Table Of ContentI
Contents
MEDICAL RADIOLOGY
Diagnostic Imaging
Editors:
A. L. Baert, Leuven
M. Knauth, Göttingen
K. Sartor, Heidelberg
III
Contents
J. W. M. Van Goethem · L. van den Hauwe
P. M. Parizel (Eds.)
Spinal
Imaging
Diagnostic Imaging
of the Spine and Spinal Cord
With Contributions by
P. R. Algra · C. Andreula · D. Balériaux · S. M. Belkoff · R. G. Bhatia · B. C. Bowen
O. Boyunaga · A. Cama · S. Capoccia · R. Cartolari · A. Y. Choi · M. Colajacomo
C. Cristaudo · P. Demaerel · A. M. De Schepper · M. Gallucci · C. Gandolfo · N. Gültas¸li
R. Gunzburg · S. H. M. Kahn · D. S. Katz · P. E. Kim · B. Koes · J. Kråkenes
S. J. Lypen · M. Maes · C. Manelfe · L. Manfré · M. Murrone · A. O. Ortiz · Ö. Özsarlak
P. M. Parizel · A. Rossi · R. Salgado · M. Szpalski · E. T. Tali · M. M. Thurnher
P. Tortori-Donati · G. Trasimeni · A. Van Campenhout · E. van de Kelft
L. van den Hauwe · J. W. M. Van Goethem · F. M. Vanhoenacker · M. van Tulder
M. Voormolen · C. S. Zee
Foreword by
A. L. Baert
With 477 Figures in 1218 Separate Illustrations, 36 in Color and 67 Tables
123
IV
Contents
Johan W. M. Van Goethem,
MD, PhD
Department of Radiology, University Hospital Antwerpen
Wilrijkstraat, 10
2650 Edegem, Belgium
and
Department of Radiology, Algemeen Ziekenhuis Nikolaas
Moerlandstraat 1
9100 Sint-Niklaas, Belgium
Luc van den Hauwe,
MD
Department of Radiology, University Hospital Antwerpen
Wilrijkstraat 10
2650 Edegem, Belgium
and
Department of Radiology, AZ KLINA
Augustijnslei 100
2930 Brasschaat, Belgium
Paul M. Parizel,
MD, PhD
Department of Radiology, University Hospital Antwerpen
Wilrijkstraat 10
2650 Edegem, Belgium
Medical Radiology · Diagnostic Imaging and Radiation Oncology
Series Editors:
A. L. Baert · L. W. Brady · H.-P. Heilmann · M. Knauth · M. Molls · C. Nieder · K. Sartor
Continuation of Handbuch der medizinischen Radiologie
Encyclopedia of Medical Radiology
Library of Congress Control Number: 2005929008
ISBN 978-3-540-21344-4 Springer Berlin Heidelberg New York
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V
Contents
Foreword
Medical imaging of the spine is among the most frequently performed diagnostic stud-
ies due to the high incidence of the very common clinical problem of acute or chronic
back pain.
Radiologists have a whole range of diagnostic modalities at their disposal to study
spine pathology. It is of the utmost importance that they be familiar with the advantages
and disadvantages of these different diagnostic techniques and are able to apply, in each
clinical situation, the method that is most likely to optimally solve the clinical problem
and indicate its correct management.
Many authors, all well known specialists in their fi eld, have contributed to this book
which offers a very complete update of our current insights into and knowledge of
common and less common disorders of the spine and the spinal cord.
The illustrations are numerous, highly informative and of impeccable technical
quality.
I am very much indebted to the editors, J.W.M. Van Goethem, L. van den Hauwe and
P.M. Parizel, for this superb volume which very much enriches the Medical Radiology
series. It will be of great interest to radiologists in training, certifi ed radiologists, as well
as to neurosurgeons, neurologists and rheumatologists.
Leuven Albert L. Baert
VII
Contents
Preface
Diseases of the spine are very common. They affect up to 80% of the population world-
wide and may cause pain, disability and economic loss. Pain or discomfort originating
in the spine is usually a self-limiting condition. In more than 50% of patients, symp-
toms usually resolve spontaneously within 4–8 weeks, but there is a very high recurrence
rate, estimated at about 85%. Back pain ranks seventh among the top costliest health
conditions and is only preceded by heart disease, diabetes, hypertension, stroke-related
conditions, osteoarthritis and pneumonia. Spinal imaging is one of the most common
radiology procedures in general and is also the most performed MR imaging examina-
tion in many countries.
Although the indication for spinal imaging in specifi c spinal problems, such as
trauma, is evident, the role of imaging in the diagnosis of neck and low back pain often
remains controversial. Many so-called radiographic abnormalities seen on CT and MRI
are commonly also encountered in asymptomatic individuals, a phenomenon carefully
explained in this book.
This book aims to provide an overview of diagnostic spinal imaging. It is a compre-
hensive textbook with many illustrations and tables, yet easy to use with logical chap-
ter-by-chapter coverage of different spinal pathologies. Extensive coverage of common
spinal conditions, such as the degenerative diseases, spinal trauma, spinal surgery and
imaging of the postoperative spine, spinal tumors, as well as spinal infection and infl am-
mation, make this a very helpful book for everyday use in any practice involved with
spinal imaging.
I would like to take the opportunity to thank everybody who made this project
p ossible.
In the Name of Friendship
My thanks go fi rst of all to my co-editors, Paul Parizel and Luc van den Hauwe, without
whom this book would not have existed. Luc was the originator, pointing out the fact that
a volume on spinal imaging was missing in the Diagnostic Imaging series. Additionally, I
have to thank Prof. Albert Baert for believing in our ability and giving us the opportunity
to write this book.
I also wish to thank the more than 40 contributors for their tremendous efforts in
making this book possible; I know most of them personally and am very grateful to have
been able to collaborate on this project with real friends. Finally, I have to thank Paul and
Luc for their remarkable efforts in realizing this book together with me – it would not
have been possible without them.
VIII
Preface
In the Name of Love and Family
This book could not have been completed without the continuing support of
my wife, Isabelle, who, as a radiologist herself, not only understood my endea-
vours to complete this work, but who was also my most loyal supporter. As the
mother of our three daughters, Alexia, Olivia and Félicia, she is also the corner-
stone of our wonderful family and I wish to dedicate this book to these four
women in my life.
Edegem Johan W. M. Van Goethem
This book is dedicated fi rst and foremost to the ones I love: Marleen, my wife,
and our children Vincent, Isabel, Liesa and Marie. Our children, they are the
future.
My thanks go to Paul and Johan, not only for teaching me neuroradiology, but
primarily for their friendship. We have been working together for many years
now in the spirit of the three musketeers (Les Trois Mousquetaires, a novel by
Alexandre Dumas), inseparable men who chant the motto “One for all, and all
for one”.
Edegem Luc van den Hauwe
I dedicate this book to:
• My wife, Vera, and to my son, Maxim, who mean everything to me
• My neuroradiology teachers in Antwerp, Boston, Brussels and Philadelphia,
who programmed my brain with their wisdom and enthusiasm
• My friends and colleagues, Johan Van Goethem and Luc van den Hauwe,
from whom I still learn everyday
• The happy coincidence which brought us all together: “in infi nito vacuo,
ex fortuita atomorum collisione”
Edegem Paul M. Parizel
IX
Contents
Contents
Congenital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1 Congenital Malformations of the Spine, Spinal Cord, and Cranio-Cervical Junction
Andrea Rossi, Carlo Gandolfo, Armando Cama, and Paolo Tortori-Donati 3
Pediatric Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
2 The Spine and Spinal Cord in Children
Turgut Tali and Oznur Boyunaga . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Biomechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
3 Biomechanics of the Spine
Stephen M. Belkoff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
4 Scoliosis
Johan W. M.Van Goethem and Anja Van Campenhout . . . . . . . . . . . . . . . 95
Degenerative Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
5 Evidence-Based Medicine for Low Back Pain
Maurits van Tulder and Bart Koes . . . . . . . . . . . . . . . . . . . . . . . . . . 111
6 Degenerative Disc Disease
Paul M. Parizel, Johan W. M. Van Goethem, Luc van den Hauwe,
and Mauritis Voormolen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
7 Pathology of the Posterior Elements
Luc van den Hauwe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
8 Spinal Stenosis
Massimo Gallucci, Siliva Capoccia, and Mauro Colajacomo . . . . . . . . . . 185
9 Spinal Instability – Axial Loaded Imaging of the Spine
Luigi Manfré, Roberto Cartolari, Guido Trasimeni, and
Concetto Cristaudo. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
10 Osteoporosis – Insuffi ciency Fractures
Menno Maes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
X
Contents
Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
11 Whiplash Injuries
Jostein Kråkenes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
12 Cervical Trauma
Özkan Özsarlak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
13 Thoracolumbar Spine Trauma
Rita G. Bhatia and Brian C. Bowen. . . . . . . . . . . . . . . . . . . . . . . . . . . 325
The Postoperative Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
14 Surgical Procedures: Discectomy and Herniectomy
Erik Van de Kelft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
15 Imaging of the Postoperative Spine: Discectomy and Herniectomy
Johan W. M. Van Goethem and Rodrigo Salgado . . . . . . . . . . . . . . . . . . 371
16 Surgical Procedures: Cages, Prostheses, and Instrumentation
Robert Gunzburg and Marek Szpalski . . . . . . . . . . . . . . . . . . . . . . . . 391
17 Imaging of the Postoperative Spine: Cages, Prostheses and Instrumentation
Paul E. Kim and Chi Shing Zee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
18 Intradural Spinal Tumors
Danielle Balériaux and Neslìhan Gültas¸li. . . . . . . . . . . . . . . . . . . . . 417
19 Metastatic Disease of the Spine
Cosma Andreula, Mario Murrone, and Paul R. Algra. . . . . . . . . . . . . . . 461
20 Primary Tumors of the Osseous Spine
S. H. M. Kahn and Arthur M. De Schepper. . . . . . . . . . . . . . . . . . . . . . . 475
Bone Marrow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501
21 Spinal Bone Marrow Disorders
Philippe Demaerel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503
Infection and Infl ammation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519
22 Spinal Infections
Majda M. Thurnher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521
23 Seronegative Spondylarthropathy
Claude Manelfe and Filip M. Vanhoenacker . . . . . . . . . . . . . . . . . . . . 543
Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565
24 Imaging of the Sacrum
Andrew Y. Choi, A. Orlando Ortiz, Douglas S. Katz, and Steven J. Lypen. . . 567
Subject Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 589
List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 599
1
Congenital Malformations of the Spine, Spinal Cord, and Cranio-Cervical Junction
Congenital
