Intra-articular synovial folds of thoracolumbar junction zygapophyseal joints

1990 ◽  
Vol 226 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Kevin P. Singer ◽  
Lynton G. F. Giles ◽  
Robert E. Day
Keyword(s):  
Thoracolumbar Junction ◽  
Zygapophyseal Joints ◽  
Synovial Folds

Microsurgical anatomy and treatment of dural defects in spontaneous spinal cerebrospinal fluid leaks

2020 ◽  
pp. 1-9
Author(s):  
Ako Matsuhashi ◽  
Keisuke Takai ◽  
Makoto Taniguchi
Keyword(s):  
Dura Mater ◽  
Fat Grafting ◽  
Thoracolumbar Junction ◽  
Microsurgical Anatomy ◽  
Dural Defect ◽  
Ct Myelography ◽  
Blood Patch ◽  
Neurosurgical Treatment ◽  
Dural Defects ◽  
Csf Leaks

OBJECTIVESpontaneous spinal CSF leaks are caused by abnormalities of the spinal dura mater. Although most cases are treated conservatively or with an epidural blood patch, some intractable cases require neurosurgical treatment. However, previous reports are limited to a small number of cases. Preoperative detection and localization of spinal dural defects are difficult, and surgical repair of these defects is technically challenging. The authors present the anatomical characteristics of dural defects and surgical techniques in treating spontaneous CSF leaks.METHODSAmong the consecutive patients who were diagnosed with spontaneous CSF leaks at the authors’ institution between 2010 and 2020, those who required neurosurgical treatment were included in the study. All patients’ clinical information, radiological studies, surgical notes, and outcomes were reviewed retrospectively. Outcomes of two different procedures in repairing dural defects were compared.RESULTSAmong 77 patients diagnosed with spontaneous CSF leaks, 21 patients (15 men; mean age 57 years) underwent neurosurgery. Dural defects were detected by FIESTA MRI in 7 patients, by CT myelography in 12, by digital subtraction myelography in 1, and by dynamic CT myelography in 1. The spinal levels of the defects were localized at the cervicothoracic junction in 16 patients (76%) and thoracolumbar junction in 4 (19%). Intraoperative findings revealed that the dural defects were small, circumscribed longitudinal slits located at the ventral aspect of the dura mater. The median dural defect size was 5 × 2 mm. The presence of dural defects at the thoracolumbar junction was associated with manifestation of an altered mental status, which was an unusual manifestation of CSF leaks (p = 0.003). Eight patients were treated via the posterior transdural approach with watertight primary sutures of the ventral defects, and 13 were treated with muscle or fat grafting. Regardless of the two different procedures, postoperative MRI showed either complete disappearance or significant reduction of the extradural CSF collection. No patient experienced postoperative neurological deficits. Clinical symptoms improved or stabilized in 20 patients with a median follow-up of 12 months.CONCLUSIONSDural defects in spontaneous CSF leaks were small, circumscribed longitudinal slits located ventral to the spinal cord at either the cervicothoracic or thoracolumbar junction. Muscle/fat grafting may be an alternative treatment to watertight primary sutures of ventral dural defects with a good outcome.

scholarly journals Definitive single-stage posterior surgical correction of complete traumatic spondyloptosis at the thoracolumbar junction

2015 ◽  
Vol 22 (6) ◽  
pp. 653-657 ◽  
Author(s):  
Lee Sandquist ◽  
Alexander Paris ◽  
Daniel K. Fahim
Keyword(s):  
Motor Vehicle ◽  
Spinal Injury ◽  
Single Stage ◽  
Thoracolumbar Junction ◽  
Surgical Reconstruction ◽  
Rare Occurrence ◽  
Postoperative Therapy ◽  
Hand Control ◽  
Solid Fusion

Complete dislocation at the thoracolumbar junction is a rare occurrence, with only 4 previously reported cases in 3 separate series. Surgical procedures in the reported cases of spondyloptosis at the thoracolumbar junction have been described using instrumentation, reduction, decompression, and stabilization techniques. In this report the authors' patient presented with spondyloptosis at the thoracolumbar junction, resulting in a T-11 American Spinal Injury Association Grade A injury. The authors corrected the patient's thoracolumbar spondyloptosis with surgical reconstruction without the use of leveraged instrumented reduction. They describe a single-stage, posterior-only spinal realignment, reconstruction, and stabilization. Within months of beginning postoperative therapy, the patient enrolled and attended courses at a local college and regained personal independence by learning to drive a motor vehicle with a hand control. Two-year radiographic and clinical follow-up confirms solid fusion across the reconstruction.

scholarly journals Posterior spinal cord herniation: a novel occurrence following surgery for an intramedullary cyst at the thoracolumbar junction

2012 ◽  
Vol 22 (S3) ◽  
pp. 399-403 ◽  
Author(s):  
Rasheed Zakaria ◽  
Jonathan R. Ellenbogen ◽  
Ishvinder S. Grewal ◽  
Neil Buxton
Keyword(s):  
Spinal Cord ◽  
Thoracolumbar Junction ◽  
Spinal Cord Herniation ◽  
Intramedullary Cyst

Ultrasound-Guided Injection of Lumbar Zygapophyseal Joints

2012 ◽  
Vol 37 (2) ◽  
pp. 228-231 ◽  
Author(s):  
Michael Gofeld ◽  
Sandee J. Bristow ◽  
Sheila Chiu
Keyword(s):  
Ultrasound Guided ◽  
Zygapophyseal Joints

Pedicle thinning at the thoracolumbar junction: a normal variant

1980 ◽  
Vol 134 (4) ◽  
pp. 825-826 ◽  
Author(s):  
OP Charlton ◽  
S Martinez ◽  
JA Gehweiler
Keyword(s):  
Normal Variant ◽  
Thoracolumbar Junction

Computed Tomographic Assessment of Sagittal Plane Alignment of the Thoracolumbar Junction in a Young Adult Korean Population

2019 ◽  
Vol 121 ◽  
pp. e351-e357
Author(s):  
Sae Min Kwon ◽  
Hyoung-Joon Chun ◽  
Hyeong-Joong Yi ◽  
Young-Soo Kim ◽  
Kee D. Kim
Keyword(s):  
Young Adult ◽  
Sagittal Plane ◽  
Korean Population ◽  
Thoracolumbar Junction ◽  
Computed Tomographic

Short versus long-segment posterior fixation in the treatment of thoracolumbar junction fractures: a comparison of outcomes

2016 ◽  
Vol 31 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Mueez Waqar ◽  
Dmitri Van-Popta ◽  
Damiano Giuseppe Barone ◽  
Maneesh Bhojak ◽  
Robin Pillay ◽  
...  
Keyword(s):  
Thoracolumbar Junction ◽  
Posterior Fixation
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