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Spinal anatomy

Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Kevin Kalisz, Vasant Garg, Kyle Basques, Robert Gilkeson, Peter Young
RATIONALE AND OBJECTIVES: This study aimed to assess the quality of and analyze trends among clinical indications received for emergency room radiograph studies. MATERIALS AND METHODS: Clinical indications provided by the emergency room and rapid care for consecutive chest, abdominal, and musculoskeletal radiographs were reviewed. Chart review was performed to analyze the provided indications compared to clinical information known to the ordering providers. Chest and abdominal radiograph indications were graded according to symptoms and physical examination signs and relevant past medical history...
October 10, 2016: Academic Radiology
Athanasios Raikos, Thomas English, Omar Khalid Yousif, Mandeep Sandhu, Allan Stirling
PURPOSE: The great auricular point (GAP) marks the exit of the great auricular nerve at the posterior border of the sternocleidomastoid muscle (SCM). It is a key landmark for the identification of the spinal accessory nerve, and its intraoperative localization is vital to avoid neurological sequelae. This study delineates the topography and surface anatomy landmarks that used to localize the GAP. METHODS: Thirty cadaveric heminecks were dissected on a layer-by-layer approach...
October 15, 2016: Surgical and Radiologic Anatomy: SRA
Eva Placheta, Ines Tinhofer, Melanie Schmid, Lukas F Reissig, Igor Pona, Wolfgang Weninger, Thomas Rath, David Chwei-Chin Chuang, Chieh-Han John Tzou
INTRODUCTION: Facial reanimation surgery is performed in severe cases of facial palsy to restore facial function. In a 1-stage procedure, the spinal accessory nerve can be used as a donor nerve to power a free gracilis muscle transplant for the reanimation of the mouth. The aim of this study was to describe the surgical anatomy of the spinal accessory nerve, provide a guide for reliable donor nerve dissection, and analyze the available donor axon counts. METHODS: Dissections were performed on 10 nonembalmed cadavers (measurements of 20 nerves)...
October 6, 2016: Annals of Plastic Surgery
Constantin Dreher, Christian Scholz, Mira Pommer, Stephan Brons, Hannah Prokesch, Swantje Ecker, Jürgen Debus, Oliver Jäkel, Stephanie E Combs, Daniel Habermehl
BACKGROUND: The aim of the thesis is to improve treatment plans of carbon ion irradiation by integrating the tissues' specific [Formula: see text]-values for patients with locally advanced pancreatic cancer (LAPC). MATERIAL AND METHODS: Five patients with LAPC were included in this study. By the use of the treatment planning system Syngo RT Planning (Siemens, Erlangen, Germany) treatment plans with carbon ion beams have been created. Dose calculation was based on [Formula: see text]-values for both organs at risk (OAR) and the tumor...
2016: PloS One
Marcus Ohlsson, Jaime H Nieto, Kari L Christe, J Pablo Villablanca, Leif A Havton
The anatomy of the vertebral column in mammals may differ between species and between subjects of the same species, especially with regards to the composition of the thoracolumbar spine. We investigated, using several non-invasive imaging techniques, the thoracolumbar spine of a total of 44 adult rhesus macaques of both genders. Radiographic examination of the vertebral column showed a predominant spine phenotype with 12 rib-bearing thoracic vertebrae and 7 lumbar vertebrae without ribs in 82% of subjects, whereas a subset of subjects demonstrated 13 rib-bearing thoracic vertebrae and 6 lumbar vertebrae without ribs...
October 12, 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
September 7, 2016: International Journal of Obstetric Anesthesia
Benjamin De Leener, Simon Lévy, Sara M Dupont, Vladimir S Fonov, Nikola Stikov, D Louis Collins, Virginie Callot, Julien Cohen-Adad
For the past 25 years, the field of neuroimaging has witnessed the development of several software packages for processing multi-parametric magnetic resonance imaging (mpMRI) to study the brain. These software packages are now routinely used by researchers and clinicians, and have contributed to important breakthroughs for the understanding of brain anatomy and function. However, no software package exists to process mpMRI data of the spinal cord. Despite the numerous clinical needs for such advanced mpMRI protocols (multiple sclerosis, spinal cord injury, cervical spondylotic myelopathy, etc...
October 5, 2016: NeuroImage
Malte Mohme, Klaus Christian Mende, Theresa Krätzig, Rosemarie Plaetke, Kerim Beseoglu, Julian Hagedorn, Hans-Jakob Steiger, Frank W Floeth, Sven O Eicker
Spinal cord or cauda equina compression (SCC) is an increasing challenge in clinical oncology due to a higher prevalence of long-term cancer survivors. Our aim was to determine the clinical relevance of SCC regarding patient outcome depending on different tumor entities and their anatomical localization (extradural/intradural/intramedullary). We retrospectively analyzed 230 patients surgically treated for SCC. Preoperative status for pain and neurological impairment were correlated to the degree of compression, tumor location, and early as well as short-term follow-up outcome parameters...
October 7, 2016: Neurosurgical Review
Quentin Welniarz, Isabelle Dusart, Emmanuel Roze
The corticospinal tract (CST) plays a major role in cortical control of spinal cord activity. In particular, it is the principal motor pathway for voluntary movements. Here, we discuss: (i) the anatomic evolution and development of the CST across mammalian species, focusing on its role in motor functions; (ii) the molecular mechanisms regulating corticospinal tract formation and guidance during mouse development; and (iii) human disorders associated with abnormal CST development. A comparison of CST anatomy and development across mammalian species first highlights important similarities...
October 5, 2016: Developmental Neurobiology
Sriram Balasubramanian, James R Peters, Lucy F Robinson, Anita Singh, Richard W Kent
PURPOSE: Based on the structural anatomy, loading condition and range of motion (ROM), no quadruped animal has been shown to accurately mimic the structure and biomechanical function of the human spine. The objective of this study is to quantify the thoracic vertebrae geometry of the kangaroo, and compare with adult human, pig, sheep, and deer. METHODS: The thoracic vertebrae (T1-T12) from whole body CT scans of ten juvenile kangaroos (ages 11-14 months) were digitally reconstructed and geometric dimensions of the vertebral bodies, endplates, pedicles, spinal canal, processes, facets and intervertebral discs were recorded...
October 4, 2016: European Spine Journal
Dasfne Lee-Liu, Emilio E Méndez-Olivos, Rosana Muñoz, Juan Larraín
While an injury to the central nervous system (CNS) in humans and mammals is irreversible, amphibians and teleost fish have the capacity to fully regenerate after severe injury to the CNS. Xenopus laevis has a high potential to regenerate the brain and spinal cord during larval stages (47-54), and loses this capacity during metamorphosis. The optic nerve has the capacity to regenerate throughout the frog's lifespan. Here, we review CNS regeneration in frogs, with a focus in X. laevis, but also provide some information about X...
September 29, 2016: Neuroscience Letters
Deng-Wei He, Wen-Jun Huang, Xiao-Yong Sheng, Li-Jun Wu, Shun-Wu Fan
A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction...
August 2016: Orthopaedic Surgery
Ramesha Papanna, Lovepreet K Mann, Saul Snowise, Yisel Morales, Sanjay P Prabhu, Scheffer C G Tseng, Raymond Grill, Stephen Fletcher, Kenneth J Moise
OBJECTIVES: The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. METHODS: Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation...
July 2016: American Journal of Perinatology Reports
Shawn M Vuong, William J Jeong, Humberto Morales, Todd A Abruzzo
Vascular pathologies of the spinal cord are rare and often overlooked. This article presents clinical and imaging approaches to the diagnosis and management of spinal vascular conditions most commonly encountered in clinical practice. Ischemia, infarction, hemorrhage, aneurysms, and vascular malformations of the spine and spinal cord are discussed. Pathophysiologic mechanisms, clinical classification schemes, clinical presentations, imaging findings, and treatment modalities are considered. Recent advances in genetic and syndromic vascular pathologies of the spinal cord are also discussed...
October 2016: Seminars in Ultrasound, CT, and MR
Eric Diaz, Humberto Morales
We review the anatomy of the spinal cord, providing correlation with key functional and clinically relevant neural pathways, as well as magnetic resonance imaging. Peripherally, the main descending (corticospinal tract) and ascending (gracilis or cuneatus fasciculi and spinothalamic tracts) pathways compose the white matter. Centrally, the gray matter can be divided into multiple laminae. Laminae 1-5 carry sensitive neuron information in the posterior horn, and lamina 9 carries most lower motor neuron information in the anterior horn...
October 2016: Seminars in Ultrasound, CT, and MR
Zhoubing Xu, Benjamin N Conrad, Rebeccah B Baucom, Seth A Smith, Benjamin K Poulose, Bennett A Landman
Active shape models (ASMs) have been widely used for extracting human anatomies in medical images given their capability for shape regularization of topology preservation. However, sensitivity to model initialization and local correspondence search often undermines their performances, especially around highly variable contexts in computed-tomography (CT) and magnetic resonance (MR) images. In this study, we propose an augmented ASM (AASM) by integrating the multiatlas label fusion (MALF) and level set (LS) techniques into the traditional ASM framework...
July 2016: Journal of Medical Imaging
Subramanian Vaidyanathan, Azi Samsudin, Gurpreet Singh, Peter L Hughes, Bakul M Soni, Fahed Selmi
INTRODUCTION: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. CASE REPORT: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications...
2016: International Medical Case Reports Journal
Vuvi H Nguyen, Hao Howe Liu, Armando Rosales, Rustin Reeves
Compression of the dorsal scapular nerve (DSN) is associated with pain in the upper extremity and back. Even though entrapment of the DSN within the middle scalene muscle is typically the primary cause of pain, it is still easily missed during diagnosis. The purpose of this study was to document the DSN's anatomy and measure the oblique course it takes with regard to the middle scalene muscle. From 20 embalmed adult cadavers, 23 DSNs were documented regarding the nerve's spinal root origin, anatomical route, and muscular innervations...
2016: Anatomy Research International
Keyvan Eghbal, Fariborz Ghaffarpasand
BACKGROUND: Several injuries in cervical region as complications of acupuncture have been previously reported in the literature including cord and medulla oblongata injuries, subdural empyema and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma and iatrogenic procedures. We herein report an acute cervical subdural hematoma following cervical acupuncture for neck and shoulder pain. CASE DESCRIPTION: A 74-year-old woman presented with progressive quadriparesis and sensory deficit after receiving acupuncture in neck and shoulder...
August 30, 2016: World Neurosurgery
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