Porter R W
Eur Spine J. 2001 Feb;10(1):2-9. doi: 10.1007/s005860000188.
Some patients with scoliosis have a relatively short vertebral canal. This poses the question of whether a short spinal cord may sometimes cause scoliosis. The present paper presents two observations that may support this concept. It presents a scoliosis model demonstrating what effect a short, unforgiving spinal cord might have on the spinal column. The model uses two flexible parallel tubes with the facility to tighten one. It demonstrates that a short, unforgiving spinal cord could produce the abnormal rotatory anatomy observed at the apex in scoliosis, with first lordosis, then lateral deviation and finally a rotation of the vertebral column, with the rotation occurring between the canal and the vertebral body, around the axis of the cord. The anatomy of the apical vertebra is described from two museum specimens, a computed tomography (CT) myelogram and seven magnetic resonance imaging (MRI) studies. The study confirms that the vertebral canal and the intervertebral foraminae retain their original orientation. The spinal cord is eccentric in the canal towards the concavity of the curve; the major component of rotation occurs anterior to the vertebral canal and the axis of this rotation seems to be at the site of the spinal cord. These observations do not establish that a short spinal cord will result in scoliosis, but the results are compatible with this hypothesis, and that impairment of spinal cord growth factors may sometimes be responsible for scoliosis.
一些脊柱侧凸患者的椎管相对较短。这就提出了一个问题，即脊髓较短是否有时会导致脊柱侧凸。本文提出了两项可能支持这一概念的观察结果。它展示了一个脊柱侧凸模型，演示了较短且缺乏弹性的脊髓可能对脊柱产生的影响。该模型使用两根可弯曲的平行管，并具备收紧其中一根的功能。它表明，较短且缺乏弹性的脊髓可产生在脊柱侧凸顶点观察到的异常旋转解剖结构，先是脊柱前凸，然后是侧偏，最后是脊柱的旋转，这种旋转发生在椎管与椎体之间，围绕脊髓轴进行。从两个博物馆标本、一份计算机断层扫描（CT）脊髓造影和七份磁共振成像（MRI）研究中描述了顶椎的解剖结构。该研究证实椎管和椎间孔保持其原始方向。脊髓在椎管内朝着曲线凹侧偏心；旋转的主要部分发生在椎管前方，且这种旋转的轴似乎位于脊髓部位。这些观察结果并未确定脊髓较短会导致脊柱侧凸，但结果与这一假设相符，并且脊髓生长因子的损伤有时可能是脊柱侧凸的原因。
