The Narrow Lumbar Canal

Inhaltsverzeichnis

1. Radiology of the Narrow Lumbar Canal.- 1.1 History.- 1.2 Terminology.- 1.3 Anatomy.- 1.3.1 Spinal Canal.- 1.3.2 Radicular Canal.- 1.3.3 Intervertebral Foramen.- 1.4 Clinical Data.- 1.4.1 Neurogenic Intermittent Claudication.- 1.4.2 Further Aspects of the Clinical Data.- 1.5 Radiologic Techniques and Their Indications.- 1.5.1 Plain Films and Tomographs of the Lumbosacral Spine.- 1.5.2 Opacification Techniques of the Subarachnoidal Space.- 1.5.3 Further Radiologic Techniques.- 1.6 Radiologic Signs of Lumbar Canal Narrowness.- 1.6.1 Anomalies of the Bones.- 1.6.1.1 Lateral Projection.- 1.6.1.2 Frontal Projection.- 1.6.1.3 Oblique Projections.- 1.6.2 Morphological Classification of the Bony Anomalies.- 1.6.2.1 Diffuse Anteroposteriorly Predominant Canalar Stenosis.- 1.6.2.2 Concentric Stenosis of the Canal Related to a Hypertrophy and a Disorientation of the Structures of the Posterior Arch on a Few or Several Segments.- 1.6.2.3 Stenosis of the Lateral Parts of the Canal Related to a Deformation of Its Lumen by Abnormal (Arthrosic or Dysplastic) Facetal Joints.- 1.6.3 Radiculosaccographic Signs.- 1.6.4 Phlebography Signs.- 1.7 Nosology.- 1.7.1 Developmental Spinal Stenosis.- 1.7.2 Acquired Spinal Stenoses.- 1.7.3 Congenital Stenoses.- Figures 1-7.- 2. Plain X-Ray Diagnosis of Developmental Narrow Lumbar Canal.- 2.1 Technique.- 2.2 Findings: To Measure or Not to Measure? That is Not the Question.- 2.3 Requirements for Reliable Measurements and Pitfalls.- 2.4 Radiologic Features of the Narrow Lumbar Canal Without Contrast Medium.- 2.4.1 Anteroposterior Plain Films or Tomograms.- 2.5 Findings on Lateral Projection.- 2.6 Various Types of Developmental Stenosis.- 2.7 Correlation Between Surgical and Radiologic Reports.- 2.8 Narrow Lumbar Canal and Associated Diseases.- Figures 8-14.- 3. Interapophysolaminar Spaces (IALS) of the Lumbar Spine and Their Utility in the Diagnosis of Narrow Lumbar Canal.- 3.1 Introduction.- 3.2 Material and Methods.- 3.3 Results.- 3.3.1 Morphological Data.- 3.3.2 Measurements.- 3.4 Conclusion.- Figures 15-18.- 4. Myelographic Signs of Narrow Lumbar Canal.- 4.1 Technical Particularities.- 4.2 Limits of the LM as an Investigation of the Narrow Lumbar Canals.- 4.3 LM Anomalies.- 4.3.1 Elementary Semeiology of Spinal Stenoses in LM.- 4.3.1.1 Anomalies of the Dural Sac and of Its Contents.- 4.3.1.2 Anomalies of the Epidural Space and Its Contents (Radicular Sheaths and Extrasaccular Parts of the Roots).- 4.3.2 Groups of Elementary Signs in Some Types of Stenoses.- Figures 19-28.- 5. Gas Myelography in Verbiest's Developmental Spinal Canal Stenosis.- 5.1 Symptomatology.- 5.2 Radiologic Examination.- 5.2.1 Conventional X-Rays.- 5.2.1.1 Frontal Projection.- 5.2.1.2 Lateral Projection.- 5.2.2 Gas Myelography.- 5.2.2.1 Technique.- 5.2.2.2 Radiologic Findings.- 5.2.2.3 Drawbacks of Gas Myelography.- 5.3 Clinical Forms of Idiopathic Developmental Spinal Stenosis.- 5.3.1 Anatomic Forms of Idiopathic Developmental Spinal Stenosis.- 5.3.1.1 Stenosis of the Entire Lumbar Canal.- 5.3.1.2 Stenosis Involving One or Two Vertebrae.- 5.3.2 Lumbar Canal Stenosis Associated with Narrowing of Other Spinal Segments.- 5.3.2.1 Lumbar Spinal Stenosis Associated with Narrowing of the Cervical Canal.- 5.3.2.2 Stenosis of the Entire Spinal Canal.- 5.3.3 Familial Forms of Idiopathic Developmental Spinal Stenosis.- Figures 29-42.- 6. Phlebographic Signs of the Narrow Lumbar CanaL.- 6.1 Physiopathology of the Venous Compression.- 6.2 Phlebographic Signs of Narrow Lumbar Canal.- 6.2.1 Narrowing of the Lumbar Canal in Its Entire Length.- 6.2.2 Segmental Stenoses of the Lumbar Canal.- Figures 43-47.- 7. Narrow Lumbar Canal by Postoperative Epidural Lesions.- 7.1 Radiculosaccographic Semeiology of Epidural Scarring.- 7.2 Phlebographic Semeiology of Epidural Scarring.- 7.3 Surgical Findings.- 7.4 Clinical Aspects.- 7.5 Physiopathology.- 7.6 Conclusion.- Figures 48-60.- 8. Spinal Phlebography in the Stenosis of the Lumbar Canal.- Figures 61-72.- 9. Computerized Tomography in Lumbar Spinal Stenosis.- 9.1 Material and Methods.- 9.2 Results.- 9.2.1 Normal Lumbar Spinal Canal.- 9.2.2 Lumbar Spinal Stenosis.- 9.3 Conclusion.- Figures 73-84.- 10. Lumbar Spinal Stenosis.- 10.1 Etiology.- 10.1.1 Developmental Stenosis.- 10.1.2 Degenerative Stenosis.- 10.1.2.1 Without Slip.- 10.1.2.2 With a Slip.- 10.1.3 Iatrogenic Stenosis.- 10.1.4 Other Etiologies of Lumbar Stenosis.- 10.2 Symptomatology.- 10.3 Treatment.- Figures 85-98.- 11. Narrow Radicular Canal.- 11.1 Nosologic Importance of the Narrow Radicular Canal with Regard to the Narrow Lumbar Canal.- 11.2 Anatomy of the Radicular Canal.- 11.3 Etiologies.- 11.4 Symptomatology of the Narrow Radicular Canal.- 11.5 Radiologic Findings.- 11.6 Surgical Procedures.- 11.7 Conclusion.- Figures 99-108.- 12. Stenosis of the Bony Lumbar Vertebral Canal.- 12.1 Introduction.- 12.2 Historical Review: Evolution of the Idea.- 12.3 Nomenclature.- 12.3.1 Quantitative Aspects in the Definition of Stenosis.- 12.4 Classification of the Types of Stenoses of the Lumbar Vertebral Canal.- 12.4.1 Nomenclature Based on Simple Deduction from Observation.- 12.4.1.1 Pathomorphology of Idiopathic Developmental Stenosis of the Bony Lumbar Vertebral Canal.- Figures 109-124.- 12.4.1.2 Additional Compressive Agents.- 12.4.2 Nomenclature Based on Observation and Conjectures.- 12.4.3 Inaccurate Nomenclature.- 12.4.3.1 Preoperative Visualization of the Pathomorphology of Stenosis of the Bony Vertebral Canal.- 12.5 Semiological Aspects.- 12.5.1 Permanent Signs of Radiculopathy.- 12.5.2 Vertebrogenous Symptoms.- 12.5.3 Neurogenic Intermittent Claudication.- Figures 125-127.- 12.5.4 Diagnosis.- 12.6 Surgical Treatment and Results.- 12.6.1 Absolute Stenosis.- 12.6.2 Vertebral Instability.- 12.6.3 Arachnitis.- 12.6.4 Relative Stenosis.- 12.6.5 Postoperative Results.- 13. Cheirolumbar Dysostosis: Developmental Brachycheiry and Narrowness of the Lumbar Canal.- Figures 128-139.- References.- Author Index.

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