Additionally, rare cases demonstrated sacral meningeal cysts extending more laterally along the nerve root ( Fig. However, the trend is unidimensional ventral-dorsal extension of CSF was not studied, and additional research is necessary to better characterize it in 3-dimensional space. This trend is notable and may prove useful in refining the spinal CTV to maximize CSF coverage and minimize bone marrow irradiation. This pattern is not unlike the natural increasing size of the lumbar vertebrae when moving caudally from L1 to S1. Rather, it increased in magnitude from L1 to S1 toward a maximum distance between L5 and S1 before then dropping to a median of 0 mm at S2 through S4. The degree of lateral CSF extension is not consistent across all lumbar and sacral spinal levels.

However, the measurements in this study also illustrate the range of variability, both between patients and spinal levels. The 90th percentile of CSF extension inferior to the caudal of the dural sac was 12 mm. The 90th percentile of lateral CSF extension reached 5 mm at L1, 7 mm at L2, 8 mm at 元, 9 mm at L4, 12 mm at L5, 14 mm at S1, 12 mm at S2, 5 mm at S3, and 1 mm at S4. Median CSF extension inferior to the caudal end of the dural sac was 5 mm (IQR, 2-8 mm Table 1). Overall, CSF extended laterally a median of 3 mm (IQR, 0-7 mm) at all spinal levels, and 90% of lateral CSF extension was within 9 mm. There was no measurement of lateral extension at S5 ( Table 1). Lateral extension of CSF with interquartile ranges (IQRs) was measured to be a median of 0 mm (IQR, 0-4 mm) at L1 3 mm (IQR, 0-5 mm) at L2 5 mm (IQR, 3-7 mm) at 元 6 mm (IQR, 4-8 mm) at L4 8 mm (IQR, 3-9 mm) at L5 8 mm (IQR, 6-12 mm) at S1 0 mm (IQR, 0-7 mm) at S2 0 mm (IQR, 0-2 mm) at S3 and 1 mm (IQR, 0-0 mm) at S4. An example of CSF extending along sacral nerve roots and beyond the magnetic resonance imaging–visualized thecal sac is shown in Fig. QArc public QArc( type,Ĭom.Computed tomography myelograms demonstrated a variety of patterns of CSF in the lumbar spine and around sacral nerve roots.QArc public QArc(.PathMetadata metadata,.QArc public QArc(.PathMetadata metadata).transition public final QTransition transition.stringId public final .dsl.StringPath stringId.sourceId public final .dsl.StringPath sourceId.reference public final QReference reference.objectId public final QObjectId objectId.multiplicity public final .dsl.NumberPath multiplicity.importId public final .dsl.StringPath importId.executable public final .dsl.BooleanPath executable.destinationId public final .dsl.StringPath destinationId.destination public final QNode destination._super public final QPetriNetObject _super.Methods inherited from interface .Path getAnnotatedElement, getMetadata, getRoot.Methods inherited from interface .Expression accept, getType.Methods inherited from class clone, finalize, getClass, notify, notifyAll, wait, wait, wait.Methods inherited from class .dsl.DslExpression equals, getType, hashCode, toString.Methods inherited from class .dsl.SimpleExpression as, as, count, countDistinct, eq, eq, eqAll, eqAll, eqAny, eqAny, in, in, in, in, in, isNotNull, isNull, ne, ne, neAll, neAny, notIn, notIn, notIn, notIn, notIn, nullif, nullif, when, when.Methods inherited from class .dsl.BeanPath accept, add, as, createArray, createBoolean, createCollection, createComparable, createDate, createDateTime, createEnum, createList, createMap, createNumber, createSet, createSimple, createString, createTime, forProperty, getAnnotatedElement, getMetadata, getRoot, instanceOf, instanceOfAny.Methods inherited from class .dsl.EntityPathBase getMetadata.QArc(.PathMetadata metadata,Ĭom.PathInits inits)Ĭom. metadata, Constructor Summary Constructors Constructor.Fields inherited from class .dsl.DslExpression hashCode, mixin.

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