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Anatomy of the head and neck
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The sensory and motor nerve roots fuse and merge into a single spinal nerve that leaves the vertebral canal via the intervertebral foramen. Leaving the foramen, the emerging nerves divide into anterior and posterior rami, each containing both motor and sensory fibres. The length of the spinal nerve within the vertebral canal increases progressively down the length of the cord, until after termination of the cord itself at the level of the second lumbar vertebra. Below this level, the nerves alone form a bundle known as the cauda equina within the vertebral canal.
Spine
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
A typical vertebra has a vertebral body situated anteriorly and the vertebral arch posterolaterally thereby enclosing the vertebral canal containing the spinal cord. Vertebral body – anterior and weight bearingVertebral arch made of Two transverse processes – posterolateral projectionsTwo pedicles connecting the body to the transverse processSingle spinous process posteriorlyTwo laminae – between transverse process and spinous processThe intervertebral foramina are present between the successive pedicles and transmit the spinal nerve and radicular vesselsSuperior and inferior articular processes with their articular facets connect adjacent vertebral arches
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.
MRI characteristics of the fetal tethered spinal cord: a comparative study
Published in International Journal of Neuroscience, 2022
Yan Sun, Gang Ning, Xuesheng Li, Haibo Qu, Jiangang Zeng
Data have shown that the spinal cord in the embryo extends the entire length of the vertebral canal, and at 24 weeks, the caudal end of the spinal cord lies at the first sacral vertebra (S1). The cord usually terminates at L2 or L3 at birth [24]. One study showed that the cord terminated at the level of S1 at 22–23 weeks [25]. Another study described the level of the CM in the second and third trimesters as the “mid-kidney” [27]. In our study, the normal fetal CM is located from L4 to L1 (24+4–37+ 4 weeks of gestation) and was mostly at L3 in our 13 normal fetuses; the position of the CM in our normal fetuses also corresponded to the “mid-kidney” level (Figure 2). We believe the level of the fetal CM can be better described as a range given the normal changes that occur during growth and development, combined with the observations in this study. Thus, it is reasonable to employ the description of “mid-kidney” during the second and third trimesters. Furthermore, the determination of the CM position relative to the vertebrae was conventionally made with reference to the level of the lumbosacral transition, the second cervical vertebrae, or the ribs on MRI and ultrasound [19,28,29], but there are variations. Moreover, it is difficult to count theses vertebrae or ribs on images. Although the normal kidney location may also vary, because of observation advantages of the kidney, this “mid-kidney” method may be more practical clinically. However, more studies must verify this determination.
The anterior versus posterior approach for the treatment of ossification of the posterior longitudinal ligament in the cervical spine: A systematic review and meta-analysis
Published in The Journal of Spinal Cord Medicine, 2021
Jian Zhang, Qingyuan Liang, Dean Qin, Jiefu Song, Qijun An, Xiaojian Wang, Zhongtao Zhao
Generally, patients with focal pathology tend to be treated with the anterior approach, but the selection of the posterior approach is usually based on the surgeon’s preference and the patient’s characteristics. Liu et al. recommended that patients with cervical OPLL involving less than 3–4 vertebrae below the C3 level with thicknesses less than 5–6 mm and spinal stenosis of less than 50% should be treated with anterior surgery. Patients with OPLL involving more than four segments, C1/C2 vertebrae, or cervical vertebrae lower than C6/C7, often resulting in poor surgical field of vision, should be treated with posterior surgery.7 However, the selection criteria for the surgical approach were ambiguous in most studies. Additionally, ACF or ADF can rebuild cervical stability and relieve pressure on the level of the compressed cervical spinal cord. However, complications, primarily dural tearing, cerebrospinal fluid (CSF) leakage, haematoma and C5 palsy, should be considered.8 In this regard, the anterior approach remains a significant surgical challenge, especially for multiple levels and high vertebral canal occupation ratios. Compared with the anterior approach, the posterior approach is an easier surgical technique. Indirect decompression via LA or LP allows the cervical spinal cord to float away from the ventral compression.
Projection of the Most Anterior Line of the Spinal Canal on Lateral Radiograph: An Anatomic Study for Percutaneous Kyphoplasty and Percutaneous Vertebroplasty
Published in Journal of Investigative Surgery, 2020
Hui Zhang, Jun Xuan, Tian-He Chen, Ze-Xin Chen, Liao-Jun Sun, Nai-Feng Tian, Xiao-Lei Zhang, Xiang-Yang Wang, Yan Lin, Yao-Sen Wu
In the present study, the SL marked by steel wire was visualized on lateral radiographs. Using the XPERT®80 Specimen Radiography System (KUB Technologies), we easily measured the distance between the PBVL and SL on the lateral radiograph and confirmed the optimal location at which to stop injection. In this study, the largest distance between the PBVL and SL was seen in the thoracolumbar spine; OVCF also occurred most frequently at thoracolumbar spine segments. Chen et al. measured the distance between the anterior border of the vertebral canal and the posterior border of the vertebral body on CT images from T11 to L2.21 However, they did not measure other vertebral bodies. Their results differed from ours, which could be due to differences in measurement methods, because our study was cadaveric and Chen et al. only obtained measurements on CT scans.21 In the current research, we measured the distance between the PBVL and SL from C3 to L5. The location of the SL was then determined on lateral radiographs. We hypothesized that preventing cement from exceeding the SL and would in turn be helpful for preventing intraspinal cement leakage in both PKP and PVP. In the cervical spine, the anterior line of the spinal canal and PBVL overlap; therefore, the PBVL can be used as the SL.