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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
The spinal cord and the nerve roots are covered by three meningeal layers: the dura, arachnoid and pia mater. Further protection of the spinal cord is provided by CSF which surrounds the cord in the subarachnoid space. The pia form the denticulate ligaments along the lateral sides of the spinal cord, providing further mechanical protection to it. The filum terminale is an extension of the pia mater that is attached to the coccygeal segments. The arachnoid and dura mater extend beyond the L2 level to the level of the S2 vertebra.
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 cerebrospinal fluid contains very little protein. It circulates in the space between the pia mater and the arachnoid, which is known as the subarachnoid (or intrathecal) space. Laterally and throughout its whole length, discontinuous fibrous tracts, called the denticulate ligament, connect the pia mater (from which they originate) with the dura mater, thus fixing the spinal cord to the dural tube (Figure 1.15B).
Life Care Planning for Spinal Cord Injury
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
David J. Altman, Dan M. Bagwell
Anatomically, the spinal cord is protected by three layers of tissue, referred to as the meninges. The outermost layer (dura mater) forms a tough protective coating. Between the dura mater and the surrounding bone of the vertebrae is the epidural space, which contains adipose tissue and an intricate network of blood vessels. The middle layer of the meninges is the arachnoid (spider) mater, which is separated from the innermost delicate (pial) layer by the subarachnoid space, which contains cerebrospinal fluid. The pial layer is extremely delicate and intimately associated with the surface of the spinal cord. The spinal cord is stabilized by the denticulate ligaments, which extend from the pia mater laterally between the dorsal and ventral roots.
High field structural MRI in the management of degenerative cervical myelopathy
Published in British Journal of Neurosurgery, 2018
Dan Wright, Sean Martin, Erlick AC Pereira, Yazhuo Kong, Irene Tracey, Thomas Cadoux-Hudson
The possibility of visualising the mechanical disruption of neurovascular structures in greater detail would be a great step forward in the understanding of DCM. For example advances have been made in the field of multiple sclerosis (MS) research using 7T MRI. White matter lesion counts averaged 4.7 vs. 3.1 (52% increase) per patient at 7T vs. 3T.23 An understanding of spinal lesion load in this condition is crucial to the early diagnosis and management in these patients. With 7T it is possible to clearly see the dorsal and ventral nerve, gray matter anterior horn, the denticulate ligament, dorsal and ventral blood vessels and the dura mater, which may help to identify surgical candidates with DCM with early spinal cord lesions that are not yet evident on conventional MRI.