Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery

1998 ◽  
Vol 89 (5) ◽  
pp. 791-795 ◽  
Author(s):  
Cargill H. Alleyne ◽  
C. Michael Cawley ◽  
George G. Shengelaia ◽  
Daniel L. Barrow
Keyword(s):  
Spinal Cord ◽  
Blood Supply ◽  
Anatomical Study ◽  
Microsurgical Anatomy ◽  
Review Of The Literature ◽  
Content Type ◽  
Segmental Artery ◽  
Artery Of Adamkiewicz ◽  
Segmental Arteries ◽  
Fine Print

Object. The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. Methods. In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. Conclusions. By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.

scholarly journals Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery

1998 ◽  
Vol 5 (3) ◽  
pp. E2
Author(s):  
Cargill H. Alleyne ◽  
C. Michael Cawley ◽  
George G. Shengelaia ◽  
Daniel L. Barrow
Keyword(s):  
Spinal Cord ◽  
Treatment Planning ◽  
Blood Supply ◽  
Anatomical Study ◽  
Microsurgical Anatomy ◽  
Review Of The Literature ◽  
Segmental Artery ◽  
Artery Of Adamkiewicz ◽  
Segmental Arteries

Object The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. Methods In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. Conclusions By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.

Intradural tuberculomas of the spinal cord

1981 ◽  
Vol 55 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Hamit Z. Gökalp ◽  
Ertuğ Özkal
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Medical Care ◽  
Review Of The Literature ◽  
Content Type ◽  
Antituberculous Treatment ◽  
Fine Print

✓ The incidence of intradural tuberculoma of the spinal cord is rare, and is becoming rarer as medical care improves. Two cases of surgically treated intradural tuberculomas are presented, with a brief review of the literature. The authors recommend surgical treatment, which carries almost no risk of meningitis if antituberculous treatment is given postoperatively.

Recurrent transient quadriparesis after minor cervical trauma associated with bilateral partial agenesis of the posterior arch of the atlas

1996 ◽  
Vol 84 (4) ◽  
pp. 663-665 ◽  
Author(s):  
Martijn Torreman ◽  
Ivo T. H. J. Verhagen ◽  
Menno Sluzewski ◽  
Alexander J. M. Kok ◽  
Willem Jan van Rooij
Keyword(s):  
Spinal Cord ◽  
Posterior Arch ◽  
Review Of The Literature ◽  
Cervical Trauma ◽  
Content Type ◽  
Causative Mechanism ◽  
Type D ◽  
Aggressive Management ◽  
Type C ◽  
Fine Print

✓ The case of a 33-year-old woman with bilateral partial agenesis (type D) of the posterior arch of the atlas and recurrent transient quadriparesis due to contusion of the spinal cord after minor cervical trauma is described. At least some patients with type C or D congenital anomalies of the posterior arch of the atlas are prone to transient quadriparesis; thus a more aggressive management is advocated for them. Radiological and surgical findings showing the possible causative mechanism are presented and a review of the literature is given.

Tethered cord syndrome from a choristoma of müllerian origin

1991 ◽  
Vol 74 (3) ◽  
pp. 497-500 ◽  
Author(s):  
Michael C. Molleston ◽  
Kevin A. Roth ◽  
Franz J. Wippold ◽  
Robert L. Grubb
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Review Of The Literature ◽  
Lumbosacral Junction ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of tethered cord syndrome due to a choristoma of müllerian origin located in the spinal cord at the lumbosacral junction. Two similar cases were found upon review of the literature. The embryology of this lesion is discussed.

Lateral interscalenic multilevel oblique corpectomies to repair ventral root avulsions after brachial plexus injury in humans: anatomical study and first clinical experience

2001 ◽  
Vol 95 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Henri-Dominique Fournier ◽  
Philippe Mercier ◽  
Philippe Menei
Keyword(s):  
Spinal Cord ◽  
White Matter ◽  
Anterior Approach ◽  
Cervical Spinal Cord ◽  
Anatomical Study ◽  
Ventral Root ◽  
Anterolateral Approach ◽  
Content Type ◽  
Anterior Aspect ◽  
Fine Print

Object. Because central nervous system white matter exerts a powerful inhibitory effect on axonal growth, implantation of nerve grafts or rootlets into the cervical spinal cord following ventral root avulsion injury should, ideally, be performed directly through the ventral root exit zone (VRExZ), which is located near the anteromedial aspect of the anterior horn; the grafts/rootlets should not be implanted into the white matter of the lateral cord. This is not possible when using a conservative posterior approach. Therefore, the authors have studied the anatomy encountered when using the anterolateral approach and evaluated the technique in the particular case of avulsed ventral nerve roots. They also present a case illustration of the procedure, which is used currently in their department. Methods. Anterior access to the rootlets is obtained using a lateral interscalenic approach; the vertebral artery is exposed and mobilized, and oblique drilling of the vertebral bodies (VBs) is performed. Because the articular processes and half of the VBs are preserved, fusion is not required. The approach allows the surgeon to expose the anterior aspect of the cervical dura and the entire length of the emerging spinal nerves. The anterior aspect of the dura is opened at the desired levels for VRExZ exposure, and the position is ideal for implantation of the graft/rootlets. The interscalenic dissection is mandatory so that the lesions of the supraclavicular plexus can be evaluated and repaired. If necessary, the anterior approach allows for exploration of the infraclavicular plexus during the same procedure. Conclusions. The use of a true anterior approach to the ventral rootlets appears to be a valuable and appropriate approach that avoids extensive laminectomy/facetectomy while reimplantation is performed through the anterolateral sulcus itself. In this approach, however, reimplantation of dorsal roots into the spinal cord remains impossible.

Microsurgical anatomy of lumbosacral spinal roots

1979 ◽  
Vol 51 (6) ◽  
pp. 819-823 ◽  
Author(s):  
Domenico d'Avella ◽  
Salvatore Mingrino
Keyword(s):  
Spinal Cord ◽  
Microscope Study ◽  
Morphological Features ◽  
Microsurgical Anatomy ◽  
Content Type ◽  
Spinal Roots ◽  
Fine Print

✓ A dissecting microscope study of the microsurgical anatomy of the lumbosacral spinal roots, carried out on the spinal cords of 30 adult subjects, is reported. The longitudinal extent of the medullary segment of origin of each root, and the morphological features of the root-spinal cord junction are described. Observations regarding intrathecal anastomoses between anterior and posterior roots, and shape, position, and real incidence of anastomotic rami are reported. The authors emphasize the importance of anastomotic rami when performing a rhizotomy.

Diaphyseal aclasis with spinal cord compression

1996 ◽  
Vol 84 (3) ◽  
pp. 518-521 ◽  
Author(s):  
Emmanuel K. Labram ◽  
J. Mohan
Keyword(s):  
Spinal Cord ◽  
Clinical Features ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Long Bones ◽  
Review Of The Literature ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45-year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.

Tuberculous meningitis presenting as an obstructive myelopathy

1984 ◽  
Vol 60 (1) ◽  
pp. 196-199 ◽  
Author(s):  
Brien Vlcek ◽  
Kim J. Burchiel ◽  
Thomas Gordon
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Tuberculous Meningitis ◽  
Cord Compression ◽  
Review Of The Literature ◽  
Content Type ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Fine Print

✓ Subacute paraplegia progressing over 3 months due to spinal cord compression was the presenting symptom of tuberculous meningitis in this patient with a normal chest x-ray film and no radiological or autopsy evidence of Pott's vertebral tuberculosis. The obstructive myelopathy was the result of proliferative granulomatous meningitis. A review of the literature indicates that this is a very unusual presentation of tuberculous meningitis.

Microsurgical anatomy of the hippocampal arteries

1993 ◽  
Vol 79 (2) ◽  
pp. 256-265 ◽  
Author(s):  
Atilla Erdem ◽  
M. Gazi Yaşargil ◽  
Peter Roth
Keyword(s):  
Hippocampal Formation ◽  
Anatomical Study ◽  
Anastomotic Site ◽  
Microsurgical Anatomy ◽  
Main Trunk ◽  
Content Type ◽  
Lateral Posterior ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Fine Print

✓ An anatomical study of the vascularization of the hippocampus was performed on 30 hemispheres. There were a total of 140 arteries supplying the hippocampi, for an average of 4.7 arteries per hemisphere (range three to seven arteries). Based on the origin and caliber of the arteries supplying the hippocampus, the hemispheres were divided into five groups: A) in 57% of the hemispheres studied, the origin was mixed and included the anterior choroidal artery (AChA), the main trunk of the posterior cerebral artery (PCA), and the inferior temporal, lateral posterior choroidal, and splenial branches of the PCA; B) in 27%, all of the inferior temporal branches of the PCA predominantly supplied the hippocampus; C) in 10%, the anterior inferior temporal branch of the PCA was the predominant supplier: D) in 3%, the hippocampus was predominantly supplied by arteries originating from the main trunk of the PCA (Uchimura artery); and E) in 3%, the AChA gave origin to the hippocampal vessel. It was found as a result of this study that the PCA directly and by its branches contributes much more to the blood supply of the hippocampal formation than the AChA. The uncal sulcus was found to be an important anastomotic site between the hippocampal branches of the AChA and the hippocampal branches of the PCA. In 26.6% of hemispheres, one of the hippocampal arteries arose from the lateral posterior choroidal artery. The splenial artery made a loop close to the extra ventricular part of the hippocampal tail and gave off multiple vessels to this structure in 36.6% of hemispheres. The finding that the AChA passes through the choroid fissure as a trunk and its later division into the lateral plexal and medial perforating branches within the choroid plexus may be of surgical significance.

Safety and efficacy of stereotactic radiosurgery for tumors of the spine

2004 ◽  
pp. 413-418 ◽  
Author(s):  
Deborah L. Benzil ◽  
Mehran Saboori ◽  
Alon Y. Mogilner ◽  
Ronald Rocchio ◽  
Chitti R. Moorthy
Keyword(s):  
Spinal Cord ◽  
Single Dose ◽  
Pain Relief ◽  
Total Dose ◽  
Stereotactic Radiosurgery ◽  
Medical Center ◽  
Primary Tumors ◽  
Content Type ◽  
Increased Risk ◽  
Fine Print

Object. The extension of stereotactic radiosurgery treatment of tumors of the spine has the potential to benefit many patients. As in the early days of cranial stereotactic radiosurgery, however, dose-related efficacy and toxicity are not well understood. The authors report their initial experience with stereotactic radiosurgery of the spine with attention to dose, efficacy, and toxicity. Methods. All patients who underwent stereotactic radiosurgery of the spine were treated using the Novalis unit at Westchester Medical Center between December 2001 and January 2004 are included in a database consisting of demographics on disease, dose, outcome, and complications. A total of 31 patients (12 men, 19 women; mean age 61 years, median age 63 years) received treatment for 35 tumors. Tumor types included 26 metastases (12 lung, nine breast, five other) and nine primary tumors (four intradural, five extradural). Thoracic tumors were most common (17 metastases and four primary) followed by lumbar tumors (four metastases and four primary). Lesions were treated to the 85 to 90% isodose line with spinal cord doses being less than 50%. The dose per fraction and total dose were selected on the basis of previous treatment (particularly radiation exposure), size of lesion, and proximity to critical structures. Conclusions. Rapid and significant pain relief was achieved after stereotactic radiosurgery in 32 of 34 treated tumors. In patients treated for metastases, pain was relieved within 72 hours and remained reduced 3 months later. Pain relief was achieved with a single dose as low as 500 cGy. Spinal cord isodoses were less than 50% in all patients except those with intradural tumors (mean single dose to spinal cord 268 cGy and mean total dose to spinal cord 689 cGy). Two patients experienced transient radiculitis (both with a biological equivalent dose (BED) > 60 Gy). One patient who suffered multiple recurrences of a conus ependymoma had permanent neurological deterioration after initial improvement. Pathological evaluation of this lesion at surgery revealed radiation necrosis with some residual/recurrent tumor. No patient experienced other organ toxicity. Stereotactic radiosurgery of the spine is safe at the doses used and provides effective pain relief. In this study, BEDs greater than 60 Gy were associated with an increased risk of radiculitis.

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