ANAT30007 Lecture 14: [H1/91 notes] Imaging of the spine
15 May 2018
School
Department
Course
Professor
Bones –scaffolding
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Joints –allow for movement
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Discs –shock absorber
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Spinal cord and nerves in the thecal sac (extension of dura)
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Canal –conduit
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Foramina –for exiting nerves
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Constituents of lumbar spine
localised
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referred to buttocks/legs -“sciatica”
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can arise from disc, joints, bone or nerves
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Pain
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scoliosis (curvature)
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Deformity
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compressive effect
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bone or disc
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Radiculopathy (nerve roots)
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Myelopathy (spinal cord)–much worse
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Loss of neurological function
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Lumbar spine symptoms
Radiography (X-ray)
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CT
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MRI (gold standard)
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Not US except in children
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Imaging modalities
Bones
Vertebral body: tough cortical bone (bright, thin) surrounding softer cancellous/medullary
bone in middle
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Right: Axial CT scan
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5.1.2 Imaging of the spine
Monday, 30 March 2015
7:30 pm
Locomotor Page 1
CT: bones well shown, but not soft tissue
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Vertebrae form a column
Variable especially at the lower end
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Total is usually correct i.e. 29
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cervical rib
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lumbar rib
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11, 12, 13 ribs
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4, 5 or 6 lumbar vertebrae
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4, 5 or 6 sacral segments
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Segmentation anomalies
Lordosis: anterior curvature e.g. lumbar, cervical
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Kyphosis: posterior curvature e.g. thoracic
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Scoliosis: lateral curvature, abnormal
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Shape of the column
Locomotor Page 2
Side profile: square to rectangular
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Anterior profile: rectangular with “overhangs”
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If not these shapes then pathology
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Shape of the vertebra
Acute back injury
Locomotor Page 3
Document Summary
Loss of neurological function compressive effect bone or disc. Spinal cord and nerves in the thecal sac (extension of dura) Lumbar spine symptoms localised referred to buttocks/legs -(cid:862)s(cid:272)iati(cid:272)a(cid:863) can arise from disc, joints, bone or nerves. Vertebral body: tough cortical bone (bright, thin) surrounding softer cancellous/medullary bone in middle. Ct: bones well shown, but not soft tissue. 11, 12, 13 ribs cervical rib lumbar rib. L1 has lost its shape (severe anterior depression fracture) Right: mri - oedema (bright fluid) within bone due to compression fracture, but not impingement into canal. Infection in disc spreads to bone, destroying it. Mri: started in bone, gone into canal, impinging on cord. Zygo-apophyseal joints allows for flexion/extension of the spine also acts to limit forward movement (cid:862)shingle(cid:863) effect. Translocation of one level over another - defect in articular process (pars defect) or primarily related to joint. Grade i because less than 1/4 of vertebral body has moved anteriorly.
