Gaidolfi et al. (1991) emphasize the importance of standard radiological studies of the rachis and express their belief that primary or metastatic pathology may be responsible for the symptoms of myeloradicular disturbance. In some meningioma cases an X-ray of the rachis can provide precise information to help in determining the level and can also identify specific rachidian alterations that are secondary to the slow compressive action of a tumour and thus suggest the presence of a meningioma. In contrast to other neoplasms, meningiomas (due to their durai attachment) are generally adjacent to the walls of the vertebral canal, causing the thinning of the internal bone cortex. These alterations are sometimes directly visible on plain X-ray and on a stratigraphy or indirectly found because the normal measurements of the interpeduncular distance (Lindgren 1952; Decker 1968) identify the metamere where the compression lies. The salient features are caused by erosion of the pedicles, laminae and posterior somatic walls (scalopping). The latter appears more frequently in extradural forms that develop in close contact with the vertebral bodies. The alterations in a pedicle are evident when the meningioma enlarges, or when it erodes the intravertebral foramen wall on one side thereby becoming intra-and extrarachidian (Figs. 114–117).
KeywordsVertebral Body Lumbar Puncture Subarachnoidal Space Spastic Paraparesis Vertebral Canal
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