↗
PubMed1985

[Endoscopy of the spinal canal].

The feasibility of inspecting the spinal canal with a needle-arthroscope of 2.7 mm diameter was tested in the spine of fresh autopsy specimens. It was possible to identify all the structures within the spinal canal, which was also photographically documentated. The clinical application of spinaloscopy for diagnostic purposes and for providing prognostic signs respectively in paraplegic spinal injuries is discussed.

Adolescent↗
PubMed1991

Magnetic resonance imaging in the diagnosis of lumbar spinal canal stenosis.

Twenty-two patients with clinical symptoms suggesting lumbar spinal canal stenosis underwent myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Patients were divided into two groups according to myelographic findings. Group I included 19 cases in which myelograms showed spinal canal stenosis, and group II consisted of 3 patients with myelograms negative for this condition. MRI showed uniform narrowing of the dural sac, indentations on the posterior aspect, or interruption of the outline of the sac in the sagittal scans and reduced area of the sac in the transverse scans. In group I patients, the diagnostic accuracy of MRI was greater than that of CT and myelography. In Group II patients, all of whom had moderate or severe lumbar scoliosis, MRI suggested spinal canal stenosis in contrast with myelography. In spinal canal stenosis surgery may be planned on the basis of MRI findings alone, except in scoliotic patients.

Aged↗
PubMed2000

Effect of low back posture on the morphology of the spinal canal.

OBJECTIVE: To define the possible mechanism of posture-dependent symptoms of spinal stenosis by measuring the effect of low back posture on morphologic changes of the intervertebral discs and spinal canal in healthy young people. DESIGN: Twenty healthy young volunteers underwent magnetic resonance imaging while supine with their spine in neutral, flexed, extended, and right and left rotational positions. The axial MR images at the middle of the intervertebral discs of L3-4 and L4-5 were analyzed to measure the difference in the size and shape of the intervertebral discs and spinal canal in each posture. RESULTS: Extension or rotation decreased the sagittal diameters and cross-sectional areas of the dural sac and spinal canal and increased the thickness of the ligamentum flavum, whereas flexion had the opposite effects. The gap between the convex posterior disc margin and the anterior margin of the facet joint on each side, represented as the subarticular sagittal diameter, increased with flexion and decreased with extension or rotation. The direction of rotation did not result in asymmetry of the subarticular sagittal diameter, but right rotation caused thickening of the right ligamentum flavum, and vice versa. The shape and dimensions of the disc did not change significantly according to the positions of the low back. CONCLUSIONS: With extension or rotation, the thickness of the ligamentum flavum increased and the posterior margin of the intervertebral disc was approximated to the facet joint without any change in shape and size of the disc. These phenomena result in a decrease in the size of the spinal canal and dural sac in extension or rotation postures in young healthy people without disc degeneration, and may explain the posture-dependent symptom of spinal stenosis.

Adult↗
PubMed1995

Hypothesis about the etiology of unexplained painful myelopathy after minor trauma in the spinal canal.

After electrode insertion for epidural spinal cord stimulation, of 625 electrode operations, unexplained, temporary paralysis resulted in 1.8%, and multidermatomal, painful allodynia in 4.2% (of whom 19% had also had temporary paralysis). Diagnostic testing yielded no anatomical explanation. In patients who were awake during operation, these deficits were noted to begin immediately after pain caused by mechanical deformation of the dura. The author hypothesized the following: myelopathy may result from cord ischemia, caused by vasospasm, triggered by pain within or near the spinal canal. The author proposes to prevent these complications by selective epidural anesthesia.

Electric Stimulation↗
PubMed2002

Three-dimensional sonographic evaluation of the fetal lumbar spinal canal.

In a prospective cross-sectional ultrasound study the size of the fetal lumbar spinal canal was evaluated to determine reference values for the lumbar part of the vertebral canal. One hundred and sixty-seven pregnant women undergoing routine obstetric ultrasound were studied between 16 and 41 weeks of gestation. Exclusion criteria consisted of structural fetal anomalies or growth restriction. Area and volume of the vertebral canal at L1, L3 and L5 were calculated by three-dimensional (3D) ultrasound. Length of the lumbar spine was also determined. The size of the spinal canal and spinal length correlated well with gestational age. No gestational-age-dependent differences in area and volume measurements between upper and lower lumbar spine were found. The results provide an in vivo assessment of the spinal canal by 3D ultrasound over the entire gestation period.

Cross-Sectional Studies↗
PubMed1987

Thoracic spinal canal stenosis.

Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological, metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Over a 2-year period the authors have treated six cases of thoracic myelopathy associated with thoracic canal stenosis. In four patients the deficits developed gradually and painlessly. The three older patients had a clinical profile characterized by complaints of pseudoclaudication, spastic lower limbs, and evidence of posterior column dysfunction. Two patients were younger adults with low thoracic myelopathy associated with local back pain after minor trauma. Both patients also had congenital narrowing of the thoracic spinal canal. Oil and metrizamide contrast myelography in the prone position were of limited value in diagnosing this condition; in fact, myelography may be misleading and result in erroneous diagnosis of thoracic disc protrusion, when the principal problem is dorsal and lateral compression from hypertrophied facets. Magnetic resonance imaging and computerized tomography sector scanning were more useful in the diagnosis of this disorder than was myelography. Thoracic canal stenosis may be more common than is currently recognized and account for a portion of the failures in anterior and lateral decompression of thoracic disc herniations.

Adult↗
PubMed1982

Behavioral self warming and cooling of spinal canal by rats.

Rats with a chronic thermode implanted in their spinal canal could bar-press to warm or cool their spinal cord. With a "cold" lever, they cooled their spinal canal less in a cold environment than in a warm environment. With a "warm" lever they behaved in the same way, i.e., warmed their spinal canal more in a warm than in a cold environment. In a two-lever situation they pressed the cold and the warm levers alternatively in warm environment, but did not press either in cold environment. These results suggest that cold and warm spinal cord provided the rats with rewards of a different nature.

Animals↗
PubMed1999

New method for measuring area of spinal canal after double-door laminoplasty.

In the double-door laminoplasty procedure used for patients with cervical myelopathy, techniques to obtain a wider spinal canal have been tested. We hypothesized that making the lateral gutters as lateral as possible may be effective for obtaining a wider spinal canal. In this study we aimed to test our hypothesis by using a new measurement method to assess the postoperative cross-sectional area of the spinal canal. Fifty-six vertebrae were operated on in 11 patients, using the STSS spacer (Asahi Optical, Tokyo, Japan). On computed tomography (CT) scans, the most posterior edge of a space-occupying lesion was defined as point A and a horizontal line through point A was drawn parallel to the posterior wall of the vertebral body (line X). Two oblique lines were drawn along the medial margin of the bilateral split laminae (lines R and L). The triangular area enclosed by lines X, R, and L was defined as the substantial area of the spinal canal (SASC). A horizontal line through the median points of the bilateral facet joint in the anteroposterior direction was defined as line B. According to the relative position of line X to line B, two types of vertebra were observed: In type 1, line X was located ventral to line B; in type 2, line X was located dorsal to line B. The mean data values for type 1 vertebra were: SASC, 133.1 mm2; ATD, 22.9 mm; angle R, 61.3 degrees; and angle L, 61.8 degrees. The mean data values for type 2 vertebra were: SASC, 99.8 mm2; ATD, 20.1 mm; angle R, 58.6 degrees; and angle L, 57.5 degrees. There were significant differences between types 1 and 2 vertebrae in values both for SASC and ATD (P < 0.01). There were no significant differences between types 1 and 2 vertebrae regarding angles R and L. The difference in SASC in the two types appeared to arise from the difference in ATD. In other words, the degree of enlargement of the spinal canal was determined not by the inclination of the bilateral split laminae, but by the transverse diameter. This result supports the validity of our hypothesis. In a double-door laminoplasty, to obtain a wider spinal canal, the lateral gutters must be made as lateral as possible (i.e., at the medial border of the facet joints, especially in type 2 vertebra). On the preoperative CT scan, the relative positions of the large-volume lesion and the facet joint must be noted.

Anatomy, Cross-Sectional↗
PubMed2000

Laminectomy for thoracic spinal canal stenosis.

Stenosis of the thoracic spinal canal is a relatively rare disorder with numerous causes. Clinical manifestations include signs and or symptoms consistent with focal thoracic radiculopathy and/or myelopathy. Several surgical approaches for the decompression of the stenotic thoracic canal have been described. Laminectomy is typically reserved for only those cases in which dorsal compression of the neural elements is demonstrated; it is contraindicated when the epidural compression is primarily ventral in location.

Decompression, Surgical↗
PubMed2004

[MR appearance of the spinal canal vascular malformations].

Vascular malformations of the spinal canal are rare and their clinical appearance is not specific. The authors demonstrate material of 6 patients, who have been diagnosed with magnetic resonance imaging (MR). MR studies in all cases showed tortuous foci of very low signal, compatible with pathological vessels. In 2 patients malformations were also visible on MR angiography and confirmed with conventional angiography. Besides, in 2 cases features of secondary spinal cord oedema (thickening and hyper-intensity on T2-weighted images) have been shown. One patient had spinal cord haematoma which was not visible on MR and has been diagnosed with computed tomography (CT). In the authors' opinion MR is an efficient method of diagnosing and evaluating spinal canal vascular malformations and should be the first diagnostic study in these cases.

Adolescent↗
PubMed1991

Spinal canal decompression in traumatic thoracolumbar burst fractures: posterior distraction rods versus transpedicular screw fixation.

Although the benefit of spinal canal decompression of traumatic thoracolumbar burst fractures is controversial, it remains a desirable procedure, as many reports describe improved neurologic outcome with spinal canal reconstruction. The optimal type of posterior instrumentation for reconstructing the spinal canal is unclear. This study focused on the efficacy of posterior distraction rods versus transpedicular screw fixation implants in decompressing the spinal canal and on the relationship between the amount of canal decompression and subsequent neurologic recovery. A medical records review was conducted to identify all patients surgically treated for traumatic burst fractures of the thoracolumbar spine from January 1, 1987 to June 30, 1989. Sixty-seven patients were selected by this review, and, of these, 30 had had both preoperative and postoperative CT scans. We could find no bias among patients who received both preoperative and postoperative CT scans as compared to those who did not, therefore the 30 patients were considered to be a random sample of the total population of 67. A retrospective study was then conducted on the 30 patients with surgically treated burst fractures--15 treated with posterior distraction rods and 15 treated with AO Fixator Interne transpedicular screw fixation implants. Preoperative and postoperative spinal canal cross-sectional areas were measured directly from the scaled CT scans. The area of most severe compromise was compared with an internal standard defined as the next, caudal, uncompromised spinal level, and the percentage of preoperative and postoperative canal compromise was calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Value of ultrasonic measurement of spinal canal diameter in general practice.

The diameter of the spinal canal was measured by ultrasonic scanning in 193 patients with back pain and 193 matched controls. The spinal canal was found to be significantly narrower in the patients compared with all 193 controls (p less than 0.01) and compared with 132 of the controls with no history of back pain (p less than 0.001), but measurement of canal size was found not to have any value in the prognosis or management of back pain in general practice.

Adult↗