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At least 19 recordsLinked to original sources
PubMed1980

Spinal elastance measurement in patients with spondylogenic narrowing of the spinal canal.

Spinal elastance and the time course of pressure decrease after saline injection into the lumbar subarachnoid space was measured in a control group and in a group of patients with spondylogenic narrowing of the cervical spinal canal. The elastance is higher with retroflexion of the head than with anteflexion. This is more pronounced in degenerative diseases of the spine, proving the existence of a pincers mechanism. High elastance values at high volume changes indicate a narrowing of the cervical spinal canal. With a normal spinal canal the pressure decrease shows a slow monoexponential slope (T/2 = 100.8 +/- 13.4 seconds). In patients with partial obstruction of the spinal canal, especially with retroflexion of the head, a secondary pressure increase after termination of the volume injection was observed. This secondary pressure increase decreases in a biexponential manner with a fast slope (T/2 = 37.62 +/- 15.88 seconds) followed by a slow slope. With severe obstructions a plateau remained. This easily performed and well-tolerated measurement can be of aid in the quantification of obstructions of the spinal subarachnoid space.

Cervical Vertebrae↗
PubMed2004

Multiple spinal epidural abscesses extending to the whole spinal canal.

Spinal epidural abscess (SEA) is a rare life-threatening disease mostly affecting patients with an altered immune system. It presents as a sequela of adjacent infection or hematogenous spread. MRI is the method of choice in evaluating patients with suspected SEAs and should always include the whole spinal canal, excluding the exceedingly rare possibility of multiple epidural collections. We present a rare case of a patient with no predisposing factors suffering from multiple SEAs, extending to the whole spinal canal.

Aged↗
PubMed1986

Dynamic studies of cervical spinal canal and spinal cord by magnetic resonance imaging.

In 15 cases dynamic studies of cervical spinal cord and canal in flexion and extension were performed by magnetic resonance imaging (MRI). In addition measurements of the complete spinal cord were made in 5 cases. As compared with extension the cervical spinal canal and spinal cord lengthen 12 mm in average during flexion, whereas the spinal canal lengthens 28 mm in average, which means a difference of about 15 mm. We feel that these results indicate that adverse mechanical tension may occur in the cervical spinal cord during flexion. The impact of these results on surgical treatment for chronic cervical myelopathy is discussed.

Humans↗
PubMed1985

[Extramedullary arteriovenous fistula of the spinal canal with spinal cord venous drainage. Apropos of 2 cases].

The authors report two cases of extramedullary arteriovenous fistulas in the spinal canal with venous return into the spinal cord veins. Both patients were middle-aged men who presented with multiple nerve root involvement of the lower extremities for one year and three months respectively. Myelography demonstrated an indentation at the level of the conus medullaris by a dilated vein in both cases. Arteriography of the spinal cord demonstrated an arteriovenous malformation from the dura mater with venous return into the ascending spinal cord veins, located in both cases at T11. Unlike typical angiomas of the spinal cord, these arteriovenous fistulas do not arise from spinal cord arteries. Only the venous return is into the spinal cord system. Initial clinical manifestations are progressive and often misleading, with pseudoradicular pain of the lower extremities or intermittent claudication which was observed in both patients. Only good quality myelography enabled visualization of the dilated vein at the level of the conus medullaris which lead to localization of the arteriovenous malformation and its afferent arteries outside of the spinal cord itself. Treatment is either surgical, or neuroradiological (embolization). Similar results are obtained by both methods, in a condition which would otherwise progress to paraplegia.

Arteriovenous Malformations↗
PubMed1978

A myelographic technique for cysts in the spinal canal and spinal cord.

A collapsing cord in six patients with hydromyelia and a collapsing intraspinal arachnoid cyst in one patient are demonstrated. The authors describe the technique for two-position gas myelography and demonstrate that both intra- and extra-medullary intraspinal processes may collapse during myelography.

Adolescent↗
PubMed1992

[Relationship between developmental stenosis of cervical spinal canal and spinal cord injury].

A retrospective study of 55 patients with acute cervical spinal cord injury caused by trauma was performed. On radiographic examination of the cervical spine in each of 55 cases showed no fracture or dislocation but developmental stenosis determined on lateral view radiograms. Ninety five point nine percent of this cases had block of the dyeing columns myelographically both in prone and supine positions. Eighty point nine percent of 47 cases demonstrated segmental instability of the cervical spine on full extension and flexion radiograms. Thirty eight cases suffered a minor trauma but resulted in incomplete spinal cord injury with moderate neurologic deficits. Most patients who had been treated conservatively for about 3 years demonstrated the neurologic deficits worsened gradually. In the later 50 cases underwent surgical treatment. A follow-up study showed that Robinson's procedure and laminectomy resulted in unsatisfactory outcome, in contrast to those of open-door technic. It is suggested that developmental stenosis may be a potential factor in the spinal cord injury.

Adult↗
PubMed2004

Cervical ventral epidural pressure response to graded spinal canal compromise and spinal motion.

STUDY DESIGN: A laboratory investigation using a feline model of graded ventral spinal canal compromise was performed. OBJECTIVE: To quantify the effects of graded ventral spinal canal compromise, both in the static condition and in combination with passive spinal motion, on cervical ventral epidural pressure (CVEP). The CVEP effects of laminectomy are also investigated. SUMMARY OF BACKGROUND DATA: Spinal canal compromise, both in the static condition and in combination with passive spinal motion, has been implicated as a cause of spinal cord dysfunction. METHODS: Seventeen cats underwent anterior corpectomy of C3 and placement of a flexible ventral graded compression device incorporating a pressure transducer. Ten animals also underwent laminectomy of C3. The implant was advanced stepwise into the spinal canal. CVEP was measured, at each degree of canal compromise, in the flexed, extended, and neutral positions, as well as during neck movement. RESULTS: CVEP rose as a function of spinal canal compromise. In animals without laminectomy, mean CVEP was higher in the extended position and lower in the flexed position than in the neutral position. Mean CVEP during continuous passive neck movement was found to be higher than mean CVEP in the neutral position. Laminectomy was found to lower CVEP during all conditions examined, although substantial rises in CVEP were still observed in the presence of a residual ventral mass. All reported differences were statistically significant (P < 0.05). CONCLUSIONS: CVEP is elevated by both spinal canal compromise and spinal motion.

Animals↗
PubMed1996

Changes in cervical canal spinal volume during in vitro flexion-extension.

STUDY DESIGN: Quasistatic flexion and extension loads were applied in vitro to lower cervical spines. The flexion-extension motion produced was checked for physiologic relevance. OBJECTIVES: To examine the changes in the volume of the cervical spinal canal in flexion-extension motion. SUMMARY OF BACKGROUND DATA: Many papers have been published concerning the cervical canal volume as inferred from standard lateral radiographs. This study compares the inferred (radiographic) volumes and their changes to the physical changes within the spinal canal. METHODS: The lower cervical spines (C2-C7) from 10 cadavers were subject to stepwise flexion and extension in a purpose-built rig. Before this testing, the spinal cord was removed from the canal space of each specimen and replaced by a thin latex tube stoppered and secured at the opening of the canal (at C2) so that the volume of liquid displaced from the tube could be measured. This was done at each loading stage by means of a graduated glass column, and a radiograph of the spine was also taken to allow angular and displacement readings to be taken from C2 to C7. RESULTS: The average recorded change in volume of the spinal canal with flexion-extension motion was 1.9 ml, and showed a significant linear correlation with the dynamic canal width (r = 0.868, P < 0.05) and also with the total angle of flexion or extension (r = 0.979, P < 0.005). The volume of liquid displaced from the canal in lateral bending was much lower than that in flexion-extension motion, and only amounted to about 0.2 ml. The angular ranges of motion produced at each level were compared to previous results obtained in vivo, and no significant differences between the angular displacements found in vivo and in vitro under this experimental arrangement were seen. CONCLUSIONS: The loading regime described in this study causes angular displacements similar to those in vivo, and on this basis is a physiologically relevant loading pattern. The change in the volume of the spinal canal between C2 and C7 shows linear relationships with the angle of flexion and the dynamic canal width.

Adult↗
PubMed1984

Intraoperative spinal sonography of soft-tissue masses of the spinal cord and spinal canal.

Intraoperative spinal sonography (IOSS) was used to evaluate and monitor the progress of surgery in 18 patients with soft-tissue masses of the spinal canal and spinal cord. With intramedullary masses, IOSS showed not only the site of maximum cord enlargement so that a precise biopsy could be performed but also was able to demonstrate the zone of transition between the mass and normal cord tissue. With extradural masses and intradural extramedullary masses, IOSS showed the exact size and location of the masses and confirmed their removal and/or adequate spinal cord decompression. IOSS indicated the extent of bone removal necessary to give adequate exposure to accomplish total removal of these masses or to localize the proper level for tissue biopsy. IOSS also indicated the need to open the dura when there had been unsuspected transdural tumor spread or when bony decompression had not been sufficient to relieve the pressure on the spinal cord in tonsillar ectopia. Intraoperative spinal sonography is recommended in all cases of spinal surgery performed to resect or biopsy soft-tissue masses of the spinal canal or spinal cord.

Adult↗
PubMed2001

The significance of thoracolumbar spinal canal size in spinal cord injury patients.

STUDY DESIGN: A prospective, consecutive case series. OBJECTIVES: To determine the relation between spinal canal dimensions and Injury Severity Score and their association with neurologic sequelae after thoracolumbar junction burst fracture. SUMMARY OF BACKGROUND DATA: There is a relation in the cervical spine between spinal canal dimension and its association with neurologic sequelae after trauma. A similar relation at the thoracolumbar junction has not been conclusively established. METHODS: Forty-three patients with thoracolumbar junction burst fractures (T12-L2),13 with and 30 without neurologic deficit, were included. Computed tomographic scans were used to measure the sagittal and transverse diameters and the surface area of the spinal canal at the level of injury, as well as one level above and one level below the fracture level. Injury severity score was calculated for both groups. Statistical analysis comparing those with a neurologic deficit to those without was performed by Student's t test. RESULTS: The ratio of sagittal-to-transverse diameter at the level of injury was significantly smaller in patients with a neurologic deficit than in those without a neurologic deficit (P < 0.05). The mean transverse diameter at the level of injury was significantly larger in patients with neurologic deficit than in the neurologically intact patients (P < 0.05). The surface area of the canal at the level below the injury was significantly larger in the patients with a neurologic deficit than in those without a deficit (P < 0.05). Patients with a neurologic deficit had a statistically higher Injury Severity Score when admitted than those without a neurologic deficit (P < 0.0001), although the difference became insignificant after the neurologic component of the scoring system was eliminated. CONCLUSION: There are no anatomic factors at the thoracolumbar junction that predispose to neurologic injury after burst fracture. The shape of the canal after injury, however, as determined by the sagittal-to-transverse diameter ratio, was predictive of neurologic deficit.

Adolescent↗
PubMed2006

A thoracic and lumbar spine injury severity classification based on neurologic function grade, spinal canal deformity, and spinal biomechanical stability.

BACKGROUND CONTEXT: Current well regarded thoracic and lumbar spine injury classifications use mechanistic and anatomical categories, which do not directly rely on quantifiable management parameters. Their clinical usefulness is not optimal. PURPOSE: Formulate an injury severity based classification. STUDY DESIGN/SETTING: This retrospective investigation studied patients who suffered thoracic and lumbar spine injuries, and examined the following three quantifiable parameters: 1) neurologic function grade; 2) spinal canal deformity; 3) biomechanical stability. These parameters are the primary clinical indications for management decisions. PATIENT SAMPLE: One hundred twenty-six consecutive patients with spinal trauma admitted to a level 1 tertiary trauma center from January 1997 to November 2005 were enrolled in this study. OUTCOME MEASURES: Spine injury severity was independently scored on three parameters: 1) neurologic function impairment grade according to the modified Frankel grading method and the American Spinal Injury Association (ASIA) function scale; 2) spinal canal deformity from translation and intrusion, measured as percent canal cross-sectional area compromise; 3) failure of five possible biomechanical functions in Denis's three anatomic columns, and a sixth group of unstable deformities. All three columns contribute to tensile function. Only the anterior and middle columns provide compression load-bearing function. A combination of three or more column biomechanical function failure or an unstable deformity renders the injury unstable. METHODS: Five fellowship-trained spine surgeons from one institution took part in the study. Hospital medical records, including admission history and physical examination, discharge summary, and operative report (if surgery was performed), were examined for neurologic deficit. Plain radiographs, computed tomographic scans and magnetic resonance imaging were assessed for canal compromise and biomechanical function status. RESULTS: Injuries were located from T3 to L5, 58% of which were at the thoracolumbar junction (T11-L2). Neurologic impairment occurred in 45% (57/126) of patients, with 19 complete paraplegias (Frankel grade A). The average spinal canal cross-sectional area compromise was 56.1% in neurologically impaired and 14.2% for patients who where neurologically intact. The number of tensile element failure patients in neurologically impaired versus intact are as follow: tri-columns 22/4; two columns 16/8; one column 11/17; all columns intact 8/40. Load-bearing element failed in 55/57 neurologically impaired and 63/69 intact patients. Sixty-seven patients had spinal reconstructive surgery. Their average instability profile score was 4.4 out of 6, and canal compromise score was 3.3 out of 5. CONCLUSIONS: A clinically useful thoracic and lumbar spine injury classification should be based on parameters that are the primary indications for management decisions. The same parameters should be injury severity quantifiable as to guide treatment. In this study we introduced spinal canal deformity and column biomechanical functions as quantifiable parameters in thoracic and lumbar injury severity classification. Validation of this method is beyond the scope of this preliminary study.

Biomechanical Phenomena↗