Spinal cord diameters in cadaveric specimens and magnetic resonance scans, to assess embalming artefacts

Anatomical and Histological Analysis of a Complex Structure Too Long Considered a Simple Ligament: The Filum Terminale

BACKGROUND

The intradural filum terminale (iFT) connects the conus medullaris (CM) with the dural sac (DS), and the extradural filum terminale (eFT) connects the DS to the coccyx. The aim of the present study was to update the description of the FT and integrate these data in a physiological and pathological context.

METHODS

Anatomical measurements and histological investigations were performed on 10 human cadavers.

RESULTS

The mean length of the iFT and eFT was 167.13 and 87.59 mm, respectively. The mean cranial diameter of the iFT was 1.84 mm. It was >2 mm in 2 specimens. The mean half and caudal diameter of the iFT was 0.71 and 0.74 mm, respectively. The cranial diameter of the eFT correlated with the caudal diameter of the eFT (ρ = 0.94; P = 0.02). The level of the CM-iFT junction correlated significantly with the iFT length (ρ = -0.67; P = 0.03). The mobilization of the iFT was not transmitted to the extradural elements and vice versa. The iFT contained axons and ependymal cells, which were dense in the first third and then randomly arranged caudally in islets. This could explain why ependymomas can occur all along the iFT. Ganglion cells were abundant around the junction with the DS. The eFT contained smooth muscle cells, adipocytes, and axons. A mechanoreceptor was identified in 1 specimen.

CONCLUSIONS

Consistently with their common embryological origin, a real anatomical and histological continuum is present between the CM and FT. The FT should, therefore, no longer be considered a simple ligament but, rather, a complex fibrocellular structure.

Anatomy of the spinal dorsal root entry zone: its clinical significance

BACKGROUND

The posterolateral sulcus (PLS) is an important surgical landmark, especially for DREZ (dorsal root entry zone) operations.

METHODS

The present study aimed to show the variations of the PLS using human spinal cord histological sections and report the variability in the number of dorsal rootlets of the spinal nerves in each the spinal cord segment. Further, measure the height and width of the dorsal horn on histological sections for cervical, thoracic, and lumbar levels.

RESULTS

The results of the present study showed various patterns of PLS 1.clearly present PLS, 2. short PLS, 3. absent PLS or 4. irregular PLS. Height and width measurements of the dorsal horn showed that the average width was greatest at lower cervical (0.48 ± 0.04 mm) and least at lower thoracic levels (0.41 ± 0.04 mm), whereas the average height was greatest at upper cervical (3.0 ± 0.06 mm) and smallest at lower lumbar levels (1.8 ± 0.08 mm). The average number of rootlets varied considerably, at cervical level it was 7.6 ± 1.4 mm, at thoracic 6.6 ± 0.8 mm and at lumbar 6.1 ± 0.4 mm.

CONCLUSIONS

The detailed anatomy of the variations of the PLS and the average number of rootlets at each spinal level can increase the success of regional surgery. Further, fine measurements on histological sections can give detailed knowledge on the size necessary for lesioning in DREZ operations.

The segmental morphometric properties of the horse cervical spinal cord: a study of cadaver

Although the cervical spinal cord (CSC) of the horse has particular importance in diseases of CNS, there is very little information about its segmental morphometry. The objective of the present study was to determine the morphometric features of the CSC segments in the horse and possible relationships among the morphometric features. The segmented CSC from five mature animals was used. Length, weight, diameter, and volume measurements of the segments were performed macroscopically. Lengths and diameters of segments were measured histologically, and area and volume measurements were performed using stereological methods. The length, weight, and volume of the CSC were 61.6±3.2 cm, 107.2±10.4 g, and 95.5±8.3 cm3, respectively. The length of the segments was increased from C1 to C3, while it decreased from C3 to C8. The gross section (GS), white matter (WM), grey matter (GM), dorsal horn (DH), and ventral horn (VH) had the largest cross-section areas at C8. The highest volume was found for the total segment and WM at C4, GM, DH, and VH at C7, and the central canal (CC) at C3. The data obtained not only contribute to the knowledge of the normal anatomy of the CSC but may also provide reference data for veterinary pathologists and clinicians.

Level of termination of the spinal cord and the dural sac: a magnetic resonance study

Previous studies concerning the level of termination of the human spinal cord have been carried out in unselected cadavers. We have used magnetic resonance imaging to determine this level of termination, and that of the dural sac, in normal living subjects. We found a wider range of the level of termination of both the spinal cord and dural sac and a higher median level of termination of each than is commonly described. These anatomical findings are of clinical relevance to clinicians practicing regional anesthesia.