Indirect decompression in burst fractures averages about half of the preexisting encroachment. Results are usually better at T12 and L1 than at L2. Additional or secondary decompression is rarely indicated if these fractures are treated early and by experienced surgeons. Burst Type B fractures in patients older versus younger than 40 years of age differ in many respects.
The CT appearance of the cervical neural foramina and contents is described in detail. Nineteen cervical spine specimens were studied with CT and corresponding cryomicrotomy in direct axial, sagittal, coronal, and oblique planes. Both ventral and dorsal nerve roots can be identified in the foramen's lower portion at or below the disk level. The dorsal nerve roots and ganglion contact the superior facet. The ventral nerve roots contact the uncinate process and bottom of the neural foramen. The ventral nerve roots, dorsal nerve roots and ganglion, and vertebral artery are resolved with current high-resolution CT.
This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates. The cause of the less constant, low intensity signal was less certain. The height of the pituitary gland in sagittal images was usually less than 8 mm, and the upper surface was flat or concave.
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