Longitudinal Development of the Spine and Spinal Cord in Human Fetuses

Manzone, Patricio; Guidobono, Juan Armando; Forlino, Daniel

doi:10.1590/s1808-185120201901221678

Cited by 3 publications

(9 citation statements)

References 14 publications

(15 reference statements)

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“…The studies that used post-mortem foetuses with either dissection 8 , 18 , 31 or post-mortem magnetic resonance 4 , 32 presented similar, low frequencies of foetuses with the CM at L2 from 19 to 25 weeks. In contrast, studies involving ultrasound performed on live foetuses 3 , 10 , 40 found that the CM was at L2 in approximately half of the entire sample of foetuses with gestational age from 19 to 25 weeks.…”

Section: Discussionmentioning

confidence: 86%

“…Regarding sexual dimorphism, despite the small number of studies that addressed this variable, no significant association was found among the articles included in the present review. Manzone et al 32 found no statistically significant difference in SC length between male and female foetuses in an Argentinian study performed with magnetic resonance. Perlitz et al 40 used ultrasound to analyse Israeli foetuses and also found no difference in CM position between the sexes.…”

Section: Discussionmentioning

confidence: 90%

“…Manzone et al 32 analyzed the growth pace of the spine and SC, reporting steady, dissimilar values. The asymmetry between the SC level and spine is due to the disproportional growth of the two structures, which results in the ascent of the CM from S1 to L2 in the second trimester of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis

Almeida

Figueiredo

Zylberman

et al. 2022

Sci Rep

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The aim of the present systematic review and meta-analysis was to identify when the ascent of the conus medullaris occurs in human foetuses considering differences in evaluation methods and sample characteristics. Five databases were searched for relevant articles using different combinations of keywords. Article selection and data extraction were performed independently by two reviewers. Disagreements were resolved by a third reviewer. The variables were distributed into four groups according to the gestational age of the specimens: I (13–18 weeks); II (19–25 weeks); III (26–32 weeks); IV (33 weeks to the probable date of birth). Eighteen articles were included. The majority used imaging exams as the evaluation method. Cadaveric dissections were reported in the remaining articles. Only morphological studies were included in the meta-analysis. Significant ascent occurs between groups I and III as well as groups II and IV. Despite the considerable heterogeneity among the studies included in the present review, the findings enabled the determination that the conus medullaris reaches its normal birth level by the 26th week. Further analyses should be performed based on nationality and ethnicity to diminish the heterogeneity of the data.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis

Almeida

Figueiredo

Zylberman

et al. 2022

Sci Rep

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“…The growth of the vertebral column is faster than that of the spinal cord in developing fetuses, and the postnatal life spinal cord terminates early within the vertebral canal. This process is known as the ascent of the spinal cord, and this terminology has passed from one author to another [1]. The exact time of this ascent has not been determined [2].…”

Section: Introductionmentioning

confidence: 99%

“…The spinal cord generally starts to "ascend" after nine weeks, reaching the level of the last sacral piece around 12 weeks of age. The cord reaches the level of the lower border of the S1 at fifteen weeks, the lower border of the L4 at six months, and the lower border of the L3 at full term [1,[3][4][5]. During childhood, once the spinal cord has reached its definitive level, the spinal cord and the spine's growth continues at the same rate and rhythm until adulthood [5].…”

Section: Introductionmentioning

confidence: 99%

Morphometric Analysis of Spinal Cord and Its Termination Within the Vertebral Canal: An Observational Study in the Fetuses of Third Trimester Gestational Age

Gupta¹,

Vaisnani²,

Gupta³

et al. 2022

Cureus

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Background & aimThe spinal cord is the continuation of the brain from the lower point of the medulla and the terminal portion of the developing neural tube. The spinal cord develops within the bony canal, called the vertebral canal, formed by the union of individual vertebrae in the vertebral column. Initially, the development of the length of the vertebral column and spinal cord are the same but later on undergo alterations. The growth of the vertebral column is faster than that of the spinal cord because the spinal cord appears to terminate early within the vertebral canal. To measure the length of the spinal cord and lowermost point of conus medullaris in the third trimester gestational age fetuses. Material and methodsThe present cross-section observational study was carried out on 30 fetuses collected from the museum of the Anatomy Department and Obstetrics and Gynecology Department. Before starting the study, permission and approval from the university's ethical committee were received. The dissection of fetuses includes the incision of the skin, removal of superficial and deep muscles, and a laminectomy. The meninges were cut and removed to note the vertebra level of the termination of the spinal cord. The spinal cord was taken out, and the total length of the spinal cord was measured. The fetuses were categorized into three groups determined by their gestational age (the first group was 28-31 weeks, the second group was 32-35 weeks, and the third group was 36-40 weeks). ObservationIn the present study, 81.8% of male fetuses were in the 36-40 weeks gestational age group, and 52.6 % of female fetuses were in the 32-35 weeks, gestational age group. The mean length of the spinal cords was 14.74±1.45cm, with a range of 10.95 cm to a maximum of 16.60 cm. In the full-term gestational age group, male fetuses had a greater length of spinal cord than female fetuses. Sixteen fetuses had a spinal cord termination at level L2, followed by eight fetuses at the L3 level and six fetuses at the L4 level. Out of 11 male fetuses, eight fetuses had spinal cord termination at the L2 vertebra level, two at the L3 level, and one fetus at the L4 level. In female fetuses, eight had a spinal cord termination at the L2 level, six at the L3 level, and five at the L4 level. ConclusionThe spinal cord length and level of conus medullaris depend on the age of the fetuses. In prenatal diagnosis for different spinal cord pathology, these values can be used as reference values in future studies.

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Examination of the Level of Conus Medullaris Termination Using Magnetic Resonance Imaging

et al. 2021

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Introduction: Recognition of the level of the conus medullaris termination (CMt) is of clinical importance for avoiding iatrogenic injuries during spinal anesthesia and lumbar puncture. Although CMt levels have been examined in a variety of studies, they vary in classical textbooks and literature studies. The aim of this study was to investigate the level of CMt and its correlation to gender, age, and body mass index (BMI) using magnetic resonance imaging (MRI) in healthy individuals and those with lumbar disc herniation. Methods: The lumbar MRIs of 341 subjects, including healthy individuals (F: 123, M: 68) and those with lumbar disc herniation (F: 105, M: 45), were retrospectively examined, and the CMt levels were determined. Results: It was found that CMt levels were most commonly located at upper 1/3 of the L1 vertebral body in both healthy individuals and those with disc herniation groups. No statistically significant difference was observed between the two groups evaluated. In addition, no significant mean level of CMt, weight, height, and BMI difference existed between the two groups. Conclusion: In the literature, the highest level of CMt is seen as being at the intervertebral disc between T11 and T12 vertebrae, while the lowest level of the CMt is seen as being at lower 1/3 of the L3 vertebral body. Consequently, we are of the opinion that the L3-4 or L4-5 intervertebral spaces should be preferred to lower the complication rate in procedures such as spinal anesthesia and lumbar puncture.

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Longitudinal Development of the Spine and Spinal Cord in Human Fetuses

Cited by 3 publications

References 14 publications

Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis

Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis

Morphometric Analysis of Spinal Cord and Its Termination Within the Vertebral Canal: An Observational Study in the Fetuses of Third Trimester Gestational Age

Examination of the Level of Conus Medullaris Termination Using Magnetic Resonance Imaging

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