[Anatomy and computed tomography of the lumbar spinal canal].
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Biomedical subjects
Publications and source records attributed to R Putz.
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In the cervical region the fibres of the interspinous and nuchal ligaments pass in an anterocranial direction: they act against diminishing of the cervical lordosis. In the thoracic region, longitudinal bundles of fibres connect the tops of the spinous processes; they act against an augmentation of the thoracal kyphosis. Between thoracal kyphosis and lumbal lordosis there is no exact course of the fibres of the interspinous ligts. ("thorakolumbaler Ubergangsbereich"). In the lumbar spine the fibres of the interspinous ligts., being very strong, pass in a posterocranial direction. They have the function of limitation the range of flexion ventrally and of limiting backwards-shifting of the cranial vertebra in dorsal-flexion. In the lumbosacral segment additional fibres, arising from the top of the 5th lumbar spinous process, pass in a posterocaudal direction and interlace with the thoracolumbar fascia, whose fibres form--below the 4th lumbar vertebra--a scissor-latticed structure. The supraspinous ligt. lies superficially to the thoracolumbar fascia. Its fibres pass several spinous processes. It ends caudally at the 4th lumbar spinous process.
The wall of the vertebral canal is formed differently at various levels of the spinal column. These differences depend both on the formation of the elements of the neural arch (pedicle and lamina), and on the arrangement of the joints of the articular processes. The outline of the vertebral canal is determined by the ligaments between the vertebrae, one of which - the ligamentum flavum - sometimes encroaches upon the space of the canal to a considerable effect. This work is intended to demonstrate that axial computed tomography is as a non-invasive technique at least as satisfactory as myelography for examination of the vertebral canal.
As a result of the new technique of axial computer tomography, it is possible to use data from transverse serial sections to construct sections in other planes. A method has been developed which allows transverse, sagittal and other sections (coronal f.e.) to be cut from the same specimen. After the C.T. exposure has been made, the specimen is frozen and cut into sections, and the sections photographed. The sections are reassembled and again frozen, so as to restore the specimen in its original form. It is then possible to cut new sections in any plan desired, and photograph them so that they may be compared with the reconstruction C.T. image.
The function of the vertebral column--the supporting axial component of the body--can only be understood by detailed knowledge of its structure. For this reason the first part of the article gives a report of the latest findings on the ligaments and zygapophysial joints of the vertebral column. Particular emphasis has been laid on the functional cooperation of these ligaments and joints during movements of the segments of the column. The second part of the paper is concerned with the dynamic behaviour of the column in children and young people, and is described in terms of the anatomical information given before. The damping capacity of the spinal column and its rigidity depend on both the age of the subject and the position of the body. In the axial direction the damping effect of the column is relatively slight, but it becomes markedly increased during ventral flexion.
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The authors introduce a new system of preservation and storage of anatomical material. The system accomplishes the following demands: (1) avoidance of fungi on section material, (2) alternative application of various preservation fluids, (3) utmost flexibility of storage capacity, (4) clearness and easy control, (5) elimination of unpleasant smell, (6) smallest possible need of staff and (7) low working expenses.
The article reports on a block formation in the lumbar vertebrae of a woman athletic. In the authors' opinion, such an anomaly has not yet been described. The article demonstrates on the basis of a detailed descussion of developmental anatomy that the block formation extended from L 3 to L 5, L 4 being merely a "quarter vertebra". The findings and the complaints resulting thereform prompt the authors to demand that in persons aspiring to become top-performance sporstmen. The locomotor system must be subjected to a thorough examination.
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Anorectal continence following low anterior resection in 37 controlled patients from the University Hospitals of Innsbruck, Department of Surgery, in the years 1970 to 1974 is described. Of these 37 patients, 10% were partially incontinent for from 18 to 24 months. It is pointed out that the partial incontinence of these patients is due to the extensive perirectal-perianal drainage. The low anterior resection can be called continence-saving, if a too extensive perirectal-perianal drainage is avoided and the criteria of the operation are considered.
Using macerated and nonmacerated lumbar vertebrae and/or whole lumbar vertebral columns as well as x-rays, the attempt was made to contribute to the knowledge of the mechanics of the small joint in the lumbar section of the spinal column on the basis of the shape of the joint surfaces. The joint surfaces of the lumbar vertebral column deviate from the usual demonstration of primarily angular surfaces. Right and left joint surfaces of a locomotor segment do not lie on the same geometrical plane, i.e., there is nothing like a common right and left curvature center. As a result, conclusions can be drawn in regard to the role played by the small joint of the lumbar vertebral column under the various types of strain during movement, particularly during rotation. The relation of the small joint in rotation positions was demonstrated radiographically in isolated preparations of individual locomotor segments.
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