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Spine
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
It is oval in shape with a deep anterior fissure and a shallow posterior septum. Anterior and posterior nerve roots arise on the lateral surface and combine to form the spinal nerves at the intervertebral foramen. They soon divide into the anterior (sensory and motor innervation to the front of the body) and posterior (sensory and motor supply to the back) primary rami. The central canal or the ependymal canal is a CSF filled space which is a continuation of the fourth ventricle and runs the entire length of the spinal cord.
Spinal CordAnatomical and Physiological Features
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
It is located within the vertebral canal which provides structural protection and encloses the central canal of the spinal cord which contains cerebrospinal fluid. It is held in place by spinal roots, the denticulate ligaments and strands of pia mater. The spinal cord extends from the foramen magnum to the level of the L2 vertebra. Caudally, the spinal cord tapers to form the conus medullaris. Beyond the L2 vertebra, the spinal canal is filled with spinal roots descending caudally to exit from their intervertebral foramina. In the caudal canal at the sacral region, the spinal roots fan out to form the cauda equina.
The Spinal Cord and the Spinal Canal
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The gray matter is formed by a large number of nerve cells and is shaped like a butterfly or the letter “H” (Figure 1.18), with dorsal and ventral horns (also referred to as posterior and anterior gray columns). There is a medial column at the junction of the dorsal and ventral horns, the lateral horn, which is readily evident (1) at the thoracic level (where it is composed of autonomic preganglionic nerve cells) and (2) in the second to fourth sacral segments (where it consists of parasympathetic preganglionic nerve cells; thus, it is usually called the sacral parasympathetic gray column). The transverse gray commissure connects the right and left symmetrical portions of the gray substance. The central canal passes through the transverse gray commissure.
Case report: Development of syringomyelia after anatomically successful craniovertebral decompression for Chiari I malformation without syrinx
Published in British Journal of Neurosurgery, 2022
This case presents an unusual example of a de-novo syrinx cavity developing after anatomically successful surgery for an uncomplicated Chiari type 1 hindbrain hernia. It also has significance in terms of current views regarding the filling mechanism underlying syringomyelia. The early theories of both Gardner and Williams, whilst proposing different energy sources (arterial pulsation and venous pressure waves respectively), both supposed that CSF was driven from the IVth ventricle, down the obex and into the spinal cord. Indeed, some of the earlier operations for hindbrain-related syringomyelia involved plugging the obex with a small piece of muscle. Current theories propose, instead, that CSF passes along the perivascular spaces of the cord. Direct flow of fluid from the IVth ventricle into the central canal has been generally discounted,1 although the case for this as a filling mechanism can still be made.2 Certainly, in the case described here, it is difficult to escape the conclusion that the cavity was filling via the obex and that, once the IVth ventricle was opened into the artificial cisterna magna, the obex ceased to provide a conduit for CSF flow and syrinx filling. The arachnoid web seen at Magendie was initially thought to be insignificant because there was no major ventricular enlargement to suggest CSF obstruction at the level of the IVth ventricle and because the previously created CSF channels at the foramen magnum were generous. Indeed, during the re-exploration no obstructive arachnoid bands were seen anywhere other than at Magendie.
Relationship between subarachnoid and central canal hemorrhage and spasticity: A first experimental study
Published in The Journal of Spinal Cord Medicine, 2021
Selim Kayaci, Mehmet Dumlu Aydin, Baris Ozoner, Tayfun Cakir, Orhan Bas, Sare Sipal
As shown in Fig. 2, one rabbit presented with SAH around the brain stem, spinal cord and nerve roots. Figure 3 shows the beginning of the central canal at the medullary level and foramen of Luchka, central canal and ependymal cells in a normal rabbit. Blood was collected from the central canal in the horizontal section, and the occluded central canal in a SAH rabbit with SAH was assessed. Figure 4 shows the basal lamina cells and desquamated ependymal cells of animals with induced SAH. Figure 5(A and B) shows degenerated/apoptotic anterior horn neurons and stereologic cell counting observed in a rabbit with SAH. Figure 6 shows the degenerated anterior horn neurons and adhesive central canal at the mid-thoracic level in a rabbit with SAH. Figure 7 shows the central canal and GM of the spinal cord at the thoracic level in animals with induced SAH, ruptured central canal and degenerated anterior horn neurons. Figure 8 shows the edematous and degenerated anterior horn in the GM. Moreover, the fragmented interglial/interglacial-neuronal connection in a rabbit with induced SAH is also depicted.
Congenital Spinal Lipomatous Malformations. Part 2. Differentiation from Selected Closed Spinal Malformations
Published in Fetal and Pediatric Pathology, 2021
A terminal myelocystocele is in part a hydromyelic cyst of variable size formed by the retained terminus of the medullary spinal cord, the area probably including but not limited to the embryonic terminal ventricle. Hydromyelia is an enlargement of the central canal of the spinal cord. As a developmental lesion, isolated hydromyelia is usually asymptomatic in a newborn, although hydromyelia may be part of a more complex malformation. When hydromyelia is a prominent enlargement of the central canal, often in the lumbar spinal cord, the term hydromyelic cyst has been used, mostly by radiologists. Hydromyelic cysts cannot become very large within the confines of a normal spinal canal. They are not pressure lesions like a syrinx, so the spinal tracts simply bend around these innocuous cysts within the otherwise intact spinal cord [28]. On the other hand, formation of a terminal myelocystocele is outside the spinal canal due to a widely bifid lower spine that allows the caudal spinal cord to expand into a large, fluctuant, subcutaneous malformation. The enlargement in this malformation is of the terminal spinal cord wherein the central canal becomes geatly expanded and there is a tight adhesion of the neural tissue wall of this “hydromyelic cyst” to overlying skin (Figure 24).