Lumbar spinal canal morphometry from computed tomography scans: reproducibility, results and clinical implications

The values of normal transverse (interpedicular) and sagittal (midsagittal) diameters are different at various levels of lumbar spinal canal in individuals of the same race and differ at identical levels in individuals of various races. The aim of the study was to determine normal reference range of the lumbar spinal canal dimensions and to evaluate lumbar pedicle dimensions with respect to spinal level, age, gender in Saudi population by using Computed Tomography. This study was conducted in Najran province (K.S.A), archival abdominal CT scan images from PACS in hospitals were used. The data of this study was collected from 210 (102 male and 108 female) normal Saudi adults individuals with different ages, gender over a period of 20 months (2019 - 2021). The mean spinal canal transverse distance (SCTR) showed steady decrease from L1 to L4, as there was an increasing in (SCTR) at L5 relative to L4, The mean spinal canal anteroposterior diameter (SCAP) showed a decrease from L1 to L3, and then a gradual increase from L4 to L5 (Fig.4-10). This pattern was observed in males only as there was an increase of female (SCAP) at L2 and L5, and no significant gender difference was noted at any lumbar level for (SCAP) The mean pedicle width (PW) showed steady increase from L1 to L5. While the mean pedicle height (PH) showed a gradual decrease from L1 to L5. The study conclude that Computed tomography is a reliable method for determining the morphological measurements of the spinal canal and pedicles diameter.

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Wild-type transthyretin amyloid cardiomyopathy complicated by spinal canal stenosis, carpal tunnel syndrome, and rotator cuff tears: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa329 ◽

2020 ◽

Author(s):

Seiji Takashio ◽

Masato Nishi ◽

Yuichiro Tsuruta ◽

Kenichi Tsujita

Keyword(s):

Rotator Cuff ◽

Spinal Canal ◽

Spinal Canal Stenosis ◽

Rotator Cuff Tears ◽

Lumbar Spinal Canal Stenosis ◽

Canal Stenosis ◽

Tunnel Syndrome ◽

Amyloid Cardiomyopathy ◽

Lumbar Spinal Canal ◽

Lumbar Spinal

Abstract Background Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is receiving increasing attention due to the availability of novel treatment options. Carpal tunnel syndrome (CTS) and lumbar spinal canal stenosis are known early symptoms of transthyretin (TTR) amyloidosis preceding the cardiac involvement and are considered as ‘Red Flags’ for transthyretin amyloid cardiomyopathy (ATTR-CM). Case summary A 67-year-old man with a history of lumbar spinal canal stenosis for the last 10 years, right rotator cuff tears for the last 4 years, and bilateral CTS for the last 1 year was scheduled for orthopaedic surgery for lumbar spinal canal stenosis. Investigations revealed severe left ventricular hypertrophy and hypertroponinaemia, which were suggestive of cardiac amyloidosis. Cardiac magnetic resonance imaging and 99mTc-labelled pyrophosphate scintigraphy demonstrated positive findings for ATTR-CM. Transthyretin deposition was found in both the myocardium and the yellow ligamentum excised during surgery. There was no transthyretin mutation on genetic testing. The final diagnosis was ATTRwt-CM. Discussion Transthyretin deposition in the ligaments or tendons has been observed in a number of patients with CTS, spinal canal stenosis, and rotator cuff tears. These orthopaedic diseases are predictive for the future occurrence of ATTR-CM. In addition, the coexistence of these multiple diseases might strongly predict ATTR-CM. This knowledge needs to be shared with orthopaedicians and cardiologists for the early diagnosis of ATTR-CM.

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