Spine

the column of vertebrae making up the backbone in vertebrates. In humans, the spine is often divided into different regions (cervical, thoracic and lumbar levels, sacrum and coccyx). Also, see cervical spine, thoracic spine, lumbar spine and sacrum.

2. Pathology

Although innumerable diseases may involve the entire spine, many disorders may show predilection for only one or two specific regions.

A variety of congenital anomalies and abnormal curvatures may affect the spine. Accurate diagnosis of these alterations relies in part on imaging examinations, including routine radiography, conventional tomography, CT scanning, ultrasonography, myelography and MR imaging. Among the congenital anomalies are those affecting the vertebral body, vertebral arch and craniovertebral junction. Sacral agenesis, spinal dysraphism, abnormalities of curvature (scoliosis, lordosis, kyphosis) and stenosis of the spinal canal are additional disorders involving the spine.

In some pathologic conditions, especially degenerative diseases, bony outgrowths may develop on the spine; examples include syndesmophytes in ankylosing spondylitis, osteophytes in spondylosis deformans, flowing anterior ossification in diffuse idiopathic skeletal hyperostosis DISH , and paravertebral ossification in Reiters syndrome and psoriatic spondylitis.

Trauma to the spine may lead to fractures and fracture dislocations, especially in the lower cervical and thoracolumbar regions. Examples of such fractures include compression fracture, burst fracture and seat belt injury.

Infections in the spine may be spread haematogenously, from a contiguous source, intra- or postoperatively, or by direct implantation. A special type of infection involving the intervertebral disc (discitis) may sometimes occur.

The rugger jersey spine is a finding that is relatively specific for secondary hyperparathyroidism. In this disorder, band-like sclerosis of the superior and inferior margins of the vertebral bodies is evident.

Numerous abnormalities of the spine occur in ankylosing spondylitis, including osteitis, shiny corner sign, squaring, syndesmophytes, bamboo spine, discitis, discal ballooning, trolley track sign and dagger sign.

The vacuum phenomenon represents a radiographic appearance involving the spine in which linear or circular radiolucent collections appear within the intervertebral discs. Vacuum phenomena are a reliable indicator of disc degeneration and are very r wires are available currently.

The failed back surgery syndrome is caused by a spectrum of disorders characterized by intractable postoperative pain and varying degrees of functional incapacitation. The most common causes of this syndrome are recurrent or persistent disc herniation, inadequate decompression of spinal stenosis, arachnoiditis and epidural fibrosis. Less common causes include facet instability, pseudarthrosis, nerve injury and surgery at the wrong level. Both CT and MR imaging have been used widely for evaluation of these patients. Pseudarthrosis (nonunion of spinal grafts) is one of the major causes of failed spinal surgery. Postoperative spinal infection is also a very serious complication of any form of spinal surgery.

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