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Introduction: Accurate anatomical descriptions of the size, shape and orientation of the main structures of thehuman vertebrae and intervertebral discs are necessary for a variety of approaches and objectives such as theidentification of clinical situations that are related to the morphometry of the spine structures, such as theincidence of low-back pain related to the spinal canal size. So the present study was done to measure the variousmorphometric parameters of thoracic vertebral body and neural canal.Materials and Methods: Total 100 sets of dry human thoracic vertebra were obtained. These are of unknown ageand sex. All Morphometric parameters were measured by digital Vernier caliper of accuracy of 0.01mm. Anteriorheight of the body (VBAH), Posterior height of the body (VBPH), Antero-posterior Diameter of Vertebral body(VBAPD), Transverse Diameter of Vertebral body (VBTD), Anteroposterior diameter of Vertebral Canal (VCAPD) andTransverse diameter of Vertebral Canal (VCTD). All parameters were entered into excel sheet and analysis wasdone by SPSS.Results: Mean VBAH ranged from 13.17+1.35mm (T1) to 17.92+2.25mm (T12), mean VBPH from 15.01+1.27mm(T1) to 20.92+4.58mm (T12), mean VBAPD ranged from 11.62+1.96mm (T1) to 18.12+5.71mm (T12), mean VBTDfrom 24.28+5.68mm (T1) to 28.59+5.97mm (T12), mean VCAPD ranged from 12.46+1.30mm (T1) to 16.05+2.41mm(T12) and VCTD from 17.15+2.19mm (T1) to 20.11+3.74mm (T12).Conclusion: The results of the present study may help in designing implants and instrumentations; understandingspine pathologies; and management of spinal disorder
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Background: Fetal anatomy is now becoming popular with advancement in fetal surgery in-utero. The knowledge regarding the embryonic development of vertebral canal plays an important role in diagnosis of congenital anomalies as well as fetal surgeries of the vertebral canal. Methods: Sixty fetuses which were preserved in 10% formalin were divided into five groups according to the gestational age. Spinal cord was exposed by opening vertebral canal from behind by laminectomy. The parameters like length of cervical part of vertebral canal, transverse diameter of canal at different vertebral levels, transverse and antero-posterior diameter of spinal cord were measured. Results: All parameters of cervical vertebral canal i.e. length of vertebral canal, transverse diameters at different vertebral levels exhibited a stable but variable rate of growth with advancing gestational age. Similarly, the parameters of spinal cord, antero-posterior and transverse diameters of spinal cord at upper, middle and lower vertebral levels revealed similar growth pattern with increasing gestational age. Conclusion: These measurements prove to be helpful in deciding the age of the fetus, early diagnosis of congenital disease and in utero fetal surgeries.
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Objective To study the technique of lumbar cathetering in lumbosacral vertebral canal operation and its effect on prevention of postoperative cerebrospinal fluid leakage.Methods Retrospectively analyzed the clinical data of patients who underwent lumbosacral ver-tebral canal surgery and suffered from difficult dural repair during the operation in Department of Neurosurgery from August 2015 to October 2015.These patients were divided into the observation group (11 cases)and the control group (12 cases)according to whether lumbar cathe-ter were placed during the operation or not.Volume of drainage was strictly controlled after surgery.Remove the epidural drainage after primi-tive healing of the dura mater.The lumbar catheter was removed after 7 to 10 days.The indwelling time of each patient was collected and sta-tistical analyzed.Results The observation group got obvious shorter epidural drainage indwelling time than the control group(P <0.05). Short-term postoperative complications did occur in some cases in observation group,however,there was no obvious increase of infection rate in patients with lumbar continuous drainage indwelling.Conclusion Lumbar cathetering during the operation could be an effective method to solve difficult problem of placeing a lumbar drainage after lumbar puncture and to prevent cerebrospinal fluid leakage after operations of lum-bosacral vertebral canal.But it can not replace the delicate operation and tight dural suture.Drainage should be used only as a remedial measure of dural repair failure.
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The determination of the normal values of the cross-sectional surface areas and ratios of the vertebral canal and the spinal cord on the healthy individuals is of great importance with regards to the fact that it provides convenience for the doctors to make correct pathological diagnosis because of the most suitable treatment. In this study, it has been aimed to determine the respective ratios between the vertebral canal and the spinal cord via measuring their cross-sectional surface areas at the C3C6 vertebra levels. The study has been implemented on the Magnetic Resonance Images (MRI) of the cervical vertebral column from healthy individuals at the Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University. The study has been applied to 67 (50 female-17 male) individuals whose ages varied between 14 and 59 and these individuals have been divided into two groups as below and over 40 years of age. During the cervical MRI examination, axial and sagittal images have been evaluated and measurements have been made on the non-pathological axial images. The vertebral canal and the spinal cord surface areas have been calculated in square millimeters at the C3C6 levels. Also, we calculated the ratio between the spinal cord surface area and the vertebral canal surface area. The obtained data has been transferred on the computer and statistical analysis has been implemented via SPSS package program (for Windows, 15.0). The summary of the data has been stated as Mean±SD. It has also been compared with regard to sex and age groups (below and over 40 years of age) using the Student t-test. The relationship between parameters has been evaluated by means of Pearson correlation test. No significant discrepancy (P>0.05) has been determined between the male and the female subjects in terms of the vertebral canal and spinal cord surface area values. On the other hand, at the C4, C5 and C6 levels, a significant discrepancy (P<0.05) has been observed between male and female subjects in terms of the ratio of spinal cord surface to the vertebral canal surface, stating that the male have it larger than the female. A positive correlation (P<0.01) between the surface area and ratio data of both sexes has been determined. We believe that the results of this study will be useful for the fields of neurology, neurosurgery and physical therapy and rehabilitation, particularly in evaluating spinal atrophy.
La determinación de los valores normales de las áreas de superficie de la sección transversal y las proporciones del canal vertebral de la médula espinal en los individuos sanos es de gran importancia para los médicos, para realizar un diagnóstico patológico correcto y un tratamiento más adecuado. Este estudio se llevó a cabo para determinar las respectivas proporciones entre el canal vertebral y la médula espinal a través de la medición transversal de áreas de superficie, entre los niveles de las vértebras C3C6. El estudio se realizó através de imágenes de resonancia magnética (IRM) de la columna vertebral cervical de individuos sanos en el Departamento de Radiología, de la Facultad de Medicina de Meram, Universidad de Necmettin Erbakan. En el estudio participaron 67 sujetos (50 mujeres, 17 hombres) entre 14 y 59 años de edad. Los sujetos fueron divididos en dos grupos, menores y mayores de 40 años de edad. Durante el examen de IRM cervical, se evaluaron imágenes axiales y sagitales, estas mediciones se realizaron en las imágenes axiales no patológicas. El canal vertebral y las áreas de superficie de la médula espinal fueron calculados en milímetros cuadrados entre los niveles C3C6. Además, se calculó el cociente entre el área de superficie de la médula espinal y la superficie del canal vertebral. Los datos obtenidos de superficie del canal vertebral, fueron transferidos al equipo y el análisis estadístico se implementó a través del programa SPSS (para Windows, 15.0). El resumen de los datos fue declarado como Media±DE. También fueron comparados grupos entre ambos sexos y por edad (menores y mayores de 40 años de edad) através de la prueba t de Student. La relación entre los parámetros fue evaluada mediante la prueba de correlación de Pearson. No se observó discrepancia significativa (P>0,05) entre hombres y mujeres en términos del canal vertebral, y los valores de la columna vertebral de la zona de superficie dorsal. Por otro lado, a nivel C4, C5 y C6, se observó una discrepancia significativa (P<0,05) entre hombres y mujeres, en términos de la proporción de la superficie de la médula espinal y la superficie del canal vertebral, indicando que fue mayor en los hombres. Se determinó una correlación positiva (P<0,01) entre el área de superficie y los datos de proporción de ambos sexos. Creemos que los resultados de este estudio serán de utilidad en las áreas de la neurología, neurocirugía, como también en terapia física y rehabilitación, en particular en la evaluación de la atrofia espinal.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Spinal Canal/anatomy & histology , Spinal Cord/anatomy & histology , Magnetic Resonance Imaging , Spinal Canal/anatomy & histology , Spinal Cord/diagnostic imagingABSTRACT
Objective To investigate the pharmacodynamic changes in local epidural anesthetic and correlated factors before and after epidural space opening during vertebral canal surgery. Methods 120 patients who underwent vertebral canal operation under epidural anesthesia from January 2008 to December 2010 in Anyang City People's Hospital in Henan Provincial were selected. A self control study method was applied to persistently monitor the patients' vital signs〔heart rate variance(HRV),mean arterial pressure(MAP),heart rate(HR),saturation of blood oxygen(SpO2)〕,and the subjective manifestations of patients,the appraisal of surgeon about the surgical local situation(the degree of skeletal muscle relaxation,neural reflex,the ooze blood and so on),the changes in movement (primarily Aαnerve fiber),feeling(primarily Aδnerve fiber),skin temperature(primarily non-myelinated nerve fiber C)within the scope of anesthesia,the dosage of local anesthetic used and the incidence of local anesthetic toxicity were record before and after epidural cavity opening. Results There were no statistical significant differences in vital signs before and after epidural cavity opening in this group of patients. After the opening of epidural space,the local use of anesthetic dosage and the incidence of local anesthetic toxicity were obviously higher than those before the opening〔lidocaine(mg/h):911.23±15.58 vs. 460.19±10.82,ropivacaine(mg/h):13.35±0.19 vs. 5.24±0.17, the incidence of local anesthetic toxicity:67.5%vs. 1.2%,all P<0.01〕,the anesthesia plane(skeletal muscle laxity, feeling,skin temperature)was poorer than that before the opening of epidural space〔the anesthetic plane before the opening was(4.0±1.7),(10.7±1.5),(12.0±1.6)segments respectively,after opening was(2.0±1.8),(10.2±1.3), (12.6±1.9)segments〕,after epidural space opening,the correlations among the three planes(movement sensation disjointed)were worse than those before the epidural space opening(good). Conclusion The opening of vertebral canal can change the action of local epidural anesthetic,decrease its therapeutic effect and increase its incidence of toxicity,therefore,it is necessary to further discuss the application of epidural anesthesia in vertebral canal operation.
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Objective To investigate clinical effect of limited decompression under endoscope combined with percutaneous transpedicular screw fixation for treatment of degenerative lumbar spinal stenosis.Methods Thirty-four senile patients with lower lumbar spinal stenosis were selected as our subjects from February 2010 to August 2011,and were treated with limited decompression under endoscope combined with percutaneous transpedicular screw fixation through posterior approach.The VAS scores of all patients were collected at the four periods including pre-operation,leaving hospital,3 months after operation,and the last follow-up.The therapeutic effectiveness for the postoperative follow-up was expressed as excellent,good,ordinary,and poor according to Nakai standard.Results The VAS scores at pre-operation,leaving hospital,3 month after operation,and the last follow-up were (7.9 ± 1.6),(2.9 ± 1.4),(1.9 ± 1.9),(2.4 ± 1.5)respectively,and the difference was significant (F =13.524,P =0.036).But no significant differences of VAS scores at three sequential tests after operation were observed (P ＞ 0.05).In the last postoperative follow-up,32 cases were graded as excellent,1 cases for good and 1 case for ordinary,and the excellent rate reached to 97％.Conclusion The therapeutic effectiveness of lumbar spinal stenosis limited decompression under endoscope combined with percutaneous transpedicular screw fixation is reliable.Furthermore,no side effects on spine and back muscles are observed.
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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.
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Animals , Body Size , Cervical Vertebrae/anatomy & histology , Dogs/anatomy & histology , Reference Values , Spinal Canal/anatomy & histology , Spinal Cord/anatomy & histology , Tomography, X-Ray Computed/veterinaryABSTRACT
Objective To explore the clinical efficacy of using the disposable whole laminectomy, laminoplasty and microsurgical tumor removal to treat intraspinal extramedullary benign tumors. Methods Sixty-four patients, 71 cases adult intraspinal extramedullary benign tumors were removed by the disposable whole laminectomy, laminoplasty and microsurgical tumor removal operation, all postoperative patients were followed up to observe the clinical efficacy. Results Patients with small tumors and large tumors all had a faster recovery of neurological function than preoperative, recent and long-term efficacy were all better than preoperative, and long-term efficacy was superior to short-term efficacy; Patients with giant tumors had a slow-er recovery of neurological function than preoperative, short-term efficacy was not better than preoperative, but the long-term efficacy was superior to preoperative. Conclusion The disposable whole laminectomy, laminoplasty and microsurgical tumor removal is an excellent method of treating intraspinal extramedullary be-nign tumors.
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Objective To study the feasibility of minimally invasive procedure for the management of dumbbel tumors of the cervical vertebral canal. Methods Fourteen cases of dumbbel tumors of the cervical vertebral canal were treated by the approch of semi-laminectomy. Results Twelve cases underwent total resections, one case underwent subtotal resection, another case underwent great part of resection. The vertebral artery was preserved well during the operation. Nine out of fourteen cases had followed up for 6～18 months. Neurological function was improvement in all cases. No recurrence or instability of spine was found. Conclusions The approch of semi-laminectomy has the advantages of minimal invasion, less bleeding, and no influence on stability of spine. It is a good choice for dumbbel tumors of the cervical vertebral canal