Pathological changes can occur in the diameters of the lumbar spinal canal. Therefore, assessing the canal size an important diagnostic procedure. Two hundred plain anterioposterior radiographs of the lumbar spine were examined. The sample consisted of 100 males and 100 females. The transverse diameter of the bony spinal canal (interpedicular distance), which was measured as the minimum distance between the medial surfaces of the pedicles of a given vertebra, was measured. In addition, the transverse diameter of the vertebral body, which was measured as the minimum distance across the waist of the vertebra, was measured. The distances were measured to the nearest one tenth of a millimetere using a Vernier caliper. At all levels (L1 - L5) the transverse diameters of the lumbar spinal canal were approximately 1 - 1.5 mm higher in males than in females. The intersegmental differences increased proximodistally, in both sexes. The ratio of the transverse diameter canal to the width of the vertebra ranged from 0.55 to 0.60 mm in both sexes. The distribution of the different lumbar canal types were 47% A, 42% B, 11% C. Additionally, subtypes were determined and classified.
Adult ; Female ; Human ; Lumbar Vertebrae/radiography ; Male ; Middle Aged ; Reference Values ; Spinal Canal/*radiography ; Turkey

Clear-cell meningioma is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes. We report two cases of clear-cell meningioma, one in the thoracolumbar spinal canal and the other in the cerebellopontine angle. Though the CT and MR imaging findings were not different from those of ordinary meningioma, after surgical removal the condition recurred repeatedly in the patient with spinal canal involvement.
Adolescent ; Case Report ; Cerebellar Neoplasms/*diagnosis/radiography ; *Cerebellopontine Angle ; Female ; Human ; Infant ; *Magnetic Resonance Imaging ; Meningioma/*diagnosis/radiography ; *Spinal Canal ; Spinal Neoplasms/*diagnosis/radiography ; *Tomography, X-Ray Computed

OBJECTIVES: Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. MATERIAL AND METHODS: The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. RESULTS: Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. CONCLUSIONS: In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Compression ; Humans ; Intention ; Osteoporosis ; Radiography ; Spinal Canal ; Transplants ; Vertebroplasty*

PURPOSE: To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. MATERIALS AND METHODS: We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition (posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. RESULTS: Mean SCR value in 27 patients with L5 spondylolysis (1.22) was significantly greater than 100 control subjects (0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition (1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition (0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis (63%) than in control subjects (9%). CONCLUSION: The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted.
Humans ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; Spinal Canal* ; Spondylolisthesis ; Spondylolysis*

BACKGROUND: This study examined the relationship between four radiological parameters (Pavlov's ratio, sagittal diameter, spinal cord area, and spinal canal area) in patients with a traumatic cervical spine injury, as well as the correlation between these parameters and the neurological outcome. METHODS: A total of 212 cervical spinal levels in 53 patients with a distractive-extension injury were examined. The following four parameters were measured: Pavlov's ratio on the plain lateral radiographs, the sagittal diameter, the spinal cord area, and the spinal canal area on the MRI scans. The Pearson correlation coefficients between the parameters at each level and between the levels of each parameter were evaluated. The correlation between the radiological parameters and the spinal cord injury status classified into four categories, A (complete), B (incomplete), C (radiculopathy), and D (normal) was assessed. RESULTS: The mean Pavlov's ratio, sagittal diameter, spinal cord area and spinal canal area was 0.84, 12.9 mm, 82.8 mm2 and 236.8 mm2, respectively. An examination of the correlation between the radiological spinal stenosis and clinical spinal cord injury revealed an increase in the values of the four radiological parameters from cohorts A to D. Pavlov's ratio was the only parameter showing statistically significant correlation with the clinical status (p = 0.006). CONCLUSIONS: There was a correlation between the underlying spinal stenosis and the development of neurological impairment after a traumatic cervical spine injury. In addition, it is believed that Pavlov's ratio can be used to help determine and predict the neurological outcome.
Adult ; Aged ; Analysis of Variance ; Cervical Vertebrae/*radiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck Injuries/*radiography ; Retrospective Studies ; Spinal Canal/pathology/*radiography ; Spinal Cord Injuries/pathology/*radiography ; Spinal Stenosis/pathology/*radiography ; Young Adult

Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma,consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipo-ma extending into the spinal canal and showing both fat and angiomatous fea-tures on CT scan.
Aged ; Angiolipoma/pathology/*radiography ; Case Report ; Female ; Human ; Mediastinal Neoplasms/pathology/*radiography ; Spinal Canal/*pathology ; Tomography, X-Ray Computed

OBJECTIVE: To study the incidence and degree of the cervical instability in the cerebral palsied patients and to investigate the cause of the high incidence of cervical myelopathy in these patients. METHOD: The static and dynamic radiography of the cervical spine in the sagittal plane was performed in seventy-two patients with athetoid and spastic cerebral palsy and the incidence of spondylolisthesis, range of motion(by the Penning Method), sagittal diameter of the cervical canal, and posture of the cervical spine were evaluated. RESULTS: The incidence of the cervical spondylolisthesis was fifty percent with athetoid cerebral palsy and twenty-seven percents with spastic cerebral palsy. The incidence of spondylolisthesis was especially high at the level of C3/4 and C4/5. The excessive range of motion in flexion/extension by the sagittal plane was observed in 66.7% of athetoid patients and 53.3% of spastic patients, especially at the C2/3 and C3/4 levels. The abnormal curvature was noted in 66.6% of athetoid and spastic patients. C-curve and S-curve were more common in athetoid patients and straightening of the C-spine was more common in spastic type. A sagittal diameter of the cervical spinal canal was significantly decreased in patients with athetoid patients with C3/4 spondylolisthesis and/or abnormal curvature such as a C-curve or S-curve(P<0.05). Height of the vertebral body was decreased in both athetoid and spastic patients. CONCLUSION: The combination of a cervical instability and a narrow spinal canal predisposes the neurological progression to a cervical myelopathy in cerebral palsied patients.
Adolescent* ; Cerebral Palsy* ; Humans ; Incidence ; Muscle Spasticity ; Posture ; Radiography ; Range of Motion, Articular ; Spinal Canal ; Spinal Cord Diseases ; Spine ; Spondylolisthesis

PURPOSE: To evaluate MR imaging findings of ossified posterior longitudinal ligament(OPLL) in the cervicalspine. MATERIALS AND METHODS: Retrospectively, simple radiography(n=34), CT(n=9), and MRI(n=11) of 34 patients with OPLL were reviewed. We evaluated the number of involved vertebral segment, morphologic type of lesions onaxial and sagittal imaging, spinal canal narrowing on the involved intervertebral disk level, intervertebral for aminal narrowing, relationship between spinal cord compression and morphologic type, and signal intensity onMRI. RESULTS: Average number of involved vertebral segment was 2.65(90/34). Most commonly involved vertebrallevel was C3--C4. On sagittal image, the lesions were classified to be continuous type(n=15), segmental type(n=7),mixed type(n=4), and circumscribed type(n=7). The most common type was continuous one(42%). On axial image, the lesions were classified to square type(n=13), mushroom type(n=18), hill type(n=13). The most common type was mushroom one(41%). Forty-five percent(20/44) showed spinal stenosis which exceeded 25% of anteroposterior diameter of spinal canal. Twenty-three percent(19/81) of the case showed intervertebral foraminal narrowing. T1- and T2-weighted MRI showed low signal intensity in every 11 case. Two cases showed focal high signal intensity within lowsinal intensity lesion on T1 weighted images. CONCLUSIONS: The ossified lesion of OPLL could be evaluated with simple radiography and CT. MRI displayed spinal cord compresion, intervertebral foraminal narrowing, and associated vertebral disease which maybe useful in preoperative evaluation of symptomatic patients.
Agaricales ; Humans ; Intervertebral Disc ; Longitudinal Ligaments* ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Cord Compression ; Spinal Stenosis ; Spine*

OBJECTIVE: The purpose of this study is to evaluate the efficacy and necessity of combined anterior approach (discectomy and fusion) and posterior approach(open-door laminoplasty) in the treatment of cervical spondylotic myelopathy. METHODS: The authors reviewed 14 cases in whom combined anterior and posterior approach performed for cervical myelopathy due to simultaneous anterior and posterior pathology such as huge central disc herniation with narrow spinal canal between January 2000 and December 2002. Clinical symptoms were evaluated by Japanese Orthopaedic Association (JOA) score and then the cervical curvature, change of spinal canal to vertebral body(SC/VB) ratio and canal widening were measured and compared to the clinical symptoms. RESULTS: The mean JOA score increased from 10.4+/-3.1 preoperatively to 14.8+/-1.2 at the final follow up with a mean recovery rate 66.4%. In all cases, there were not neurologic deterioration. Mild postoperative complications developed in two cases. One patient had a limitation of range of neck motion and the other one showed kyphotic change. Postoperative radiography showed an improvement of body to canal ratios (average 0.70+/-0.08 before surgery to 1.05+/-0.12 after surgery) and mainte nance or recovery of cervical lordosis. Canal widening of antero-posterior diameter and dimension after operation is 6.8 mm, 116.61 mm2. CONCLUSION: Combined anterior and posterior procedure could be helpful in decompression of the spinal cord and good functional recovery in spondylotic myelopathy patients with combined anterior and posterior pathology such as huge disc herniation accompanying narrow spinal canal.
Animals ; Asian Continental Ancestry Group ; Decompression ; Follow-Up Studies ; Humans ; Lordosis ; Neck ; Pathology ; Postoperative Complications ; Radiography ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases*

The height, width, and cross-sectional area of the vertebral canal and spinal cord along with the area ratio of spinal cord to vertebral canal in the cervical vertebra were evaluated in images obtained using computed tomography (CT). Measurements were taken at the cranial, middle, and caudal point of each cervical vertebra in eight clinically normal small breed dogs (two shih tzu, two miniature schnauzers, and four mixed breed), 10 beagles, and four German shepherds. CT myelography facilitated the delineation of the epidural space, subarachnoid space, and spinal cord except at the caudal portion of the 7th cervical vertebra. The spinal cord had a tendency to have a clear ventral border in the middle portion of the vertebral canal and lateral borders near both end plates. The height, width, and area of the vertebral canal and spinal cord in the cervical vertebra were increased as the size of dog increased. However, the ratio of the spinal cord area to vertebral canal area in the small dogs was higher than that of the larger dogs. Results of the present study could provide basic and quantitative information for CT evaluation of pathologic lesions in the cervical vertebra and spinal cord.
Animals ; Body Size ; Cervical Vertebrae/*anatomy & histology/radiography ; Dogs/*anatomy & histology/growth & development ; Reference Values ; Spinal Canal/*anatomy & histology/radiography ; Spinal Cord/*anatomy & histology/radiography ; Tomography, X-Ray Computed/*veterinary