Items tagged “spine”

A mnemonic to help recall the causes of basilar invagination is: PF ROACH Mnemonic P: Paget disease of bone F: fibrous dysplasia R: rheumatoid arthritis, rickets O: osteogenesis imperfecta, osteomalacia A: achondroplasia C: Chiari I and Chiari II, cleidocranial dysostosis H: hyperparath...

The term kissing carotids refers to tortuous and elongated carotid arteries which touch in the midline. They can be found in:  retropharynx 2 intrasphenoid 1 within the pituitary fossa within sphenoid sinuses within sphenoid bones The significance of kissing ca...

Caudal epidural injections, or sacral hiatus epidural injections, are one of several possible spinal epidural injections.  Indications Typically, epidural injections are performed in patients who are currently not surgical candidates. The caudal injection can be performed when patients are on ...

Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal canal. Clinical presentation Tethered cord syndrome is a clinical diagnosis based on neurologic deterioration involving the lower spinal cord 7. Patients ...

Hemivertebra is a type of vertebral anomaly that results from a lack of formation of one half of a vertebral body. It is a common cause of congenital scoliosis.  Epidemiology The estimated incidence is at ~0.3 per 1000 live births 2. Associations Recognized associations are many and include:...

Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and can be seen in ~25% (range 15-35%) of the general population 1-3. Non-recognition of this variant and/or poor description in the report can lead to operations or procedures performed at the wrong level.  Depending on ...

The iliolumbar ligament is a strong band of connective tissue which courses from the transverse process of L5 (in over 96% of cases) to the posterior iliac wing and crest of the ilium. It functions to maintain the alignment of L5 on the sacrum during various movements 1,2. It is an important la...

Spinal metastasis is a vague term that can be variably taken to refer to metastatic disease to any of the following: vertebral metastases (94%) may have epidural extension intradural extramedullary metastases (5%) intramedullary metastases (1%) Each of these are discussed separately. Below ...

The empty thecal sac sign or empty sac sign is when the thecal sac appears empty on MRI of the lumbar spine, best seen on T2-weighted images. If the empty thecal sac sign is present, a diagnosis of adhesive arachnoiditis can be made.​ Radiographic features MRI There is usually no gadolinium c...

Chiari III malformation is an extremely rare anomaly characterized by a low occipital and high cervical encephalocele with herniation of posterior fossa contents, that is, the cerebellum and/or the brainstem, occipital lobe, and fourth ventricle.  Pathology Associations agenesis of the corpus...

The (absent) pedicle sign, also called the winking owl sign, occurs on plain radiograph of the spine when a pedicle is absent 5. The term, winking owl sign, where the missing pedicle corresponds to the closed eye, the contralateral pedicle to the other round open eye, and the spinous process to...

Fibrocartilaginous embolism (also known as nucleus pulposus embolism) is a rare cause of spinal cord ischemia due to embolization of nucleus pulposus material from intervertebral disc in a retrograde direction into a spinal artery or vein. Fibrocartilaginous embolism is a diagnosis of suspicion...

Diplomyelia is a rare spinal cord malformation in which the cord is duplicated. It should be distinguished from diastematomyelia in which a single cord is split. Having said that it has been proposed that the term be abandoned in favor of split cord malformation, which encompasses both diastemat...

The differential diagnosis for a vertebral body mass is broad and may range from a completely benign bone island to a malignant primary bone tumor. Classification Broadly, these lesions can be separated into: non-neoplastic lesions primary bone tumors secondary metastatic disease Non-neopl...

The Magerl classification, one of many thoracolumbar spinal fracture classification systems, was adopted as the original AO classification in 1994 but has since then been superseded: see the current AO Spine classification of thoracolumbar injuries. Usage Although the Magerl classification is ...

Thoracolumbar spinal fracture classification systems are numerous and represent attempts by various authors to create systems that allow uniform and reproducible classification and description of thoracolumbar fractures which in turn can help with treatment decision making and prognostication.  ...

Spinal neurenteric cysts are a rare type of foregut duplication cyst, accounting for ~1% of all spinal cord tumors. They are usually classified as spinal or intracranial and are associated with vertebral or CNS abnormalities respectively.  Pathology Neurenteric cysts result from incomplete res...

Meningiomas arising from the coverings of the spinal cord are one of the two most common intradural extramedullary spinal tumors, representing 25-30% of all such tumors 2.  This article specifically relates to spinal meningiomas. For a discussion on intracranial meningiomas and a general discus...

Intradural extramedullary neoplasms are located outside the spinal cord but within the dural sheath.  Epidemiology The majority (70-80%) of spinal canal tumors are intradural extramedullary 1. Clinical presentation Patients present with signs and symptoms of spinal cord or nerve root compres...

Spinal nerve sheath tumors are the most common intradural extramedullary masses. This article is an overview of spinal nerve sheath tumors. For a discussion on the epidemiology, clinical presentation, pathology and treatment/prognosis of spinal schwannomas and neurofibromas, please refer to spi...