Holsheimer J, den Boer J A, Struijk J J, Rozeboom A R
Institute for Biomedical Technology, University of Twente, Enschede, The Netherlands.
AJNR Am J Neuroradiol. 1994 May;15(5):951-9.
To investigate intradural geometry, which strongly influences the effects of epidural spinal cord stimulation.
Axial MR images with turbo spin-echo were made of 26 healthy subjects at C-4 through C-6, T-5 and T-6, and T-11 and T-12, at T-11 and T-12 both in the supine and the prone position. Measurements were made of the dorsomedial and the ventromedial cerebrospinal fluid layer and the anteroposterior and transverse sizes of both the spinal cord and the dural sac. The samples of all variables were analyzed statistically. The distance between spinal and vertebral midline was also determined.
The dorsal cerebrospinal fluid layer was 1.5 to 4.0 mm at C-4 through C-6 and 4.0 to 8.5 mm at T-5 and T-6. At T-11 it was 2.0 to 6.0 mm in the supine position and was increased by approximately 2.2 mm in the prone position. At T-12 these values were 1.5 to 4.5 mm and approximately 3.4 mm, respectively. Differences between the spinal and vertebral midline up to 1.5 to 2.0 mm occurred in approximately 40% of the images.
Because there are variations of the dorsal cerebrospinal fluid layer among subjects by more than a factor of 2, and significant variations of the mediolateral position of the spinal cord, information on these parameters in patients will be essential for the optimal application of epidural spinal cord stimulation.
研究硬膜内几何结构，其对硬膜外脊髓刺激效果有重大影响。
对26名健康受试者在C-4至C-6、T-5和T-6以及T-11和T-12水平进行轴向快速自旋回波磁共振成像，T-11和T-12水平的成像分别在仰卧位和俯卧位进行。测量背内侧和腹内侧脑脊液层厚度以及脊髓和硬膜囊的前后径与横径。对所有变量样本进行统计学分析。还测定脊髓与椎体中线之间的距离。
C-4至C-6水平的背侧脑脊液层厚度为1.5至4.0毫米，T-5和T-6水平为4.0至8.5毫米。T-11水平在仰卧位时为2.0至6.0毫米，俯卧位时增加约2.2毫米。T-12水平的这些值分别为1.5至4.5毫米和约3.4毫米。约40%的图像中脊髓与椎体中线之间的差异达1.5至2.0毫米。
由于受试者之间背侧脑脊液层厚度变化超过2倍，且脊髓内外侧位置存在显著差异，因此了解患者的这些参数对于硬膜外脊髓刺激的最佳应用至关重要。
