53:. Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain. Other common symptoms include
365:
amenable to resection than intramedullary tumours, and even possible to be operated through microendoscopic or pure endoscopic approaches. In patients with metastatic tumors, treatment is palliative with the goal of improving the patient's quality of life. In these cases, indications for surgery include pain, stabilization, and spinal cord decompression.
332:(STIR) is also commonly added to the MRI protocol for detecting spinal cord tumors. Myelography may be used as a substitute when the patient cannot undergo an MRI or it is unavailable. X-rays and CT are more commonly used to view the bony structures. They are less frequently used for spinal cord tumors, however, since they cannot reliably detect them.
1333:
Patchell, Dr. Roy A.; Tibbs, Phillip A.; Regine, William F.; Payne, Richard; Saris, Stephen; Kryscio, Richard J.; Mohiuddin, Mohammed; Young, Byron (20 August 2005). "Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial".
279:
The diagnosis of spinal tumors is challenging, as the symptoms can be non-specific and often mimic more common and benign degenerative spinal diseases. A comprehensive medical examination is necessary to look for signs or symptoms that may point towards a more serious condition. This includes a
364:
Surgery has several indications depending on the type of tumor, which includes complete resection, decompression of the nerves, and stabilization. An attempt at total gross resection for a possible cure is an option for patients with primary spinal cord tumors. Extramedullary tumours are more
96:
Treatment often involves some combination of surgery, radiation, and chemotherapy. Observation with follow-up imaging may be an option for small, benign lesions. Steroids may also be given before surgery in cases of significant cord compression. Outcomes depend on a number of factors including
381:
are possible options as an adjunct to surgery or for tumors not amenable to surgery. Intradural-extramedullary tumors are often benign, so observation with follow-up imaging is an option in cases where the lesions are small and the patient is asymptomatic. Radiotherapy and chemotherapy may be
405:, either metastatic or primary. Some suggest that direct decompressive surgery combined with postoperative radiotherapy, provide better outcomes than treatment with radiotherapy alone for patients with spinal cord compression due to metastatic cancer.
109:
The symptoms of spinal tumors are often non-specific, resulting in a delay in diagnosis. Spinal nerve compression and weakening of the vertebral structure cause the symptoms. Pain is the most common symptom at presentation. Other common symptoms of
386:, type of tumor, and amount of surgical resection achieved. In cases where radiotherapy is chosen, radiation is usually delivered to the involved segment in the spinal cord and the uninvolved segment above and below the involved segment.
217:
Intradural tumors are located within the dura mater. These are further broken down into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the spinal cord itself, with the most common being
249:
Common primary cancers in metastatic spinal tumors includes breast, prostate, lung, and kidney cancer. It is important to diagnose and promptly treat metastatic tumors as they can lead to long-term neurologic deficit from epidural
815:
Hamamoto, Yasushi; Kataoka, M.; Senba, T.; Uwatsu, K.; Sugawara, Y.; Inoue, T.; Sakai, S.; Aono, S.; Takahashi, T.; Oda, S. (9 May 2009). "Vertebral
Metastases with High Risk of Symptomatic Malignant Spinal Cord Compression".
197:
at the lumbar spine. Most symptoms from spinal tumors occur due to compression of the spinal cord as it plays a primary role in motor and sensory function. The spinal cord is surrounded by three layers known as the spinal
1818:
64:
The cause of spinal tumors is unknown. Most extradural tumors are metastatic commonly from breast, prostate, lung, and kidney cancer. There are many genetic factors associated with intradural tumors, most commonly
1536:
1976:
1961:
45:. There are three main types of spinal tumors classified based on their location: extradural and intradural (intradural-intramedullary and intradural-extramedullary). Extradural tumors are located outside the
1477:
300:
Imaging is often the next step when the diagnosis is unclear or there is greater suspicion for a serious condition that may need immediate intervention. Common types of medical imaging include
344:
Treatment greatly varies depending on the type of spinal cord tumors, goals of care, and prognosis. The primary forms of treatment include surgical resection, radiotherapy, and chemotherapy.
93:. Diagnosis involves a complete medical evaluation followed by imaging with a CT or MRI. A biopsy may be obtained in certain cases to categorize the lesion if the diagnosis is uncertain.
919:
Holt, T.; Hoskin, P.; Maranzano, E.; Sahgal, A.; Schild, S.E.; Ryu, S.; Loblaw, A. (6 March 2012). "Malignant epidural spinal cord compression: the role of external beam radiotherapy".
173:
are commonly seen in patients with suppressed immune systems. The majority of extradural tumors are due to metastasis, most commonly from breast, prostate, lung, and kidney cancer.
1918:
356:. These do not affect the tumor mass itself, but tend to reduce the inflammatory reaction around it and decrease the overall volume of the mass impinging on the spinal cord.
1319:
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to confirm or exclude spinal metastasis. Rapid identification and intervention of metastatic spinal cord compression is necessary to preserve neurologic function.
284:
focusing on any motor or sensory deficits. Patients with either benign degenerative spinal disease or spinal tumors often present with back pain. A patient with
1299:
214:. Spinal cord tumors are classified based on their location within the spinal cord: intradural (intradmedullary and extramedullary) and extradural tumors.
1379:"The combined use of surgery and radiotherapy to treat patients with epidural cord compression due to metastatic disease: a cost-utility analysis"
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administered alone or in conjunction with surgery. The choice of chemotherapy or radiotherapy is a multidisciplinary process and depends on the
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230:. Intradural-extramedullary tumors are located within the dura but outside of the spinal cord parenchyma, with the most common being
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Furlan, J.C.; Chan, K.K.; Sandoval, G.A.; Lam, K.C.; Klinger, C.A.; Patchell, R.A.; Laporte, A.; Fehlings, M.G. (May 2012).
134:. The diagnosis is challenging, primarily because symptoms often mimic more common and benign degenerative spinal diseases.
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1442:
1254:""Microendoscopic" versus "pure endoscopic" surgery for spinal intradural mass lesions: a comparative study and review"
769:
Nambiar, Mithun; Kavar, B (2012). "Clinical presentation and outcome of patients with intradural spinal cord tumours".
246:). Extradural tumors are located outside the dura mater most commonly in the vertebral bodies from metastatic disease.
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The cause of the majority of spinal tumors is currently not known. Primary spinal tumors are associated with a few
254:. Primary extradural tumors are rare and most arise from surrounding bony and soft tissue structures, including
1435:
1099:
Chamberlain, Marc C.; Tredway, Trent L. (2011-06-01). "Adult
Primary Intradural Spinal Cord Tumors: A Review".
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whether the tumor is benign or malignant, primary or metastatic, and location of the tumor. Treatment is often
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401:
is a new technique for treating spinal tumors. This treatment can be tailored to the particular tumor of the
74:
17:
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1300:"When cancer spreads to the spine, a new operation can cut both hospital and recovery time - NY Daily News"
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Mechtler, Laszlo L.; Nandigam, Kaveer (2013-02-01). "Spinal Cord Tumors: New Views and Future
Directions".
1930:
Note: Not all brain tumors are of nervous tissue, and not all nervous tissue tumors are in the brain (see
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is a primary symptom of spinal cord compression in patients with known malignancy. Back pain may prompt a
320:. MRI is the imaging of choice for spinal tumors. The MRI protocol that is most frequently used includes
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often occur in the later stages of the disease. Children may present with spinal deformities such as
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may be used as a supplementary imaging modality for tumors involving bony structures of the spine.
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Jennelle, Richard L. S.; Vijayakumar, Vani; Vijayakumar, Srinivasan (2 August 2011).
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1007:"A Systemic and Evidence-Based Approach to the Management of Vertebral Metastasis"
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Spinal cord compression is commonly found in patients with metastatic malignancy.
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Ribas, Eduardo S. C.; Schiff, David (1 May 2012). "Spinal Cord
Compression".
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77:(VHL) syndrome. The most common type of intradural-extramedullary tumors are
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is a long, cylindrical anatomical structure that is located within the
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Bilsky, Mark H. (2005-11-01). "New therapeutics in spine metastases".
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470:. Arnautović, Kenan I.,, Gokaslan, Ziya L. Cham, Switzerland. 2018.
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can be seen in patients with von Hippel-Lindau disease. Spinal cord
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Neoplasms located in either the vertebral column or the spinal cord
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weakness, sensory loss, and difficulty walking. Loss of bowel and
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are associated with neurofibromatosis 1 (NF1). Meningiomas and
85:. The most common type of intradural-intramedullary tumors are
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WHO classification of the tumors of the central nervous system
1203:"Delay In Diagnosis of Primary Intra Dural Spinal Cord Tumors"
328:
sequences, including contrast enhanced T1-weighted sequences.
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are associated with neurofibromatosis 2 (NF2). Intramedullary
301:
520:
Gossman, William; Hoang, Stanley; Mesfin, Fassil B. (2019),
693:"Spinal Tumors – Types, Symptoms, Diagnosis and Treatment"
61:
control may occur during the later stages of the disease.
692:
557:
Balériaux, D. L. F. (1999-08-01). "Spinal cord tumors".
1201:
Segal D, Constantini S. C.; Korn, Lidar (14 May 2012).
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921:Current Opinion in Supportive and Palliative Care
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292:raises suspicion for a more serious condition.
627:Burton, Matthew R.; Mesfin, Fassil B. (2019),
352:) may be administered if there is evidence of
118:, numbness in hands and legs, and rapid onset
1443:
1320:"Spinal Tumors | Mount Sinai - New York"
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101:for the vast majority of metastatic tumors.
1782:Embryonal tumour with multilayered rosettes
962:Reith, W.; Yilmaz, U. (December 2011). "".
522:"Cancer, Intramedullary Spinal Cord Tumors"
1450:
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1252:Dhandapani, S; Karthigeyan, M (Sep 2018).
1101:Current Neurology and Neuroscience Reports
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1903:Malignant peripheral nerve sheath tumor
1827:Primary central nervous system lymphoma
1751:Dysembryoplastic neuroepithelial tumour
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629:"Cancer, Conus And Cauda Equina Tumors"
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1871:Cranial and paraspinal nerves
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1584:Pleomorphic xanthoastrocytoma
1459:Tumours of the nervous system
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49:lining and are most commonly
1629:Anaplastic oligodendroglioma
1270:10.1016/j.spinee.2018.02.002
933:10.1097/spc.0b013e32834de701
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330:Short-TI Inversion Recovery
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391:minimally invasive surgery
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733:10.1016/j.ncl.2012.09.011
635:, StatPearls Publishing,
528:, StatPearls Publishing,
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114:include muscle weakness,
2072:Nervous system neoplasia
1756:Lhermitte–Duclos disease
1680:Choroid plexus carcinoma
1675:Choroid plexus papilloma
1164:10.1586/14737175.5.6.831
1061:Surgery of Spinal Tumors
723:. Spinal Cord Diseases.
306:computer tomography scan
1220:10.4103/2152-7806.96075
354:spinal cord compression
252:spinal cord compression
112:spinal cord compression
1599:Anaplastic astrocytoma
1594:Fibrillary astrocytoma
369:Non-Surgical Treatment
37:located in either the
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275:Medical Examination
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2018:External resources
1867:Nerve sheath tumor
1809:Hemangiopericytoma
721:Neurologic Clinics
559:European Radiology
468:Spinal cord tumors
384:histological grade
105:Signs and symptoms
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1972:
1968:
1967:
1963:
1959:
1958:
1955:
1950:
1946:
1935:
1933:
1926:
1920:
1917:
1916:
1914:
1910:
1904:
1901:
1897:
1894:
1893:
1892:
1888:
1885:
1881:
1878:
1876:
1873:
1872:
1870:
1868:
1865:
1861:
1858:
1856:
1853:
1852:
1851:
1850:Neuroblastoma
1848:
1847:
1845:
1842:
1838:
1828:
1825:
1824:
1822:
1820:
1819:Hematopoietic
1816:
1810:
1807:
1805:
1802:
1801:
1799:
1797:
1793:
1783:
1780:
1778:
1775:
1773:
1770:
1769:
1767:
1763:
1757:
1754:
1752:
1749:
1747:
1744:
1742:
1739:
1737:
1736:Ganglioglioma
1733:
1730:
1729:
1727:
1725:
1719:
1709:
1706:
1704:
1701:
1699:
1696:
1695:
1693:
1689:
1681:
1678:
1676:
1673:
1672:
1671:
1668:
1667:
1665:
1663:
1659:
1653:
1652:Subependymoma
1650:
1648:
1645:
1644:
1642:
1640:
1636:
1630:
1627:
1625:
1622:
1621:
1619:
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1613:
1605:
1602:
1600:
1597:
1595:
1592:
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1587:
1585:
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1580:
1577:
1576:
1575:
1572:
1571:
1569:
1567:
1563:
1560:
1558:
1554:
1551:
1548:
1547:spinal tumors
1543:
1538:
1534:
1531:
1529:
1525:
1515:
1512:
1511:
1509:
1506:
1501:
1495:
1492:
1490:
1487:
1486:
1484:
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1479:
1473:
1470:
1468:
1464:
1460:
1453:
1448:
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1434:
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1430:
1414:
1410:
1405:
1400:
1396:
1392:
1388:
1384:
1380:
1373:
1365:
1361:
1357:
1353:
1349:
1345:
1341:
1337:
1329:
1321:
1315:
1307:
1306:
1301:
1295:
1287:
1283:
1279:
1275:
1271:
1267:
1263:
1259:
1255:
1248:
1240:
1236:
1231:
1226:
1221:
1216:
1212:
1208:
1204:
1197:
1189:
1185:
1181:
1177:
1173:
1169:
1165:
1161:
1157:
1153:
1146:
1138:
1134:
1130:
1126:
1122:
1118:
1114:
1110:
1106:
1102:
1095:
1093:
1084:
1078:
1074:
1070:
1063:
1062:
1055:
1053:
1044:
1040:
1035:
1030:
1025:
1020:
1016:
1012:
1008:
1001:
993:
989:
985:
981:
977:
973:
969:
965:
964:Der Radiologe
958:
950:
946:
942:
938:
934:
930:
926:
922:
915:
907:
903:
899:
895:
891:
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882:
877:
873:
869:
862:
860:
858:
849:
845:
841:
837:
832:
827:
823:
819:
811:
809:
800:
796:
792:
788:
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780:
776:
772:
765:
763:
761:
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750:
746:
742:
738:
734:
730:
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722:
715:
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682:
680:
678:
676:
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664:
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642:
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623:
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619:
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588:
584:
580:
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568:
564:
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531:
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523:
516:
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425:
423:
421:
419:
414:
406:
404:
400:
396:
392:
387:
385:
380:
376:
373:Observation,
366:
357:
355:
351:
347:
337:
335:
334:Bone scanning
331:
327:
323:
319:
315:
311:
307:
303:
293:
291:
287:
286:radiculopathy
283:
267:
265:
261:
257:
253:
247:
245:
244:neurofibromas
241:
237:
233:
229:
225:
221:
215:
213:
209:
205:
201:
196:
192:
188:
184:
174:
172:
168:
164:
160:
159:Neurofibromas
156:
146:
144:
140:
135:
133:
129:
125:
121:
117:
113:
102:
100:
94:
92:
88:
84:
80:
76:
72:
68:
62:
60:
56:
52:
48:
44:
40:
36:
32:
31:Spinal tumors
19:
18:Spinal cancer
2036:
2025:
2001:
1990:
1975:
1960:
1929:
1887:Neurilemmoma
1875:Neurofibroma
1604:Glioblastoma
1546:
1542:brain tumors
1504:
1476:
1386:
1382:
1372:
1339:
1335:
1328:
1314:
1303:
1294:
1261:
1257:
1247:
1210:
1206:
1196:
1155:
1151:
1145:
1104:
1100:
1060:
1014:
1011:ISRN Surgery
1010:
1000:
967:
963:
957:
927:(1): 103–8.
924:
920:
914:
871:
867:
821:
817:
777:(2): 262–6.
774:
770:
724:
720:
700:. Retrieved
697:www.aans.org
696:
644:, retrieved
632:
562:
558:
537:, retrieved
525:
467:
399:chemotherapy
388:
379:radiotherapy
375:chemotherapy
372:
363:
343:
299:
278:
260:osteosarcoma
248:
224:astrocytomas
216:
180:
152:
136:
116:sensory loss
108:
95:
91:astrocytomas
63:
30:
29:
2043:orthoped/49
2027:MedlinePlus
1746:Neurocytoma
1708:Gliosarcoma
1574:Astrocytoma
1494:Pituicytoma
326:T2-weighted
322:T1-weighted
314:myelography
240:schwannomas
232:meningiomas
220:ependymomas
183:spinal cord
163:schwannomas
87:ependymomas
79:meningiomas
73:(NF2), and
43:spinal cord
2003:DiseasesDB
1891:Schwannoma
1804:Meningioma
1647:Ependymoma
1336:The Lancet
1017:: 719715.
702:2019-12-03
646:2019-12-03
633:StatPearls
539:2019-12-03
526:StatPearls
486:1084270205
409:References
318:bone scans
290:myelopathy
204:dura mater
99:palliative
51:metastatic
47:dura mater
2050:radio/169
2038:eMedicine
1566:Astrocyte
1514:Pinealoma
1467:Endocrine
1172:1473-7175
1121:1534-6293
876:CiteSeerX
826:CiteSeerX
741:0733-8619
579:1432-1084
494:cite book
395:radiation
340:Treatment
280:complete
270:Diagnosis
212:pia mater
171:lymphomas
143:bone scan
139:Back pain
132:scoliosis
120:paralysis
35:neoplasms
2066:Category
2046:med/2993
1796:Meninges
1639:Ependyma
1413:22505658
1356:16112300
1278:29452284
1239:22629489
1188:32071879
1180:16274340
1137:14866999
1129:21327734
1067:. 2007.
1043:22084772
984:22198141
949:40059786
941:22156794
906:25396373
898:22547256
848:19429929
799:11919425
791:22099075
749:23186903
641:28722908
587:10460357
534:28723060
346:Steroids
200:meninges
1997:D013120
1404:3337309
1364:7761862
1286:3834414
1258:Spine J
1230:3356987
1034:3200210
992:2875418
595:6586168
360:Surgery
312:(MRI),
296:Imaging
69:(NF1),
59:bladder
41:or the
2032:001403
1724:neuron
1721:Mature
1557:Glioma
1505:Other:
1478:Sellar
1411:
1401:
1362:
1354:
1284:
1276:
1237:
1227:
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747:
739:
639:
593:
585:
577:
532:
484:
474:
377:, and
348:(e.g.
316:, and
308:(CT),
302:X-rays
238:(e.g.
226:, and
210:, and
149:Causes
55:muscle
2008:31483
1986:192.2
1971:C72.0
1912:Other
1360:S2CID
1282:S2CID
1184:S2CID
1133:S2CID
1065:(PDF)
988:S2CID
945:S2CID
902:S2CID
795:S2CID
591:S2CID
403:spine
124:Bowel
1992:MeSH
1981:9-CM
1409:PMID
1352:PMID
1274:PMID
1235:PMID
1176:PMID
1168:ISSN
1125:PMID
1117:ISSN
1077:ISBN
1039:PMID
1015:2011
980:PMID
937:PMID
894:PMID
844:PMID
787:PMID
745:PMID
737:ISSN
637:PMID
583:PMID
575:ISSN
530:PMID
504:link
500:link
482:OCLC
472:ISBN
393:and
324:and
234:and
181:The
89:and
81:and
33:are
1977:ICD
1962:ICD
1841:PNS
1528:CNS
1399:PMC
1391:doi
1344:doi
1340:366
1266:doi
1225:PMC
1215:doi
1160:doi
1109:doi
1069:doi
1029:PMC
1019:doi
972:doi
929:doi
886:doi
836:doi
779:doi
729:doi
567:doi
397:or
288:or
126:or
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