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- Title
Effect of spinal flexion on the conus medullaris: a case series using magnetic resonance imaging.
- Authors
Fettes, P. D. W.; Leslie, K.; McNabb, S.; Smith, P. J.
- Abstract
Anatomy textbooks state that the conus medullaris moves cephalad when the vertebral column is flexed. This could confer protection against spinal cord damage during dural puncture, but has not been demonstrated in vivo. We therefore imaged the spine of 10 volunteers using magnetic resonance imaging to determine if such movement occurs with the spine in the neutral and flexed positions. The position of the conus medullaris in relation to the superior endplate of the L1 vertebra was determined. On spinal flexion, the conus medullaris moved cephalad in three subjects and caudad in three subjects, with no change in the remaining four. The median overall movement (95% CI [range]) was 0 mm (4 mm caudad to 1 mm cephalad [3 mm caudad to 1 mm cephalad]; p = 1.0). Whilst spinal flexion may facilitate needle insertion during dural puncture, it is unlikely to confer extra protection against spinal cord damage.
- Subjects
ANATOMY; TEXTBOOKS; CONUS medullaris; MAGNETIC resonance imaging; SPINAL cord injuries; SPINE
- Publication
Anaesthesia, 2006, Vol 61, Issue 6, p521
- ISSN
0003-2409
- Publication type
Article
- DOI
10.1111/j.1365-2044.2006.04641.x