MRI in Dural Lesions

A thorough understanding of spinal dural anatomy and pathology is important for surgeons and radiologists alike. The dura plays an important role in the function of the central and peripheral nervous system, and on imaging, it serves as a useful landmark for the classification of spinal lesions. Spinal lesions can be classified on imaging according to whether they arise outside the dura or thecal sac, within the different layers of the dura, or whether they arise within the substance of the spinal cord itself. This allows the surgeon and the radiologist to generate a pertinent differential diagnosis of what the lesion could be, and to formulate a path for treatment or additional diagnostic tests if needed. In this chapter, a discussion of the anatomy and common pathology of the dura is presented, with examples of the more common lesions encountered in a typical spine practice. The lesions are classified according to their location in relation to the dura, as they would be during their workup in clinical practice.