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Título

Roots of the Spine: A Pictorial Review of Notochord Embryology and Pathology

Introdução e objetivo(s)

The notochord is a midline embryological structure derived from the mesoderm that plays a central role in vertebrate development.
Its presence is transient in humans, being observed in a residual form in the nucleus pulposus of the intervertebral discs. However, these remnants can give rise to a spectrum of entities, such as anatomical variants and benign and malignant tumors, so radiologists must have a solid knowledge of notochordal development and pathology.

Purpose
Describe the origin, development, and functions of the notochord
Identify clinical entities related to the notochord

Método(s)

An exhaustive literature review will be carried out for embryological and pathological review. An analysis of many institutional cases will be carried out and the distinctive characteristics and tips for differential diagnoses will be shown through them.

Discussão

The embryological development of the notochord begins during the third week during gastrulation. It originates from mesenchymal cells derived from the primitive node with the consequent formation of the notochordal process, which subsequently fuses with endodermal cells, forming the notochordal plate that will later become the notochord.
The functions of the notochord during embryology are:
1. The secretion of signaling molecules
2. It provides structural support to the developing embryo.
It extends from Rathke's pouch to the coccyx.
The cells of the human notochord are replaced at four years of age by chondrocyte-like cells. They remain near the midline and become trapped in the bone.
These remains present as a spectrum of entities, ranging from anatomical variants (canalis basilaris medianu, persistent notochordal canal), benign tumors (benign notochordal cell tumor, Tornwaldt cyst, ecchordosis physaliphora) and malignant neoplasms of notochordal origin (chordoma).

Conclusões

The notochord plays a key role in the formation of the spinal column, leaving traces in the nucleus pulposus of the intervertebral discs. These remains can give rise to anatomical variants as well as benign and malignant tumors.
Understanding embryonic development and associated pathological conditions is essential for an accurate diagnosis.

Palavras Chave

CNS; embriology; Notochord

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