An overview of the tumors affecting the spine—inside to out
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Abstract:
Spine tumors may arise within or surrounding the spinal cord and/or vertebral column. Spinal tumors can be benign or malignant. Based on their epicenter, they may be classified as intradural-intramedullary, intradural-extramedullary, or extradural. Of these, extradural lesions are the most common, and are typically metastatic. Primary bone tumors of the spinal column comprise 5% of all primary skeletal tumors. The majority of primary spinal column tumors are benign, with malignant tumors comprising only 20%. Overall, spine metastases are the most common malignant spine tumor, and these usually arise from primaries such as lung, breast, and prostate cancers. The advent of improved systemic therapies leading to improved survival and the frequent use of imaging has positioned metastatic spine disease as the new epidemic in oncology. For spine tumors, establishing the correct diagnosis is heavily reliant on magnetic resonance imaging and histological confirmation. In this review, we will provide an overview of the epidemiology, radiological and histopathological features, and the natural history of key primary (benign and malignant) spinal cord and column tumors and metastatic spine tumors. Treatment principles for primary spinal cord or column tumors are aimed toward curative resection, whereas palliative resection forms the treatment principle for most metastatic tumors.Keywords:
Spinal column
Vertebral column
Primary tumor
Vertebral column
Spinal column
Neuroradiology
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Vertebral column
Spinal column
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Abstract The vertebral body, neural arch and its processes develop from the sclerotome of the primitive mesodermal segments. After chondrification, separate ossification centres appear for the body and one for each of the neural arches. Vertebrae are composed of a body and a vertebral arch. The vertebral foramina, which consist of the vertebral arch and back of vertebral body, form the vertebral canal including and protecting the spinal cord. The vertebral arches are formed by two pedicles and two laminae which unite as a spinous process. Relation between the vertebrae and spinal cord during pregnancy is interesting. In embryonal period, the CNS develops earlier than other part of embryonal structures and occupies approximately one third of the whole embryonal body. At the 3rd month of development the length of the spinal cord equals that of the vertebral column. The spinal nerves and the relationship of the spinal nerves to the vertebra are established. Therefore the spinal cord segment is at the same level as the corresponding vertebral level. In subsequent fetal period, however, fetal body structure including vertebral column develops faster than the neural tube. As the consequence of this different development of the column and nerves, caudal end of the spinal cord within the vertebral column relatively moves upward with advancing gestation and reaches to the level of the third lumber vertebra at birth.
Vertebral column
Vertebra
Spinal column
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The vertebra column is a complex series of bones designed to protect the spinal cord; to allow movement and transmit propulsive forces; and provide support for the rest of the skeleton. As a consequence of these functions, it is very liable to injury and to degenerative changes, with diseases of the spinal column being far more common than diseases of the spinal cord. Despite the focus of this article being on diseases resulting in an emergency spinal presentation, it is worth remembering that any chronic compressive spinal cord disease can present acutely due to ongoing vascular and contusive injuries to the spinal cord. This article will focus only on the common diseases requiring emergency management.
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Spinal column
Presentation (obstetrics)
Spinal cord compression
Vertebra
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Vertebral column
Meninges
Spinal column
Vertebra
Thoracic vertebrae
Intervertebral foramen
Posterior column
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The spinal level includes the vertebral column and its contents. The spinal canal within the vertebral column is the passage formed by the vertebrae. It extends from the foramen magnum of the skull through the sacrum of the spinal column and contains the spinal cord, nerve roots, spinal nerves, meninges, and vascular supply of the spinal cord. Five of the major systems are represented in the spinal canal: the sensory, motor, autonomic, vascular, and cerebrospinal fluid systems. The vascular and cerebrospinal fluid structures are the support systems of the spinal cord. Diseases of the spinal canal involve 1 or more of these systems and produce patterns of disease distinctive to this level. The anatomical and physiologic characteristics of the spinal cord and spinal nerves that permit the identification and localization of diseases in the spinal canal are presented in this chapter.
Foramen magnum
Vertebral column
Spinal column
Meninges
Foramen
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Roughly 2,000 U.S. children experience spinal column injuries annually. However, thousands more present to emergency departments with mechanisms of injury that could injure their spine. When children can follow commands and understand questions, performing a careful and accurate spine assessment may eliminate the need for unnecessary spine immobilization. When a spine injury is suspected, proper pediatric immobilization requires careful control of the spine's weight centers and proper padding to ensure the spine remains in a neutral position.
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Spinal injury
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Thoracic spinal cord transections were performed in adult rats. The animals were divided into two groups, with or without internal fixation of the involved vertebral column. Histologic and immunohistochemical studies were performed to compare the effect of internal fixation of the vertebral column.To find out the aspects and extent of beneficial effects of vertebral column fixation for spinal cord repair.Vertebral column fixation is a routine procedure in clinical spinal cord surgery. Paradoxically, most, if not all, animal spinal cord experiments seem to have ignored the importance of vertebral column fixation. During trunk movements, the vertebral column flexes to different directions, accompanied by bending of the spinal cord. Following spinal cord lesions, with frequent bending of the cord there will be repeated bleeding, inflammation, and other pathologic processes at the lesion site. Thus, the healing process will be hampered. The severity of the damages that will be brought about by bending of the cord is, to a certain degree, unpredictable. There will be rather big individual variations in injury and repair among the same type of experiments, rendering quantification and conclusion difficult.Adult Sprague-Dawley rats were used. The thoracic spinal cord was transected. Strong stainless steel wires were used for internal fixation of the vertebral column. The histology of the horizontal sections of the spinal cord segment, which included the lesion site, was examined at the 14th postoperative day. The volumes of the secondary degeneration and meningeal scar, the gap between the borders of the proximal and distal stumps of the transected spinal cord, the thickness of the meningeal scar, the astrocytic reaction, and the abundance of regenerating nerve fibers at the lesion site were compared between the vertebral column fixed and nonfixed groups. Whenever possible, the results were evaluated quantitatively.In all these aspects, the internally fixed group was consistently far better than the unfixed group. The quantitative analyses were as follows (fixed/unfixed): 1)volume of secondary degeneration: 1.07 +/- 0.20/1.81 +/- 0.43 mm3 (P < 0.01); 2) volume of meningeal scar: 2.38 +/- 0.55/4.34 +/- 1.40 mm3 (P < 0.05); 3) distance between cord stumps: 1.38 +/- 0.34/2.35 +/- 0.79 mm (P < 0.05); 4) the mean thinnest dimension of the meningeal scar: 0.90 +/- 0.43/1.98 +/- 0.85 mm (P < 0.05).Vertebral column fixation is a crucial procedure for spinal cord animal experiments.
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Posterior column
Spinal column
Thoracic vertebrae
Vertebra
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Abstract The rate of growth of the various regions of the spinal cord and the vertebral column of the albino mouse aged, 1, 10, 20, 30 and 120 days was studied. It was found that: There is more rapid growth in the length of the vertebral column than that of the spinal cord. The lower regions of the vertebral column grow more rapidly than the upper regions but the reverse was found in the spinal cord resulting in regression of the spinal cord. The cord ends at one day opposite the fifth sacral vertebra and then receded to the fifth lumbar vertebra till 120 days. The white matter has a more rapid rate of growth in volume than the gray matter. So the process of myelination and the growth of the fibers in diameter exceed the rate of growth of the neurons and their dendrites. The packing density of the neurons is nearly the same in all regions of the cord with the exception of the cervical region which showed less packing density due to more branching of their dendrites. The total number of neurons at each region is fixed from birth till maturity. The thoracic region contains the highest number of neurons followed by the cervical then the lumbar and the least number is in the sacral region.
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Regional growth of spinal cord and vertebral column during the prenatal development of goat was studied using 52 foetuses of various ages. The maximum and minimum regional spinal cord length was measured in the thoracic and coccygeal regions, respectively. A highly significant positive correlation was observed between total cord length and length of different cord regions except coccygeal region. Regional length of the vertebral column was dependant on the regional length of the spinal cord except at the coccygeal region and changed accordingly. The thoracic region of spinal cord exhibited an increased growth rate over that of vertebral column during second and third month. Cervical and lumbar spinal cord regions showed isometric growth rate with corresponding vertebral column regions during all stages. The sacral region also was isometric upto fourth month, which declined in the fifth month.
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Spinal column
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