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Spinal Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The spinal cord extends from the foramen magnum, through the spinal canal to terminate between T12 and L3 (usually the lower margin of the L1 vertebral body). Below this level, the canal contains the lumbar, sacral and coccygeal spinal nerves (the cauda equina nerve roots). The spinal cord is surrounded by cerebrospinal fluid contained within the dura mater. There is an epidural space between the dura mater and the bony canal containing extradural fat and blood vessels. The spinal canal diameter varies along the length of the spine with the narrowest areas in the sub-axial cervical and thoracic regions. Pre-existing degeneration can cause further narrowing of the spinal canal and hence fractures of the cervical and thoracic spine are frequently complicated by spinal cord injury.7
Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The spinal canal is the cavity that contains the spinal cord within the vertebral column, and many columns form the vertebrae through which the spinal cord passes. The canal is enclosed within the intervertebral foramen of the vertebrae. In the intervertebral spaces, the canal is protected by the ligamentum flavum posteriorly and the posterior longitudinal ligament anteriorly. Lumbar spinal stenosis is a narrowing of the lumbar spinal canal50 resulting in symptoms.
Spinal injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Skeletal anatomy at the craniovertebral junction provides for a wide range of movement of the head upon the neck but relies on the synovial joints and associated ligaments for stability. Because of the relatively wide diameter of the spinal canal at this level, the cord often escapes injury but when it is damaged deficits may be profound. Associated injuries to the vertebral artery may be overlooked as they may be clinically silent.
Percutaneous endoscopic decompression for calcified thoracic disc herniation using a novel T rigid bendable burr
Published in British Journal of Neurosurgery, 2023
Lei-Ming Zhang, Wen-Ying Lv, Gang Cheng, Deng-Yuan Wang, Jian-Ning Zhang, Xi-Feng Zhang
TDH is an uncommon disease. The pathogenesis of neurologic deficits secondary to herniated thoracic discs are believed to be a combination of direct compression and vascular insufficiency.2,25,27 Anatomic features of the thoracic spine and spinal cord are vulnerable to injuries from manipulation and trauma. The thoracic spinal canal is small, and most of its space is occupied by the cord. The blood supply to the cord is tenuous in this region. In addition, TDH is often central and calcified, and may adhere to or penetrate the dura.2,6,25,28–30 Surgery is regarded as the first choice of treatment for a symptomatic herniated thoracic disc with axial pain, radiculopathy, and myelopathy to prevent the sequelae of cord compression. Many surgical approaches for the treatment of TDH have been described, including transthoracic approaches, lateral extracavitary or costotransversectomy approaches, transpedicular or transfacet pedicle-sparing approaches, as well as thoracoscopic microdiscectomy.5–12
The effect of repeated flexion-based exercises versus extension-based exercises on the clinical outcomes of patients with lumbar disk herniation surgery: a randomized clinical trial
Published in Neurological Research, 2023
Alireza Abdi, Seyed Reza Bagheri, Zahra Shekarbeigi, Soheila Usefvand, Ehsan Alimohammadi
This study was a single-blind randomized clinical trial (RCT) study conducted at Kermanshah University of Medical Sciences in 2019. The population is the patients with lumbar disc herniation surgery. The samples were the patients with lumbar disc herniation who were referred to Imam Reza hospital from Kermanshah-Iran and underwent an operation. Inclusion criteria were: 1- patients with a single-level lumbar laminectomy and discectomy 2- age between 20 and 50 years 3- absence of any contraindication for the subsequent exercises program. Patients with a history of previous lumbar disk herniation surgery and those with spinal canal stenosis and/or spondylolisthesis were excluded. The sample size was estimated at 23 subjects in each group, with regards to pain score after Williams exercise in the study of Nwuga and Nwuga [1985, 19], power 95% and first type error 5% by G-power software. Because of the possibility of attrition, thirty people were included in each group. The subjects were recruited conveniently and allocated into three groups randomly.
Comprehensive review on intravertebral intraspinal, intrajoint, and intradiscal vacuum phenomenon: From anatomy and physiology to pathology
Published in Modern Rheumatology, 2021
Francesco Cianci, Gianfranco Ferraccioli, Edoardo Sean Ferraccioli, Elisa Gremese
The intradiscal VP is usually asymptomatic, it is mainly an incidental finding in radiological examinations performed for other reasons. As manifestations of disc degeneration, VP contributes to modify load distribution through the spine, promoting further degeneration and causing discogenic pain. Some Authors have reported in 105 patients with lumbar spinal canal stenosis that low back pain in those with an associated VP in one or more discs was related to movements such as standing up or rolling and to changes in the weather [59]. These findings could be explained by changes in the internal pressure in discs with vacuum; Kasai et al. [60] using hyperbaric chamber showed that a worsening of low back pain in patients with VP is related to the reduction of atmospheric pressure, which is able to induce the intravacuum gases to expand, stretching annulus fibers and causing pain; this effect is supposedly due to the impairment of processes responsible for maintenance of intradiscal pressure [60]. Moreover it has been shown that early in the morning the fluid content in the disc is increased [53] and this is associated with a higher risk of disc injury [61].