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Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.
The thecal sac or dural sac is the membranous sheath (theca) or tube of dura mater that surrounds the spinal cord and the cauda equina. The thecal sac contains the cerebrospinal fluid which provides nutrients and buoyancy to the spinal cord. [ 1 ]
After the skin area has been numbed, the dye is injected into the thecal sac, then the table is slowly rotated in a circular motion, first down at the head end for approximately 4 to 6 minutes, then rotated up at the head end for the same duration. Several more minutes lying flat and the process is complete.
It is estimated that around 200,000 adults are affected by LSS in the United States and that by the year 2025, this number will rise to 64 million elderly. [34] The syndrome occurs in 12% of older community-dwelling men [40] and up to 21% of those in retirement communities. [37] Spinal stenosis generally affects more men than women.
Dural ectasia is defined as a ballooning or outpouching of the dura with a dural volume greater than two standard deviations above the mean value in controls. [9] It is usually identified by MRI or CT Scan, [7] which can be used to distinguish it from tumors. [16]
The dura mater covering the spinal cord is known as the dural sac or thecal sac, and only has one layer (the meningeal layer) unlike cranial dura mater. The potential space between these two layers is known as the epidural space , [ 5 ] which can accumulate blood in the case of traumatic laceration to the meningeal arteries .
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Stagnation of the CSF within the thecal sac facilitates exudation from the tumour itself and activation of coagulation factors. A clinical test formerly used for evaluation of spinal stenosis is Queckenstedt's maneuver. Nowadays, a magnetic resonance imaging is used for identification of CSF flow obstruction.
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