The Use of Radiological Guidelines to Achieve a Sustained Reduction in the Number of Radiographic Examinations of the Cervical Spine, Lumbar Spine and Knees Performed for GPs

Object Congenital cervical and lumbar stenosis occurs when the bony anatomy of the spinal canal is smaller than expected, predisposing an individual to symptomatic neural compression. While tandem stenosis is known to occur in 5%–25% of individuals, it is not known whether this relationship is due to an increased risk of degenerative disease in these individuals or whether this finding is due to the tandem presence of a congenitally small cervical and lumbar canal. The purpose of the present study was to determine if the presence of congenital cervical stenosis is associated with congenital lumbar stenosis. Methods One thousand seventy-two adult skeletal specimens from the Hamann-Todd Collection in the Cleveland Museum of Natural History were selected. The canal area at each level was calculated using a formula that was verified by computerized measurements. Values that were 2 standard deviations below the mean were considered to represent congenitally stenotic regions. Linear regression analysis was used to determine the association between the sum of canal areas at all levels in the cervical and lumbar spine. Logistic regression was used to calculate odds ratios for congenital stenosis in one area if congenital stenosis was present in the other. Results A positive association was found between the additive area of all cervical (that is, the sum of C3–7) and lumbar (that is, the sum of L1–5) levels (p < 0.01). A positive association was also found between the number of cervical and lumbar levels affected by congenital stenosis (p < 0.01). Logistic regression also demonstrated a significant association between congenital stenosis in the cervical and lumbar spine, with an odds ratio of 0.2 (p < 0.05). Conclusions Based on the authors' findings in a large population of adult skeletal specimens, it appears that congenital stenosis of the cervical spine is associated with congenital stenosis of the lumbar spine. Thus, the presence of tandem stenosis appears to be, at least in part, related to the tandem presence of a congenitally small cervical and lumbar canal.

Download Full-text

Common Neurosurgical Procedures

Medical Management of Neurosurgical Patients ◽

10.1093/med/9780190913779.003.0001 ◽

2019 ◽

pp. 1-15

Author(s):

Kevin Hines ◽

Stavropoula Tjoumakaris ◽

Pascal M. Jabbour ◽

Robert H. Rosenwasser ◽

M. Reid Gooch

Keyword(s):

Cervical Spine ◽

Lumbar Spine ◽

Adverse Events ◽

Medical Management ◽

Neurosurgical Procedures ◽

Ventriculoperitoneal Shunting ◽

Neurosurgical Patient ◽

Neurosurgical Patients

Medical management of the neurosurgical patient can be complicated. These patients may suffer from a difficult neurosurgical pathology while still living with challenging comorbidities. As a result, this population often requires cooperation between multiple teams including neurosurgeons, neurologists, neurointensivists, and hospitalists. In this chapter, the authors review common neurosurgical procedures that the neurohospitalist encounters, including ventriculoperitoneal shunting, craniotomy and craniectomy, cervical spine decompression with or without fusion, lumbar spine decompression and/or fusion, and cerebral angiograms. The authors aim to highlight the methodology, indications, and issues of perioperative medical management. Understanding these procedures is vital to minimizing adverse events and providing the best possible care for neurosurgical patients.

Download Full-text

Hemangiopericytoma-like synovial sarcoma of the lumbar spine

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.4.2.179 ◽

2006 ◽

Vol 4 (2) ◽

pp. 179-182 ◽

Cited By ~ 16

Author(s):

Nikolaos Sakellaridis ◽

Helen Mahera ◽

Spiros Pomonis

Keyword(s):

Differential Diagnosis ◽

Cervical Spine ◽

Lumbar Spine ◽

Synovial Sarcoma ◽

Spindle Cell ◽

Cell Tumor ◽

Spindle Cell Tumor ◽

Deep Soft Tissue ◽

Pathological Characteristics ◽

The Brain

✓The purpose of this report is to demonstrate that synovial sarcoma should be included in the differential diagnosis of tumors originating from the lumbar spine, especially if they show hemangiopericytoma-like pathological characteristics. A synovial sarcoma is a mesenchymal spindle cell tumor that displays variable epithelial differentiation including glandular formation. It is unrelated to a synovium. More than 80% of these lesions arise in the deep soft tissue of the extremities. The tumor frequently arises adjacent to joints or tendon sheaths. The authors describe a young woman with a hemangiopericytoma-like tumor of the lumbar spine. During repeated operation, this lesion was shown to be a synovial sarcoma, which had invaded the dura mater. The tumor metastasized to the mediastinum and the intradural cervical spine and, finally, to the brain and the lungs. To the authors’ knowledge, this is the first reported case of a synovial sarcoma originating from the lumbar spine.

Download Full-text

Facet tropism in lumbar spine and cervical spine: A systematic review and meta-analysis

World Neurosurgery ◽

10.1016/j.wneu.2020.11.171 ◽

2020 ◽

Author(s):

Kanwaljeet Garg ◽

Ankita Aggarwal

Keyword(s):

Systematic Review ◽

Cervical Spine ◽

Lumbar Spine ◽

Meta Analysis ◽

Facet Tropism

Download Full-text

The Porcine Cervical Spine as a Model of the Human Lumbar Spine

Journal of Spinal Disorders ◽

10.1097/00002517-199910000-00012 ◽

1999 ◽

Vol 12 (5) ◽

pp. 415-423 ◽

Cited By ~ 2

Author(s):

Vanessa R. Yingling ◽

Jack P. Callaghan ◽

Stuart M. McGill

Keyword(s):

Cervical Spine ◽

Lumbar Spine ◽

Human Lumbar Spine

Download Full-text

ANALYSIS OF INTERVERTEBRAL ANGULATIONS AND MUSCULOSKELETAL SYMPTOMS OF THE SPINE IN THE MILITARY AIRCREWS OF TAIWAN

Biomedical Engineering Applications Basis and Communications ◽

10.4015/s1016237217500107 ◽

2017 ◽

Vol 29 (02) ◽

pp. 1750010

Author(s):

Hsiang-Ho Chen ◽

Cheng-Han Chung ◽

Chi-Chen Lee ◽

Cheng-Shu Yang ◽

Yu-Shin Wen ◽

...

Keyword(s):

Cervical Spine ◽

Lumbar Spine ◽

Sagittal Plane ◽

Musculoskeletal Symptoms ◽

Low Back ◽

Regular Group ◽

High Prevalence ◽

Tangent Method ◽

Cobb Method ◽

The Military

Background: The purpose of this study is to investigate the prevalence of neck and low back discomfort and its association with intervertebral angulations of cervical and lumbar during neutral and flexion among aircrews. Methods: There were 283 subjects participating in this survey. All participants finished one questionnaire each regarding complaints about musculoskeletal symptoms, and three sagittal plane radiographs. The measurements of intervertebral angulations were completed using the Cobb method for lumbar spine and the Harrison posterior tangent method for the cervical spine. Results: In the questionnaire, 26.5% subjects self-reported neck discomfort and 33.2% subjects self-reported low back discomfort. Based on categorization by self-reported complaints, there was significant decrease in two intervertebral flexion angles of the Discomfort group than those of the Regular group, including C3/C4 and C2/C7. Based on categorization by radiological diagnoses, the abnormal group revealed significant decreases in the regular range of motion from neutral to flexion at C3/C4 segment. Lordotic angles between L1 and L5 were also found to be significantly different between the Discomfort group and the Regular group. Conclusions: A high prevalence of neck and low back discomfort among the aircrews is revealed and needs more suitable intervention. A certain level of association between spinal discomfort and the intervertebral angulations of the lumbar spine and the cervical spine in aircrews was found when compared to the normal group.

Download Full-text