Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SPINAL CANAL”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed1985

Myelography in the elderly and the diagnosis of spinal stenosis.

To evaluate the width of the spinal canal when diagnosing spinal stenosis, 91 patients older than 59 years of age when undergoing myelography were studied. Using a sagittal diameter of 11 mm as border for the diagnosis of spinal stenosis, it was found that 31 of the 66 patients with spinal claudication, suspicion of spinal claudication and sciatic pain fulfilled this criterion and that 3/25 of the control group and those with atypic symptoms had a sagittal diameter of 11 mm or less. Five patients showed a complete block on the myelogram, and all of them had a typical spinal claudication. The spinal canal will narrow with age in asymptomatic patients as well, and the myelographic stenosis in elderly patients is not always equivalent to a clinical diagnosis of spinal stenosis.

Aged↗
PubMed1984

Unstable thoracolumbar fractures. A study by CT and conventional roentgenology of the reduction effect of Harrington instrumentation.

Fourteen patients with unstable thoracolumbar fractures were examined with conventional roentgenologic technique and CT before and after operation with Harrington instrumentation. CT was superior in evaluating posterior elements, bone fragments in the spinal canal, and degree of narrowing of the spinal canal. Harrington rods restored the general spinal alignment. However, even after surgery, the midsagittal diameter, as well as the cross-sectional area of the spinal canal were still diminished by 26%. The reduction of the spinal canal improved significantly by early surgical intervention. Open reduction and stabilization with Harrington rods and fusion within three days after injury is recommended.

Adolescent↗
PubMed2002

Palliative radiation for vertebral metastases: the effect of variation in prescription parameters on the dose received at depth.

PURPOSE: To assess the effect of prescription parameters on the dose received by the spine during palliative radiotherapy. MATERIALS AND METHODS: In a survey, members of the Canadian Association of Radiation Oncologists were asked to define their prescription parameters for vertebral metastases. The depth of the spinal canal and vertebral body at 8 spinal levels was measured in 20 magnetic resonance imaging studies (MRIs). Survey results were applied to the measurements to assess the dose received at depth. The depth of spinal structures assessed at simulation and by diagnostic imaging was compared. RESULTS: Prescriptions were most commonly to D(max) 3 cm or 5 cm using 60Co-6MV photons delivering 8-30 Gy in 1-10 fractions. Mean depths from MRI were: posterior spinal canal, 5.5 cm; anterior spinal canal, 6.9 cm; and anterior vertebral body, 9.6 cm. Application of the prescription parameters from the survey to these measurements showed a wide range in the dose at depth with variation in technique. Depths measured at simulation correlated well with diagnostic imaging. CONCLUSION: The spinal canal and vertebral body lie >5 cm beneath the skin, and the dose received varies by up to 50% with changes in prescription depth. We suggest a suitable prescription point for vertebral metastases and a method for determining this at simulation.

Adult↗
PubMed1991

Profiles of spinal cord injury and recovery after gunshot injury.

Prospective motor and sensory examinations were conducted on 135 patients with neurologic deficits caused by spinal cord injuries resulting from gunshot wounds. Annual follow-up motor and sensory examinations were conducted for 67 patients. The neurologic data (motor and sensory neurologic levels of injury, zone of injury, and completeness of lesion) were assessed in terms of the vertebral level of injury, region of injury, bullet caliber, direction of bullet entry, and whether the bullet penetrated the spinal canal, completely traversed the spinal canal, or entered and remained lodged in the spinal canal. Seventy-seven of the patients sustained complete lesions and 58 sustained incomplete lesions. Anatomically, 19.3% of the injuries were in the cervical region, 51.8% in the thoracic, and 28.9% in the thoracolumbar. In 93 cases, the neurologic level was at least one level higher than vertebral level of injury. Although twice as many individuals were shot from the back as from the front and from the left as from the right, the point of bullet entry did not appear to be related to the severity of the injury. At the annual follow-up examinations, 66.7% of the patients with complete lesions and 64.0% of the patients with incomplete lesions had no improvement in the neurologic level of injury. Nevertheless, there was a significant (p less than 0.0001) improvement in the American Spinal Injury Association motor index scores one year after injury.

Adolescent↗
PubMed1993

Achondroplasia and spinal cord lesion. Three case reports.

The most important complications encountered by achondroplastic dwarfs are neurological problems related to a narrowed spinal canal. Stenosis of the spinal canal is secondary to abnormalities of endochondral ossification with premature synostosis of the ossification centres of the vertebral body and the posterior arch, resulting in thickening of the lamina, shortening of the pedicles, and reduced height of the vertebral bodies. Additional factors such as prolapsed intervertebral discs, osteophytes and progressive thoracolumbar kyphosis contribute to the narrowing of the spinal canal. Three achondroplastic dwarfs having spinal stenosis and spinal cord lesion representing typical clinical courses are described.

Achondroplasia↗
PubMed1992

Management of thoracolumbar fractures with accompanying neurological injury.

The optimal surgical approach for spinal canal reconstruction of thoracolumbar fractures is controversial, and the relationship between spinal canal reconstruction and neurological recovery remains unclear. To address these issues, 22 consecutive cases of thoracolumbar fracture with accompanying neurological deficit were reviewed. Neurological status was graded at the time of admission, postoperatively, and at a mean of 15 months postinjury. By using preoperative and postoperative radiographs and computed tomographic scans, the degree of spinal canal compromise was quantified in the sagittal, coronal, and axial planes. All fractures were stabilized by posterior instrumentation and fusion, and in 10 injuries, retropulsed vertebral body fragments were further reduced by posterolateral decompression. Spinal canal dimensions, neurological function, and operative approach were compared by using nonparametric statistical analysis. The greater the initial spinal canal compromise, the more severe the neurological deficit (P = 0.04). With injuries involving L1 and above, this relationship increased (P = 0.003). The extent of spinal canal reconstruction failed to correlate with neurological recovery. Compared with spinal instrumentation alone, transpedicular decompression showed no benefit in terms of postoperative canal dimensions or neurological outcome. On the basis of this experience, transpedicular decompression offers no advantage over spinal instrumentation alone. The relationship between initial spinal canal encroachment and neurological deficit demonstrates that the degrees of bony and neurological injury directly reflect the kinetic energy transferred at the time of impact. The lack of correlation between the extent of spinal canal reconstruction and neurological recovery suggests that ongoing neural compression/distortion contributes little to the overall neurological injury.

Adolescent↗
PubMed2006

Anatomical considerations for cervical pedicle screw insertion: the use of multiplanar computerized tomography reconstruction measurements.

OBJECT: The purpose of this study was to evaluate the linear and angular parameters of the vertebral body (VB) required for cervical pedicle screw (CPS) insertion by using multiplanar computerized tomography (CT) reconstructions. METHODS: Three hundred fifteen vertebrae from C-3 to C-7 in 63 patients were studied. Pedicle dimensions such as pedicle transverse angle (PTA), pedicle sagittal angle (PSA), and pedicle outer width (POW) were measured on axial CT reconstructions, as were linear parameters including the lateral mass thickness (LMT), the anteroposterior (AP) and mediolateral distances between spinal canal and transverse foramen, and spinal canal longitudinal and transverse diameter. In addition, the correlations between PTA and other parameters were calculated using univariate linear regression analysis. The overall mean LMT ranged from 10.7 to 12.6 mm. The smallest mean AP spinal canal-transverse foramen distance was found at C-7 (1.1 mm),whereas the largest mean distance was at C-4 (3.1 mm). The smallest mean mediolateral spinal canal-transverse foramen distance was found at C-4 (1.2 mm), whereas the largest mean distance was at C-7 (4.7 mm). There were significant intergroup differences between male and female patients except for PTA and spinal canal longitudinal diameter. The PTA had a direct linear correlation with AP and mediolateral spinal canal-transverse foramen distances. The largest Pearson coefficient was 0.71 between the PTA and AP spinal canal-transverse foramen distance and the inverse one was -0.73 between the PTA and mediolateral spinal canal-transverse foramen distance. CONCLUSIONS: Analysis of the data obtained in this study suggests that not only pedicle dimensions but also linear and angular parameters of the VB can be useful data when inserting a CPS.

Adolescent↗
PubMed1980

Sacral epidermoid cyst communicating with the spinal CSF canal.

A 6-year-old girl was found to show a presacral epidermoid cyst which had a communication with the spinal canal. The patient was admitted as a case of meningitis, but squamous cells and cholesterin crystals were observed in the cerebrospinal fluid (CSF), and the CSF cholesterol level was very high. Diagnosis was established by myelography, and a cyst measuring 4.5 x 6.0 x 4.0 cm wide was totally excised surgically. A comparative discussion of this case and other reported cases of dermoid and epidermoid cysts in the central nervous system is given.

Child↗
PubMed1995

[Kinematic MRI in degenerative cervical spine changes].

AIM: To evaluate functional stenosis of the cervical spine, kinematic MRI was performed in 23 healthy volunteers and 23 patients with degenerative disease. MATERIAL AND METHOD: Kinematic MRI of the cervical spine was done from 50 degrees of inclination to 30 degrees of reclination. Depending on the maximum inclination and reclination the range of motion was divided into 9 equal angle positions. At each angle position sagittal T2* weighted gradient echo sequences were performed. RESULTS: In relation to the neutral position a physiological narrowing of the ventral epidural space was seen in healthy volunteers at inclination (50 degrees) in up to 50% and respectively widening at reclination (30 degrees) in up to 10%. An increase of spinal canal stenosis or even spinal cord compression was seen at inclination in 5 patients (22%) and in 15 patients (65%) at reclination. No change of spinal canal stenosis was found in three patients (13%). CONCLUSION: In patients with degenerative disease of the cervical spine kinematic MRI demonstrated in some patients functional spinal canal stenosis with myelon compression which was not seen in standard MRI. Therefore kinematic MR imaging can be recommended as a complementary examination in the early detection of functional myelon compression and in planning the further therapeutic work-up.

Adult↗
PubMed1991

Degenerative lumbar spondylolisthesis. Part I: Etiology, pathogenesis, pathomorphology, and clinical features.

The authors analyze the clinical features and the results of various imaging studies in 77 patients with degenerative lumbar spondylolisthesis. The most commonly olisthetic vertebra was L-4, followed by L-3. The extent of the olisthesis ranged from 8-43%. Forty-two percent of the patients with L-3 or L-4 olisthesis had reduced mobility of the underlying vertebra. Five different clinical pictures were present: no symptoms except occasional low back pain; chronic low back pain with no radicular symptoms; radicular symptoms and no signs of nerve root compression, with or without low back pain; radicular symptoms with neurologic deficit; intermittent claudication. Various pathological conditions were identified: slight narrowing of the central spinal canal without compression of neural structures; isolated stenosis of the nerve root canal; stenosis of both the nerve root canal and the central spinal canal. The onset of degenerative spondylolisthesis seems to be connected to excessive shear forces on the olisthetic vertebra. The extent of neural structure compression, and thus the clinical picture, depends on three factors: the primitive size of the spinal canal, the extent of degenerative changes in the zygapophyseal joints, and the extent of olisthesis.

Adult↗
PubMed2005

[Application of restorative laminoplasty combined with spinous process osteotomy and internal fixation for treatment of degenerative scoliosis].

OBJECTIVE: For treatment of mild degenerative scoliosis (DS) complicated with lumbar canal stenosis (LCS), posterior decompression and the spinal canal enlargement with spinous process osteotomy was performed in combination with fusion and pedicle screw instrument fixation. METHODS: Between 1999 and 2003, 18 male and 26 female elderly patients (with mean age of 63 years, ranging from 47 to 72 years) with DS complicated with LCS were treated with the described surgical procedures, including 25 with single segment lesion and 19 with involvement of 2 segments. A posterior medical incision from one vertebra superior to the target fusion area till the vertebral segment below it was made for spinal exposure. Undermining enlargement of the spinal canal was carried out according to the segments of the stenosis; in some cases the intervertebral disc was resected. Osteotomy was subsequently performed at the base of the spinous process, and the bony defect was covered with the spinous processes. Finally Moe fusion and Isola (17 cases) or Diapason (27 cases) instrument fixation were performed. The therapeutic effects were evaluated according to Oswestry scores and postoperative imaging examinations. RESULTS: The average follow-up period was 3 years, ranging from 1 to 4 years. Thirty-three patients were followed up for one year and 93.9% of them had excellent or good outcome; 27 patients were followed up of 2 years and showed a rate for excellent or good results of 88.9%. Both sagittal and transverse diameters of the lumbar spinal canal were increased obviously as found by CT scanning without spinal canal scar. A rate of 92.6% of the ostetomized spinous processes had bony fusions. Successful covering bone healing was achieved in a mean of 4 months after surgery. Compressive vertebral fractures superior to the fixed segments occurred in 2 cases, including 1 with pedicle screw loosening and the other with pedicle screw breakage. Another patient had delayed wound healing. No recurrence of LCS, spondylolisthesis and decompensation, or pseudarthrosis of the spine was observed in these cases. CONCLUSION: The described surgical procedures for DS can decrease the occurrence of spinal canal scar and promote the healing of the covering bone, and can be a satisfactory treatment for mild DS complicated with LCS in the lumbar sagittal curve.

Adult↗
PubMed2000

Cervical spinal cord injury without radiological abnormality in adults.

Spinal cord injury occurring without concomitant radiologically demonstrable trauma to the skeletal elements of the spinal canal rim, or compromise of the spinal canal rim without fracture, is a rare event. Though documented in children, the injury is not very well reported in adults. We present seventeen adult patients with spinal cord injury without accompanying fracture of the spinal canal rim, or vertebral dislocation, seen over seven years. None had preexisting spinal canal stenosis or cervical spondylosis. Following trauma, these patients had weakness of all four limbs. They were evaluated by MRI (CT scan in one patient), which showed hypo / isointense lesion in the cord on T1 weighted images, and hyperintensity on T2 weighted images, suggesting cord contusion or oedema. MRI was normal in two patients. With conservative management, fifteen patients showed neurological improvement, one remained quadriplegic and one died. With increasing use of MRI in the evaluation of traumatic myelopathy, such injuries will be diagnosed more often. The mechanism of injury is probably acute stretching of the cord as in flexion and torsional strain. Management is essentially conservative and prognosis is better than that seen in patients with fracture or dislocation of cervical spine.

Adolescent↗
PubMed1994

Musculoskeletal causes of spinal axis compromise: beyond the usual suspects.

The majority of cases of spinal canal compromise are caused by common pathologic conditions, including degenerative spondylosis, infection, trauma, and metastatic disease. However, there are other causes of spinal canal compromise that, though unusual, may be seen in everyday practice. Congenital abnormalities of the spine that may produce spinal canal compromise include the os odontoideum, hemivertebra, diastematomyelia, and achondroplasia. Arthritides and enthesopathies such as rheumatoid arthritis, ankylosing spondylitis, synovial cysts of the facet joint, calcium pyrophosphate dihydrate deposition or hydroxyapatite deposition, and ossification of the posterior longitudinal ligament or ligamentum flavum may lead to narrowing of the spinal canal. Primary spinal tumors and tumorlike lesions such as hemangioma, aneurysmal bone cysts, osteochondroma, and osteoblastoma may also cause spinal canal stenosis. Finally, Paget disease of bone may compromise the spinal cord. Radiologists should be aware of these unusual musculoskeletal causes of spinal canal compromise and their radiologic and clinical features.

Humans↗
PubMed2006

The phenomenon and efficiency of ligamentotaxis after dorsal stabilization of thoracolumbar burst fractures.

Thirty-six consecutive patients with burst fractures of the thoracolumbar spine and with a fractured posterior vertebral surface dislocated into the spinal canal without neurological symptoms were treated with the AO internal fixator. Computed tomography-aided planimetry of the spinal canal was undertaken preoperatively and within 1 week postoperatively to elucidate the effect of kyphosis correction and distraction on spinal canal widening (ligamentotaxis). The stenosis of the spinal canal area (SCA) was reduced from 29% preoperatively to 19% postoperatively (+10%) of the estimated original area, and the stenosis of the mid-sagittal diameter (MSD) reduced from 31 to 23% (+8%). The widening of the SCA was greater at the level of L1/L2 (+13%) than at L3/L4 (+6%). High preoperative canal compromise was associated with greater absolute spinal canal widening. Large trapezoid-shaped fragments resisted reduction by ligamentotaxis. Even though the effect of ligamentotaxis after operative treatment with the internal fixator was proven, a certain stenosis of the spinal canal remains in most cases. Especially for patients with fracture-related neurological symptoms, ligamentotaxis alone does not seem sufficient for the requested spinal decompression. Even an exact analysis of preoperative CT scans under consideration of the fracture level will not always allow an exact prognosis of the expected effect of ligamentotaxis.

Adolescent↗
PubMed1998

[Presence of epithelial cells in the medullary canal after spinal anesthesia].

BACKGROUND AND AIM: Several authors have focused on a causal link between the onset of neurological complications after lumbar injections and the fact that epithelial cells may be drawn into the vertebral canal during these procedures. Complications may arise both early (cephalea, septic and aseptic meningitis) and late (epidermoid tumours). The authors aimed to evaluate whether skin fragments which are carried down by the needle during subarachnoid anesthesia may even be present in the epidural or subarachnoid space three days later and may therefore justify the onset of the above neurological syndromes. METHODS: Five adult cats under narcosis underwent subarachnoid anesthesia using disposable 22G Quincke type needles. Between 0.7 and 1 ml isobaric bupivacaine at 0.50% was injected. The presence of the motor block of the lower limbs was ascertained once the effects of general anesthesia wore off. On the third day, again under general anesthesia, cardio-respiratory arrest was provoked by intravenous injection. Samples of meninges were collected in the injection area. After fixation in a phosphate glutaraldehyde buffer, dehydration in acetone, dehydration by critical point and gold metalisation, the samples were examined using SEM. RESULTS: No epidermal cells were found on the surface of the meninges. On the other hand, a squamous epithelial cell was observed which drained inside a sectioned epidural vessel towards the systemic circulation. CONCLUSIONS: This study confirms the possibility that, after subarachnoid anesthesia using 22G Quincke needles, skin fragments may enter the spinal canal. The permanence or otherwise of the epithelial fragments on the third day depends on the size of the fragment drawn down and the efficacy of the drainage system which removes isolated epithelial cells. This phenomenon may justify the self-limiting character of cephalea and meningisms which, even if not treated, regress in a few days, as well as the scarce development of epidermoid tumours.

Anesthesia, Spinal↗
PubMed2006

Correlation among canal compromise, neurologic deficit, and injury severity in thoracolumbar burst fractures.

STUDY DESIGN: Review the association between injury severity, narrowing of the spinal canal, and neurologic deficit in thoracolumbar burst fractures. OBJECTIVE: To determine which variable has a stronger association with neurologic deficit: spinal canal compromise or injury severity. SUMMARY OF BACKGROUND DATA: Literature has not reached a consensus regarding the cause of neurologic deficits in these fractures. Some believe it to be the spinal canal compromise and others the energy of trauma. METHODS: A review of the clinical data and axial computerized tomography of 184 patients was performed. The injury severity was determined by subtracting neurologic data from the Injury Severity Score and New Injury Severity Score (ISSM and NISSM) to avoid the bias of overestimating neurologic lesions. RESULTS: Patients with neurologic deficit presented higher canal compromise (52% vs. 34%), higher Injury Severity Score (24 vs. 11), New Injury Severity Score (26 vs. 13), ISSM (10 vs. 7), and NISSM (11 vs. 8, respectively). A positive correlation was found among these scores and the spinal canal compromise (P < 0.005; r < 0.35). In the current methodology, logistic regression proved narrowing of the spinal canal to be the only independent variable associated with neurologic deficit. CONCLUSIONS: Narrowing of the spinal canal has a stronger association with neurologic deficit than injury severity in thoracolumbar burst fractures.

Adolescent↗
PubMed1989

Comparison of computerized tomography parameters of the cervical spine in normal control subjects and spinal cord-injured patients.

The cross-sectional area and the sagittal and transverse diameters of the cervical spinal canal were measured, using high-resolution, thin-section computerized-tomography images, in 100 control subjects and forty-two patients who had a traumatic injury to the spinal cord. No significant differences were found between the control and the spinal cord-injured group with regard to the cross-sectional area of the spinal canal; however, the differences between the two groups were significant with regard to mean sagittal and transverse diameters of the spinal canal. The sagittal diameters of the spinal canal of the control group were significantly larger than those of the spinal cord-injured group. Conversely, the transverse diameters of the spinal canal of the spinal cord-injured group were significantly larger than those of the control group. These findings suggest that certain patients may be predisposed to spinal cord injury, given sufficient trauma. It is not the total volume of space in the spinal canal that is the critical factor; rather, it is the shape. An index of shape is the ratio of the sagittal to the transverse diameter. The difference between the two groups, based on the ratio of sagittal to transverse diameter, was highly significant. Because this measure is a ratio, there is no need to evaluate an individual on the basis of measurements of absolute values.

Adolescent↗