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. Nandigama Pratap Kumar 2016-10-01 Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare.
We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date.
The search was conducted through a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple.
Sureka, Binit; Mittal, Aliza; Mittal, Mahesh K; Agarwal, Kanhaiya; Sinha, Mukul; Thukral, Brij Bhushan 2018-01-01 Accurate and detailed measurements of spinal canal diameter (SCD) and transverse foraminal morphometry are essential for understanding spinal column-related diseases and for surgical planning, especially for transpedicular screw fixation. This is especially because lateral cervical radiographs do not provide accurate measurements.
This study was conducted to measure the dimensions of the transverse foramen sagittal and transverse diameters (SFD, TFD), SCD, and the distance of spinal canal from the transverse foramina (dSC-TF) at C1-C7 level in the Indian population. The study population comprised 84 male and 42 female subjects. The mean age of the study group was 44.63 years (range, 19-81 years). A retrospective study was conducted, and data were collected and analyzed for patients who underwent cervical spine computed tomography (CT) imaging for various reasons. One hundred and twenty-six patients were included in the study. Detailed readings were taken at all levels from C1-C7 for SCD, SFD, TFD, and dSc-TF.
Values for male and female subjects were separately calculated and compared. For both the groups, the widest SCD were measured at the C1 level and the narrowest SCD at the C4 level. The narrowest SFD was measured at C7 for both male and female subjects on the right and left sides. The widest SFD was measured at C1 both for male and female subjects on the right and left side. The narrowest TFD on the left side was measured at C7 for male and at C1 for female subjects.
The narrowest mean distance of dSC-TF was found to be at C4 for both male and female subjects on both left and right side. The computed tomographic (CT) imaging is better than conventional radiographs for the preoperative evaluation of cervical spine and for better understanding cervical spine morphometry. Care must be taken during transpedicular screw fixation, especially in female subjects, more so at the C2, C4, and C6 levels due to a decrease in the distance of dSC-TF. Papanagiotou, P.; Boutchakova, M.
Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany) 2014-11-15 Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) German Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung.
(orig.). Kimura, Isao; Niimiya, Hikosuke; Nasu, Kichiro; Shioya, Akihide; Ohhama, Mitsuru 1983-01-01 The cervical spinal canal and cervical spinal cord were measured in normal cases and 34 cases of spinal or spinal cord injury. The anteroposterior diameter and area of the normal cervical spinal canal showed a high correlation. The area ratio of the normal cervical spinal canal to the cervical spinal cord showed that the proportion of the cervical spinal cord in the spinal canal was 1/3 - 1/5, Csub(4,5) showing a particularly large proportion. In acute and subacute spinal or spinal cord injury, CT visualized in more details of the spinal canal in cases that x-ray showed definite bone injuries. Computer assisted myelography visualized more clearly the condition of the spinal cord in cases without definite findings bone injuries on x-ray.
Demonstrating the morphology of spinal injury in more details, CT is useful for selection of therapy for injured spines. (Chiba, N.). Struck, Aaron F.; Carr, Carrie M.; Shah, Vinil; Hesselink, John R.; Haughton, Victor M. 2016-01-01 The cervical spine in Chiari I patient with syringomyelia has significantly different anteroposterior diameters than it does in Chiari I patients without syringomyelia. We tested the hypothesis that patients with idiopathic syringomyelia (IS) also have abnormal cervical spinal canal diameters. The finding in both groups may relate to the pathogenesis of syringomyelia.
Local institutional review boards approved this retrospective study. Patients with IS were compared to age-matched controls with normal sagittal spine MR. All subjects had T1-weighted spin-echo (500/20) and T2-weighted fast spin-echo (2000/90) sagittal cervical spine images at 1.5 T.
Readers blinded to demographic data and study hypothesis measured anteroposterior diameters at each cervical level. The spinal canal diameters were compared with a Mann-Whitney U test. The overall difference was assessed with a Friedman test.
Seventeen subjects were read by two reviewers to assess inter-rater reliability. Fifty IS patients with 50 age-matched controls were studied. IS subjects had one or more syrinxes varying from 1 to 19 spinal segments. Spinal canal diameters narrowed from C1 to C3 and then enlarged from C5 to C7 in both groups.
Diameters from C2 to C4 were narrower in the IS group (p 0.8). A simple linear model MSCD (mm)=3×Weight (kg)+5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm)=3×Weight (kg)+5 could result in fewer traumatic LPs in this population. Copyright © 2012 Elsevier Ireland Ltd.
All rights reserved. Dugal, T.P.; Brazier, D.; Roche, J. 2002-01-01 Full text: The sensitivity of MRI can make differentiation of normal from abnormal challenging.The study investigates whether a visible central spinal canal is pathological or a normal variant. We review eight MRI (mostly on a 1.5 Tesla unit) cases where there is a visible central cavity in keeping with a central canal and review the literature. The central canal is a space in the medial part of the grey-matter commissure between the anterior and posterior horns.
Histopathological studies show that the canal is present at birth with the majority showing subsequent involution but is uncommonly imaged on MRI. The main differential diagnosis is syringomyelia which usually presents with deficits in pain and sensation corresponding to the appropriate level often with a demonstrable aetiology. Two thirds of our patients were female with an average age of thirty-six years (range 26-45). The patients were largely asymptomatic or their symptoms appeared unrelated to the imaging findings.
Three patients had minor previous trauma and two others had non-bacterial meningitis up to twenty years earlier. No patient had known spinal surgery or trauma.The cavity corresponded tomographically to the expected site of the central canal. The canal was in the thoracic location. The canal diameter ranged from one to five millimetres and its length varied from one half a vertebral body height to extending over the entire thoracic region. Its configuration was either filiform or fusiform, with smooth contours. No predisposing features to suggest syringomyelia or other structural abnormalities were noted. Where Gadolinium was given no abnormal enhancement was observed.
These cases add to the literature and suggest that these prominent canals are largely asymptomatic and should be viewed as normal variants. Copyright (2002) Blackwell Science Pty Ltd. Hurme, M.; Alaranta, H.; Aalto, T.; Knuts, L.R.; Vanharanta, H.; Troup, J.D.G. (Turku City Hospital (Finland). Of Surgery; Social Insurance Institution, Turku (Finland). Rehabilitation Research Centre; Helsinki Univ.
Of Physical Medicine and Rehabilitation; Liverpool Univ. Of Orthopaedic and Accident Surgery) Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females.
The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p. Madsen, Rasmus; Jensen, Tue Secher; Pope, Malcolm 2007-01-01 STUDY DESIGN: A method comparison study. OBJECTIVE: To investigate the effect of body position and axial load of the lumbar spine on disc height, lumbar lordosis, and dural sac cross-sectional area (DCSA). SUMMARY OF BACKGROUND DATA.: The effects of flexion and extension on spinal canal diameters. With applied axial loading. Disc height, lumbar lordosis, and DCSA were measured and the different positions were compared.
RESULTS: In section 1, the only significant difference between positions was a reduced lumbar lordosis during standing when compared with lying (P = 0.04), most probably a consequence. Remes, V.M. Hospital for Children and Adolescents, Helsinki University Central Hospital (Finland); Heinaenen, M.T.; Marttinen, E.J. Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Kinnunen, J.S. Department of Radiology, Helsinki University Central Hospital, HYKS (Finland) 2000-03-01 Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances.
Tai Phan Mem Ch Play
Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods.
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Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated.
This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty.
At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.).
Remes, V.M.; Heinaenen, M.T.; Marttinen, E.J.; Kinnunen, J.S. 2000-01-01 Background.
Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults.
Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated.
This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age.
(orig.). Nakashima, Hiroaki; Yukawa, Yasutsugu; Suda, Kota; Yamagata, Masatsune; Ueta, Takayoshi; Kato, Fumihiko 2016-07-01 Narrow cervical canal (NCC) has been a suspected risk factor for later development of cervical myelopathy. However, few studies have evaluated the prevalence in asymptomatic subjects. The purpose of this study was to investigate the prevalence of NCC in a large cohort of asymptomatic volunteers. This study was a cross-sectional study of 1211 asymptomatic volunteers. Approximately 100 men and 100 women representing each decade of life from the 20s to the 70s were included in this study. Cervical canal anteroposterior diameters at C5 midvertebral level on X-rays, and the prevalence of spinal cord compression (SCC) and increased signal intensity (ISI) changes on MRI were evaluated.
Receiver operating characteristic analysis was performed to determine the cut-off value of the severity of canal stenosis resulting in SCC.