scholarly journals Torg’s ratio in normal adult nepalese population

2017 ◽  
Vol 18 (1) ◽  
pp. 5-9
Author(s):  
Badri Rijal ◽  
R K Pokharel ◽  
S Paudel ◽  
L L Shah
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Stenosis ◽  
Spinal Canal ◽  
Cervical Spinal Cord ◽  
Canal Stenosis ◽  
Cervical Spinal Canal ◽  
Cord Injury ◽  
History Of ◽  
Cervical Spinal Stenosis

Introduction: Acute cervical trauma occasionally leads to cervical canal stenosis in some individuals in spite of minor trauma. The spinal canal-to-vertebral body ratio (Torg-Pavlov ratio) has been proposed for assessing developmental spinal canal stenosis. It is not affected by magnification, and is measured on lateral plain films of cervical vertebrae. The result of this study may help in better understanding of the Torg’s ratio, which is more reliable than direct measuring of the mid-sagittal diameter of the cervical spinal canal in the diagnosis of cervical spinal stenosis or predicting the prognosis of cervical spinal cord injury. If Torg’s ratio is below normal there is risk of cervical cord injury whereas relatively safe in large Torg’s ratio. Torg’s ratio can be accessed even in rural areas where x-rays are easily available and more economical than MRI and CT scan. It can assess the risk of cord injury during sports and outdoor activities and help individuals’ choose safe carrier in sports or others activities.Methods: In order to ascertain the normal values of the Torg’s ratio in adults Nepalese, hundred sets of cervical vertebral columns of hundred adult Nepalese population of age group 20-40 years were examined. Consecutive patients presenting with history of neck pain with normal x-ray findings or history of trauma without cervical spine injury from Orthopaedic OPD (out patients department) and emergency department of Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu from March 2011 to August 2012 were included in the study.Results: There were 48 males and 52 females with age ranging from 20 yrs to 40 yrs with the mean of 30.34±5.36 years. The normal average canal/body ratio of the cervical spine is 0.99 +/- 0.09 in male and 1.01 +/- 0.07 in female. It was observed that the ratio of the antero-posterior diameters of cervical spinal canal and vertebral bodies showed sexual dimorphism.Conclusion: The Torg’s ratio is the same irrespective of gender and height. The result of this study will help in better understanding of the Torg’s ratio, which is more reliable than direct measuring of the mid-sagittal diameter of the cervical spinal canal in the diagnosis of cervical spinal stenosis or predicting the prognosis of cervical spinal cord injury.JSSN 2015; 18 (1), Page: 5-9

Case report of ervical myelopathy due to ossification of the posterior longitudinal ligament in association with flavum ligament ossification: MRI and CT appearance

2013 ◽  
Vol 20 (2) ◽  
pp. 79-83
Author(s):  
Monique Boukobza ◽  
Jurgita Ušinskienė ◽  
Simona Letautienė
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Double Layer ◽  
Spinal Canal ◽  
Mixed Type ◽  
Cervical Spinal Cord ◽  
Asian Population ◽  
Posterior Longitudinal Ligament ◽  
Cord Compression ◽  
Cord Injury

Background. Our objective is to analyze the cervical spinal cord damage and spinal canal stenosis due to OPLL which usually affects the cervical spine and leads to progressive myelopathy in 50–60s in Asian population; to demonstrate the mixed type OPLL and to show OPLL specific dural penetration signs: “double- layer” and “C-sign” on imaging. Materials and methods. Subacute cord compression developed over a 3-month period in a 43-year-old Japanese patient. Severe spinal canal narrowing was related to the mixed type OPLL at C3–C4 through C6–C7 associated to flavum ligament ossification at T3–T4. Lateral radiograph of the cervical spine showed intraspinal ossification, CT demonstrated specific dural penetration signs, and MRI disclosed spinal cord compression. Laminectomy at C3–C7 was performed and decompression of the spinal cord was confirmed by postoperative MRI. Conclusions. Absolute cervical stenosis and association with other diseases (like calcification of flavum ligament) predispose the patient to develop more severe deficit earlier in the clinical course. Specific CT signs, “double-layer” and “C-sign”, show dural involvement. MRI is a very useful modality to identify the precise level and extent of the spinal cord injury. OPLL must be included in the differential diagnosis of subacute cervical myelopathy.

scholarly journals Do the cervical spinal canal dimensions predict pre-myelopathic changes of cervical spinal cord? - a magnetic resonance image study

2015 ◽  
Vol 04 (03) ◽  
pp. 139-144
Author(s):  
Smitha S Nair ◽  
A S Lakshmi ◽  
Ushadevi K B. ◽  
A K Gupta
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Cervical Spinal Cord ◽  
Spin Echo ◽  
Cervical Region ◽  
Cervical Canal ◽  
Image Study ◽  
Cervical Spinal Canal ◽  
Spin Echo Sequence

Abstract Background and aims: The cervical region is the most mobile portion of the spinal column and it is here that the earliest disc degenerations are encountered. Hence it is of great interest to neurologists and neurosurgeons. Degenerative arthritic changes in the cervical spine secondary to ageing may result in bony and soft tissue overgrowth causing encroachment on the cervical spinal canal resulting in cervical canal stenosis. This may predispose to compressive myelopathy. The study aims to determine the predictability of myelopathy based on the dimensions of spinal canal at the cervical region. Materials and methods: The study included 600 patients who underwent MRI scan of cervical spine in the Department of Imaging Sciences and Interventional Radiology, Sree Chithra Thirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, Kerala. It included patients of different age groups of both sexes who were classified into six groups. T1 weighted axial images were obtained using spin echo sequence. The axial slices were made at the mid vertebral levels from C2-C7 vertebrae. The anteroposterior diameters of spinal canal in axial images at mid cervical vertebral levels from C2-C7 were measured. Analysis of data was done by mean, standard deviation, independent sample t test, ANOVA and Chi­ square test. Results: The mean anteroposterior diameter of the canal at different cervical vertebral levels decreases as age advances. Tbe premyelopathic changes were more in males which may be attributed to change in canal shape. Conclusion: Cervical spinal canal dimensions are useful to predict premyelopathic changes of cervical spinal cord.

scholarly journals Stenosis of cervical spinal canal due to ossification of posterior longitudinal ligament

1996 ◽  
Vol 3 (1) ◽  
pp. 12-15
Author(s):  
A. I. Protsenko ◽  
V. K. Nikuradze ◽  
M. A. Klyuchnikov ◽  
K. T. Hudoiberdiev
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Posterior Longitudinal Ligament ◽  
Spinal Canal Stenosis ◽  
Complete Elimination ◽  
Canal Stenosis ◽  
Cervical Spinal Canal ◽  
Partial Elimination ◽  
Positive Results

Authors present their experience with 36 cases of spinal canal stenosis due to ossification of posterior longitudinal ligament in cervical spine. Ligament ossification extent was found to be local (1 segment) or segmental (2-3 segments). Clinical examination showed cervical myelopathy of various severity. Diagnosis of cervical spinal canal stenosis was determined mainly by CT and MRT. All patients underwent surgical treatment - anterior transcorporal decompression of spinal cord. Positive results were achieved in 34 patients including 22 patients with complete elimination of myelopathy, 9 patients with partial elimination and 3 patients with stopping of the process progression. In 2 patients, surgical procedure was inefficient.

Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries At the Cervical Spine

2021 ◽  
Author(s):  
Marie-Helene Beausejour ◽  
Eric Wagnac ◽  
Pierre-Jean Arnoux ◽  
Jean-Marc Mac-Thiong ◽  
Yvan Petit
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
White Matter ◽  
Cervical Spinal Cord ◽  
Element Model ◽  
Von Mises Stress ◽  
Study Objective ◽  
Cord Injury ◽  
Post Traumatic

Abstract Flexion-distraction injuries frequently cause traumatic cervical spinal cord injury (SCI). Post-traumatic instability can cause aggravation of the secondary SCI during patient's care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how different flexion-distraction disco-ligamentous injuries affect the SCI mechanisms during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4-C5, C5-C6 or C6-C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the most extreme von Mises stress (47 to 66 kPa), principal strains p1 (0.32 to 0.41 in white matter) and p3 (-0.78 to -0.96 in white matter) in the spinal cord and to the most important spinal cord compression (35 to 48 %). The main post-trauma SCI mechanism was identified as compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter after injury. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure in protecting the spinal cord. Its status should be carefully examined during patient's management.

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