Thecaloscopy Part II: Anatomical Landmarks

Abstract

Endoscopic anatomy differs from microsurgical anatomy. Topographical orientation as well as the proportion of objects, is different as they depend on the lens/object distance. Orientation under endoscopic conditions requires structures with defined positions or recognisable structures previously identified radiolologically. Structures are anatomical landmarks if the topographical relation to their surroundings is constant and they are easy and reliable to recognise. The contents of the dural sack are nerve roots with their supplying vessels, arachnoid trabeculars, filum terminale, and CSF. Safe navigation of a thecaloscope in relation to the bony structures is only possible with the simultaneous use of intraoperative fluoroscopy. To facilitate the navigation of scopes and instruments in the subarachnoid space we attempted to identify and describe reliable, and therefore constant recognisable anatomical landmarks.

Key words

Thecaloscopy - Subarachnoid Space - Filum Terminale - Spinal Nerves

References

• 1 Rauber A, Kopsch F. Lehrbuch und Atlas der Anatomie des Menschen. 3. Bd. Nervensystem - Sinnesorgane. 15. Aufl. Leipzig: Georg Thieme 1940
• 2 Clara M. Das Nervensystem des Menschen. 3. Aufl. Leipzig: Johann Ambrosius Barth Verlag 1959
• 3 Rickenbacher J, Landlot A M, Theiler K. In: Lanz TV, Wachsmuth W (ed). Praktische Anatomie Vol. 2, Part 7. Berlin, Heidelberg, New York: Springer-Verlag 1982
• 4 Williams P L, Warwick R, Dyson M, Bannister L H. (ed) .Gray's Anatomy. 37 ed. Edinburgh, London, Melbourne, New York: Churchill Livingstone 1989
• 5 Braus-Elze H C. Anatomie des Menschen. 3. Bd. Berlin: Springer-Verlag 1932
• 6 Pernkopf E. Topographische Anatomie des Menschen. 2. Bd. 2. Teil. Bauch, Becken und Beckengliedmaße. Berlin, Wien: Urban und Schwarzenberg 1943
• 7 Choi B H, Kim R C, Suzuki M. The ventriculus terminalis and filum terminale of the human spinal cord.  Hum Pathol. 1992 Aug;  23 (8) 916-920