Neuroimaging clinics of North America
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Spinal MR imaging is excellent for identifying details of spinal anatomy, including intraspinal contents, neural foramina, joints, ligaments, intervertebral discs, and bone marrow. Cortical bony structures of the spine are better imaged using CT. ⋯ Motion- and flow-related artifacts may occur during imaging and should not be mistaken for lesions. With advancements in MR imaging hardware and software, spinal MR imaging can expand its role in the delineation of normal and abnormal spinal anatomy.
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Neuroimaging Clin. N. Am. · Nov 2019
ReviewSpontaneous Intracranial Hypotension: Pathogenesis, Diagnosis, and Treatment.
Spontaneous intracranial hypotension (SIH) is a clinical syndrome that is increasingly recognized as an important and treatable secondary cause of headaches. Insight into the condition has evolved significantly over the past decade, resulting in a greater understanding of the underlying pathophysiology, development of new diagnostic imaging tools, and a broadening array of targeted treatment options. This article reviews the clinical presentation and pathogenesis of SIH, discusses the important role of imaging in diagnosis, and describes how imaging guides treatment.
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Neuroimaging Clin. N. Am. · Nov 2019
ReviewPercutaneous Vertebroplasty: A History of Procedure, Technology, Culture, Specialty, and Economics.
Percutaneous vertebroplasty (VP) progressed from a virtually unknown procedure to one performed on hundreds of thousands of patients annually. The development of VP provides a historically exciting case study into a rapidly adopted procedure. ⋯ It was designed as a revolutionary technique to treat vertebral body fractures with minimal side effects and was rapidly adopted and marketed in the United States. The impact of percutaneous vertebroplasty on spine surgery was profound.
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This article reviews the arterial and venous anatomy of the spine and spinal cord. Special emphasis is placed on vessels critical to the conduct and interpretation of spinal angiography, notably the intersegmental artery and its cranial and caudal derivatives: the vertebral, supreme intercostal, and sacral arteries.
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In addition to basic image-guided injections, there are many advanced procedures to address the challenges of spine pain. Patients with debilitating symptoms are offered relief, a shorter recovery period, and fewer potential complications. Pain arises from numerous sites along the spine, presenting as spine pain or radiculopathy. This article is an overview of advanced techniques in this rapidly progressing field, including neuromodulation, radiofrequency thermocoagulation, discography, intradiscal thermocoagulation, and percutaneous image-guided lumbar decompression; and it highlights etiologic factors and their relationship to therapeutic technique and clinical evidence.