الفهرس | Only 14 pages are availabe for public view |
Abstract Spinal canal has a complex anatomy and contains highly important structures such as spinal cord, and spinal nerves. Spinal canal stenosis; Decline in the size of this canal would increase chance of compression of these important structures. The aim of this study is to evaluate the normal dimensions of spinal canal in Egyptian population with respect to spinal level and age. The bony spinal canal of lumbar and cervical regions was studied in three age groups; (20-39 years), (40-59) and (60and older). The canal was also evaluated by dry bone examination. Ninety eight CT scan; fifty six for cervical spine and forty two for lumber spine were done in Massara Radiology center and Techno Radiology center between January 2016 and June 2017 using TOSHIBA, Japanese (multislice 16) machine. One hundred and four MR imaging; fifty cases for cervical MRI and fifty four cases for lumber MRI was done in Massara Radiology center and Techno Radiology center between January 2016 and June 2017 using HITACHI, Japanese (0.3 tsla) machine. One hundred and forty dry human vertebrae, eighty four cervical vertebrae and fifty six lumbar one, obtained from the Anatomy department, faculty of medicine, Sohag University. For cervical canal (from C2 to C7), diameters found to be widely variable fromC2 to C7, and normal diameters defined as antero-posterior (APD) ranged (from 9.60to20mm), and (from 11.2to19.5mm) in CT and MRI respectively. Whereas normal lumbar spinal canal defined as antero-posterior diameter (APD) (from 10.3 to 18.6 mm), (from 11.5 to 20 mm) in CT and MRI respectively and interpedicular diameter ranged from 17.8 to 35 mm. Summary 127 Comparison between levels showed that the longest mean AP diameter and widest mean CSA of the cervical canal were at C2, then diameters decrease gradually to reach the shortest mean AP diameter and narrowest mean CSA were at C4 then increase slightly gradually till C7. And As regard IPD; the longest mean IPD diameter was at C2. Whereas the longest mean AP diameter and widest mean CSA area of the lumbar canal was at L1, then measurements gradually decreased from L1 to L5, but Shortest mean AP diameter in CT and dry bone was at L4. As regarding the IPD the longest mean was at L5; with gradual increase from L1 to L5. Cervical and lumbar Spinal canal diameters, both midsagittal antero-posterior canal diameter and Cross sectional area, decreased steadily with age at all levels. But this decrease is not significant in CT measurements of the lumbar canal. Difference in the significance of aging effect between levels and methods could be attributed to presence of other factors which suggested having effect on spinal canal diameters; such as height and weight. It was concluded that the normal spinal canal diameters have a wide range which affected by many factors including race and age. In Egyptian population, bony canal stenosis considered with radiological APD less than 9.6 mm. in cervical segments and 10.3 mm. in lumbar levels. Aging is accompanied with steady decrease in the canal diameters but the significance of aging is not constant among peoples or levels due to presence of other factors which have an effect on spinal canal. |