Sagittal diameter of the lumbar spinal canal and canal/body ratio in normal adult Saudis

The determination of normal sagittal diameter of the lumbar spinal canal in normal adult Saudis, and as to whether there are any racial difference in the morphometry of the lumbar spinal canal which are essential in a reliable evaluation of patients with symptoms of lumbar canal stenosis or low back pain. A retrospective study over a period of 5 years [June 2001 - May 2006] utilizing the computer system [magic web] which saves all x-ray images where computed tomography measurements of the mid-sagittal diameter of the lower three lumbar vertebral canal were made in 170 adults. For the sake of consistency, all measurements were taken by one observer and results were recorded as the mean of two measurements. To evaluate the significance obtained, Student t-test were carried out. The measurements showed that the mean mid-sagittal diameter of the lumbar spinal canal in the Saudi population was smilar to Caucasian and wider than the Far Eastern Asian or African. The mean male mid-sagittal diameters were slightly wider than those of the female but the differences were not statistically significant. The ratio is increased steadily as we go from L3 - L5, especially in the females. The mid-sagittal body/canal ratio is higher in the female in this population, which indicates that the lumbar canal is more capacious in females than that of the males. In age group over 60 years, the mid-sagittal diameters were smaller than those of younger generations at all levels. The mid-sagittal diameter of the lumbar spinal canal among Saudis is similar to the measurement in the Caucasian population; the radiological criteria of spinal canal stenosis should be identical between these two populations

Terminal myelocystocele: a case report

Terminal myelocystocele is a rare form of occult spinal dysraphism in which the hydromyelic caudal spinal cord and the subarachnoid space are hemiated through a posterior spina bifida. A 1.5 month old boy presented with a large lumbosacral mass and urinary incontinence. The magnetic resonance imaging, operative findings and pathological findings revealed a low lying conus with a dilated central canal dorsally attached to the subcutaneous tissue. Ventral subarachnoid space was enlarged and herniated through the laminar defect of the sacrum. The lesion was typical of a terminal myelocystocele. The clinical features are different from those of myelomeningocele in many aspects. Though the incidence is low, terminal myelocystocele should be included in the differential diagnosis of congenital lesions presenting as a lumbosacral mass.