The Posterior Vertebral Scalloping Sign

Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

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“…Other radiological findings[45] include posterior vertebral scalloping on X-ray. However, it is not specific for dural ectasia.…”

Section: Discussionmentioning

confidence: 99%

Dural ectasia

Gupta

Kumar

et al. 2014

Indian J Anaesth

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“…Ependymoma, dermoid cysts, epidermoid cysts, schwannoma, lipomas, and lymphomas frequently show thinning of laminae and pedicles [4, 7, 8, 20]. Dural ectasia, associated with inherited disorders such as Marfan syndrome, and Ehlers–Danlos syndrome, and neurofibromatosis is also a cause of scalloping of vertebral bodies [4, 8, 9, 11, 12, 15]. There have been few reports, however, of scalloping of the spinal osseous structures caused by HNP.…”

Section: Discussionmentioning

confidence: 99%

“…Increased intraspinal pressure exerted by an expanding mass such as a slow-growing intraspinal tumor is a common cause of erosion (scalloping) of the posterior vertebral wall [1–8]. As for other causes of scalloping, communicating hydrocephalus, Marfan syndrome, Ehlers–Danlos syndrome, ankylosing spondylitis, neurofibromatosis, achondroplasia, Morquio syndrome, Hurler syndrome, acromegaly, tuberculosis, and fungal infections have been reported [4, 8–15].…”

Section: Introductionmentioning

confidence: 99%

“…As for other causes of scalloping, communicating hydrocephalus, Marfan syndrome, Ehlers–Danlos syndrome, ankylosing spondylitis, neurofibromatosis, achondroplasia, Morquio syndrome, Hurler syndrome, acromegaly, tuberculosis, and fungal infections have been reported [4, 8–15]. Erosion of the spinal osseous structure by herniated nucleus pulposus (HNP) has rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

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Osseous erosion by herniated nucleus pulposus mimicking intraspinal tumor: a case report

Yoshioka

Sairyo

Sakai

et al. 2010

J Orthopaed Traumatol

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Erosion of spinal osseous structure, so-called scalloping, has been rarely reported associated with herniated nucleus pulposus (HNP). We report a rare case of HNP causing erosion of the spinal osseous structure (including lamina). The patient was an 81-year-old woman with 3-year history of low-back pain and left leg radiating pain. Muscle weakness of the left leg was also apparent. Computed tomography following myelography showed severe compression of the dural sac at the level of L3–L4; furthermore, erosion of the lamina, pedicle, and vertebral body was noted, indicating that the space-occupying mass was most probably a tumorous lesion. The mass also showed calcification inside. During the surgery, the mass was confirmed to be an HNP with calcification. Following resection, the pain disappeared. Surgeons should be aware of the possibility of scalloping of the vertebrae caused by HNP mimicking a tumorous lesion.

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“…It can cause posterior vertebral scalloping, widening of the central spinal canal progressively from the upper lumbar to the sacral region, thinning of the pedicles and laminae of the vertebrae, meningoceles, increased interpedicular distance, and widening of the neural foramina. 8 Dural ectasia can be diagnosed on radiographs. When dural ectasia is identified, it is necessary to evaluate this finding with MR imaging or CT to exclude an underlying, slow-growing intraspinal mass.…”

Section: Diffuse Dural Ectasiamentioning

confidence: 99%

Cystic Lesions in Spinal Imaging: A Pictorial Review and Classification

Noujaim¹,

Moreng²,

Noujaim³

2013

neurograph

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The authors present a variety of common and uncommon extraosseous cystic lesions encountered in the spine. Accurate localization of a detected lesion within the spinal canal, assessment of its imaging features, and understanding its relationship with surrounding structures will help differentiate many of the lesions and aid in the preoperative diagnosis. Congenital spinal and spinal cord malformations referred to as spinal dysraphisms will not be discussed in this article. This pictorial review discusses the imaging findings and distinguishing features of a variety of intramedullary and extramedullary intraspinal cystic lesions with the use of MR imaging, CT, myelography, and sonography.

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The Posterior Vertebral Scalloping Sign

Cited by 26 publications

References 16 publications

Dural ectasia

Dural ectasia

Osseous erosion by herniated nucleus pulposus mimicking intraspinal tumor: a case report

Cystic Lesions in Spinal Imaging: A Pictorial Review and Classification

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