Compression fractures of vertebral bodies affect approximately 750,000 people each year in the United States and up to 25% of postmenopausal women. The leading cause of vertebral compression fractures is osteoporosis, a disease that affects 44 million Americans. Younger patients…
First described more than 40 years ago, intraoperative neurophysiologic monitoring (IONM) is now used routinely in many surgical procedures that carry risk to the brain, spinal cord, and peripheral nervous system. These include closure of intracranial aneurysms and arteriovenous malformations;…
The spine and the peripheral nervous system remain diagnostically challenging to image owing to the extensive bony canal, relatively small size of the neural elements, and multiplicity of clinical symptoms. A wide variety of techniques are available for imaging the…
Noninfectious inflammatory spinal cord lesions include multiple sclerosis (MS), acute transverse myelitis (ATM), neuromyelitis optica (NMO), neurosarcoidosis, and Guillain-Barré syndrome (GBS). Except for MS, these entities are rare. The disease etiologies are incompletely understood but seem to involve immune system…
Noninfective inflammations of the vertebral spine can be caused by seronegative spondyloarthropathies or by seropositive rheumatoid arthritis. The seronegative spondyloarthropathies include ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel diseases, and undifferentiated arthritis. ANYLOSING SPONDYLITIS Epidemiology Ankylosing…
SPINAL MENINGITIS Spinal meningitis is infection of the spinal cord, leptomeninges, and subarachnoid space by various pathogens. It is also called infectious arachnoiditis. Epidemiology The incidence of bacterial meningitis is 2 to 3 per 100,000. It occurs most commonly in…
Spinal infection frequently injures the vertebral bodies, intervertebral discs, paraspinal soft tissues, epidural space, meninges, and spinal cord. Clinically, it is notoriously difficult to differentiate spinal infection from degenerative processes, noninfective inflammatory disorders, and spinal neoplasms. Spinal infections are a…
Metabolic disorders of the spinal cord are less common than metabolic disorders of the brain and peripheral nerves. Such metabolic myelopathies can be secondary to nutritional deficiencies, especially vitamin B 12 deficiency, or to systemic metabolic disorders. VITAMIN B 12…
The skeletal manifestations of metabolic disease are a heterogeneous group of conditions resulting from endocrinopathy, vitamin deficiency, renal tubular dysfunction, and disorders of endogenous metabolism. As a group, they are characterized by altered function of the osteoblasts and osteoclasts or…
Spinal tumors comprise a large spectrum of distinct histologic entities that may arise primarily from the spinal cord (intra-axial or intramedullary space), the surrounding leptomeninges (intradural extramedullary space), or the extradural soft tissues and bony structures (extradural space). All three…