1.3;Preface;4 1.4;Acknowledgements;6 1.5;Contents;7 1.6;Chapter 1;9 1.6.1;The Nature of Radicular Pain and Related Conditions;9 1.6.1.1;1.1 Introduction;9 1.6.1.2;1.2 Radicular Pain: Nomenclature and Pathogenesis;9 1.6.1.3;1.3 Neurogenic Claudication;12 1.6.1.4;1.4 Cauda Equina Syndrome;13 1.6.1.5;1.5 Conclusion;14 1.6.1.6;References;14 1.7;Chapter 2;16 1.7.1;Imaging Techniques for the Lumbar Spine: Conventional Radiology, Computed Tomography; Magnetic Resonance Imaging;16 1.7.1.1;2.1 Introduction;16 1.7.1.2;2.2 Conventional X-ray Studies;16 1.7.1.2.1;2.2.1 Contrast Studies:;17 1.7.1.3;2.3 X-Ray Computed Tomography;19 1.7.1.3.1;2.3.1 CT Myelography;21 1.7.1.4;2.4 Magnetic Resonance Imaging (MRI);22 1.7.1.4.1;2.4.1 T1-Weighted (T1-W) Images;25 1.7.1.4.2;2.4.2 T2-Weighted (T2-W) and T2*-Weighted (T2*-W) Images;25 1.7.1.4.3;2.4.3 Proton Density-Weighted (PD-W) Images;28 1.7.1.4.4;2.4.4 Fat-Suppressed Images;28 1.7.1.4.5;2.4.5 MR Myelography:;28 1.7.1.4.6;2.4.6 Imaging Planes;34 1.7.1.4.7;2.4.7 Upright Imaging;35 1.7.1.4.8;2.4.8 Considerations of Field Strength;35 1.7.1.4.9;2.4.9 Abbreviated Scanning Protocols;35 1.7.1.4.10;References;36 1.8;Chapter 3;38 1.8.1;Normal Anatomy;38 1.8.1.1;3.1 Topographic Anatomy;38 1.8.1.2;3.2 Sectional Anatomy;49 1.8.1.2.1;3.2.1 Transverse Sectional Anatomy;49 1.8.1.2.2;3.2.2 Sagittal and Coronal Sectional Anatomy;54 1.8.1.3;3.3 Functional Anatomy;55 1.8.1.4;References;63 1.9;Chapter 4;65 1.9.1;Pathologic Anatomy and Mechanisms of Nerve Root Compression;65 1.9.1.1;4.1 Herniated Disc;65 1.9.1.1.1;4.1.1 Why Are Disc Herniations Diagnosed So Rarely in the Upper Lumbar Region?;85 1.9.1.1.2;4.1.2 Other Focal Mass Conditions Causing Intraspinal Compression of Nerve Roots;93 1.9.1.1.2.1;4.1.2.1 Tumours;93 1.9.1.1.2.2;4.1.2.2 Synovial (Juxta-Articular) Cysts;93 1.9.1.1.2.3;4.1.2.3 Hypertrophic Callus Formation in Spondylolysis;93 1.9.1.2;4.2 Narrowing of Spinal Canal; General or Regional;93 1.9.1.2.1;4.2.1 Why Is Narrowing of the Spinal Canal Seen So Rarely at L5-S1?;99 1.9.1.2.2;4.2.2 Factors Further Contributing to Reduction of Space in the Spinal Canal;99 1.9.1.3;4.3 Regional Spinal Narrowing;101 1.9.1.4;Appendix : Morphometrics of Lumbar Intraspinal Structures, A Literature Review;116 1.9.1.5;Measurements in Normals and Patients, Static;116 1.9.1.6;Measurements in Normals and Patients, Dynamic;116 1.9.1.7;Imaging Features of Compression of Individual Nerve Roots and Cauda Equina;117 1.9.1.8;References;117 1.10;Chapter 5;120 1.10.1;Spinal Imaging in Relation to Surgical Therapy: Pre- and Post-Operative;120 1.10.1.1;5.1 Introduction;120 1.10.1.2;5.2 Pre-Operative Imaging;120 1.10.1.2.1;5.2.1 Is the Lesion Responsible for the Presenting Symptoms?;120 1.10.1.2.1.1;5.2.1.1 Radiologic Features of a Disc Lesion Related to Clinical Significance: Shape and Size;121 1.10.1.2.1.2;5.2.1.2 Assessment of Relative Size of the Herniation with Respect to Dimensions of the Canal;122 1.10.1.2.1.3;5.2.1.3 Imaging of Nerve Root Compression: MR Myelography;124 1.10.1.2.1.4;5.2.1.4 Intravenous Contrast Studies of Nerve Root Enhancement;128 1.10.1.2.1.5;5.2.1.5 Conclusion;128 1.10.1.2.2;5.2.2 Is the Condition Likely to Follow a Favourable Early Natural Course, or Is Conservative Management Likely to Fail in the Long Run, and Is Early Surgery Preferable?;131 1.10.1.2.2.1;5.2.2.1 Shape and Size of the Herniation, Nerve Root Compression, Concomitant Pathology;136 1.10.1.2.2.2;5.2.2.2 Gadolinium Enhancement of the Herniated Disc;137 1.10.1.2.3;5.2.3 Conclusion;137 1.10.1.3;5.3 Post-Operative Imaging;137 1.10.1.3.1;5.3.1 Introduction;137 1.10.1.3.2;5.3.2 Normal Post-Operative Findings;140 1.10.1.3.3;5.3.3 Residual or Recurrent Disc Herniation and Epidural Scarring;140 1.10.1.3.4;5.3.4 Spondylodiscitis;142 1.10.1.3.5;5.3.5 Hematoma, Pseudomeningocele;147 1.10.1.3.6;5.3.6 Arachnoiditis;149 1.10.1.4;Appendix;159 1.10.1.5;References;160 1.11;Index;163