An erect method of myelography.
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Humans↗
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Results for “SPINAL CANAL ROENTGENOGRAPHY”
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Selective angiocardiography.
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Angiocardiography↗
[Myelogram of parents of children with Colley disease].
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Anemia↗
CT findings in tuberculous spondylitis.
The computed tomographic (CT) features of ten documented cases of spinal tuberculosis were analyzed. All cases showed evidence of vertebral body destruction, with paravertebral soft tissue masses. Four cases revealed extension of involvement into the neural arches. Calcification within the paraspinal soft tissue was found in only two cases. Two of four cases who received intravenous contrast medium demonstrated evidence of rim enhancement around multilocuated fluid collections. Compared to conventional roentgenography, CT better delineated the extent of bony destruction, involvement of the spinal canal and existence of paraspinal soft tissue masses.
Adolescent↗
Stenosis of the foramen magnum and rostral spinal canal, with spinal cord deformity, in Jeune's asphyxiating thoracic dystrophy.
Ventilatory compromise in Jeune's asphyxiating thoracic dystrophy (JTD) generally is attributed to abnormalities in thoracic configuration that produce restrictive pulmonary disease and pulmonary hypoplasia. We present our findings following dissection and roentgenography of the base of the skull and the vertebral column in a premature infant with JTD. They suggest that malformations of the vertebral laminae in JTD may lead to compression of the distal medulla and rostral cervical spinal cord. Similar compression is known to contribute to ventilatory dysfunction in other osteochondrodysplasias. It is possible that vertebral laminar malformations may be partly responsible for ventilatory dysfunction in some patients with JTD. We recommend attention at necropsy in JTD to malformations of the neural arch and to their possible sequelae.
Abnormalities, Multiple↗
Recent progress in vertebral body section roentgenography in the study of the pathology of the lumbar vertebrae.
The potentialities of vertebral body section roentgenography have recently been enlarged to include the direct study of soft tissues within the vertebral canal. The writers report a series of observations on the pathology of disc protrusion, spinal stenosis and cicatricial stenosis following laminectomy, carried out by means of a third generation scanner, the Somatom SF. This apparatus makes it possible to integrate the data furnished by traditional radiological investigations and by scanners of previous generations, thus demonstrating new aspects of the pathology of the lumbar nerve roots.
Humans↗
Magnetic resonance imaging in the evaluation of a gunshot wound to the cervical spine.
A patient in the second trimester of pregnancy sustained a gunshot wound of the upper cervical spine with a partial Brown-Séquard syndrome. The patient's condition was evaluated by conventional roentgenography, computed axial tomography (CT), and magnetic resonance imaging (MRI). The MRI alone clearly demonstrated the relationship of the bullet and the spinal cord, whereas the CT image was obliterated by metal artifacts. The bullet was removed from the spinal canal by a posterior approach with the patient in the sitting position and in skeletal cervical traction. The neurological status of the patient improved markedly after the surgery.
Adult↗
Neural arch stenosis and spinal cord injury in thanatophoric dysplasia.
Bony abnormalities caused by thanatophoric dysplasia affect the base of the skull and the vertebrae as well as the ribs and appendicular long bones. We present our findings in a full-term infant with thanatophoric dysplasia in whom the posterior fossa, the rostral vertebral column, and the neuraxis at and adjoining the craniovertebral junction were studied by dissection, roentgenography, and histologic examination. In this infant, malformations of the vertebral laminae, most prominent in the basiocciput and atlas vertebra, led to compression of the rostral cervical spinal cord, causing gliosis and focal necrosis. Stenosis of the foramen magnum and spinal canal may contribute to the ventilatory insufficiency that often causes death in patients with thanatophoric dysplasia. We suggest that the causes of death in patients with thanatophoric dysplasia and other severe forms of osteochondrodysplasia should be sought in neuraxial injury rather than attributed solely to pulmonary hypoplasia.
Autopsy↗
[Pneumography of the membranous spaces in the spinal cord].
The author describes one-stage investigation of the epidural and preneural spaces at the lumbar level using gas and a needle for lumbar puncture with a longitudinal side hole at the working end with subsequent roentgenography (pneumospondylography). Altogether 140 patients with lumbar vertebral osteochondrosis with neurological disorders were examined. Pneumospondylography gives 3 levels of contrast and ensures information on the sizes of the epidural and arachnoidal spaces, function of the invertebral holes and paravertebral tissues. The phenomenon of differentiation of the dural sac wall helps to diagnose in more detail the posterior protrusions of the intervertebral disks with concomitant epiduritis, pachymeningitis, arachnoiditis by the length and diameter of the vertebral canal.
Adolescent↗
[Computed tomography in the diagnosis of degenerative diseases of the spine].
CT and roentgenography were used for the investigation of 78 patients with the radicular syndrome. The state of the intervertebral disks, intervertebral joints and cerebrospinal canal in degenerative vertebral diseases was assessed. CT permits the detection of hernia, protrusion of the intervertebral disks, deformity of the intervertebral joints, and the narrowing of the cerebrospinal canal as a result of degenerative changes, as well as establishing the cause of the affection of neural structures in the cerebrospinal canal, radicular holes. CT possesses some advantages over roentgenography in the diagnosis of degenerative vertebral diseases and can be recommended as the principal method together with roentgenography for investigation of patients with lumbar pains.
Humans↗
Current assessment of spinal degenerative disease with magnetic resonance imaging.
Radiography (plain roentgenography, myelography, computed tomography (CT), computed tomographic myelography) has been used to identify morphologic changes involving the various components of the diskovertebral unit. Added to this armamentarium of imaging techniques is magnetic resonance (MR) imaging, with its superior ability to define anatomy, its improved contrast sensitivity, and its potential to provide unique biochemical and physiologic information. The authors review the current use of MR imaging in defining degenerative changes in the spine including the various patterns of herniation, annular tears, canal stenosis, and the use of gadolinium-diethylenetriamine-pentaacetic acid for previously unoperated and operated patients. Prospective studies have compared surface-coil MR imaging, CT, and myelography in the evaluation of disk herniation and stenosis and found an 82.6% accuracy between MR imaging and surgical findings for the type and location of the disease. Recent experience with precontrast and postcontrast MR imaging in the postoperative lumbar spine indicated that it was 96% accurate in differentiating scar from disk in 44 patients at 50 reoperated levels. Three-dimensional imaging is, more and more, becoming an integral part of routine MR imaging. The theoretical and practical advantages of three-dimensional imaging are several and include a theoretical increase in the signal-to-noise ratio over two-dimensional imaging (by the square root of the number of partitions selected), the ability to obtain thin contiguous slices from the volume without the problem of cross-talk found in two-dimensional imaging, more accurate slice thickness than that achieved in two-dimensional imaging, and a reduction in susceptibility artifacts. Different three-dimensional techniques are capable of providing either high or low signal intensity cerebrospinal fluid (CSF), with excellent suppression of CSF pulsation artifacts. Certain sequences provide a high enough signal intensity that a computer algorithm may be used to display the CSF in a rotating three-dimensional manner, similar to a myelogram. This three-dimensional myelographic image has the potential of providing the clinician with a global assessment of the CSF spaces, an advantage previously lacking with other imaging techniques.
Contrast Media↗
Lumbosacral skin lesions as markers of occult spinal dysraphism.
Early treatment of occult spinal dysraphism may prevent progressive neurological deficits. However, diagnosis is often delayed until the onset of irreversible neurological damage. A review of data from the literature and patients at Johns Hopkins Hospital suggests that lumbosacral skin abnormalities such as tufts of hair, hemangiomas, lipomas, skin tags, or pigmented nevi should alert the physician to search for occult spinal dysraphism. In the asymptomatic patient with a skin lesion, roentgenography of the lumbosacral spine is a useful screening procedure for identifying treatable underlying problems.
Adolescent↗
[Intramedullary holocord tumor. Report of an autopsy case and review of literature].
This report describes a case of cystic astrocytoma that extended from C4 to the conus, and reviews intramedullary holocord tumors. A two-year-old body was admitted because of gait disturbance. He had suffered from rigidity of his left upper and lower limbs and thoracic scoliosis for six months prior to admission. On admission, neurologic examination revealed spastic paraparesis with muscle atrophy of the left lower extremity, sphincter disturbances and neck rigidity. All deep tendon reflexes were bilaterally hyperactive. Spine roentgenography demonstrated widening of the interpedicular distance from the midthoracic to the upper lumbar segments. A lumbar myelography disclosed a block at the L2 level, and a suboccipital myelography revealed a block with tapering of contrast medium at the level of the C2 vertebra. A laminectomy was performed from C1 to L3, and a myelotomy was performed from C4 to L2. Grossly total removal of solid tumor which extended from Th3 to Th8 was carried out. There were large intramedullary cysts extending from C4 to Th3, and from Th9 to L2. Eight hours after surgery, high fever, tachycardia and anuria developed, and he died next day. Cross section of the spinal cord revealed the tumor cells infiltrated diffusely in the midthoracic region, and histologically the tumor was diagnosed to be astrocytoma. The cystic portion was separate from the central canal, and the lining of the cyst was a band of fibroglial tissue without infiltration of tumor cells. A tumor of this kind extending throughout the almost whole spinal cord is extremely rate. For such a holocord tumor complete removal is the ideal treatment, but the possibilities for removal must be evaluated in terms of the tumor's relationship to the spinal cord, the histological nature and the general condition of the patient.
Astrocytoma↗
Reliability of roentgenogram evaluation of pedicle screw position.
STUDY DESIGN: This was a human cadaver study of the accuracy of biplanar roentgenography in determining pedicle screw position. OBJECTIVE: To determine the independent accuracy of radiologic evaluation of screw placement and to determine if there are any particular screw malpositions that are more likely to produce a false sense of acceptable screw position. SUMMARY OF BACKGROUND DATA: Other investigators have reported the correlation between radiologic evaluation and anatomic dissection. However, in those studies the radiologic evaluation was not independent of the surgeons placing the screws. There has been no comment in the literature regarding particular screw malpositions that would lead the surgeon into a false sense of successful screw placement. METHODS: Pedicle screws were placed in cadaver spines, and biplanar roentgenograms of the specimens were evaluated by independent observers. The results of the roantgenogram evaluation then were compared to those of the anatomic dissection. RESULTS: The accuracy of roentgenogram evaluation varied from 73% to 83%, depending on the experience of the surgeon grading the roentgenograms. Screws misplaced medially into the spinal canal are more likely to give the surgeon a false sense of successful screw placement. CONCLUSIONS: The surgeon must not rely solely on the roentgenograms, but instead continue to use tactile sensory skills, anatomic knowledge, and additional modalities such as electromyography monitoring.
Bone Screws↗