Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography
Objective Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological pattern...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2018-12-01
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| Series: | Neurospine |
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| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-1836112-056.pdf |
| _version_ | 1797331317085437952 |
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| author | Yuki Oichi Junya Hanakita Toshiyuki Takahashi Manabu Minami Taigo Kawaoka Yusuke Funakoshi Takeshi Kawauchi Yasufumi Ohtake |
| author_facet | Yuki Oichi Junya Hanakita Toshiyuki Takahashi Manabu Minami Taigo Kawaoka Yusuke Funakoshi Takeshi Kawauchi Yasufumi Ohtake |
| author_sort | Yuki Oichi |
| collection | DOAJ |
| description | Objective Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation. |
| first_indexed | 2024-03-08T07:32:44Z |
| format | Article |
| id | doaj.art-fdf0bffb05384257845775cbc257a34f |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:32:44Z |
| publishDate | 2018-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-fdf0bffb05384257845775cbc257a34f2024-02-02T20:01:28ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912018-12-0115438839310.14245/ns.1836112.056813Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After MyelographyYuki Oichi0Junya Hanakita1Toshiyuki Takahashi2Manabu Minami3Taigo Kawaoka4Yusuke Funakoshi5Takeshi Kawauchi6Yasufumi Ohtake7 Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, Japan Department of Neurosurgery, Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fukui, JapanObjective Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.http://www.e-neurospine.org/upload/pdf/ns-1836112-056.pdfComputed tomographyMyelographyAnterior median fissureSpinal cordCervical spondylosis |
| spellingShingle | Yuki Oichi Junya Hanakita Toshiyuki Takahashi Manabu Minami Taigo Kawaoka Yusuke Funakoshi Takeshi Kawauchi Yasufumi Ohtake Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography Neurospine Computed tomography Myelography Anterior median fissure Spinal cord Cervical spondylosis |
| title | Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography |
| title_full | Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography |
| title_fullStr | Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography |
| title_full_unstemmed | Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography |
| title_short | Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography |
| title_sort | morphological patterns of the anterior median fissure in the cervical spinal cord evaluated by computed tomography after myelography |
| topic | Computed tomography Myelography Anterior median fissure Spinal cord Cervical spondylosis |
| url | http://www.e-neurospine.org/upload/pdf/ns-1836112-056.pdf |
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