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The lumbar cistern is part of the subarachnoid space.It is the space within the thecal sac which extends from below the end of the spinal cord (the conus medularis), typically at the level of the first to second lumbar vertebrae down to tapering of the dura at the level of the second sacral vertebra.
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]
It can be classified by the part of the spine affected into cervical, thoracic, and lumbar stenosis. [2] Lumbar stenosis is the most common, followed by cervical stenosis. [2] Diagnosis is generally based on symptoms and medical imaging. [4] Treatment may involve medications, bracing, or surgery. [6]
Cervical canal stenosis may lead to serious symptoms such as major body weakness and paralysis. 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. [3]
This process is called spondylosis, and is part of the normal aging of the spine. This has been seen in studies of normal and diseased spines. Degenerative changes begin to occur without symptoms as early as age 25–30 years. Not uncommonly, people experience at least one severe case of low back pain by the age of 35.
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 .
Histologic examination reveals the Tarlov-cyst outer wall is composed of vascular connective tissue, and the inner wall is lined with flattened arachnoid tissue. In addition, part of the lining containing nerve fibers also occasionally contains ganglion cells. [7]
The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. Surgical treatment that includes a laminectomy is the most effective remedy for severe spinal stenosis; however, most cases of spinal stenosis are not severe enough to require surgery.