Limits...
Imaging in spinal posterior epidural space lesions: A pictorial essay

View Article: PubMed Central - PubMed

ABSTRACT

Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed. Various pathologies affecting the posterior epidural space either arising from the space itself or occurring secondary to vertebral/intervertebral disc pathologies. Primary spinal bone tumors affecting the posterior epidural space have been excluded. The etiological spectrum affecting the posterior epidural space ranges from degenerative, infective, neoplastic - benign or malignant to miscellaneous pathologies. MRI is the modality of choice in evaluation of these lesions with CT scan mainly helpful in detecting calcification. Due to its excellent soft tissue contrast, Magnetic Resonance Imaging is extremely useful in assessing the pathologies of posterior epidural space, to know their entire extent, characterize them and along with clinical history and laboratory data, arrive at a specific diagnosis and guide the referring clinician. It is important to diagnose these lesions early so as to prevent permanent neurological complication.

No MeSH data available.


Related in: MedlinePlus

Benign lesions: Arachnoid cyst: Sagittal T1-weighted (A) and T2-weighted (B) images in a 72-year-old female, with long standing back ache, show a well-defined cerebrospinal fluid signal intensity lesion (arrow) in the posterior epidural space extending from T10 to L1 levels. The lesion effaces posterior epidural fat and shows mass effect on the spinal cord, which is displaced anteriorly
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5036327&req=5

Figure 29: Benign lesions: Arachnoid cyst: Sagittal T1-weighted (A) and T2-weighted (B) images in a 72-year-old female, with long standing back ache, show a well-defined cerebrospinal fluid signal intensity lesion (arrow) in the posterior epidural space extending from T10 to L1 levels. The lesion effaces posterior epidural fat and shows mass effect on the spinal cord, which is displaced anteriorly

Mentions: MRI is the modality of choice for diagnosing arachnoid cysts. It shows a cystic lesion following CSF signal intensity, with variable compression on the spinal cord and nerve roots. On T1W images, epidural fat capping of the lesion at superior and inferior aspect of the cyst confirms extradural location. Long standing lesions may cause vertebral body scalloping, neural foraminal widening and expansion, erosion of pedicles, and widening of interpedicular distance [Figure 18]. CT myelography shows communication of the cyst with the subarachnoid space.[43]


Imaging in spinal posterior epidural space lesions: A pictorial essay
Benign lesions: Arachnoid cyst: Sagittal T1-weighted (A) and T2-weighted (B) images in a 72-year-old female, with long standing back ache, show a well-defined cerebrospinal fluid signal intensity lesion (arrow) in the posterior epidural space extending from T10 to L1 levels. The lesion effaces posterior epidural fat and shows mass effect on the spinal cord, which is displaced anteriorly
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036327&req=5

Figure 29: Benign lesions: Arachnoid cyst: Sagittal T1-weighted (A) and T2-weighted (B) images in a 72-year-old female, with long standing back ache, show a well-defined cerebrospinal fluid signal intensity lesion (arrow) in the posterior epidural space extending from T10 to L1 levels. The lesion effaces posterior epidural fat and shows mass effect on the spinal cord, which is displaced anteriorly
Mentions: MRI is the modality of choice for diagnosing arachnoid cysts. It shows a cystic lesion following CSF signal intensity, with variable compression on the spinal cord and nerve roots. On T1W images, epidural fat capping of the lesion at superior and inferior aspect of the cyst confirms extradural location. Long standing lesions may cause vertebral body scalloping, neural foraminal widening and expansion, erosion of pedicles, and widening of interpedicular distance [Figure 18]. CT myelography shows communication of the cyst with the subarachnoid space.[43]

View Article: PubMed Central - PubMed

ABSTRACT

Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed. Various pathologies affecting the posterior epidural space either arising from the space itself or occurring secondary to vertebral/intervertebral disc pathologies. Primary spinal bone tumors affecting the posterior epidural space have been excluded. The etiological spectrum affecting the posterior epidural space ranges from degenerative, infective, neoplastic - benign or malignant to miscellaneous pathologies. MRI is the modality of choice in evaluation of these lesions with CT scan mainly helpful in detecting calcification. Due to its excellent soft tissue contrast, Magnetic Resonance Imaging is extremely useful in assessing the pathologies of posterior epidural space, to know their entire extent, characterize them and along with clinical history and laboratory data, arrive at a specific diagnosis and guide the referring clinician. It is important to diagnose these lesions early so as to prevent permanent neurological complication.

No MeSH data available.


Related in: MedlinePlus