Radiological Measurements of Cervical Spinal Canal in Normal Korean Adults

The concept of using radiographic measurements in the diagnosis of intraspinal lesions is not new. There have been many studies for the measurements of the spinal canal and normal ranges of variation in normal human and patient with spondylosis or developments stenosis. The author measured the cervical spinal canal in 89 normal Korean adults plain X-rays(male;62 cases, female;27 cases) in order to establish a range of normal value in X-ray diagnosis. The sagittal diameters of the cervical spinal canal were measured from the middle of the posterior surface of the vertebral body to the "nearest point" on the cortical line at the point of fusion of the corresponding laminae. The transverse diameters of the cervical spinal canal were measured the interpediculate distance which represents the greatest diameter of the cervical neural canal from C3 to C7. According to the normal ranges of the sagittal and transverse diameters of the cervical spinal canal, It was concluded: 1. The sagittal diameter is progressively narrowed from C1 to C4(Mean+/-SD=C1; 21.83+/-2.43, C2; 19.30+/-2.39, C3; 17.14+/-2.65, C4; 16.41+/-2.47) thereafter it is progressively widened from C5 to C7(C5; 16.79+/-2.72, C6; 17.39+/-2.74, C7; 17.68+/-2.81). 2. The transverse diameter is progressively widened from C3 to C6(Mean+/-SD= C3; 27.10+/-2.23, C4; 28.05+/-2.30, C5; 28.95+/-2.36, C6; 29.12+/-2.25) thereafter it is narrowed in C7(C7; 27.81+/-2.28). 3. Generally, the length of the male are more longer than that of female both in sagittal and transverse diameter in cervical spinal canal(average;1.29 mm). 4. Ranges of normal values both in sagittal and transverse diameters in whole length of the cervical spinal canal were established(Fig. 5. Table 4, and 5).

Bladder Dysfunction Caused by Herniated Lumbar Disc

The cystometry had been performed in 28 cases of H.L.D. and 1 case of unstable lumbar spine due to spondylolysis from January 1974 to September. Among them, 24 cases were checked cystometry again after one week of postoperative period. We obtained the results as follows: 1. Preoperative cystometrograms were revealed that 21 cases were bladder hypofunction,3 cases were bladder irritability, and 5 cases were normal. 2. The postoperative cystometrograms were revealed that were improved in 3 cases, unchanged in 19 cases, and worsened in 2 cases. 3. It is likely that the bladder hypofunction is related to the severity of radiating pain rather than the severity of myelographic findings, the direction and the level of disc herniation.

A Case of Myelomeningocele with Associated Anomalies

We were recently encountered a cases of newborn infant with a congenital lumbar mass with associated anomalies which proved to be quite bizarre. This case if presented with review of the literatures because we were seldom able to find a cases of myelomeningocele as usual, interesting as this. A 15 day-old infant, the product of full term, was admitted to Busan National University Hospital on May 26th, 1972, because of a large pedunculated lumbar mass without any neurologic deficits. The tumor mass was translucent, flabby, infected and increased in tension when the infant cried. Chest film showed the underdeveloped with agenesis and fork rib in right upper 5 ribs and narrowed intercostal spaces between right 5,6,7 and 8th ribs. Right scapula was higher in position of axis. Total spine films showed non-fusion pattern of 3rd and 4rh thoracic vertebral bodies with cleft vertebrae, scoliosis in upper thoracic region, widening of lumbar canal, a large soft tissue mass overlying the abdominal region and hypoplasia of the spinous process at 4th lumbar vertebra. The sac of myelomeningocele was repaired successfully. He has regularly been followed up in the out-patient after discharge and has remained well. Repeated neurologic examination performed after discharge showed no neurologic deficits. We feel our present case will be of added interest.

Two Cases of Carotico-carvernous Fistula

Two cases of carotico-cavernous fistula, which experienced at Dept. of Neurosurgery of Busan National University Hospital, are presented with a brief review of the literature. Because it is the very interesting disease. These were of spontaneous onset. One was 39 year-old woman who was treated with the ligations of internal and common carotid artery in the neck, another was 17 year-old boy treated with the ligations of internal and common carotid artery followed by intraluminal mascular embolization. This surgical management was successful and there was neither recurrence nor other neurologic deficit.