Analysis of sagittal spinopelvic parameters in achondroplasia.

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Hong, Jae-Young; Suh, Seung-Woo; Modi, Hitesh N; Park, Jong-Woong; Park, Jung-Ho

2011-08-15

Prospective radiological analysis of patients with achondroplasia. To analyze sagittal spinal alignment and pelvic orientation in achondroplasia patients. Knowledge of sagittal spinopelvic parameters is important for the treatment of achondroplasia, because they differ from those of the normal population and can induce pain. The study and control groups were composed of 32 achondroplasia patients and 24 healthy volunteers, respectively. All underwent lateral radiography of the whole spine including hip joints. The radiographic parameters examined were sacral slope (SS), pelvic tilt, pelvic incidence (PI), S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis (LL1, LL2), and sagittal balance. Statistical analysis was performed to identify significant differences between the two groups. In addition, correlations between parameters and symptoms were sought. Sagittal spinopelvic parameters, namely, pelvic tilt, pelvic incidence, S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis 1 and sagittal balance were found to be significantly different in the patient and control groups (P achondroplasia patients and normal healthy controls. The present study shows that sagittal spinal and pelvic parameters can assist the treatment of spinal disorders in achondroplasia patients.

A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism

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Čutović Tatjana

2014-01-01

Full Text Available Bacground/Aim. The literature suggests different views on the correlation between the cranial base morphology and size and saggital intermaxillary relationships. The aim of this study was to investigate the cranial base morphology, including the frontal facial part in patients with mandibular prognathism, to clarify a certain ambiguities, in opposing viewspoints in the literature. Methods. Cephalometric radiographies of 60 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, with no previous orthodontic treatment. On the basis of dental and sceletal relations of jaws and teeth, the patients were divided into two groups: the group P (patients with mandibular prognathism and the group E (the control group or eugnathic patients. A total of 15 cephalometric parametres related to the cranial base, frontal part of the face and sagittal intermaxillary relationships were measured and analyzed. Results. The results show that cranial base dimensions and the angle do not play a significant role in the development of mandibular prognathism. Interrelationship analysis indicated a statistically significant negative correlation between the cranial base angle (NSAr and the angles of maxillary (SNA and mandibular (SNB prognathism, as well as a positive correlation between the angle of inclination of the ramus to the cranial base (GoArNS and the angle of sagittal intermaxillary relationships (ANB. Sella turcica dimensions, its width and depth, as well as the nasal bone length were significantly increased in the patients with mandibular prognathism, while the other analyzed frontal part dimensions of the face were not changed by the malocclusion in comparison with the eugnathic patients. Conclusion. This study shows that the impact of the cranial base and the frontal part of the face on the development of profile in patients with mandibular prognathism is much smaller, but

The Influence of Natural Head Position on the Cervical Sagittal Alignment

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Kuan Wang

2017-01-01

Full Text Available Introduction. This study investigated the relationship between the parameters related to the natural head position and cervical segmental angles and alignment of patients with neck pain. Material and Methods. The lateral radiographs of the cervical spine were collected from 103 patients and were used to retrospectively analyze the correlation between the natural head position, cervical local sagittal angles, and alignment. Sagittal measurements were as follows: cervical curvature classification, slope of McGregor’s line (McGS, local sagittal angles (C0–C2 angle, C2–C5 angle, C5–C7 angle, and C2–C7 angle, T1 slope, center of gravity of the head to sagittal vertical axis (CG–C7 SVA, and local sagittal alignment (C0–C2 SVA and C2–C7 SVA. Results. McGS was significantly correlated to C0–C2 angle (r=0.57, C0–C2 SVA (r=−0.53, C2–C7 SVA (r=−0.28, and CG–C7 SVA (r=−0.47. CG–C7 SVA was also significantly correlated to curvature type (r=0.27, C5–C7 angle (r=−0.37, and C2–C7 angle (r=−0.39. Conclusions. A backward shift with an extended head position may accompany a relatively normal curvature of the cervical spine. The effect of posture control in relieving abnormal mechanical state of the cervical spine needs to be further confirmed by biomechanical analysis.

Correlation Between Lumbopelvic and Sagittal Parameters and Health-Related Quality of Life in Adults With Lumbosacral Spondylolisthesis.

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Gussous, Yazeed; Theologis, Alexander A; Demb, Joshua B; Tangtiphaiboontana, Jennifer; Berven, Sigurd

2018-02-01

Secondary analysis of prospective, multicenter data. To evaluate impact of sagittal parameters on health-related quality of life (HRQoL) in adults with lumbosacral spondylolisthesis. Adults with unoperated lumbosacral spondylolisthesis were identified in the Spinal Deformity Study Group database. Pearson's correlations were calculated between SF-12 (Short Form-12)/Scoliosis Research Society-30 (SRS-30) scores and radiographic parameters (C7 sagittal vertical axis [SVA] deviation, T1 pelvic angle, pelvic tilt [PT], pelvic incidence, sacral slope, slip angle, Meyerding slip grade, Labelle classification). Main effects linear regression models measured association between individual health status measures and individual radiographic predictor variables. Forty-five patients were analyzed (male, 15; female, 30; average age 40.5 ± 18.7 years; 14 low-grade, 31 high-grade). For low-grade slips, SVA had strong negative correlations with SF-12 mental component score (MCS), SRS-30 appearance, mental, and satisfaction domains ( r = -0.57, r = -0.60, r = -0.58, r = -0.53, respectively; P grade slips, slip angle had a moderate negative correlation with SF-12 MCS ( r = -0.36; P = .05) and SVA had strong negative correlations with SF-12 physical component score (PCS), SRS-30 appearance and activity domains ( r = -0.48, r = -0.48, r = -0.45; P point decrease in SRS appearance, 0.05-point decrease in SRS activity, 0.06-point decrease in SRS satisfaction, and 0.04-point decrease in SRS total score ( P grade slips. Improvement of sagittal parameters is an important goal of surgery for adults with lumbosacral spondylolisthesis.

Training intensity and sagittal curvature of the spine in male and female artistic gymnasts.

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Sanz-Mengibar, Jose M; Sainz-de-Baranda, Pilar; Santonja-Medina, Fernando

2018-04-01

Specific adaptations of the spine in the sagittal plane have been described according to different sports disciplines. The goal of this study was to describe the integrative diagnosis of the sagittal morphotype of the spine in male and female artistic gymnasts. Forty-eight gymnasts were measured with an inclinometer. Thoracic and lumbar curves were quantified in standing position, in Sit and Reach and Slump Sitting in order to assess the sagittal spine posture and analyze if adaptations were related to training intensity. Correlation values of the sagittal plane spine measurements showed significantly increased thoracic kyphosis in men (-0.445, Partistic gymnastics; however, this sport seems to cause specific adaptations in postural hypolordosis, functional thoracic kyphosis and lumbar kyphotic attitude during sitting and trunk flexion. The implications of the functional adaptations observed in our results may require a preventive intervention in male and female artistic gymnasts can be assessed with the integrative diagnosis of the sagittal morphotype of the spine.

'Lumbar Degenerative Kyphosis' Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception.

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Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-03-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

Influence of the sagittal anatomy of the pelvis on the intercrestal line position.

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Horduna, M; Legaye, J

2008-03-01

The line joining the two iliac crests is classically regarded as the anatomical landmark determining the inter-vertebral space L4-L5 for the spinal punctures. Its variability has been reported but never related to predictive clinical anatomic factors identifying patients groups in which there is increased risk of miscalculation of the spinal level. Two sagittal pelvic anatomical angles, called 'pelvic incidence' and 'pelvic lordosis' were measured on lateral X-rays of the pelvis of 132 normal individuals and 49 spondylolysis patients. The values were compared with the sagittal projection of the intercrestal line on the disco-vertebral lumbar structures. A strict relation was observed between this projection of the intercrestal line and the sagittal pelvic anatomical angles. The greater the pelvic incidence, the higher the intercrestal line was projected, all the more in patients with spondylolysis with a listhesis or a disc narrowing. The relation between the pelvic sagittal angles and the intercrestal line projection explains the variability described for this anatomical landmark. It implies precautions minimizing neurological risk in the case of a puncture carried out more cranially than expected, particularly for high values of pelvic incidence occurring in spinal pathologies such as spondylolysis, in the elderly or in the obese patients. In these cases, we recommend the use of spinal imaging during the procedure to assist selection of the desired insertion level.

The usefulness of sagittal reformation for diagnosis of sternal fracture

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Im, Dong Jin; Hahn, Seok; Kim, Young Ju [Dept. of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

2014-01-15

The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

The usefulness of sagittal reformation for diagnosis of sternal fracture

International Nuclear Information System (INIS)

Im, Dong Jin; Hahn, Seok; Kim, Young Ju

2014-01-01

The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

‘Lumbar Degenerative Kyphosis’ Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception

Science.gov (United States)

Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-01-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name “primary degenerative sagittal imbalance” (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK. PMID:28264231

Acute proximal junctional failure in patients with preoperative sagittal imbalance.

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Smith, Micah W; Annis, Prokopis; Lawrence, Brandon D; Daubs, Michael D; Brodke, Darrel S

2015-10-01

Proximal junctional failure (PJF) is a recognized complication of spinal deformity surgery. Acute PJF (APJF) has recently been demonstrated to be 5.6% in the adult spinal deformity (ASD) population. The incidence and rate of return to the operating room for APJF have not been specifically investigated in individuals with sagittal imbalance. The purpose of this study was to report the incidence of APJF in patients with preoperative sagittal imbalance and the rate of return to the operating room for APJF. This study is based on a retrospective review of prospectively collected database of ASD patients. One hundred seventy-three consecutive patients were included with preoperative sagittal imbalance according to one of the following common parameters: sagittal vertical axis (SVA) greater than 50 mm, global sagittal alignment greater than 45°, or pelvic incidence minus lumbar lordosis greater than 10°. Outcome measure was presence and/or absence of APJF defined as fracture at the upper instrumented vertebra (UIV) or UIV+1, failure of UIV fixation, 15° or more proximal junctional kyphosis, or need for extension of instrumentation within 6 months of surgery. We performed radiographic measurements on X-rays at preoperative, immediate postoperative, and 6-month follow-up visits. The APJF rate was reported for the entire patient population with preoperative sagittal imbalance. Acute PJF incidence was calculated postoperatively for each of the accepted sagittal balance parameters and/or formulas. Patients with persistent postoperative sagittal imbalance were compared with the sagittally balanced group. We also assessed for threshold values. Acute PJF was observed in 60 of 173 patients (35%) and was least common in fusions with the UIV in the upper thoracic (UT) spine (p=.035). Of those who developed APJF, 21.7% required surgery. Proximal junctional kyphosis 15° or more was the most common form of APJF in fusions to the UT spine but least likely to need revision (p=.014

FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

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Luis Muñiz Luna

2016-03-01

Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

Comparing Outcomes and Cost of 3 Surgical Treatments for Sagittal Synostosis: A Retrospective Study Including Procedure-Related Cost Analysis.

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Garber, Sarah T; Karsy, Michael; Kestle, John R W; Siddiqi, Faizi; Spanos, Stephen P; Riva-Cambrin, Jay

2017-10-01

Neurosurgical techniques for repair of sagittal synostosis include total cranial vault (TCV) reconstruction, open sagittal strip (OSS) craniectomy, and endoscopic strip (ES) craniectomy. To evaluate outcomes and cost associated with these 3 techniques. Via retrospective chart review with waiver of informed consent, the last consecutive 100 patients with sagittal synostosis who underwent each of the 3 surgical correction techniques before June 30, 2013, were identified. Clinical, operative, and process of care variables and their associated specific charges were analyzed along with overall charge. The study included 300 total patients. ES patients had fewer transfusion requirements (13% vs 83%, P cost savings compared with the TCV reconstruction. The charges were similar to those incurred with OSS craniectomy, but patients had a shorter length of stay and fewer revisions. Copyright © 2017 by the Congress of Neurological Surgeons

Measuring Fractional Anisotropy of the Corpus Callosum Using Diffusion Tensor Imaging: Mid-Sagittal versus Axial Imaging Planes

International Nuclear Information System (INIS)

Kim, Eung Yeop; Park, Hae Jeong; Kim, Dong Hyun; Lee, Seung Koo; Kim, Jin Na

2008-01-01

Many diffusion tensor imaging (DTI) studies of the corpus callosum (CC) have been performed with a relatively thick slice thickness in the axial plane, which may result in underestimating the fractional anisotropy (FA) of the CC due to a partial volume effect. We hypothesized that the FA of the CC can be more accurately measured by using mid-sagittal DTI. We compared the FA values of the CC between the axial and mid-sagittal DTI. Fourteen healthy volunteers underwent MRI at 3.0 T. DTI was performed in both the mid-sagittal and axial planes. One 5-mm mid-sagittal image and twenty-five 2-mm axial images were obtained for the CC. The five regions of interest (ROIs) that included the prefrontal (I), premotor and supplementary motor (II), motor (III), sensory (IV) and parietal, temporal and occipital regions (V) were drawn along the border of the CC on each sagittal FA map. The FA values obtained from each region were compared between the two sagittal maps. The FA values of all the regions, except for region V, were significantly increased on the mid-sagittal imaging. The FA values in region IV were significantly underestimated on the mid-sagittal image from the axial imaging, compared with those in the regions I and V (p = 0.037 and p = 0.001, respectively). The FA values of the CC were significantly higher on the midsagittal DTI than those on the axial DTI in regions I-IV, and particularly in the region IV. Mid-sagittal DTI may provide more accurate FA values of the CC than can the axial DTI, and mid-sagittal DTI may be more desirable for studies that compare between patients and healthy subjects

Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis.

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Vidal, Christophe; Ilharreborde, Brice; Azoulay, Robin; Sebag, Guy; Mazda, Keyvan

2013-06-01

Radiological reproducibility study. To assess intra and interobserver reliability of radiographic measurements for global sagittal balance parameters and sagittal spine curves, including cervical spine. Sagittal spine balance in adolescent idiopathic scoliosis (AIS) is a main issue and many studies have been reported, showing that coronal and sagittal deformities often involve sagittal cervical unbalance. Global sagittal balance aims to obtain a horizontal gaze and gravity line at top of hips when subject is in a static position, involving adjustment of each spine curvature in the sagittal plane. To our knowledge, no study did use a methodologically validated imaging analysis tool able to appreciate sagittal spine contours and distances in AIS and especially in the cervical region. Lateral full-spine low-dose EOS radiographs were performed in 75 patients divided in three groups (control subjects, AIS, operated AIS). Three observers digitally analyzed twice each radiograph and 11 sagittal measures were collected for each image. Reliability was assessed calculating intraobserver Pearson's r correlation coefficient, interobserver intra-class correlation coefficient (ICC) completed with a two-by-two Bland-Altman plot analysis. This measurement method has shown excellent intra and interobserver reliability in all parameters, sagittal curvatures, pelvic parameters and global sagittal balance. This study validated a simple and efficient tool in AIS sagittal contour analysis. It defined new relevant landmarks allowing to characterize cervical segmental curvatures and cervical involvement in global balance.

Back to the future: sagittal CT in the evaluation of COPD

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Hightower, Jessica S.; Amadi, Chiemezie; Den, Elana; Schmitt, James E.; Shah, Rosita M.; Miller, Wallace T.

2016-01-01

To identify features of obstructive airway disease on sagittal reconstruction, compare the accuracy of findings to traditional imaging characteristics of COPD, and determine the fraction of additional cases identified using new characteristics. The study was approved by the centre's Institutional Review Board and is HIPAA compliant. Two hundred sixteen patients with HRCT and spirometry within a 3-month window were included. Four radiologists evaluated each HRCT for traditional characteristics of COPD and new quantitative and qualitative features of obstruction on axial and sagittal reconstructions. Imaging characteristics were assessed for correlation with the spirometric diagnosis of obstructive airway disease. Quantitative and qualitative findings on sagittal reconstruction are highly specific for COPD (specificity >90 %). Features of hyperinflation on sagittal reconstruction are more accurate predictors of obstruction than traditional axial measures, with greater interobserver reliability (hyperinflation left hemidiaphragm: accuracy: 70.08 % ± 2.49 %; kappa: 0.511 versus traditional measures: accuracy: 62.00 % ± 5.38 %; kappa: 0.407). Sagittal reconstruction identified 27-70 % more patients with COPD than traditional axial findings (p < 0.05). Analysis of sagittal reconstruction enables greater accuracy and specificity in the diagnosis of obstructive airway disease compared to traditional measures on axial imaging. Use of sagittal reconstructions can help identify up to 70 % more patients with COPD than traditional imaging findings alone. (orig.)

Anthropometric outcome of sagittal craniosynostosis following surgery

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Takagi, Toshinori; Morota, Nobuhito; Ihara, Satoshi; Kaneko, Tsuyoshi

2011-01-01

Several studies have shown good short-term outcomes after surgery for sagittal synostosis. However, the improvement in head shape usually regresses over the long term. The aim of this study was to compare anthropometric changes after surgery between osteoplastic expansion surgery and distraction osteogenesis for correcting sagittal synostosis. From November 2002 through December 2008, 17 patients with sagittal synostosis were analyzed. Anthropometric changes were assessed with cephalic indices obtained with computed tomography of the skull. The age of the patients at the time of surgery ranged from 2 to 25 months (mean, 8.2 months), and the follow-up period ranged from 6 to 63 months (mean, 17 months). In 16 patients, the cephalic index showed improvement immediately after surgery but gradually decreased in the follow-up period. The improving rate was decreased more after osteoplastic expansion surgery than after distraction osteogenesis (p<0.01). Although long-term follow-up is necessary, morphological improvement persists to a greater degree after distraction surgery. (author)

A clinico-radiographic study to compare and co-relate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in completely edentulous patients.

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Shetty, Sanath; Kunta, Mythili; Shenoy, Kamalakanth

2018-01-01

The purpose of this study was to compare and correlate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in edentulous patients. Twelve completely edentulous patients were selected by the inclusion and exclusion criteria. Conventional steps in the fabrication of complete denture till jaw relation were carried out. Intraoral gothic arch tracing and protrusive interocclusal records were obtained for each patient. Protrusive interocclusal record was used to program the Hanau Wide-Vue semi-adjustable articulator, thus obtaining the sagittal condylar guidance angle. Using RadiAnt DICOM software, on the orthopantomogram obtained for each patient in the study, two reference lines were drawn. The Frankfort's horizontal plane and the mean curvature line (joining the most superior and the inferior points on the glenoid fossa curvature) were drawn. The mean curvature line was extended to intersect the Frankfort's horizontal plane, thus obtaining the radiographic sagittal condylar guidance angle. The condylar guidance angles obtained by these two methods were compared and subjected to paired t -test. There was no statistically significant difference between the sagittal condylar guidance angles obtained between right and left sides with intraoral gothic arch tracing and radiographic methods ( P = 0.107 and 0.07, respectively). Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used for programming semi-adjustable articulators.

Pedicle subtraction osteotomy in elderly patients with degenerative sagittal imbalance.

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Cho, Kyu-Jung; Kim, Ki-Tack; Kim, Whoan-Jeang; Lee, Sang-Hoon; Jung, Jae-Hoon; Kim, Young-Tae; Park, Hae-Bong

2013-11-15

Retrospective, radiographical analysis. To evaluate pedicle subtraction osteotomy (PSO) as a means of correcting severe degenerative sagittal imbalance in elderly patients. PSO in patients with degenerative sagittal imbalance is likely to cause more complications than in patients with iatrogenic flatback deformity. This study analyzed 34 patients who underwent fusion to the sacrum, with a minimum 2-year follow-up. Age of the patients were in the range from 58 to 73 with the mean at 65.5 years. PSO was performed at one segment in all cases, consisting of L3 (n = 26), L4 (n = 4), L2 (n = 3), and L1 (n = 1). The average number of levels fused was 8.15. Ten patients had structural interbody fusion at the lumbosacral junction. Applying PSO at one segment, the mean correction of the lordotic angle at the osteotomy site was 33.3°, of which the loss of correction (LOC) was 4.0° at the last visit. The correction of lumbar lordosis was 33.7° and the LOC was 8.5°. The sagittal C7 plumb was 215.9 mm before surgery, corrected to 35.1 mm after surgery, and changed to 95.9 mm by the last visit. The correction of the sagittal C7 plumb was 119.9 mm and the LOC was 60.9 mm. There was substantial LOC in lumbar lordosis and sagittal C7 plumb. In 10 patients with addition of posterior lumbar interbody fusion, the LOC of lumbar lordosis was 7.4°, which was less than 9° in those without it. PSO for the correction of degenerative sagittal imbalance in elderly patients resulted in correction of sagittal alignment with a significant LOC of lumbar lordosis and sagittal C7 plumb. The LOC of lumbar lordosis occurred at both the osteotomy and non-osteotomy site. The addition of anterior column support is helpful to maintain correction and reduce complications. N/A.

Walking sagittal balance correction by pedicle subtraction osteotomy in adults with fixed sagittal imbalance.

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Yagi, Mitsuru; Kaneko, Shinjiro; Yato, Yoshiyuki; Asazuma, Takashi; Machida, Masafumi

2016-08-01

Pedicle subtraction osteotomy (PSO) is widely used to treat severe fixed sagittal imbalance. However, the effect of PSO on balance has not been fully documented. The aim of this study was to assess dynamic walking balance after PSO to treat fixed sagittal imbalance. Gait and balance were assessed in 15 consecutive adult female patients who had been treated by PSO for a fixed sagittal imbalance and compare patients' preop and postop dynamic walking balance with that of 15 age- and gender-matched healthy volunteers (HV). Each patient's chart, X-rays, pre and postop SRS22 outcome scores, and ODI were reviewed. Means were compared by Mann-Whitney U test and Chi-square test. The mean age was 66.3 years (51-74 years). The mean follow-up was 2.7 years (2-3.5 years). The C7PL and GL, measured on the force platform, were both improved from 24.2 ± 7.3 cm and 27.6 ± 9.4 to 5.4 ± 2.6 cm and 7.2 ± 3.4 cm, respectively. The baseline hip ROM was significantly smaller in patients compared to HV, whereas no significant difference was observed in the knee or ankle ROM. The pelvic tilt (preop -0.4° ± 1.4°, postop 8.9° ± 1.0°), and maximum hip-extension angle (preop -1.2° ± 14.2°, postop -11.2° ± 7.2°) were also improved after surgery. Cadence (116 s/min), stance-swing ratio (stance 63.2 % vs. swing 36.8 %), and stride (98.0 cm) were all increased after surgery. On the other hand, gait velocity was significantly slower in the PSO group at both pre and postop than in HV (PSO 53.3 m/min at preop and 58.8 m/min at postop vs. HV 71.1 m/min, p = 0.04). Despite a mild residual spinal-pelvic malalignment, PSO restored sagittal alignment and balance satisfactorily and has improved the gait pattern.

Impact of sagittal spinopelvic alignment on clinical outcomes after decompression surgery for lumbar spinal canal stenosis without coronal imbalance.

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Hikata, Tomohiro; Watanabe, Kota; Fujita, Nobuyuki; Iwanami, Akio; Hosogane, Naobumi; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

2015-10-01

The object of this study was to investigate correlations between sagittal spinopelvic alignment and improvements in clinical and quality-of-life (QOL) outcomes after lumbar decompression surgery for lumbar spinal canal stenosis (LCS) without coronal imbalance. The authors retrospectively reviewed data from consecutive patients treated for LCS with decompression surgery in the period from 2009 through 2011. They examined correlations between preoperative or postoperative sagittal vertical axis (SVA) and radiological parameters, clinical outcomes, and health-related (HR)QOL scores in patients divided according to SVA. Clinical outcomes were assessed according to Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores. Health-related QOL was evaluated using the Roland-Morris Disability Questionnaire (RMDQ) and the JOA Back Pain Evaluation Questionnaire (JOABPEQ). One hundred nine patients were eligible for inclusion in the study. Compared to patients with normal sagittal alignment prior to surgery (Group A: SVA imbalance (Group B: SVA ≥ 50 mm) had significantly smaller lumbar lordosis and thoracic kyphosis angles and larger pelvic tilt. In Group B, there was a significant decrease in postoperative SVA compared with the preoperative SVA (76.3 ± 29.7 mm vs. 54.3 ± 39.8 mm, p = 0.004). The patients in Group B with severe preoperative sagittal imbalance (SVA > 80 mm) had residual sagittal imbalance after surgery (82.8 ± 41.6 mm). There were no significant differences in clinical and HRQOL outcomes between Groups A and B. Compared to patients with normal postoperative SVA (Group C: SVA imbalance. Decompression surgery improved the SVA value in patients with preoperative sagittal imbalance; however, the patients with severe preoperative sagittal imbalance (SVA > 80 mm) had residual imbalance after decompression surgery. Both clinical and HRQOL outcomes were negatively affected by postoperative residual sagittal imbalance.

Measurement and Finite Element Model Validation of Immature Porcine Brain-Skull Displacement during Rapid Sagittal Head Rotations.

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Pasquesi, Stephanie A; Margulies, Susan S

2018-01-01

Computational models are valuable tools for studying tissue-level mechanisms of traumatic brain injury, but to produce more accurate estimates of tissue deformation, these models must be validated against experimental data. In this study, we present in situ measurements of brain-skull displacement in the neonatal piglet head ( n  = 3) at the sagittal midline during six rapid non-impact rotations (two rotations per specimen) with peak angular velocities averaging 51.7 ± 1.4 rad/s. Marks on the sagittally cut brain and skull/rigid potting surfaces were tracked, and peak values of relative brain-skull displacement were extracted and found to be significantly less than values extracted from a previous axial plane model. In a finite element model of the sagittally transected neonatal porcine head, the brain-skull boundary condition was matched to the measured physical experiment data. Despite smaller sagittal plane displacements at the brain-skull boundary, the corresponding finite element boundary condition optimized for sagittal plane rotations is far less stiff than its axial counterpart, likely due to the prominent role of the boundary geometry in restricting interface movement. Finally, bridging veins were included in the finite element model. Varying the bridging vein mechanical behavior over a previously reported range had no influence on the brain-skull boundary displacements. This direction-specific sagittal plane boundary condition can be employed in finite element models of rapid sagittal head rotations.

Measurement and Finite Element Model Validation of Immature Porcine Brain–Skull Displacement during Rapid Sagittal Head Rotations

Science.gov (United States)

Pasquesi, Stephanie A.; Margulies, Susan S.

2018-01-01

Computational models are valuable tools for studying tissue-level mechanisms of traumatic brain injury, but to produce more accurate estimates of tissue deformation, these models must be validated against experimental data. In this study, we present in situ measurements of brain–skull displacement in the neonatal piglet head (n = 3) at the sagittal midline during six rapid non-impact rotations (two rotations per specimen) with peak angular velocities averaging 51.7 ± 1.4 rad/s. Marks on the sagittally cut brain and skull/rigid potting surfaces were tracked, and peak values of relative brain–skull displacement were extracted and found to be significantly less than values extracted from a previous axial plane model. In a finite element model of the sagittally transected neonatal porcine head, the brain–skull boundary condition was matched to the measured physical experiment data. Despite smaller sagittal plane displacements at the brain–skull boundary, the corresponding finite element boundary condition optimized for sagittal plane rotations is far less stiff than its axial counterpart, likely due to the prominent role of the boundary geometry in restricting interface movement. Finally, bridging veins were included in the finite element model. Varying the bridging vein mechanical behavior over a previously reported range had no influence on the brain–skull boundary displacements. This direction-specific sagittal plane boundary condition can be employed in finite element models of rapid sagittal head rotations. PMID:29515995

Lenke 1 and 5: changes in sagittal balance

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Delson Valdemir Pessin

2014-09-01

Full Text Available OBJECTIVE: To assess in a cross-sectional study whether there are changes in sagittal balance in patients with adolescent idiopathic scoliosis Lenke types 1 and 5 compared with patients without pathology of the spine and compare the values of the parameters of normal subjects with the parameters found in the literature. METHODS: We measured the values of the parameters of sagittal balance of 21 patients with scoliosis and 14 patients without scoliosis in panoramic radiographs or simply collected data previously measured from the medical records. We compared the mean values of normal subjects, the mean values found in the literature, and the means between normal subjects and patients with scoliosis. For this, we used the Student t test. RESULTS: Using a confidence interval of 5% (p < 0.05 and the Student t test we obtained statistical significance in the comparison of two parameters of sagittal balance between normal subjects and patients with scoliosis. We observed similarities in the measurements of the average parameters of normal subjects with regard to the work already published. CONCLUSIONS: The adolescent idiopathic scoliosis causes changes in two parameters of sagittal balance with statistical significance but suggests changes in all other parameters. As for comparison with previously published work, the results were similar.

Gender difference of ankle stability in the sagittal and frontal planes.

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Hanzlick, Harrison; Hyunglae Lee

2017-07-01

This paper offers quantification of ankle stability in relation to simulated haptic environments of varying stiffness. This study analyzes the stability trends of male and female subjects independently over a wide range of simulated environments after subjects were exposed to vigorous position perturbation. Ankle stability was quantified for both degrees-of-freedom of the ankle in the sagittal and frontal planes. Subjects' stability consistently decreased when exposed to environments of negative simulated stiffness. In the frontal plane, male and female subjects exhibited nearly identical stability levels. In the sagittal plane, however, male subjects demonstrated marginally more stability than female subjects in environments with negative stiffness. Results of this study are beneficial to understanding situations in which the ankle is likely to lose stability, potentially resulting in injury.

Sagittal Alignment As a Predictor of Clinical Adjacent Segment Pathology requiring Surgery after Anterior Cervical Arthrodesis

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Park, Moon Soo; Kelly, Michael P.; Lee, Dong-Ho; Min, Woo-Kie; Rahman, Ra’Kerry K.; Riew, K. Daniel

2014-01-01

BACKGROUND CONTEXT Postoperative malalignment of the cervical spine may alter cervical spine mechanics, and put patients at risk for clinical adjacent segment pathology requiring surgery. PURPOSE To investigate whether a relationship exists between cervical spine sagittal alignment and clinical adjacent segment pathology requiring surgery (CASP-S) following anterior cervical fusion (ACF). STUDY DESIGN Retrospective matched study. PATIENT SAMPLE One hundred twenty two patients undergoing ACF from 1996 to 2008 were identified, with a minimum of 2 year follow-up. OUTCOME MEASURES Radiographs were reviewed to measure the sagittal alignment using C2 and C7 sagittal plumb lines, distance from the fusion mass plumb line to the C2 and C7 plumb lines, the alignment of the fusion mass, caudally adjacent disc angle, the sagittal slope angle of the superior endplate of the vertebra caudally adjacent to the fusion mass, T1 sagittal angle, overall cervical sagittal alignment, and curve patterns by Katsuura classification. METHODS One hundred twenty two patients undergoing ACF from 1996 to 2008 were identified, with a minimum of 1 year follow-up. Patients were divided into groups according to the development of CASP requiring surgery (Control / CASP-S) and by number/location of levels fused. Radiographs were reviewed to measure the sagittal alignment using C2 and C7 sagittal plumb lines, distance from the fusion mass plumb line to the C2 and C7 plumb lines, the alignment of the fusion mass, caudally adjacent disc angle, the sagittal slope angle of the superior endplate of the vertebra caudally adjacent to the fusion mass, T1 sagittal angle, overall cervical sagittal alignment, and curve patterns by Katsuura classification. Appropriate statistical tests were performed to calculate relationships between the variables and the development of CASP-S. No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related

Ipsilateral wrist-ankle movements in the sagittal plane encoded in extrinsic reference frame.

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Muraoka, Tetsuro; Ishida, Yuki; Obu, Takashi; Crawshaw, Larry; Kanosue, Kazuyuki

2013-04-01

When performing oscillatory movements of two joints in the sagittal plane, there is a directional constraint for performing such movements. Previous studies could not distinguish whether the directional constraint reflected movement direction encoded in the extrinsic (outside the body) reference frame or in the intrinsic (the participants' torso/head) reference frame since participants performed coordinated movements in a sitting position where the torso/head was stationary relative to the external world. In order to discern the reference frame in the present study, participants performed paced oscillatory movements of the ipsilateral wrist and ankle in the sagittal plane in a standing position so that the torso/head moved relative to the external world. The coordinated movements were performed in one of two modes of coordination, moving the hand upward concomitant with either ankle plantarflexion or ankle dorsiflexion. The same directional mode relative to extrinsic space was more stable and accurate as compared with the opposite directional mode. When forearm position was changed from the pronated position to the supinated position, similar results were obtained, indicating that the results were independent of a particular coupling of muscles. These findings suggest that the directional constraint on ipsilateral joints movements in the sagittal plane reflects movement direction encoded in the extrinsic reference frame. Copyright © 2013 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

Direct coronary and sagittal computerized tomography of the pelvis

International Nuclear Information System (INIS)

Maier, W.; Bargon, G.

1981-01-01

Whereas quite a number of reports have been published on direct coronary and sagittal computed tomography of the cranium, no extensive experience has been collected on multidimensional computerized tomography of the pelvis. In this article, the authors report on their preliminary experiences in direct approximately sagittal and coronary computerized tomography of the pelvis in a group of 76 patients. (orig.) [de

Spinal Schmorl's nodes: Sagittal sectional imaging and pathological examination

International Nuclear Information System (INIS)

Silberstein, M.; Opeskin, K.

1999-01-01

The presence, location and number of Schmorl's nodes was determined in the thoracolumbar spines of 70 motor vehicle accident victims using radiographic examination of a midline sagittal section and subsequent pathological examinations, including histology. In 28% of spines, a greater number of Schmorl's nodes were identified with radiography, while in 44%, pathological examination revealed a greater number of nodes. The visibility of Schmorl's nodes was enhanced by using a sagittal radiographic approach, and, in contrast to previous work, nodes below 0.5 cm 2 were readily detected. The results of the present study offer an additional imaging technique for postmortem analysis of the spine, and support the use of sagittal MR imaging for the evaluation of this condition. Copyright (1999) Blackwell Science Pty Ltd

An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures.

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Farber, Scott J; Nguyen, Dennis C; Harvey, Alan A; Patel, Kamlesh B

2016-03-01

Mandibular fractures represent a substantial portion of facial fractures in the pediatric population. Pediatric mandibles differ from their adult counterparts in the presence of mixed dentition. Avoidance of injury to developing tooth follicles is critical. Simple mandibular fractures can be treated with intermaxillary fixation (IMF) using arch bars or bone screws. This report describes an alternative to these methods using silk sutures and an algorithm to assist in treating simple mandibular fractures in the pediatric population. A retrospective chart review was performed and the records of 1 surgeon were examined. Pediatric patients who underwent treatment for a mandibular fracture in the operating room from 2011 to 2015 were identified using Common Procedural Terminology codes. Data collected included age, gender, type of fracture, type of treatment used, duration of fixation, and presence of complications. Five patients with a mean age of 6.8 years at presentation were identified. Fracture types were unilateral fractures of the condylar neck (n = 3), bilateral fractures of the condylar head (n = 1), and a unilateral fracture of the condylar head with an associated parasymphyseal fracture (n = 1). IMF was performed in 4 patients using silk sutures, and bone screw fixation was performed in the other patient. No post-treatment complications or malocclusion were reported. Average duration of IMF was 18.5 days. An algorithm is presented to assist in the treatment of pediatric mandibular fractures. Silk suture fixation is a viable and safe alternative to arch bars or bone screws for routine mandibular fractures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Influence of implant rod curvature on sagittal correction of scoliosis deformity.

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Salmingo, Remel Alingalan; Tadano, Shigeru; Abe, Yuichiro; Ito, Manabu

2014-08-01

Deformation of in vivo-implanted rods could alter the scoliosis sagittal correction. To our knowledge, no previous authors have investigated the influence of implanted-rod deformation on the sagittal deformity correction during scoliosis surgery. To analyze the changes of the implant rod's angle of curvature during surgery and establish its influence on sagittal correction of scoliosis deformity. A retrospective analysis of the preoperative and postoperative implant rod geometry and angle of curvature was conducted. Twenty adolescent idiopathic scoliosis patients underwent surgery. Average age at the time of operation was 14 years. The preoperative and postoperative implant rod angle of curvature expressed in degrees was obtained for each patient. Two implant rods were attached to the concave and convex side of the spinal deformity. The preoperative implant rod geometry was measured before surgical implantation. The postoperative implant rod geometry after surgery was measured by computed tomography. The implant rod angle of curvature at the sagittal plane was obtained from the implant rod geometry. The angle of curvature between the implant rod extreme ends was measured before implantation and after surgery. The sagittal curvature between the corresponding spinal levels of healthy adolescents obtained by previous studies was compared with the implant rod angle of curvature to evaluate the sagittal curve correction. The difference between the postoperative implant rod angle of curvature and normal spine sagittal curvature of the corresponding instrumented level was used to evaluate over or under correction of the sagittal deformity. The implant rods at the concave side of deformity of all patients were significantly deformed after surgery. The average degree of rod deformation Δθ at the concave and convex sides was 15.8° and 1.6°, respectively. The average preoperative and postoperative implant rod angle of curvature at the concave side was 33.6° and 17.8�

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella.

Science.gov (United States)

Aksahin, Ertugrul; Aktekin, Cem Nuri; Kocadal, Onur; Duran, Semra; Gunay, Cüneyd; Kaya, Defne; Hapa, Onur; Pepe, Murad

2017-10-01

patellofemoral joint might be related to chondromalacia, especially in the presence of lesions in the upper and lower part of the patella. This condition leads to supraphysiological loadings on the patellofemoral joint. Sagittal patellar tilt should be considered in the evaluation and management of patellar cartilage defects. Taking sagittal plane malalignment into consideration in patellofemoral joint evaluation will enable us to design new physical and surgical modalities. IV.

Superior sagittal sinus thrombosis: a rare complication of nephrotic syndrome.

Directory of Open Access Journals (Sweden)

Tullu M

1999-10-01

Full Text Available A two and half year-old-male child, known case of steroid responsive nephrotic syndrome presented with fever and vomiting of acute onset. He was diagnosed to have superior sagittal sinus thrombosis on a contrast computerised tomographic scan of brain. Recovery was complete without anticoagulant therapy. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome.

Radiographic assessment of lower third molar eruption in different anteroposterior skeletal patterns and age-related groups.

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Jakovljevic, Aleksandar; Lazic, Emira; Soldatovic, Ivan; Nedeljkovic, Nenad; Andric, Miroslav

2015-07-01

To analyze radiographic predictors for lower third molar eruption among subjects with different anteroposterior skeletal relations and of different age groups. In total, 300 lower third molars were recorded on diagnostic digital orthopantomograms (DPTs) and lateral cephalograms (LCs). The radiographs were grouped according to sagittal intermaxillary angle (ANB), subject age, and level of lower third molar eruption. The DPT was used to analyze retromolar space, mesiodistal crown width, space/width ratio, third and second molar angulation (α, γ), third molar inclination (β), and gonion angle. The LC was used to determine ANB, angles of maxillar and mandibular prognathism (SNA, SNB), mandibular plane angle (SN/MP), and mandibular lengths. A logistic regression model was created using the statistically significant predictors. The logistic regression analysis revealed a statistically significant impact of β angle and distance between gonion and gnathion (Go-Gn) on the level of lower third molar eruption (P third molar impaction rate was significantly higher in the adult subgroup with the Class II (62.3%) compared with Class III subjects (31.7%; P third molar eruption were measured in Class III subjects. For valid estimation of mandibular third molar eruption, certain linear and angular measures (β angle, Go-Gn), as well as the size of the retromolar space, need to be considered.

Evaluation of uterine peristalsis using cine MRI on the coronal plane in comparison with the sagittal plane.

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Shitano, Fuki; Kido, Aki; Kataoka, Masako; Fujimoto, Koji; Kiguchi, Kayo; Fushimi, Yasutaka; Togashi, Kaori

2016-01-01

Uterine peristalsis is supposed to be closely related to the early stages of reproduction. Sperms are preferentially transported from the uterine cervix to the side of the tube with the dominant follicle. However, with respect to magnetic resonance imaging (MRI), uterine peristalsis has only been evaluated at the sagittal plane of cine MRI. To evaluate and compare uterine peristalsis both on sagittal and coronal planes using cine MRI. Internal ethics committee approval was obtained, and subjects provided informed written consent. Thirty-one women underwent MRI scans in the periovulatory phase of the menstrual cycle. Cine MR images obtained by fast advanced spin echo sequence at 3-T field strength magnet (Toshiba Medical Systems) were visually evaluated by two independent radiologists. The frequency and the direction of peristalsis, and the presence of outer myometrium conduction of signal intensities (OMC), were evaluated. The laterality of the dominant follicle was determined on axial images and compared with the peristaltic direction in fundus. The subjects in which peristaltic directions were more clearly recognized were significantly frequent in coronal planes than in sagittal planes (P < 0.05). There was no significant difference in the peristaltic frequency between the sagittal and the coronal plane. However, the OMC was more recognized in the coronal plane than in the sagittal plane (P < 0.05). Peristaltic waves conducted toward the possible ovulation side were observed in only three of the 10 subjects. OMC of uterine peristalsis was better demonstrated in the coronal plane compared to the sagittal plane. © The Foundation Acta Radiologica 2015.

Reproduction of superior sagittal sinus animal model by bypass transplantation of biomaterial graft

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Qing-yong LUO

2011-03-01

Full Text Available Objective To establish the beagles model of superior sagittal sinus bypass graft,and explore the feasibility of reconstruction of superior sagittal sinus with biomaterials using this model.Methods Eight adult male beagles(weight: 12.5-22.0kg were involved in the present study.The superior sagittal sinus was exposed and blocked via bone window,and then anastomosed side-to-end to the biomaterial graft under the dedicated microscope of neurosurgery surgery,expectant treatment such as anti-inflammatory was given for the animals.The digital subtraction venography(DSV and color Doppler flow imaging(CDFI of superior sagittal sinus were performed in 1,2,4 and 8 weeks after the operation.Eight weeks after the operation,all the animals were sacrificed and the material graft was examined histologically.Results The DSV and CDFI of superior sagittal sinus showed that the stomas of 2 beagles were with slight stenosis and high flow velocity,of 1 beagle with small leakage and low flow velocity,while of other 5 beagles were normal.The histological examination showed endothelial cells were growing on the graft and superior sagittal sinus,and crawling toward the lumen of graft 8 weeks after the operation.Conclusion The beagles model of superior sagittal sinus bypass graft was established successfully.The short-term effect of the model was satisfactory,while further work should be performed to determine the long-term effects.

Mid-sagittal plane and mid-sagittal surface optimization in brain MRI using a local symmetry measure

DEFF Research Database (Denmark)

Stegmann, Mikkel Bille; Skoglund, Karl; Ryberg, Charlotte

2005-01-01

, the mid-sagittal plane is not always planar, but a curved surface resulting in poor partitioning of the brain hemispheres. To account for this, this paper also investigates an optimization strategy which fits a thin-plate spline surface to the brain data using a robust least median of squares estimator...

Development of synthetic simulators for endoscope-assisted repair of metopic and sagittal craniosynostosis.

Science.gov (United States)

Eastwood, Kyle W; Bodani, Vivek P; Haji, Faizal A; Looi, Thomas; Naguib, Hani E; Drake, James M

2018-06-01

OBJECTIVE Endoscope-assisted repair of craniosynostosis is a safe and efficacious alternative to open techniques. However, this procedure is challenging to learn, and there is significant variation in both its execution and outcomes. Surgical simulators may allow trainees to learn and practice this procedure prior to operating on an actual patient. The purpose of this study was to develop a realistic, relatively inexpensive simulator for endoscope-assisted repair of metopic and sagittal craniosynostosis and to evaluate the models' fidelity and teaching content. METHODS Two separate, 3D-printed, plastic powder-based replica skulls exhibiting metopic (age 1 month) and sagittal (age 2 months) craniosynostosis were developed. These models were made into consumable skull "cartridges" that insert into a reusable base resembling an infant's head. Each cartridge consists of a multilayer scalp (skin, subcutaneous fat, galea, and periosteum); cranial bones with accurate landmarks; and the dura mater. Data related to model construction, use, and cost were collected. Eleven novice surgeons (residents), 9 experienced surgeons (fellows), and 5 expert surgeons (attendings) performed a simulated metopic and sagittal craniosynostosis repair using a neuroendoscope, high-speed drill, rongeurs, lighted retractors, and suction/irrigation. All participants completed a 13-item questionnaire (using 5-point Likert scales) to rate the realism and utility of the models for teaching endoscope-assisted strip suturectomy. RESULTS The simulators are compact, robust, and relatively inexpensive. They can be rapidly reset for repeated use and contain a minimal amount of consumable material while providing a realistic simulation experience. More than 80% of participants agreed or strongly agreed that the models' anatomical features, including surface anatomy, subgaleal and subperiosteal tissue planes, anterior fontanelle, and epidural spaces, were realistic and contained appropriate detail. More

Video raster stereography back shape reconstruction: a reliability study for sagittal, frontal, and transversal plane parameters.

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Schroeder, J; Reer, R; Braumann, K M

2015-02-01

As reliability of raster stereography was proved only for sagittal plane parameters with repeated measures on the same day, the present study was aiming at investigating variability and reliability of back shape reconstruction for all dimensions (sagittal, frontal, transversal) and for different intervals. For a sample of 20 healthy volunteers, intra-individual variability (SEM and CV%) and reliability (ICC ± 95% CI) were proved for sagittal (thoracic kyphosis, lumbar lordosis, pelvis tilt angle, and trunk inclination), frontal (pelvis torsion, pelvis and trunk imbalance, vertebral side deviation, and scoliosis angle), transversal (vertebral rotation), and functional (hyperextension) spine shape reconstruction parameters for different test-retest intervals (on the same day, between-day, between-week) by means of video raster stereography. Reliability was high for the sagittal plane (pelvis tilt, kyphosis and lordosis angle, and trunk inclination: ICC > 0.90), and good to high for lumbar mobility (0.86 < ICC < 0.97). Apart from sagittal plane spinal alignment, there was a lack of certainty for a high reproducibility indicated by wider ICC confidence intervals. So, reliability was fair to high for vertebral side deviation and the scoliosis angle (0.71 < ICC < 0.95), and poor to good for vertebral rotation values as well as for frontal plane upper body and pelvis position parameters (0.65 < ICC < 0.92). Coefficients for the between-day and between-week interval were a little lower than for repeated measures on the same day. Variability (SEM) was less than 1.5° or 1.5 mm, except for trunk inclination. Relative variability (CV) was greater in global trunk position and pelvis parameters (35-98%) than in scoliosis (14-20%) or sagittal sway parameters (4-8 %). Although we found a lower reproducibility for the frontal plane, raster stereography is considered to be a reliable method for the non-invasive, three-dimensional assessment of spinal alignment in normal non

Sagittal synostosis: I. Preoperative morphology of the skull

DEFF Research Database (Denmark)

Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

2006-01-01

The aim of this study was to characterise the preoperative morphology of the skull in sagittal synostosis in an objective and quantified way. The shapes of the skulls of 105 patients with isolated premature synostosis of the sagittal suture ( SS group) were studied and compared with those......, skull base, and orbit ( 42 in the lateral and 46 in the frontal projections), the production of plots of mean shape for each group, and the intergroup comparison of a series of 81 variables ( linear distance between selected landmarks, and angles defined by groups of three landmarks). Data from...... skull width. Comparison of the mean values of an SS subgroup to age-matched normative data showed a longer (p differ significantly...

Postural Consequences of Cervical Sagittal Imbalance: A Novel Laboratory Model.

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Patwardhan, Avinash G; Havey, Robert M; Khayatzadeh, Saeed; Muriuki, Muturi G; Voronov, Leonard I; Carandang, Gerard; Nguyen, Ngoc-Lam; Ghanayem, Alexander J; Schuit, Dale; Patel, Alpesh A; Smith, Zachary A; Sears, William

2015-06-01

A biomechanical study using human spine specimens. To study postural compensations in lordosis angles that are necessary to maintain horizontal gaze in the presence of forward head posture and increasing T1 sagittal tilt. Forward head posture relative to the shoulders, assessed radiographically using the horizontal offset distance between the C2 and C7 vertebral bodies (C2-C7 [sagittal vertical alignment] SVA), is a measure of global cervical imbalance. This may result from kyphotic alignment of cervical segments, muscle imbalance, as well as malalignment of thoracolumbar spine. Ten cadaveric cervical spines (occiput-T1) were tested. The T1 vertebra was anchored to a tilting and translating base. The occiput was free to move vertically but its angular orientation was constrained to ensure horizontal gaze regardless of sagittal imbalance. A 5-kg mass was attached to the occiput to mimic head weight. Forward head posture magnitude and T1 tilt were varied and motions of individual vertebrae were measured to calculate C2-C7 SVA and lordosis across C0-C2 and C2-C7. Increasing C2-C7 SVA caused flexion of lower cervical (C2-C7) segments and hyperextension of suboccipital (C0-C1-C2) segments to maintain horizontal gaze. Increasing kyphotic T1 tilt primarily increased lordosis across the C2-C7 segments. Regression models were developed to predict the compensatory C0-C2 and C2-C7 angulation needed to maintain horizontal gaze given values of C2-C7 SVA and T1 tilt. This study established predictive relationships between radiographical measures of forward head posture, T1 tilt, and postural compensations in the cervical lordosis angles needed to maintain horizontal gaze. The laboratory model predicted that normalization of C2-C7 SVA will reduce suboccipital (C0-C2) hyperextension, whereas T1 tilt reduction will reduce the hyperextension in the C2-C7 segments. The predictive relationships may help in planning corrective strategy in patients experiencing neck pain, which may be

Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery.

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Shin, E Kyung; Kim, Chi Heon; Chung, Chun Kee; Choi, Yunhee; Yim, Dahae; Jung, Whei; Park, Sung Bae; Moon, Jung Hyeon; Heo, Won; Kim, Sung-Mi

2017-02-01

Lumbar spinal stenosis (LSS) is the most common lumbar degenerative disease, and sagittal imbalance is uncommon. Forward-bending posture, which is primarily caused by buckling of the ligamentum flavum, may be improved via simple decompression surgery. The objectives of this study were to identify the risk factors for sagittal imbalance and to describe the outcomes of simple decompression surgery. This is a retrospective nested case-control study PATIENT SAMPLE: This was a retrospective study that included 83 consecutive patients (M:F=46:37; mean age, 68.5±7.7 years) who underwent decompression surgery and a minimum of 12 months of follow-up. The primary end point was normalization of sagittal imbalance after decompression surgery. Sagittal imbalance was defined as a C7 sagittal vertical axis (SVA) ≥40 mm on a 36-inch-long lateral whole spine radiograph. Logistic regression analysis was used to identify the risk factors for sagittal imbalance. Bilateral decompression was performed via a unilateral approach with a tubular retractor. The SVA was measured on serial radiographs performed 1, 3, 6, and 12 months postoperatively. The prognostic factors for sagittal balance recovery were determined based on various clinical and radiological parameters. Sagittal imbalance was observed in 54% (45/83) of patients, and its risk factors were old age and a large mismatch between pelvic incidence and lumbar lordosis. The 1-year normalization rate was 73% after decompression surgery, and the median time to normalization was 1 to 3 months. Patients who did not experience SVA normalization exhibited low thoracic kyphosis (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.02-1.10) (pimbalance was observed in more than 50% of LSS patients, but this imbalance was correctable via simple decompression surgery in 70% of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Corpus callosum thickness on mid-sagittal MRI as a marker of brain volume: a pilot study in children with HIV-related brain disease and controls

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Andronikou, Savvas [University of the Witwatersrand, Department of Radiology, Faculty of Health Sciences, Cape Town (South Africa); Ackermann, Christelle [University of Stellenbosch, Department of Radiology, Stellenbosch (South Africa); Laughton, Barbara; Cotton, Mark [Stellenbosch University and Tygerberg Children' s Hospital, Children' s Infectious Diseases Research Unit, Stellenbosch (South Africa); Tomazos, Nicollette [University of Cape Town, Faculty of Commerce, Department of Management Studies, Cape Town (South Africa); Spottiswoode, Bruce [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town (South Africa); Mauff, Katya [University of Cape Town, Department of Statistical Sciences, Cape Town (South Africa); Pettifor, John M. [University of the Witwatersrand, MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, Witwatersrand (South Africa)

2015-07-15

Corpus callosum thickness measurement on mid-sagittal MRI may be a surrogate marker of brain volume. This is important for evaluation of diseases causing brain volume gain or loss, such as HIV-related brain disease and HIV encephalopathy. To determine if thickness of the corpus callosum on mid-sagittal MRI is a surrogate marker of brain volume in children with HIV-related brain disease and in controls without HIV. A retrospective MRI analysis in children (<5 years old) with HIV-related brain disease and controls used a custom-developed semi-automated tool, which divided the midline corpus callosum and measured its thickness in multiple locations. Brain volume was determined using volumetric analysis. Overall corpus callosum thickness and thickness of segments of the corpus callosum were correlated with overall and segmented (grey and white matter) brain volume. Forty-four children (33 HIV-infected patients and 11 controls) were included. Significant correlations included overall corpus callosum (mean) and total brain volume (P = 0.05); prefrontal corpus callosum maximum with white matter volume (P = 0.02); premotor corpus callosum mean with total brain volume (P = 0.04) and white matter volume (P = 0.02), premotor corpus callosum maximum with white matter volume (P = 0.02) and sensory corpus callosum mean with total brain volume (P = 0.02). Corpus callosum thickness correlates with brain volume both in HIV-infected patients and controls. (orig.)

Corpus callosum thickness on mid-sagittal MRI as a marker of brain volume: a pilot study in children with HIV-related brain disease and controls

International Nuclear Information System (INIS)

Andronikou, Savvas; Ackermann, Christelle; Laughton, Barbara; Cotton, Mark; Tomazos, Nicollette; Spottiswoode, Bruce; Mauff, Katya; Pettifor, John M.

2015-01-01

Corpus callosum thickness measurement on mid-sagittal MRI may be a surrogate marker of brain volume. This is important for evaluation of diseases causing brain volume gain or loss, such as HIV-related brain disease and HIV encephalopathy. To determine if thickness of the corpus callosum on mid-sagittal MRI is a surrogate marker of brain volume in children with HIV-related brain disease and in controls without HIV. A retrospective MRI analysis in children (<5 years old) with HIV-related brain disease and controls used a custom-developed semi-automated tool, which divided the midline corpus callosum and measured its thickness in multiple locations. Brain volume was determined using volumetric analysis. Overall corpus callosum thickness and thickness of segments of the corpus callosum were correlated with overall and segmented (grey and white matter) brain volume. Forty-four children (33 HIV-infected patients and 11 controls) were included. Significant correlations included overall corpus callosum (mean) and total brain volume (P = 0.05); prefrontal corpus callosum maximum with white matter volume (P = 0.02); premotor corpus callosum mean with total brain volume (P = 0.04) and white matter volume (P = 0.02), premotor corpus callosum maximum with white matter volume (P = 0.02) and sensory corpus callosum mean with total brain volume (P = 0.02). Corpus callosum thickness correlates with brain volume both in HIV-infected patients and controls. (orig.)

Sagittal reconstruction computed tomography in metrizamide cisternography. Useful diagnostic procedure for malformations in craniovertebral junction and posterior fossa

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Mochizuki, H.; Okita, N.; Fujii, T.; Yoshioka, M.; Saito, H. (Tohoku Univ., Sendai (Japan). School of Medicine)

1982-08-01

We studied the sagittal reconstruction technique in computed tomography with metrizamide. Ten ml of metrizamide, 170 mg iodine/ml in concentration, were injected by lumbar puncture. After diffusion of the injected metrizamide, axial computed tomograms were taken by thin slice width (5 mm) with overlapped technique. Then electrical sagittal reconstruction was carried out by optioned software. Injection of metrizamide, non-ionic water soluble contrast media, made clear contrasts among bone, brain parenchyma and cerebrospinal fluid with computed tomography. Sagittal reconstruction technique could reveal more precise details and accurate anatomical relations than ordinary axial computed tomography. This technique was applied on 3 cases (Arnold-Chiari malformation, large cisterna magna and partial agenesis cerebellar vermis), which demonstrated a useful diagnostic procedure for abnormalities of craniovertebral junction and posterior fossa. The adverse reactions of metrizamide were negligible in our series.

Sagittal alignment after single cervical disc arthroplasty.

Science.gov (United States)

Guérin, Patrick; Obeid, Ibrahim; Gille, Olivier; Bourghli, Anouar; Luc, Stéphane; Pointillart, Vincent; Vital, Jean-Marc

2012-02-01

Prospective study. To analyze the sagittal balance after single-level cervical disc replacement (CDR) and range of motion (ROM). To define clinical and radiologic parameters those have a significant correlation with segmental and overall cervical curvature after CDR. Clinical outcomes and ROM after CDR with Mobi-C (LDR, Troyes, France) prosthesis have been documented in few studies. No earlier report of this prosthesis has studied correlations between static and dynamic parameters or those between static parameters and clinical outcomes. Forty patients were evaluated. Clinical outcome was assessed using the Short Form-36 questionnaire, Neck Disability Index, and a Visual Analog Scale. Spineview software (Surgiview, Paris, France) was used to investigate sagittal balance parameters and ROM. The mean follow-up was 24.3 months (range: 12 to 36 mo). Clinical outcomes were satisfactory. There was a significant improvement of Short Form-36, Neck Disability Index, and Visual Analog Scale scores. Mean ROM was 8.3 degrees preoperatively and 11.0 degrees postoperatively (P=0.013). Mean preoperative C2C7 curvature was 12.8 and 16.0 degrees at last follow-up (P=0.001). Mean preoperative functional spinal unit (FSU) angle was 2.3 and 5.3 degrees postoperatively (P<0.0001). Mean postoperative shell angle was 5.5 degrees. There was a significant correlation between postoperative C2C7 alignment and preoperative C2C7 alignment, change of C2C7 alignment, preoperative and postoperative FSU angle, and prosthesis shell angle. There was also a significant correlation between postoperative FSU angle and preoperative C2C7 alignment, preoperative FSU angle, change of FSU angle, and prosthesis shell angle. Regression analysis showed that prosthesis shell angle and preoperative FSU angle contributed significantly to postoperative FSU angle. Moreover, preoperative C2C7 alignment, preoperative FSU angle, postoperative FSU angle, and prosthesis shell angle contributed significantly to

Strategic Considerations for Effective Sagittal Resection of the Mandible to Achieve a Slim and Attractive Jawline.

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Park, Sanghoon; Lee, Tae Sung

2018-01-01

Sagittal resection of the mandible has been widely used to reduce the width of the lower face and is usually carried out in combination with a mandibular contouring procedure. However, the surgical outcomes of this procedure are unclear because sagittal resection is rarely performed as a single procedure. The authors clarify misunderstandings regarding this procedure and introduce an improved strategic approach for sagittal resection of the mandible. Under general anesthesia, mandible contouring was performed first with a curved osteotomy, followed by sagittal resection of the outer cortex of mandible. The amount and extent of each procedure was determined in accordance with preoperative analysis. From 2012 to 2014, a consecutive series of 212 patients who underwent mandible contouring surgery without concomitant chin surgery were included in the study. A total of 189 patients underwent both mandibular contouring surgery and sagittal resection, whereas 13 underwent only sagittal resection and 10 underwent only mandibular contouring surgery. All operations were carried out successfully without any severe complications, and most patients had satisfactory aesthetic outcomes. The authors found that the sagittal resection of the mandible should be performed in accordance with the shape of the mandible to effectively reduce facial width and achieve better aesthetic outcomes for both profile and frontal views. In an outcurved-type mandible, conventional mandibular contouring may be effective alone, whereas sagittal resection focusing on removing the mandible body region is essential for incurved-type mandibles. In straight line-type mandibles, both procedures are necessary. Therapeutic, IV.

SAGITTAL DIAMETER OF FORAMEN MAGNUM IN NORMAL POPULATION: AN MRI STUDY

OpenAIRE

Lakshmi

2015-01-01

Lower position of cerebellar tonsils was frequently noticed in Western studies. In some of the studies, sagittal diameter of foramen magnum was found to be larger in cases of Chiari malformation. However, there are no Indian studies for comparison. Our study was proposed to determine the standard values for sagittal diameter of foramen magnum in various age groups and both sexes. This gives a guideline for further studies in pathological conditions like Craniovertebral Junctional ...

[Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures].

Science.gov (United States)

Chuanjun, Chen; Xiaoyang, Chen; Jing, Chen

2016-10-01

This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures. Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated com-plications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination. Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening. Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable place-ment of the fixation appliances.

Comparison of accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions: An exvivo study

Directory of Open Access Journals (Sweden)

Asieh Zamani Naser

2010-01-01

Full Text Available Background: Radiographic examination of TMJ is indicated when there are clinical signs of pathological conditions, mainly bone changes that may influence the diagnosis and treatment planning. The purpose of this study was to evaluate and to compare the validity and diagnostic accuracy of uncorrected and corrected sagittal tomographic images in the detection of simulated mandibular condyle erosions. Methods : Simulated lesions were created in 10 dry mandibles using a dental round bur. Using uncorrected and corrected sagittal tomography techniques, mandibular condyles were imaged by a Cranex Tome X-ray unit before and after creating the lesions. The uncorrected and corrected tomography images were examined by two independent observers for absence or presence of a lesion. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, and validity values. Differences between the two radiographic modalities were tested by Wilcoxon for paired data tests. Inter-observer agreement was determined by Cohen′s Kappa. Results: The sensitivity, specificity and validity were 45%, 85% and 30% in uncorrected sagittal tomographic images, respectively, and 70%, 92.5% and 60% in corrected sagittal tomographic images, respectively. There was a significant statistical difference between the accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions (P = 0.016. The inter-observer agreement was slight for uncorrected sagittal tomography and moderate for corrected sagittal tomography. Conclusion: The accuracy of corrected sagittal tomography is significantly higher than that of uncorrected sagittal tomography. Therefore, corrected sagittal tomography seems to be a better modality in detection of mandibular condyle erosions.

Direct CT scanning of the lesser pelvis - frontal vs sagittal plane

International Nuclear Information System (INIS)

Khadzhigeorgiev, G.; Lichev, A.

1994-01-01

Whenever axial scanning alone is used, the anatomical patterns of the true pelvis and the organs contained in it, particularly in women, give rise to diagnostic difficulties during CT assessment of neoplasms originating from these organs. The high demands on precision characterization of the pathological changes in the pelvis minor organs necessitate the obtaining of reliable density and size measurement data, not merely from the axial plane, but from the frontal and sagittal ones as well. The deficient information afforded by secondary reconstruction of the pelvis mind images requires an mandatory evaluation of the potentialities of direct frontal and direct sagittal scanning of the pelvis minor using standard CT equipment. Information yielded by images from direct frontal and direct sagittal pelvis minor scanning as well as diagnostic problems where application of this type of scanning is indicated operational difficulties and their overcoming, are among the issues discussed. 8 figs., 7 refs

A comparison of cephalometric analyses for assessing sagittal jaw relationship

International Nuclear Information System (INIS)

Erum, G.; Fida, M.

2008-01-01

To compare the seven methods of cephalometric analysis for assessing sagittal jaw relationship and to determine the level of agreement between them. Seven methods, describing anteroposterior jaw relationships (A-B plane, ANB, Wits, AXB, AF-BF, FABA and Beta angle) were measured on the lateral cephalographs of 85 patients. Correlation analysis, using Cramer's V-test, was performed to determine the possible agreement between the pair of analyses. The mean age of the sample, comprising 35 males and 50 females was 15 years and 3 months. Statistically significant relationships were found among seven sagittal parameters with p-value <0.001. Very strong correlation was found between AXB and AF-BF distance (r=0.924); and weak correlation between ANB and Beta angle (r=0.377). Wits appraisal showed the greatest coefficient of variability. Despite varying strengths of association, statistically significant correlations were found among seven methods for assessing sagittal jaw relationship. FABA and A-B plane may be used to predict the skeletal class in addition to the established ANB angle. (author)

PARAMETERS FOR THE EVALUATION OF CERVICAL SAGITTAL BALANCE IN IDIOPATHIC SCOLIOSIS

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MAURICIO COELHO LIMA

Full Text Available ABSTRACT Objective: There are no values defined as standard in the literature for the parameters of assessment of cervical sagittal balance in patients with idiopathic scoliosis. This study describes the sagittal cervical parameters in patients with idiopathic scoliosis. Methods: Study carried out in a tertiary public hospital in patients with adolescent idiopathic scoliosis, through the evaluation of panoramic radiographs in lateral view. The Cobb method was used to evaluate cervical lordosis from C2 to C7, distance from the center of gravity (COG of the skull to C7, measurement of T1 slope, thoracic inlet angle (TIA, neck tilt, and plumb line from C7 to S1 (SVA C7-S1. A statistical analysis was performed, to demonstrate the relationship between the alignment of the thoracic spine in the sagittal plane and the cervical sagittal balance of patients with scoliosis. Results: Thirty-four patients were female (69.4% and 15 male (30.6%. The mean values for COG-C7 were 0.71 mm (median 0.8 mm/standard deviation [SD]= 0.51 mm. For Cobb C2-C7, the mean was -11.7° (median -10°/SD= 20.4°. The mean slope of T1 was 23.5° (median 25°/SD= 9.5°. The mean cervical version was 58.8° (median 60°/DP= 15.4°. The mean TIA was 81.8° (median 85°/SD= 16.7°. The mean plumb line C7-S1 was -0.28 (-0.3/SD= 1.0. Conclusion: The analysis of the results showed that the mean values for the cervical lordosis are lower than the values described as normal in the literature, suggesting a loss of sagittal cervical balance in these patients.

The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain.

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Kim, J; Hwang, J Y; Oh, J K; Park, M S; Kim, S W; Chang, H; Kim, T-H

2017-05-01

The objective of this study was to assess the association between whole body sagittal balance and risk of falls in elderly patients who have sought treatment for back pain. Balanced spinal sagittal alignment is known to be important for the prevention of falls. However, spinal sagittal imbalance can be markedly compensated by the lower extremities, and whole body sagittal balance including the lower extremities should be assessed to evaluate actual imbalances related to falls. Patients over 70 years old who visited an outpatient clinic for back pain treatment and underwent a standing whole-body radiograph were enrolled. Falls were prospectively assessed for 12 months using a monthly fall diary, and patients were divided into fallers and non-fallers according to the history of falls. Radiological parameters from whole-body radiographs and clinical data were compared between the two groups. A total of 144 patients (120 female patients and 24 male patients) completed a 12-month follow-up for assessing falls. A total of 31 patients (21.5%) reported at least one fall within the 12-month follow-up. In univariate logistic regression analysis, the risk of falls was significantly increased in older patients and those with more medical comorbidities, decreased lumbar lordosis, increased sagittal vertical axis, and increased horizontal distance between the C7 plumb line and the centre of the ankle (C7A). Increased C7A was significantly associated with increased risk of falls even after multivariate adjustment. Whole body sagittal balance, measured by the horizontal distance between the C7 plumb line and the centre of the ankle, was significantly associated with risk of falls among elderly patients with back pain. Cite this article : J. Kim, J. Y. Hwang, J. K. Oh, M. S. Park, S. W. Kim, H. Chang, T-H. Kim. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017;6:-344. DOI: 10

Sagittal plane analysis of the spine and pelvis in degenerative lumbar scoliosis.

Science.gov (United States)

Han, Fei; Weishi, Li; Zhuoran, Sun; Qingwei, Ma; Zhongqiang, Chen

2017-01-01

Previous studies have reported the normative values of pelvic sagittal parameters, but no study has analyzed the sagittal spino-pelvic alignment in degenerative lumbar scoliosis (DLS) and its role in the pathogenesis. Retrospective analysis was applied to 104 patients with DLS, together with 100 cases of asymptomatic young adults as a control group and another control group consisting of 145 cases with cervical spondylosis. The coronal and sagittal parameters were measured on the anteroposterior and lateral radiograph of the whole spine in the DLS group as well as in the two control groups. Statistical analysis showed that the DLS group had a higher pelvic incidence (PI) value (50.5° ± 10.2°), than the normal control group (with PI 47.2° ± 8.8°) and the cervical spondylosis group (46.9° ± 9.1°). In DLS group, there were 38 cases (36.5%) complicated with degenerative lumbar spondylolisthesis, who had higher PI values than patients without it. Besides, the lumbar lordosis (LL) and sacral slope (SS) of DLS group were lower; the scoliosis Cobb's angle was correlated with pelvic tilt (PT); thoracic kyphosis was correlated with LL, SS, and PT; and LL was correlated with other sagittal parameters. Patients with DLS may have a higher PI, which may impact the pathogenesis of DLS. A high PI value is probably associated with the high prevalence of degenerative lumbar spondylolisthesis among DLS patients. In DLS patients, the lumbar spine maintains the ability of regulating the sagittal balance, and the regulation depends more on thoracic curve.

Influence of implant rod curvature on sagittal correction of scoliosis deformity

DEFF Research Database (Denmark)

Salmingo, Remel A.; Tadano, Shigeru; Abe, Yuichiro

2014-01-01

of the implant rod’s angle of curvature during surgery and establish its influence on sagittal correction of scoliosis deformity. STUDY DESIGN: A retrospective analysis of the preoperative and postoperative implant rod geometry and angle of curvature was conducted. PATIENT SAMPLE: Twenty adolescent idiopathic......BACKGROUND CONTEXT: Deformation of in vivo–implanted rods could alter the scoliosis sagittal correction. To our knowledge, no previous authors have investigated the influence of implanted-rod deformation on the sagittal deformity correction during scoliosis surgery. PURPOSE: To analyze the changes...... scoliosis patients underwent surgery. Average age at the time of operation was 14 years. OUTCOME MEASURES: The preoperative and postoperative implant rod angle of curvature expressed in degrees was obtained for each patient. METHODS: Two implant rods were attached to the concave and convex side...

The longitudinal sagittal growth changes of maxilla and mandible according to quantitative cervical vertebral maturation.

Science.gov (United States)

Chen, Lili; Lin, Jiuxiang; Xu, Tianmin; Long, Xiaosi

2009-04-01

To investigate the longitudinal sagittal growth changes of maxilla and mandible according to the quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion, mixed longitudinal data were used. The samples included 87 adolescents aged from 8 to 18 y old with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year, lasting for 6 y. The longitudinal sagittal growth changes of maxilla and mandible according to QCVM were measured. There were some significant differences between maxilla and mandible according to QCVM. The sagittal growth change of maxilla showed a trend towards high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. The sagittal growth change of mandible showed a trend towards accelerating velocity-->high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. With sagittal relationship, growth magnitude was almost the same between maxilla and mandible at QCVM stage I. At stage II the growth of mandible exceeded that of maxilla and growth in mandible continued at stages III and IV, while the maxilla ceased to grow. Growth magnitude was greater and the growth duration was longer with male mandible. It is concluded that the longitudinal sagittal growth changes of maxilla and mandible on the basis of QCVM is of value in the orthodontic practice.

Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study.

Science.gov (United States)

Smith, Justin S; Lafage, Virginie; Ryan, Devon J; Shaffrey, Christopher I; Schwab, Frank J; Patel, Alpesh A; Brodke, Darrel S; Arnold, Paul M; Riew, K Daniel; Traynelis, Vincent C; Radcliff, Kris; Vaccaro, Alexander R; Fehlings, Michael G; Ames, Christopher P

2013-10-15

Post hoc analysis of prospectively collected data. Development of methods to determine in vivo spinal cord dimensions and application to correlate preoperative alignment, myelopathy, and health-related quality-of-life scores in patients with cervical spondylotic myelopathy (CSM). CSM is the leading cause of spinal cord dysfunction. The association between cervical alignment, sagittal balance, and myelopathy has not been well characterized. This was a post hoc analysis of the prospective, multicenter AOSpine North America CSM study. Inclusion criteria for this study required preoperative cervical magnetic resonance imaging (MRI) and neutral sagittal cervical radiography. Techniques for MRI assessment of spinal cord dimensions were developed. Correlations between imaging and health-related quality-of-life scores were assessed. Fifty-six patients met inclusion criteria (mean age = 55.4 yr). The modified Japanese Orthopedic Association (mJOA) scores correlated with C2-C7 sagittal vertical axis (SVA) (r = -0.282, P = 0.035). Spinal cord volume correlated with cord length (r = 0.472, P balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the basis of sagittal alignment. It is interesting to note that sagittal balance but not kyphosis is tied to myelopathy score. Future work will correlate alignment changes to cord morphology changes and myelopathy outcomes. SUMMARY STATEMENTS: This is the first study to correlate sagittal balance (C2-C7 SVA) to myelopathy severity. We found a moderate negative correlation in kyphotic patients of cord volume and cross-sectional area to mJOA scores. The opposite (positive correlation) was found for lordotic patients, suggesting a relationship of cord volume to myelopathy that differs on the

Fracture of fusion mass after hardware removal in patients with high sagittal imbalance.

Science.gov (United States)

Sedney, Cara L; Daffner, Scott D; Stefanko, Jared J; Abdelfattah, Hesham; Emery, Sanford E; France, John C

2016-04-01

patients who underwent surgery for ASD after a remote fusion. These patients later developed a fracture of the fusion mass after hardware removal from their previously successfully fused segment. All patients had a high sagittal imbalance and had previously undergone multiple spinal operations. The development of a spontaneous fracture of the fusion mass may be related to sagittal imbalance. Consideration should be given to reimplanting hardware for these patients, even across good fusions, to prevent spontaneous fracture of these areas if the sagittal imbalance is not corrected.

Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients

Science.gov (United States)

Hyun, Seung-Jae; Kim, Yongjung J; Rhim, Seung-Chul

2013-01-01

In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided. PMID:24340276

The angle of inclination of the native ACL in the coronal and sagittal planes.

Science.gov (United States)

Reid, Jonathan C; Yonke, Bret; Tompkins, Marc

2017-04-01

The purpose of this cross-sectional study was to evaluate the angle of inclination of the native anterior cruciate ligament (ACL) in both the sagittal and coronal planes and to evaluate these findings based on sex, height, BMI, and skeletal maturity. Inclusion criteria for the study included patients undergoing routine magnetic resonance imaging (MRI) of the knee at a single outpatient orthopedic center who had an intact ACL on MRI. Measurements of the angle of inclination were made on MRIs in both the sagittal and coronal planes. Patients were compared based on sex, height, BMI, and skeletal maturity. One-hundred and eighty-eight patients were included (36 skeletally immature/152 skeletally mature; 98 male/90 female). The overall angle of inclination was 74.3° ± 4.8° in the coronal plane and 46.9° ± 4.9° in the sagittal plane. Skeletally immature patients (coronal: 71.8° ± 6.1°; sagittal: 44.7° ± 5.5°) were significantly different in both coronal and sagittal planes (P = 0.04 and 0.01, respectively) from skeletally mature patients (coronal: 75.3° ± 4.7°; sagittal: 47.4° ± 4.7°). There were no differences based on sex, height, or BMI. There are differences between the angle of inclination findings in this study and other studies, which could be due to MRI and measurement techniques. Clinically, skeletal maturity may be important to account for when using the ACL angle of inclination to evaluate anatomic ACL reconstruction. Prognostic retrospective study, Level of evidence III.

Investigation of reconstruction conditions in sagittal-plane multiplanar reconstruction of the temporal bone

International Nuclear Information System (INIS)

Suzuki, Miyako; Yoshikawa, Hiroshi; Hosokawa, Akira; Ichikawa, Ginichiro; Kobayashi, Kenichi; Ando, Ichiro

2002-01-01

In recent years, it has become possible to quickly obtain a large amount of 3D data with high continuity by helical CT scanning, in which the body is scanned continuously in a helical fashion. MPR (multiplanar reconstruction) can be performed using this data to generate images in arbitrary sectional planes, making it possible to obtain sagittal-plane images of the highest quality, which is useful for surgical planning. However, the procedures involved are rather complicated. Therefore, this study was conducted to investigate conditions for standardization of sagittal-plane MPR examinations performed using Xvigor CT scanners and Xtension. The results showed that a slice interval of 1 mm, no imaging filter, a zooming factor of 1.5, a window level of 350, and a window width of 3500 are the optimal imaging conditions. The stapes can be visualized in 70% of cases with sagittal-plane MPR based on axial images, and can be recognized at surgery in 75% or more of cases. Images of consistent quality can be obtained by standardizing the conditions for sagittal-plane MPR, which should prove advantageous in the clinical setting. (author)

Signs of patellar chondromalacia on sagittal T2-weighted magnetic resonance imaging

International Nuclear Information System (INIS)

De Smet, A.A.; Monu, J.U.; Fisher, D.R.; Keene, J.S.; Graf, B.K.

1992-01-01

We incidentally noted distinctive high signal defects or fissures in the patellar articular cartilage on sagittal T2-weighted magnetic resonance (MR) images in 4 patients. At subsequent arthroscopy all 4 patients were found to have patellar chondromalacia. To determine the reliabilty of these signs, we retrospectively evaluated, in a blinded manner, sagittal T2-weighted MR images of the knee in 75 patients who were undergoing arthroscopic assessment of their patellar articular cartilage. We indentified high signal defects of fissures in the patellar cartilage of 5 patients. Patellar chondromalacia was noted at arthroscopy in all 5 patients. Arthroscopy demonstrated patellar chondromalacia in an additional 21 patients with normal MR images. We conclude that high signal defects or fissures on sagittal T2-weighted images are usefull signs of patellar chondromalacia. This single imaging sequence will, however, detect only a small number of the cartilage lesions that may be present. (orig.)

Signs of patellar chondromalacia on sagittal T2-weighted magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

De Smet, A.A.; Monu, J.U.; Fisher, D.R. (Univ. of Wisconsin Hospital and Clinics, Dept. of Radiology, Madison, WI (United States)); Keene, J.S.; Graf, B.K. (Univ. of Wisconsin Hospital and Clinics, Div. of Orthopedic Surgery, Madison, WI (United States))

1992-02-01

We incidentally noted distinctive high signal defects or fissures in the patellar articular cartilage on sagittal T2-weighted magnetic resonance (MR) images in 4 patients. At subsequent arthroscopy all 4 patients were found to have patellar chondromalacia. To determine the reliabilty of these signs, we retrospectively evaluated, in a blinded manner, sagittal T2-weighted MR images of the knee in 75 patients who were undergoing arthroscopic assessment of their patellar articular cartilage. We indentified high signal defects of fissures in the patellar cartilage of 5 patients. Patellar chondromalacia was noted at arthroscopy in all 5 patients. Arthroscopy demonstrated patellar chondromalacia in an additional 21 patients with normal MR images. We conclude that high signal defects or fissures on sagittal T2-weighted images are usefull signs of patellar chondromalacia. This single imaging sequence will, however, detect only a small number of the cartilage lesions that may be present. (orig.).

Noninvasive Optoelectronic Assessment of Induced Sagittal Imbalance Using the Vicon System.

Science.gov (United States)

Ould-Slimane, Mourad; Latrobe, Charles; Michelin, Paul; Chastan, Nathalie; Dujardin, Franck; Roussignol, Xavier; Gauthé, Rémi

2017-06-01

Spinal diseases often induce gait disorders with multifactorial origins such as lumbar pain, radicular pain, neurologic complications, or spinal deformities. However, radiography does not permit an analysis of spinal dynamics; therefore, sagittal balance dynamics during gait remain largely unexplored. This prospective and controlled pilot study assessed the Vicon system for detecting sagittal spinopelvic imbalance, to determine the correlations between optoelectronic and radiographic parameters. Reversible anterior sagittal imbalance was induced in 24 healthy men using a thoracolumbar corset. Radiographic, optoelectronic, and comparative analyses were conducted. Corset wearing induced significant variations in radiographic parameters indicative of imbalance; the mean C7-tilt and d/D ratio increased by 15° ± 7.4° and 359%, respectively, whereas the mean spinosacral angle decreased by 16.8° ± 8° (all P imbalance; the mean spinal angle increased by 15.4° ± 5.6° (P imbalance detected using the Vicon system. Optoelectronic C7'S1' correlated with radiographic C7-tilt and d/D ratio. Copyright © 2017 Elsevier Inc. All rights reserved.

A previously unreported variant of the synostotic sagittal suture: Case report and review of salient literature

Directory of Open Access Journals (Sweden)

Madison Budinich

2016-12-01

Full Text Available Introduction: Sagittal synostosis is a rare congenital disease caused by the premature fusion of the sagittal suture. Craniosynostosis occurs for a variety of reasons, different for every case, and often the etiology is unclear but the anomaly can frequently be seen as part of Crouzon's or Apert's syndromes. Herein, we discuss a rare case of craniosynostosis where the patient presented with a, to our knowledge, a previously undescribed variant of sagittal synostosis. Case report: A 3-month-old female infant presented to a craniofacial clinic for a consultation regarding an abnormal head shape. Images of the skull were performed, demonstrating that the patient had craniosynostosis. The patient displayed no other significant symptoms besides abnormalities in head shape. The sagittal suture was found to extend into the occipital bone where it was synostotic. Conclusion: To our knowledge, a synostotic sagittal suture has not been reported that extended posteriorly it involve the occipital bone. Those who interpret imaging or operate on this part of the skull should consider such a variation. Keywords: Anatomy, Craniosynostosis, Skull, Malformation, Pediatrics

Does Andrews facial analysis predict esthetic sagittal maxillary position?

Science.gov (United States)

Resnick, Cory M; Daniels, Kimberly M; Vlahos, Maryann

2018-04-01

Cephalometric analyses have limited utility in planning maxillary sagittal position for orthognathic surgery. In Six Elements of Orofacial Harmony, Andrews quantified maxillary position relative to forehead projection and angulation and proposed an ideal relationship. The purpose of this study was to investigate the ability of this technique to predict esthetic sagittal maxillary position. Survey study including a male and female with straight facial profiles, normal maxillary incisor angulations, and Angle's Class I. Maxillary position was modified on lateral photographs to create 5 images for each participant with incisor-goal anterior limit line (GALL) distances of -4, -2, 0, +2, and +4 mm. A series of health care professionals and laypeople were asked to rate each photo in order of attractiveness. A total of 100 complete responses were received. Incisor-GALL distances of +4 mm (41%) and +2 mm (40%) were most commonly considered "most esthetic" for the female volunteer (P < .001). For the male volunteer, there were 2 peak "most esthetic" responses: incisor-GALL distances of 0 mm (37%) and -4 mm (32%) (P < .001). Respondents considered maxillary incisor position 2 to 4 mm anterior to GALL most attractive in a woman and 0 to 4 mm posterior to GALL most esthetic in a man. Using these modified target distances, this analysis may be useful for orthognathic surgery planning. Copyright © 2018 Elsevier Inc. All rights reserved.

Benefits of sagittal-oblique MRI reconstruction of anterior cruciate ligament of the knee

International Nuclear Information System (INIS)

Nenezić, D.

2015-01-01

Full text: MRI examination of the anterior cruciate ligament (ACL) of the knee gives valuable information for conventional, physiatrist and/or arthroscopic microinvasiv treatment. three planar MRI examination and 3D reconstructions are highly precise in the analysis of the intra and periarticular structures, with exceptions of anterior cruciate ligament. Direct contact with the roof of the intercondilar fossa (in the full extension during the examination) and its specific orientation makes visualization of ACL diagnostically problematic. In a one year period precise protocol for MRI visualization of ACL was tested and applied as “Sagittal Oblique MRI Reconstruction”. In short, it has been Angled biplanar reconstruction in the parasagital and paratransversal planes (patientrelated and arbitrary selected in full extension), on T2, 2mm slice and 0,2 mm gap. 153 MRI examinations of the patients with lesions of the ACL were included in the study in the Clinical Center of Montenegro during 2005 year. Beside standard Knee MRI protocol all patients had the Sagittal Oblique MRI reconstruction of ACL and the Flexion MRI examination, to compare with. The Sagittal Oblique MRI reconstruction of ACL it is adapted to the concrete morphology of the patients ACL and it does not depend of the volume of the examined knee. In comparison with the Standard Knee MRI protocol and with the Flexion MRI examination, the Sagittal Oblique MRI reconstruction of ACL takes less time to perform, and the ligament is shown in fool length at three to five slices, which is more than with the both compared protocols. Sagittal Oblique MRI Reconstruction of ACL is therefore patient dependable, orientated in shape of concrete ligament of the patient’s knee. In combination with age, occupation, physical activity and level of patients while to contribute in healing process, the Sagittal Oblique MRI reconstruction of ACL contribute to scholastic approach, as highest benefit to patients with

INFLUENCE OF THE SAGITTAL BALANCE ON THE CLINICAL OUTCOME IN SPINAL FUSION

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Marcela Almeida Campos Coutinho

2016-03-01

Full Text Available ABSTRACT Objective: Evaluates which radiographic parameters of the sagittal and spinopelvic balance influence the clinical and functional outcomes of a sample of patients undergoing spinal fusion. Methods: We studied 32 patients who underwent spinal fusion. Radiographs of the total spine were obtained from all patients. The clinical and functional parameters studied were analysis of pain by visual analogic scale (VAS and Oswestry and SRS-30 questionnaires. We analyzed the correlation between the clinical and functional parameters and radiographic parameters of the sagittal and spinopelvic balance. Results: There was no significant correlation between parameters pelvic incidence (PI, pelvic tilt (PT, lumbar lordosis (LL and difference between PI and LL (PI-LL and clinical parameters (p > 0.05 and r <0.2. Significant correlation were identified only between Sagittal Vertical Axis (SVA and Satisfaction with Treatment domain of SRS-30 (r = 0.402 e p = 0.023 and between thoracic kyphosis (TK and the total SRS-30 (r = 0.419 and p = 0.017. Conclusions: According to the study results, it was not possible to precisely characterize the role of the parameters of the sagittal and spinopelvic balance in the post-operative analysis of the clinical outcome of spinal fusion. There was a significant correlation only between SVA and the Satisfaction with Treatment domain of SRS-30 and between TK and total SRS-30.

Tracking errors in tractography of the gastrocnemius muscle. A comparison between the transverse and sagittal planes

International Nuclear Information System (INIS)

Aoki, Takako; Tohdoh, Yukihiro; Tawara, Noriyuki; Okuwaki, Toru; Horiuchi, Akira; Itagaki, Takuma; Niitsu, Mamoru

2010-01-01

In scans taken in conventional direction, tracking errors may occur when using a streamline-based algorithm for the tractography of the gastrocnemius muscle. To solve errors in tracking, we applied tractography to the musculotendinous junction and performed fiber tracking on the gastrocnemius muscle of 10 healthy subjects with their written informed consent. We employed a spin-echo diffusion tensor imaging (SE-DTI) sequence with 6-direction diffusion gradient sensitization and acquired DTI images at 1.5 tesla using a body array coil with parallel imaging. We compared tractography obtained in the transverse and sagittal planes using anatomical reference and found that the gastrocnemius muscle and musculotendinous junction were significantly better visualized on sagittal scans and in 3 regions of interest. We utilized Mann-Whitney U-test to determine significant differences between rates of concordance (P 2 value of skeletal muscle is around 50 ms, and TE should be as short as possible. A streamline-based algorithm is based on the continuity of a vector. It is easy to take running of the muscle fiber in sagittal scan. Therefore, tracking error is hard to occur. In conclusion, sagittal scanning may be one way to eliminate tracking errors in the tractography of the gastrocnemius muscle. Tracking errors were smaller with sagittal scans than transverse scans, and sagittal scans allow better fiber tracking. (author)

The accuracy of intramedullary tibial guide of sagittal alignment of PCL-substituting total knee arthroplasty.

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Han, Hyuk-Soo; Kang, Seung-Baik; Jo, Chris H; Kim, Sun-Hong; Lee, Jung-Ha

2010-10-01

Experimental and clinical studies on the accuracy of the intramedullary alignment method have produced different results, and few have addressed accuracy in the sagittal plane. Reported deviations are not only attributable to the alignment method but also to radiological errors. The purpose of this study was to evaluate the accuracy of the intramedullary alignment method in the sagittal plane using computed tomography (CT) and 3-dimensional imaging software. Thirty-one TKAs were performed using an intramedullary alignment method involving the insertion of a long 8-mm diameter rod into the medullary canal to the distal metaphysis of the tibia. All alignment instruments were set to achieve an ideal varus/valgus angle of 0° in the coronal plane and a tibial slope of 0° in the sagittal plane. The accuracy of the intramedullary alignment system was assessed by measuring the coronal tibial component angle and sagittal tibial slope angles, i.e., angles between the tibial anatomical axis and the tangent to the medial and lateral tibial plateau or the cut-surface. The mean coronal tibial component angle was 88.5° ± 1.2° and the mean tibial component slope in the sagittal plane was 1.6° ± 1.2° without anterior slope. Our intramedullary tibial alignment method, which involves passing an 8-mm diameter long rod through the tibial shaft isthmus, showed good accuracy (less than 3 degrees of variation and no anterior slope) in the sagittal plane in neutral or varus knees.

Conjoined lumbosacral nerve roots compromised by disk herniation: sagittal shoulder sign for the preoperative diagnosis

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Kang, Chang Ho [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Korea University College of Medicine, Department of Radiology, Anam Hospital, Seoul (Korea); Shin, Myung Jin; Kim, Sung Moon; Lee, Sang Hoon; Kim, Hee Kyung; Ryu, Jeong Ah [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Lee, Choon-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Orthopedic Surgery, Seoul (Korea); Kim, Sam Soo [Kangwon National University College of Medicine, Department of Radiology, Kangwon (Korea)

2008-03-15

The objective was to determine the importance of the ''sagittal shoulder sign'' on magnetic resonance (MR) images for the diagnosis of conjoined lumbosacral nerve roots (CLNR) that are compromised by herniated disks. Magnetic resonance images of 11 patients (6 men and 5 women; age range, 25-71 years; average age, 48.7 years) with surgically proven CLNR, which was compromised by herniated disks, were retrospectively evaluated by two musculoskeletal radiologists. MR images were evaluated for the presence or absence of the sagittal shoulder sign - a vertical structure connecting two consecutive nerve roots and overlying disk on the sagittal MR images. The radiologists noted the type of accompanying disk herniation and bony spinal canal changes, as well as other characteristic MR features of CLNR, the common passage of two consecutive nerve roots through the neural foramen on axial MR images. The sagittal shoulder sign was identified with a mean frequency of 90.9% by the two observers (in 10 of 11 patients). The common passage of two consecutive nerve roots through the neural foramen on axial MR images was identified with a mean frequency of 59.1% (in 7 and 6 out of 11 patients, by observers 1 and 2, respectively). Good interobserver agreement for the sagittal shoulder sign was present (k = 0.621, p < 0.05). Observation of the sagittal shoulder sign may prove helpful for diagnosing CLNR in patients with disk herniation. In particular, this sign appears to be useful when there is no evidence of CLNR on axial MR images. (orig.)

Bone-femoral component interface gap after sagittal mechanical axis alignment is filled with new bone after cementless total knee arthroplasty.

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Kuriyama, Shinichi; Hyakuna, Katsufumi; Inoue, Satoshi; Kawai, Yasutsugu; Tamaki, Yasuyuki; Ito, Hiromu; Matsuda, Shuichi

2018-05-01

This study retrospectively evaluated the fate of mismatch between an uncemented femoral component and each femoral cut surface (i.e., wedge-shaped gap) relative to sagittal mechanical alignment in total knee arthroplasty (TKA). Primary TKA was performed on 99 consecutive knees. The femoral components were aligned to the sagittal mechanical axis with CT-based navigation. All patients were assessed with postoperative true lateral radiographs. Bone-side surfaces of the uncemented femoral component were divided into five zones: anterior flange, anterior chamfer, posterior chamfer, posterior part, and distal part, which were defined as zones 1 to 5, respectively. Bone filling of wedge-shaped gaps in each zone was evaluated after 1 year. Femoral anterior notching did not occur. However, wedge-shaped gaps were observed in at least one zone in 23 of 99 knees (23%), most frequently in zone 5 (18%). There were 9 and 7 gaps in zones 1 and 2, respectively. The femoral component showed malpositioning of approximately 3° of flexion in cases with wedge-shaped gaps in zones 2 and/or 5. After one year, 67% (6/9) of zone 1, 100% (7/7) of zone 2, and 94% (17/18) of zone 5 wedge-shaped gaps were filled in with new bone. Femoral alignment relative to sagittal mechanical axis caused wedge-shaped gaps due to unstable anterior bone cutting through hard bone, but the small gaps were not clinically significant and filled in within one year. Sagittal setting of the femoral component should aim for the anatomical axis rather than the mechanical axis. IV.

Transforaminal Anterior Release for the Treatment of Fixed Sagittal Imbalance and Segmental Kyphosis, Minimum 2-Year Follow-Up Study.

Science.gov (United States)

Sweet, Fred A; Sweet, Andrea

2015-09-01

Retrospective review of prospectively accrued patient cohort. To report minimum 2 years' follow-up after a single-surgeon series of 47 consecutive patients in whom fixed sagittal imbalance or segmental kyphosis was treated with a novel unilateral transforaminal annular release. Fixed sagittal imbalance has been treated most recently with pedicle subtraction osteotomy with great success but is associated with significant blood loss and neurologic risk. Forty-seven consecutive patients with fixed sagittal imbalance (n = 29) or segmental kyphosis (n = 18) were treated by a single surgeon with a single-level transforaminal anterior release (TFAR) to effect an opening wedge correction. Sagittal and coronal correction was performed with in situ rod contouring. An interbody cage was captured in the disc space with rod compression. Radiographic and clinical outcome analysis was performed with a minimum 2-year follow-up (range 2-7.8 years). The average increase in lordosis was 36° (range 24°-56°) in the fixed sagittal deformity group. Coronal corrections averaged 34° (range 18°-48°). The average improvement in plumb line was 13.6 cm. There were four pseudarthroses, one at the TFAR. Average blood loss was 578 mL (range 200-1,200). One patient had a transient grade 4/5 anterior tibialis weakness. There were no vascular injuries or permanent neurologic deficits. There were significant improvements in the Oswestry Disability Index (p imbalance with relatively low blood loss and was found to be neurologically safe in this single-surgeon series. Therapeutic study, Level IV (case series, no control group). Copyright © 2015 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Not all sagittal band tears come with extensor instability. A case report with radiological and operative correlation

International Nuclear Information System (INIS)

Li, Shuo; Jacob, Jubin; Ghasemiesfe, Ahmadreza; Marrinan, Greg B.; Brooks, Jeffrey J.

2018-01-01

The sagittal bands are a component of the extensor hood. They serve an important role in stabilizing the extensor tendon by forming a ''check-rein'' to radial-ulnar translation of the tendon over the metacarpal head, and extending the metacarpophalangeal (MCP) joint by virtue of attaching the extensor tendon to the palmar plate. Injury to the sagittal band is thought to cause extensor instability and subluxation to the contralateral side by disruption of this ''check-rein'' function, although recent evidence from cadaver studies suggests that ulnar sagittal band tear may be spared of extensor instability. As a case in point, we encountered a patient with surgically proven ulnar sagittal band tear, who did not have any extensor tendon subluxation or any limitation in motion. Intraoperative findings demonstrated a chronic-appearing ulnar sagittal band tear, indicating that chronic injury with fibrosis may stabilize the central band. Therefore, in patients with metacarpophalangeal pain without central tendon subluxation or limitation of motion, it remains important to raise the concern of sagittal band tear for appropriate treatment. We present the clinical course of this case, with radiological and operative findings, followed by a review of the relevant literature. (orig.)

Not all sagittal band tears come with extensor instability. A case report with radiological and operative correlation

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Li, Shuo; Jacob, Jubin; Ghasemiesfe, Ahmadreza; Marrinan, Greg B. [Yale New Haven Health Bridgeport Hospital, Bridgeport, CT (United States); Brooks, Jeffrey J. [Orthopedic Surgery and Sports Medicine Center, New Canaan, CT (United States)

2018-04-15

The sagittal bands are a component of the extensor hood. They serve an important role in stabilizing the extensor tendon by forming a ''check-rein'' to radial-ulnar translation of the tendon over the metacarpal head, and extending the metacarpophalangeal (MCP) joint by virtue of attaching the extensor tendon to the palmar plate. Injury to the sagittal band is thought to cause extensor instability and subluxation to the contralateral side by disruption of this ''check-rein'' function, although recent evidence from cadaver studies suggests that ulnar sagittal band tear may be spared of extensor instability. As a case in point, we encountered a patient with surgically proven ulnar sagittal band tear, who did not have any extensor tendon subluxation or any limitation in motion. Intraoperative findings demonstrated a chronic-appearing ulnar sagittal band tear, indicating that chronic injury with fibrosis may stabilize the central band. Therefore, in patients with metacarpophalangeal pain without central tendon subluxation or limitation of motion, it remains important to raise the concern of sagittal band tear for appropriate treatment. We present the clinical course of this case, with radiological and operative findings, followed by a review of the relevant literature. (orig.)

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

Science.gov (United States)

Huang, Dong-Ning; Yu, Miao; Xu, Nan-Fang; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Liu, Zhong-Jun

2017-02-20

Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal

The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study

Directory of Open Access Journals (Sweden)

Dong-Ning Huang

2017-02-01

Full Text Available Abstract Background Anterior cervical discectomy and fusion (ACDF is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. Methods A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2–C7 angles (C2–C7, C0–C7 angles (C0–C7, external auditory meatus (EAM tilt, sacral slope (SS, thoracic kyphosis (TK, lumbar lordosis (LL, spinal sacral angles (SSA, Superior adjacent inter-vertebral angle (SAIV, inferior adjacent inter-vertebral angle (IAIV and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Results Among the parameters, C2–C7 and C0–C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0–C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2–C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. Conclusion The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment

Sagittal fractures of the third carpal bone in horses: 12 cases (1977-1985)

International Nuclear Information System (INIS)

Fischer, A.T. Jr.; Stover, S.M.

1987-01-01

Third carpal sagittal fractures were found to be related to racing injuries in 10 of 12 horses. These fractures occurred most commonly on the medial aspect of the bone. A dorsoproximal-dorsodistal view of the carpus was required to visualize the fracture in all cases. Healing of the fracture required periods of rest of up to one year. Conservative management of these fractures resulted in return to function in 7 of 12 horses

Accuracy of the sagittal vertical axis in a standing lateral radiograph as a measurement of balance in spinal deformities

NARCIS (Netherlands)

van Royen, B.J.; Toussaint, H.M.; Kingma, I.; Bot, S.D.M.; Caspers, M.; Harlaar, J.

1998-01-01

Sagittal balance of the spine is becoming an important issue in the assessment of the degree of spinal deformity. On a standing lateral full- length radiograph of the spine, the plumb line, or sagittal vertical axis (SVA), can be used to determine the spinal sagittal balance. In this procedure

How is sagittal balance acquired during bipedal gait acquisition? Comparison of neonatal and adult pelves in three dimensions. Evolutionary implications.

Science.gov (United States)

Tardieu, Christine; Bonneau, Noémie; Hecquet, Jérôme; Boulay, Christophe; Marty, Catherine; Legaye, Jean; Duval-Beaupère, Geneviève

2013-08-01

We compare adult and intact neonatal pelves, using a pelvic sagittal variable, the angle of sacral incidence, which presents significant correlations with vertebral curvature in adults and plays an important role in sagittal balance of the trunk on the lower limbs. Since the lumbar curvature develops in the child in association with gait acquisition, we expect a change in this angle during growth which could contribute to the acquisition of sagittal balance. To understand the mechanisms underlying the sagittal balance in the evolution of human bipedalism, we also measure the angle of incidence of hominid fossils. Fourty-seven landmarks were digitized on 50 adult and 19 intact neonatal pelves. We used a three-dimensional model of the pelvis (DE-VISU program) which calculates the angle of sacral incidence and related functional variables. Cross-sectional data from newborns and adults show that the angle of sacral incidence increases and becomes negatively correlated with the sacro-acetabular distance. During ontogeny the sacrum becomes curved, tends to sink down between the iliac blades as a wedge and moves backward in the sagittal plane relative to the acetabula, thus contributing to the backwards displacement of the center of gravity of the trunk. A chain of correlations links the degree of the sacral slope and of the angle of incidence, which is tightly linked with the lumbar lordosis. We sketch a model showing the coordinated changes occurring in the pelvis and vertebral column during the acquisition of bipedalism in infancy. In the australopithecine pelves, Sts 14 and AL 288-1, and in the Homo erectus Gona pelvis the angle of sacral incidence reaches the mean values of humans. Discussing the incomplete pelves of Ardipithecus ramidus, Australopithecus sediba and the Nariokotome Boy, we suggest how the functional linkage between pelvis and spine, observed in humans, could have emerged during hominid evolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Biomechanical analysis on healing process of sagittal fracture of the mandibular condyle after rigid fixation].

Science.gov (United States)

Jing, Jie; Qu, Ai-li; Ding, Xiao-mei; Hei, Yu-na

2015-04-01

To analyze the biomechanical healing process on rigid fixation of sagittal fracture of the mandibular condyle (SFMC), and to provide guidelines for surgical treatment. Three-dimensional finite element model (3D-FEAM) of mandible and condyle was established. The right condyle was simulated as SFMC with 0.1 mm space across the condyle length ways. The 3D-FEAM of rigid fixation was established. The biomechanical factors such as stress distribution of condylar surface, displacement around fracture, stress on the plate and stress shielding were calculated during 0, 4, 8 and 12-week after rigid fixation. The maximum equivalent stress of normal condyle was located at the area of middle 1/3 of condylar neck. The maximum equivalent stress at 0-week after fixation was 23 times than that on normal condyle. They were located at the condylar stump and the plate near inferior punctual areas of fracture line. There were little stress on the other areas. The maximum equivalent stress at 4, 8 and 12-week was approximately 6 times than that on normal condyle. They were located at the areas same as the area at 0-week. There were little stress on the other areas at the condyle. The maximum total displacement and maximum total corner were increased 0.57-0.75 mm and 0.01-0.09° respectively during healing process. The maximum equivalent stress at 0-week on the condylar trump was 5-6 times compared with that at 4, 8, and 12-week. The maximum equivalent stress, maximum total displacement and maximum total corner on the fractured fragment were not changed significantly during healing process. The maximum equivalent stress at 0-week on the plate was 7-9 times compared with that at 4, 8, 12-week. The stress of the condyle and stress shielding of the plate may be the reasons of absorbing and rebuilding on the condyle in healing process of SFMC. The biomechanical parameters increase obviously at 4-week after fixation. Elastic intermaxillary traction is necessary to decrease total displacement

Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

International Nuclear Information System (INIS)

Pirogovsky, A.; Adi, M.; Barzilai, N.; Dagan, A.; Sinai, L.; Sthoeger, D.; Tabachnik, E.

2001-01-01

A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

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Pirogovsky, A.; Adi, M.; Barzilai, N. [Dept. of Radiology, Kaplan Medical Center, Rehovot (Israel); Dagan, A.; Sinai, L.; Sthoeger, D. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Tabachnik, E. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Paediatric ICU, Kaplan Hospital, Rehovot (Israel)

2001-10-01

A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

Science.gov (United States)

Yang, Yang; Fang, Ying; Zhang, Xini; He, Junliang; Fu, Weijie

2017-01-01

The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively) performed a weight-bearing dorsiflexion (WB-DF) maneuver, drop jumps (DJs), and lay-up jumps (LJs). Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041) was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028) and power (p = 0.022) were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion–extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane. Key points An increased shoe collar height effectively reduced ankle joint ROM in the sagittal plane in weight-bearing dorsiflexion maneuver. Shoe collar height did not affect sagittal plane ankle kinematics and had no effect on performance during realistic jumping. Shoe collar height can affect the ankle plantarflexion torque and peak power during the push-off phase in lay-up jump. PMID:29238255

Sagittal alignment and complications following lumbar 3-column osteotomy: does the level of resection matter?

Science.gov (United States)

Ferrero, Emmanuelle; Liabaud, Barthelemy; Henry, Jensen K; Ames, Christopher P; Kebaish, Khaled; Mundis, Gregory M; Hostin, Richard; Gupta, Munish C; Boachie-Adjei, Oheneba; Smith, Justin S; Hart, Robert A; Obeid, Ibrahim; Diebo, Bassel G; Schwab, Frank J; Lafage, Virginie

2017-11-01

OBJECTIVE Three-column osteotomy (3CO) is a demanding technique that is performed to correct sagittal spinal malalignment. However, the impact of the 3CO level on pelvic or truncal sagittal correction remains unclear. In this study, the authors assessed the impact of 3CO level and postoperative apex of lumbar lordosis on sagittal alignment correction, complications, and revisions. METHODS In this retrospective study of a multicenter spinal deformity database, radiographic data were analyzed at baseline and at 1- and 2-year follow-up to quantify spinopelvic alignment, apex of lordosis, and resection angle. The impact of 3CO level and apex level of lumbar lordosis on the sagittal correction was assessed. Logistic regression analyses were performed, controlling for cofounders, to investigate the effects of 3CO level and apex level on intraoperative and postoperative complications as well as on the need for subsequent revision surgery. RESULTS A total of 468 patients were included (mean age 60.8 years, mean body mass index 28.1 kg/m 2 ); 70% of patients were female. The average 3CO resection angle was 25.1° and did not significantly differ with regard to 3CO level. There were no significant correlations between the 3CO level and amount of sagittal vertical axis or pelvic tilt correction. The postoperative apex level significantly correlated with greater correction of pelvic tilt (2° per more caudal level, R = -0.2, p = 0.006). Lower-level 3CO significantly correlated with revisions for pseudarthrosis (OR = 3.88, p = 0.001) and postoperative motor deficits (OR = 2.02, p = 0.026). CONCLUSIONS In this study, a more caudal lumbar 3CO level did not lead to greater sagittal vertical axis correction. The postoperative apex of lumbar lordosis significantly impacted pelvic tilt. 3CO levels that were more caudal were associated with more postoperative motor deficits and revisions.

Radiographic analysis of the correlation between ossification of the nuchal ligament and sagittal alignment and segmental stability of the cervical spine in patients with cervical spondylotic myelopathy.

Science.gov (United States)

Ying, Jinwei; Teng, Honglin; Qian, Yunfan; Hu, Yingying; Wen, Tianyong; Ruan, Dike; Zhu, Minyu

2018-01-01

Background Ossification of the nuchal ligament (ONL) caused by chronic injury to the nuchal ligament (NL) is very common in instability-related cervical disorders. Purpose To determine possible correlations between ONL, sagittal alignment, and segmental stability of the cervical spine. Material and Methods Seventy-three patients with cervical spondylotic myelopathy (CSM) and ONL (ONL group) and 118 patients with CSM only (control group) were recruited. Radiographic data included the characteristics of ONL, sagittal alignment and segmental stability, and ossification of the posterior longitudinal ligament (OPLL). We performed comparisons in terms of radiographic parameters between the ONL and control groups. The correlations between ONL size, cervical sagittal alignment, and segmental stability were analyzed. Multivariate logistic regression was used to identify the independent risk factors of the development of ONL. Results C2-C7 sagittal vertical axis (SVA), T1 slope (T1S), T1S minus cervical lordosis (T1S-CL) on the lateral plain, angular displacement (AD), and horizontal displacement (HD) on the dynamic radiograph increased significantly in the ONL group compared with the control group. The size of ONL significantly correlated with C2-C7 SVA, T1S, AD, and HD. The incidence of ONL was higher in patients with OPLL and segmental instability. Cervical instability, sagittal malalignment, and OPLL were independent predictors of the development of ONL through multivariate analysis. Conclusion Patients with ONL are more likely to have abnormal sagittal alignment and instability of the cervical spine. Thus, increased awareness and appreciation of this often-overlooked radiographic finding is warranted during diagnosis and treatment of instability-related cervical pathologies and injuries.

Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns.

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Steenen, S A; Becking, A G

2016-07-01

An unfavourable and unanticipated pattern of the mandibular sagittal split osteotomy is generally referred to as a 'bad split'. Few restorative techniques to manage the situation have been described. In this article, a classification of reported bad split pattern types is proposed and appropriate salvage procedures to manage the different types of undesired fracture are presented. A systematic review was undertaken, yielding a total of 33 studies published between 1971 and 2015. These reported a total of 458 cases of bad splits among 19,527 sagittal ramus osteotomies in 10,271 patients. The total reported incidence of bad split was 2.3% of sagittal splits. The most frequently encountered were buccal plate fractures of the proximal segment (types 1A-F) and lingual fractures of the distal segment (types 2A and 2B). Coronoid fractures (type 3) and condylar neck fractures (type 4) have seldom been reported. The various types of bad split may require different salvage approaches. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Brief communication: age and fractal dimensions of human sagittal and coronal sutures

DEFF Research Database (Denmark)

Lynnerup, Niels; Jacobsen, Jens Christian Brings

2003-01-01

The fractal dimensions of human sagittal and coronal sutures were calculated on 31 complete skulls from the Terry Collection. The aim was to investigate whether the fractal dimension, relying on the whole sutural length, might yield a better description of age-related changes in sutural morphology......, as opposed to other methods of quantification, which generally rely on more arbitrary scoring systems. However, the fractal dimension did not yield better age correlations than other previously described methods. At best, the results reflected the general observation that young adults below age 40 years...

Reliability of the xipho-pubic angle in patients with sagittal imbalance of the spine.

Science.gov (United States)

Langella, Francesco; Villafañe, Jorge H; Ismael, Maryem; Buric, Josip; Piazzola, Andrea; Lamartina, Claudio; Berjano, Pedro

2018-04-01

Proximal junctional kyphosis (PJK) is a frequent complication that compromises the outcomes of spinal surgery, especially for adult deformity. To the date no single risk factor or cause has been identified that explains its occurrence. The purpose of this study was to investigate the test-retest reliability of the radiologic measurements using xipho-pubic angle (XPA) for subjects undergoing surgery for sagittal misalignment of the spine. Retrospective observational cross-sectional study of prospectively collected data. Full-spine standing lateral radiographs of 50 patients who underwent surgery for fixed sagittal imbalance (preoperative and postoperative) were evaluated. Internal consistency, reproducibility, concurrent validity, and discriminative ability of the XPA. Two physicians measured XPA on the 100 randomly sorted and anonymized radiographs on two occasions, one week apart (test and retest conditions), were calculated for inter and intraobserver agreement. Test-retest reliability of XPA measurement was excellent for pre- (ICC=0.98; P=0.001) and post-surgical (ICC=0.86; P=0.001) radiographs of subjects with sagittal imbalance of the spine. XPA was able to discriminate between preoperative and postoperative radiographs F=17.924, Pimbalance for both raters. There were significant differences between pre- vs. postoperative XPA, pelvic tilt, lumbar lordosis and sagittal vertical axis values (all Pimbalance.

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis.

Science.gov (United States)

Clément, Jean-Luc; Geoffray, Anne; Yagoubi, Fatima; Chau, Edouard; Solla, Federico; Oborocianu, Ioana; Rampal, Virginie

2013-11-01

Sagittal spine and pelvic alignment of adolescent idiopathic scoliosis (AIS) is poorly described in the literature. It generally reports the sagittal alignment with regard to the type of curve and never correlated to the thoracic kyphosis. The objective of this study is to investigate the relationship between thoracic kyphosis, lumbar lordosis and sagittal pelvic parameters in thoracic AIS. Spinal and pelvic sagittal parameters were evaluated on lateral radiographs of 86 patients with thoracic AIS; patients were separated into hypokyphosis group (n = 42) and normokyphosis group (n = 44). Results were statistically analyzed. The lumbar lordosis was lower in the hypokyphosis group, due to the low proximal lordosis. The thoracic kyphosis was not correlated with any pelvic parameters but with the proximal lordosis. The pelvic incidence was correlated with sacral slope, pelvic tilt, lumbar lordosis and highly correlated with distal lumbar lordosis in the two groups. There was a significant linear regression between thoracic kyphosis and proximal lordosis and between pelvic incidence and distal lordosis. We can consider that the proximal part of the lordosis depends on the thoracic kyphosis and the distal part depends on the pelvic incidence. The hypokyphosis in AIS is independent of the pelvic parameters and could be described as a structural parameter, characteristic of the scoliotic deformity.

Extensor Tendon Instability Due to Sagittal Band Injury in a Martial Arts Athlete: A Case Report.

Science.gov (United States)

Kochevar, Andrew; Rayan, Ghazi

2017-03-01

A Taekwondo participant sustained a hand injury from punching an opponent that resulted in painful instability of the ring finger extensor digitorum communis tendon due to sagittal band damage. His symptoms resolved after reconstructive surgery on the sagittal band (SB) with stabilization of the extensor tendon over the metacarpophalangeal joint.

[Application of temporomandibular joint dics reduction in the operation of condylar sagittal fracture].

Science.gov (United States)

Wenli, Zeng; Wuchao, Zhou; Jingkun, Zhang; Yisen, Shao; Weihong, Xi

2017-10-01

To explore the selection of temporomandibular joint (TMJ) disc reduction and fixation methods in condylar sagittal fracture surgery. A total of 36 patients with condylar fractures were chosen. The follow-up period was more 6 months. All 36 cases of condylar sagittal fracture were fixed with long screw. In the operation, the displaced joint disc was repositioned and fixed. The fixed method included direct suture (22 cases) and anchorage (14 cases). Clinical followups were performed before surgery and 1 month, 3 months, 6 months and 1 year after surgery. Clinicians recorded data related to the Fricton craniomandibular index (CMI) and evaluated the postoperative joint function during followup before surgery and 6 months after surgery. In both groups, function of TMJ significantly improved after surgery. The CMI decreased from 0.213±0.162 and 0.273±0.154 to 0.059±0.072 and 0.064±0.068 (P0.05) before or after surgery. Both methods could effectively improve the dysfunction of the TMJ caused by trauma. The selection of joint disc reduction and fixation methods is based on the displacement and damage degree of the joint disc.

Anterior sagittal transanorectal approach to the posterior urethra in the pediatric age group.

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Rossi, F; De Castro, R; Ceccarelli, P L; Dòmini, R

1998-09-01

Surgical access to the posterior urethra is often difficult and several surgical solutions have been proposed. We suggest an anterior sagittal transanorectal approach based on splitting the anterior rectal wall only. This alternative technique provides excellent exposure to the retrourethral region, permitting simple and safe surgery. Between 1994 and 1996 we performed surgery via the anterior sagittal transanorectal approach in 8 patients with a mean age of 9.06 years. Patients included 1 girl with a posttraumatic urethrovaginal fistula, 3 with intersex disorders (2 with mixed gonadal dysgenesis raised as boys and 1 with male dysgenetic pseudohermaphroditism with an enlarged urtricle) and 4 boys (1 with penile agenesis raised as girl, 2 with urethral duplication and 1 with prostatic rhabdomyosarcoma). The patient was placed in a knee-chest position. A midline sagittal incision was made through the anterior anorectal wall only and deepened through the perineal body to expose the posterior urethra and retrovesical space. After the pathological condition was corrected the anterior rectal wall and perineal body were reconstructed. The operation was completed with protective colostomy. In our final patient with prostatic rhabdomyosarcoma the anterior sagittal transanorectal approach was used without colostomy. Anorectal manometry was done 6 months postoperatively. All patients were completely continent of stool and urine. Convalescence was unremarkable in all cases. Postoperative manometry in 7 patients revealed no differences from preoperative measurements. This procedure should be considered a useful alternative to other techniques for various congenital and acquired pelvic disorders.

[Sagittal otolith morphology and the relationship between its mass and the age of Liza haematocheila in the Yangtze Estuary, China].

Science.gov (United States)

Ji, Yan; Zhao, Feng; Yang, Qin; Ma, Rong Rong; Yang, Gang; Zhang, Tao; Zhuang, Ping

2018-03-01

To examine the relationship of morphological characters of sagittal otolith and the age of Liza haematocheila in the Yangtze Estuary, we analyzed the morphological parameters of 324 pairs of otoliths extracted from 358 L. haematocheila specimens from the Yangtze Estuary in February to June of 2017. The results showed that sagittal otolith had rostrum, antirostrum and obvious central notch. The size and shape of sagittal otolith significantly changed with their growth, from regular melon seeds shape outline to long narrow leaf shape and increasing irregular wavy outline. The average density of sagittal otolith was 1.52 mg·mm -2 . The average rectangularity was 0.68. The length of sagittal otolith was 0.021%-0.047% of entire body length (BL), the width was 0.009%-0.021% of entire BL, and the mass was 0.045‰-0.731‰ of the entire body mass (BM). Otolith length (OL), otolith width (OW) and otolith mass (OM) were all significantly related to the BL, with the determination coefficient for OW and OM model being the highest (R 2 =0.928). The relationship between OM and BL was described best by exponential regression: OM=0.0009BL 1.8737 (R 2 =0.967). The relationships between OM and age (A), BL and A were well fitted by multinomial regressions, respectively: OM=2.9262A 2 +4.8437A+2.1894 (R 2 =0.847), BL=-3.2248A 2 +102.54A+38.373 (R 2 =0.858). In addition, OM was linearly correlated with A. The estimated otolith's ages from the model did not significantly variate from the real ages counting from annulus counts. Therefore, OM could be an effective parameter for the age estimation of L. haematocheila.

Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine-What Radiologists Should Know.

Science.gov (United States)

Takahashi, T; Kainth, D; Marette, S; Polly, D

2018-04-01

Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation. © 2018 by American Journal of Neuroradiology.

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia.

Science.gov (United States)

Ağlarcı, Cahide; Esenlik, Elçin; Fındık, Yavuz

2016-06-01

The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P journals.permissions@oup.com.

A morphological description of the sagittal otoliths of two mormyrids ...

African Journals Online (AJOL)

The morphology of the sagittal otoliths of two South African mormyrid fish, Marcusenius macrolepidotus and Petrocephalus catostoma, were studied to determine possible morphological significance. The sagittae of M. macrolepidotus and P. catostoma are kidney-shaped and oblong, respectively. The ventral margin is ...

Sagittal balance, a useful tool for neurosurgeons?

Science.gov (United States)

Villard, Jimmy; Ringel, Florian; Meyer, Bernhard

2014-01-01

New instrumentation techniques have made any correction of the spinal architecture possible. Sagittal balance has been described as an important parameter for assessing spinal deformity in the early 1970s, but over the last decade its importance has grown with the published results in terms of overall quality of life and fusion rate. Up until now, most of the studies have concentrated on spinal deformity surgery, but its use in the daily neurosurgery practice remains uncertain and may warrant further studies.

The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

OpenAIRE

Pereira Marcelo P.; Pelicioni Paulo H. Silva; Gobbi Lilian T.B.

2015-01-01

Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA) during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during m...

Usefulness of the dynamic gadolinium-enhanced magnetic resonance imaging with simultaneous acquisition of coronal and sagittal planes for detection of pituitary microadenomas.

Science.gov (United States)

Lee, Han Bee; Kim, Sung Tae; Kim, Hyung-Jin; Kim, Keon Ha; Jeon, Pyoung; Byun, Hong Sik; Choi, Jin Wook

2012-03-01

Does dynamic gadolinium-enhanced imaging with simultaneous acquisition of coronal and sagittal planes improve diagnostic accuracy of pituitary microadenomas compared with coronal images alone? Fifty-six patients underwent 3-T sella MRI including dynamic simultaneous acquisition of coronal and sagittal planes after gadolinium injection. According to conspicuity, lesions were divided into four scores (0, no; 1, possible; 2, probable; 3, definite delayed enhancing lesion). Additional information on supplementary sagittal images compared with coronal ones was evaluated with a 4-point score (0, no; 1, possible; 2, probable; 3, definite additional information). Accuracy of tumour detection was calculated. Average scores for lesion detection of a combination of two planes, coronal, and sagittal images were 2.59, 2.32, and 2.18. 6/10 lesions negative on coronal images were detected on sagittal ones. Accuracy of a combination of two planes, of coronal and of sagittal images was 92.86%, 82.14% and 75%. Six patients had probable or definite additional information on supplementary sagittal images compared with coronal ones alone (10.71%). Dynamic MRI with combined coronal and sagittal planes was more accurate for detection of pituitary microadenomas than routinely used coronal images. Simultaneous dynamic enhanced acquisition can make study time fast and costs low. We present a new dynamic MRI technique for evaluating pituitary microadenomas • This technique provides simultaneous acquisition of contrast enhanced coronal and sagittal images. • This technique makes the diagnosis more accurate and reduces the examination time. • Such MR imaging only requires one single bolus of contrast agent.

Conservative treatment of a mandibular condyle fracture: Comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial.

Science.gov (United States)

van den Bergh, B; Blankestijn, J; van der Ploeg, T; Tuinzing, D B; Forouzanfar, T

2015-06-01

A mandibular condyle fracture can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation (ORIF). Many IMF-modalities can be chosen, including IMF-screws (IMFS). This prospective multi-centre randomised clinical trial compared the use of IMFS with the use of arch bars in the treatment of mandibular condyle fractures. The study population consisted of 50 patients (mean age: 31.8 years). Twenty-four (48%) patients were allocated in the IMFS group. Twenty-six (52%) patients were assigned to the arch bars group. In total 188 IMF-screws were used (5-12 screws per patient, mean 7.83 screws per patient). All pain scores were lower in the IMFS group. Three patients developed a malocclusion (IFMS-group: one patient, arch bars-group: two patients). Mean surgical time was significantly shorter in the IMFS group (59 vs. 126 min; pfractured on insertion (0.53%), one (0.53%) screw was inserted into a root. Six (3.2%) screws loosened spontaneously in four patients. Mucosal disturbances were seen in 22 patients, equally divided over both groups. Considering the advantages and the disadvantages of IMFS, and observing the results of this study, the authors conclude that IMFS provide a superior method for IMF. IMFS are safer for the patients and surgeons. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health

DEFF Research Database (Denmark)

Christensen, Sanne Toftgaard; Hartvigsen, Jan

2008-01-01

The purposes of this study were to (1) determine whether sagittal spinal curves are associated with health in epidemiological studies, (2) estimate the strength of such associations, and (3) consider whether these relations are likely to be causal....

Body posture in the sagittal plane and scoliotic variables in girls aged 7-18

Directory of Open Access Journals (Sweden)

Jacek Wilczyński

2018-02-01

Introduction. The aim of the study was to analyze the correlation between the variable posture in the sagittal plane and the scoliotic variables. Material and methods. The study involved 28 girls aged 7-18 years with scoliotic posture and scoliosis. Body posture as well as the spine were examined using Moiré’s spatial photogrammetry and the Exhibeon digital radiography method. Based on the size of the spinal curvature, the following were distinguished: scoliotic postures: 1-9° and scoliosis: ≥10°. Results. There were 21 (75% with scoliotic posture and 7 (25% with scoliosis. The size of the thoracic kyphosis and lumbar lordosis was normal. Conclusions. Between the body postural variables in the sagittal plane and the scoliotic variables, both positive (direct proportional and negative (inversely proportional correlations occurred. In the selection of scoliosis treatment method, the size of the postural variables in the sagittal plane should be taken into account, and each patient’s case should be individually considered.

Bilateral sagittal split osteotomy versus distraction osteogenesis for mandibular advancements

NARCIS (Netherlands)

Baas, E.M.

2015-01-01

The aim of this thesis was to compare the treatment modality of distraction osteogenesis (DO) with the gold standard for mandibular advancement surgery. In fact we compare distraction osteogenesis with the standard of care, which is a conventional bilateral sagittal split osteotomy as described by

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

Science.gov (United States)

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

Skull fracture with effacement of the superior sagittal sinus following drone impact: a case report.

Science.gov (United States)

Chung, Lawrance K; Cheung, Yuri; Lagman, Carlito; Au Yong, Nicholas; McBride, Duncan Q; Yang, Isaac

2017-09-01

The popularity of unmanned aerial vehicles, or drones, raises safety concerns as they become increasingly common for commercial, personal, and recreational use. Collisions between drones and people may result in serious injuries. A 13-year-old male presented with a comminuted depressed skull fracture causing effacement of the superior sagittal sinus secondary to a racing drone impact. The patient experienced a brief loss of consciousness and reported lower extremity numbness and weakness after the accident. Imaging studies revealed bone fragments crossing the superior sagittal sinus with a short, focal segment of blood flow interruption. Neurosurgical intervention was deferred given the patient's improving neurological deficits, and the patient was treated conservatively. He was discharged home in stable condition. Drones may represent a hazard when operated inappropriately due to their capacity to fly at high speeds and altitudes. Impacts from drones can carry enough force to cause skull fractures and significant head injuries. The rising popularity of drones likely translates to an increased incidence of drone-related injuries. Thus, clinicians should be aware of this growing trend.

Correlation and Reliability of Cervical Sagittal Alignment Parameters between Lateral Cervical Radiograph and Lateral Whole-Body EOS Stereoradiograph

Science.gov (United States)

Singhatanadgige, Weerasak; Kang, Daniel G.; Luksanapruksa, Panya; Peters, Colleen; Riew, K. Daniel

2015-01-01

Study Design  Retrospective analysis. Objective  To evaluate the correlation and reliability of cervical sagittal alignment parameters obtained from lateral cervical radiographs (XRs) compared with lateral whole-body stereoradiographs (SRs). Methods  We evaluated adults with cervical deformity using both lateral XRs and lateral SRs obtained within 1 week of each other between 2010 and 2014. XR and SR images were measured by two independent spine surgeons using the following sagittal alignment parameters: C2–C7 sagittal Cobb angle (SCA), C2–C7 sagittal vertical axis (SVA), C1–C7 translational distance (C1–7), T1 slope (T1-S), neck tilt (NT), and thoracic inlet angle (TIA). Pearson correlation and paired t test were used for statistical analysis, with intra- and interrater reliability analyzed using intraclass correlation coefficient (ICC). Results  A total of 35 patients were included in the study. We found excellent intrarater reliability for all sagittal alignment parameters in both the XR and SR groups with ICC ranging from 0.799 to 0.994 for XR and 0.791 to 0.995 for SR. Interrater reliability was also excellent for all parameters except NT and TIA, which had fair reliability. We also found excellent correlations between XR and SR measurements for most sagittal alignment parameters; SCA, SVA, and C1–C7 had r > 0.90, and only NT had r < 0.70. There was a significant difference between groups, with SR having lower measurements compared with XR for both SVA (0.68 cm lower, p < 0.001) and C1–C7 (1.02 cm lower, p < 0.001). There were no differences between groups for SCA, T1-S, NT, and TIA. Conclusion  Whole-body stereoradiography appears to be a viable alternative for measuring cervical sagittal alignment parameters compared with standard radiography. XR and SR demonstrated excellent correlation for most sagittal alignment parameters except NT. However, SR had significantly lower average SVA and C1–C7 measurements than XR

Sagittal spinal balance after lumbar spinal fusion: the impact of anterior column support results from a randomized clinical trial with an eight- to thirteen-year radiographic follow-up.

Science.gov (United States)

Videbaek, Tina S; Bünger, Cody E; Henriksen, Mads; Neils, Egund; Christensen, Finn B

2011-02-01

Randomized clinical trial. To analyze the long-term clinical impact of anterior column support on sagittal balance after lumbar spinal fusion. Several investigators have stressed the importance of maintaining sagittal balance in relation to spinal fusion to avoid lumbar 'flat back,' accelerated adjacent segment degeneration, pain, and inferior functional outcome. Only limited evidence exists on how sagittal alignment affects clinical outcome. Anterior lumbar interbody fusion combined with posterolateral fusion has been proved superior to posterolateral fusion alone regarding outcome and cost-effectiveness. No randomized controlled trial has been published analyzing the effect of anterior support on radiographic measurements of sagittal balance. Between 1996 and 1999, 148 patients with severe chronic low back pain were randomly selected for posterolateral lumbar fusion plus anterior support (PLF + ALIF) or posterolateral lumbar fusion. A total of 92 patients participated. Sagittal balance parameters were examined on full lateral radiographs of the spine: pelvic incidence (PI), pelvic tilt (PT), sacral slope, thoracic kyphosis, lumbar lordosis, and positioning of C7 plumb line. The type of lumbar lordosis was evaluated and outcome assessed by Oswestry Disability Index (ODI). Follow-up rate was 74%. Sagittal balance parameters were similar between randomization groups. None of the parameters differed significantly between patients with an ODI from 0 to 40 and patients with ODI over 40. Balanced patients had a significantly superior outcome as measured by ODI (P Lumbar lordosis and type of lordosis correlated with outcome but could not explain the superior outcome in the group with anterior support. Whether sagittal balance and anterior support during fusion provide a protective effect on adjacent motion segments remains unclear.

The stability of mandibular prognathism corrected by bilateral sagittal split osteotomies: a comparison of bi-cortical osteosynthesis and mono-cortical osteosynthesis.

Science.gov (United States)

Hsu, S S-P; Huang, C-S; Chen, P K-T; Ko, E W-C; Chen, Y-R

2012-02-01

This study evaluated the differences in surgical changes and post-surgical changes between bi-cortical and mono-cortical osteosynthesis (MCO) in the correction of skeletal Class III malocclusion with bilateral sagittal split osteotomies (BSSOs). Twenty-five patients had bi-cortical osteosynthesis (BCO), 32 patients had mono-cortical fixation. Lateral and postero-anterior cephalometric radiographs, taken at the time of surgery, before surgery, 1 month after surgery, and on completion of orthodontic treatment (mean 9.9 months after surgery), were obtained for evaluation. Cephalometric analysis and superimposition were used to investigate the surgical and post-surgical changes. Independent t-test was performed to compare the difference between the two groups. Pearson's correlations were tested to evaluate the factors related to the relapse of the mandible. The sagittal relapse rate was 20% in the bi-cortical and 25% in the mono-cortical group. The forward-upward rotation of the mandible in the post-surgical period contributed most of the sagittal relapse. There were no statistically significant differences in sagittal and vertical changes between the two groups during surgery and in the post-surgical period. No factors were found to correlate with post-surgical relapse, but the intergonial width increased more in the bi-cortical group. The study suggested that both methods of skeletal fixation had similar postoperative stability. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy.

Science.gov (United States)

Liang, Chen; Sun, Jianmin; Cui, Xingang; Jiang, Zhensong; Zhang, Wen; Li, Tao

2016-07-22

Spinal sagittal imbalance is a widely acknowledged problem, but there is insufficient knowledge regarding its occurrence. In some patients with lumbar disc herniation (LDH), their symptom is similar to spinal sagittal imbalance. The aim of this study is to illustrate the spinopelvic sagittal characteristics and identity the role of spinal musculature in the mechanism of sagittal imbalance in patients with LDH. Twenty-five adults with spinal sagittal imbalance who initially came to our clinic for treatment of LDH, followed by posterior discectomy were reviewed. The horizontal distance between C7 plumb line-sagittal vertical axis (C7PL-SVA) greater than 5 cm anteriorly with forward bending posture is considered as spinal sagittal imbalance. Radiographic parameters including thoracic kyphotic angle (TK), lumbar lordotic angle (LL), pelvic tilting angle (PT), sacral slope angle (SS) and an electromyography(EMG) index 'the largest recruitment order' were recorded and compared. All patients restored coronal and sagittal balance immediately after lumbar discectomy. The mean C7PL-SVA and trunk shift value decreased from (11.6 ± 6.6 cm, and 2.9 ± 6.1 cm) preoperatively to (-0.5 ± 2.6 cm and 0.2 ± 0.5 cm) postoperatively, while preoperative LL and SS increased from (25.3° ± 14.0° and 25.6° ± 9.5°) to (42.4° ± 10.2° and 30.4° ± 8.7°) after surgery (P imbalance caused by LDH is one type of compensatory sagittal imbalance. Compensatory mechanism of spinal sagittal imbalance mainly includes a loss of lumbar lordosis, an increase of thoracic kyphosis and pelvis tilt. Spinal musculature plays an important role in spinal sagittal imbalance in patients with LDH.

Factors influencing spinal sagittal balance, bone mineral density, and Oswestry Disability Index outcome measures in patients with rheumatoid arthritis.

Science.gov (United States)

Masamoto, Kazutaka; Otsuki, Bungo; Fujibayashi, Shunsuke; Shima, Koichiro; Ito, Hiromu; Furu, Moritoshi; Hashimoto, Motomu; Tanaka, Masao; Lyman, Stephen; Yoshitomi, Hiroyuki; Tanida, Shimei; Mimori, Tsuneyo; Matsuda, Shuichi

2018-02-01

To identify the factors influencing spinal sagittal alignment, bone mineral density (BMD), and Oswestry Disability Index (ODI) outcome measures in patients with rheumatoid arthritis (RA). We enrolled 272 RA patients to identify the factors influencing sagittal vertical axis (SVA). Out of this, 220 had evaluation of bone mineral density (BMD) and vertebral deformity (VD) on the sagittal plane; 183 completed the ODI questionnaire. We collected data regarding RA-associated clinical parameters and standing lateral X-ray images via an ODI questionnaire from April to December 2012 at a single center. Patients with a history of spinal surgery or any missing clinical data were excluded. Clinical parameters included age, sex, body mass index, RA disease duration, disease activity score 28 erythrocyte sedimentation rate (DAS28-ESR), serum anti-cyclic citrullinated peptide antibody, serum rheumatoid factor, serum matrix metalloproteinase-3, BMD and treatment type at survey, such as methotrexate (MTX), biological disease-modifying anti-rheumatic drugs, and glucocorticoids. We measured radiological parameters including pelvic incidence (PI), lumbar lordosis (LL), and SVA. We statistically identified the factors influencing SVA, BMD, VD, and ODI using multivariate regression analysis. Multivariate regression analysis showed that larger SVA correlated with older age, higher DAS28-ESR, MTX nonuse, and glucocorticoid use. Lower BMD was associated with female, older age, higher DAS28-ESR, and MTX nonuse. VD was associated with older age, longer disease duration, lower BMD, and glucocorticoid use. Worse ODI correlated with older age, larger PI-LL mismatch or larger SVA, higher DAS28-ESR, and glucocorticoid use. In managing low back pain and spinal sagittal alignment in RA patients, RA-related clinical factors and the treatment type should be taken into consideration.

?Lumbar Degenerative Kyphosis? Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception

OpenAIRE

Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-01-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal...

CORRELATION BETWEEN OBESITY, SAGITTAL BALANCE AND CLINICAL OUTCOME IN SPINAL FUSION

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Marcel Machado da Motta

2015-09-01

Full Text Available Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS and the Oswestry questionnaire (ODI. Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83. There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively.Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.

Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults.

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Yin, Jin; Peng, Bao-Gan; Li, Yong-Chao; Zhang, Nai-Yang; Yang, Liang; Li, Duan-Ming

2016-05-20

Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population. A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage spondylolysis group and the control group with independent-sample t- test. There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P spondylolysis group than those in the control group, but STA was lower (P spondylolysis group. Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.

Sagittal x-ray beam deviation at asymmetric inclined diffractors

Czech Academy of Sciences Publication Activity Database

Korytár, D.; Hrdý, Jaromír; Artemiev, Nikolai; Ferrari, C.; Freund, A.

2001-01-01

Roč. 8, - (2001), s. 1136-1139 ISSN 0909-0495 R&D Projects: GA MŠk OK 305; GA MPO PZ-CH/22 Institutional research plan: CEZ:AV0Z1010914 Keywords : x-ray optics * Si(111) W/grooved crystals * inclined diffraction * out-of-diffraction-plane beams * sagittal focusing Subject RIV: BH - Optics, Masers, Lasers Impact factor: 1.519, year: 2001

Natural Head Posture in the Setting of Sagittal Spinal Deformity: Validation of Chin-Brow Vertical Angle, Slope of Line of Sight, and McGregor's Slope With Health-Related Quality of Life.

Science.gov (United States)

Lafage, Renaud; Challier, Vincent; Liabaud, Barthelemy; Vira, Shaleen; Ferrero, Emmanuelle; Diebo, Bassel G; Liu, Shian; Vital, Jean-Marc; Mazda, Keyvan; Protopsaltis, Themistocles S; Errico, Thomas J; Schwab, Frank J; Lafage, Virginie

2016-07-01

The maintenance of horizontal gaze is an essential function of upright posture and global sagittal spinal alignment. Horizontal gaze is classically measured by the chin-brow vertical angle (CBVA), which is not readily measured on most lateral spine radiographs. To evaluate relations between CBVA and the slope of the line of sight, the slope of McGregor's line (McGS), and Oswestry Disability Index. Patients were identified from a single center database of 531 spine patients who underwent full-body EOS x-rays. Correlations between CBVA, the slope of the line of sight, and McGS were assessed. Using a quadratic regression with Oswestry Disability Index and CBVA, windows of low disability were identified. Comparison of sagittal spinopelvic parameters was carried out between patients with "ascending gaze" and "neutral position." Three hundred three patients were included (74% female, mean age 54.8 years, body mass index 26.6 ± 6.0 kg/m). CBVA strongly correlated with the slope of the line of sight (r = 0.996) and McGS (r = 0.862). Regression studies between Oswestry Disability Index and CBVA yielded a range of values corresponding to low disability (-4.7 degrees to 17.7 degrees). Similarly, a low disability range for the slope of the line of sight (-5.1 degrees to 18.5 degrees) and McGS (-5.7 degrees to 14.3 degrees) was computed. Patients with "ascending gaze" had a worse spinopelvic alignment than "neutral position" patients. The slope of the line of sight and McGS correlated strongly with CBVA and can be used as surrogate measures. The range of values for these measures corresponding to low disability was identified. These values can be used as a general guideline to assess alignment for diagnostic purposes. Cervical compensatory mechanism may modify the natural head position in sagittally misaligned patients. CBVA, chin-brow vertical angleHRQoL, health-related quality of lifeMcGS, slope of McGregor's lineODI, Oswestry Disability IndexSLs, slope of the line of sight.

The sagittal stem alignment and the stem version clearly influence the impingement-free range of motion in total hip arthroplasty: a computer model-based analysis.

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Müller, Michael; Duda, Georg; Perka, Carsten; Tohtz, Stephan

2016-03-01

The component alignment in total hip arthroplasty influences the impingement-free range of motion (ROM). While substantiated data is available for the cup positioning, little is known about the stem alignment. Especially stem rotation and the sagittal alignment influence the position of the cone in relation to the edge of the socket and thus the impingement-free functioning. Hence, the question arises as to what influence do these parameters have on the impingement-free ROM? With the help of a computer model the influence of the sagittal stem alignment and rotation on the impingement-free ROM were investigated. The computer model was based on the CT dataset of a patient with a non-cemented THA. In the model the stem version was set at 10°/0°/-10° and the sagittal alignment at 5°/0°/-5°, which resulted in nine alternative stem positions. For each position, the maximum impingement-free ROM was investigated. Both stem version and sagittal stem alignment have a relevant influence on the impingement-free ROM. In particular, flexion and extension as well as internal and external rotation capability present evident differences. In the position intervals of 10° sagittal stem alignment and 20° stem version a difference was found of about 80° in the flexion and 50° in the extension capability. Likewise, differences were evidenced of up to 72° in the internal and up to 36° in the external rotation. The sagittal stem alignment and the stem torsion have a relevant influence on the impingement-free ROM. To clarify the causes of an impingement or accompanying problems, both parameters should be examined and, if possible, a combined assessment of these factors should be made.

Spino-pelvic sagittal balance of spondylolisthesis: a review and classification.

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Labelle, Hubert; Mac-Thiong, Jean-Marc; Roussouly, Pierre

2011-09-01

In L5-S1 spondylolisthesis, it has been clearly demonstrated over the past decade that sacro-pelvic morphology is abnormal and that it can be associated to an abnormal sacro-pelvic orientation as well as to a disturbed global sagittal balance of the spine. The purpose of this article is to review the work done within the Spinal Deformity Study Group (SDSG) over the past decade, which has led to a classification incorporating this recent knowledge. The evidence presented has been derived from the analysis of the SDSG database, a multi-center radiological database of patients with L5-S1 spondylolisthesis, collected from 43 spine surgeons in North America and Europe. The classification defines 6 types of spondylolisthesis based on features that can be assessed on sagittal radiographs of the spine and pelvis: (1) grade of slip, (2) pelvic incidence, and (3) spino-pelvic alignment. A reliability study has demonstrated substantial intra- and inter-observer reliability similar to other currently used classifications for spinal deformity. Furthermore, health-related quality of life measures were found to be significantly different between the 6 types, thus supporting the value of a classification based on spino-pelvic alignment. The clinical relevance is that clinicians need to keep in mind when planning treatment that subjects with L5-S1 spondylolisthesis are a heterogeneous group with various adaptations of their posture. In the current controversy on whether high-grade deformities should or should not be reduced, it is suggested that reduction techniques should preferably be used in subjects with evidence of abnormal posture, in order to restore global spino-pelvic balance and improve the biomechanical environment for fusion.

Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness.

Science.gov (United States)

Schmitz, Randy J; Harrison, David; Wang, Hsin-Min; Shultz, Sandra J

2017-06-02

  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown.   To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals.   Descriptive laboratory study.   Laboratory.   Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg).   Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex.   Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R 2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R 2 Δ = 0.31, PΔ = .003).   Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population

Sagittal-lung CT measurements in the evaluation of asthma-COPD overlap syndrome: a distinctive phenotype from COPD alone.

Science.gov (United States)

Qu, Yanjuan; Cao, Yiyuan; Liao, Meiyan; Lu, Zhiyan

2017-07-01

This study aimed at investigating the capability of sagittal-lung computed tomography (CT) measurements in differentiating chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS). Clinical and high-resolution CT of 229 patients including 123 pure COPD patients and 106 ACOS patients were included. Sagittal-lung CT measurements in terms of bilateral lung height (LH), anterior-posterior lung diameter (APLD), diaphragm height (DH), and anterior sterno-diaphragmatic angle (ASDA), as well as inter-pulmonary septum length (IPSL) on axial images were measured both before and after bronchodilator (BD) administration. Comparisons of clinical characteristics and CT measurements between patient groups were performed. All pre-BD quantitative sagittal features measuring diaphragm flattening and hyperinflation were not significantly different between patients with COPD and patients with ACOS (P values all >0.05). Following BD administration, the ACOS patients exhibited lower left LH, bilateral APLD, and bilateral ASDA, but higher right DH, compared to pure COPD patients (P values all <0.05). Right LH, left DH and IPSL were not significantly different between patient groups. Besides, variations of all sagittal-lung CT measurements were significantly larger in patients with ACOS than in patients with pure COPD (P values all <0.001) and showed high performance in differentiating these two kinds of patient, with diagnostic sensitivities ranging from 76.4 to 97.2%, specificities ranging from 86.2 to 100.0%, and accuracies ranging from 80.9 to 90.7%. Sagittal-lung CT measurements allow for differentiating patients with ACOS from those with pure COPD. The ACOS patients had larger post-BD variations of sagittal-lung CT measurements than patients with pure COPD.

Variations of cervical lordosis and head alignment after pedicle subtraction osteotomy surgery for sagittal imbalance.

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Cecchinato, R; Langella, F; Bassani, R; Sansone, V; Lamartina, C; Berjano, P

2014-10-01

The variations of the cervical lordosis after correction of sagittal imbalance have been poorly studied. The aim of our study is to verify whether the cervical lordosis changes after surgery for sagittal imbalance. Thirty-nine patients were included in the study. Cervical, thoracic and lumbar spine, pelvic and lower-limb sagittal parameters were recorded. The cranial alignment was measured by the newly described Cranial Slope. The global cervical kyphosis (preop -43°, postop -31.5°) and the upper (preop -24.1°, postop -20.2°) and lower cervical kyphosis (preop -18.1°, postop -9.2°) were significantly reduced after surgical realignment of the trunk. A positive linear correlation was observed between the changes in T1 slope and the lower cervical lordosis, and between T1 slope and the global cervical alignment. The cervical lordosis is reduced by surgical correction of malalignment of the trunk, suggesting an adaptive role to maintain the head's neutral position.

Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

Directory of Open Access Journals (Sweden)

Yang Yang, Ying Fang, Xini Zhang, Junliang He, Weijie Fu

2017-12-01

Full Text Available The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively performed a weight-bearing dorsiflexion (WB-DF maneuver, drop jumps (DJs, and lay-up jumps (LJs. Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041 was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028 and power (p = 0.022 were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion–extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

Science.gov (United States)

Yang, Yang; Fang, Ying; Zhang, Xini; He, Junliang; Fu, Weijie

2017-12-01

The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively) performed a weight-bearing dorsiflexion (WB-DF) maneuver, drop jumps (DJs), and lay-up jumps (LJs). Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041) was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028) and power (p = 0.022) were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion-extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

A Comparison of Plain Radiography with Computer Tomography in Determining Coronal and Sagittal Alignments following Total Knee Arthroplasty

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Solayar GN

2017-07-01

Full Text Available INTRODUCTION: Optimal coronal and sagittal component positioning is important in achieving a successful outcome following total knee arthroplasty (TKA. Modalities to determine post-operative alignment include plain radiography and computer tomography (CT imaging. This study aims to determine the accuracy and reliability of plain radiographs in measuring coronal and sagittal alignment following TKA. MATERIALS AND METHODS: A prospective, consecutive study of 58 patients undergoing TKA was performed comparing alignment data from plain radiographs and CT imaging. Hip- knee-angle (HKA, sagittal femoral angle (SFA and sagittal tibial angle (STA measurements were taken by two observers from plain radiographs and compared with CT alignment. Intra- and inter-observer correlation was calculated for each measurement. RESULTS: Intra-observer correlation was excellent for HKA (r>0.89 with a mean difference of 0.95 and STA (r>0.8 compared to SFA (r=0.5. When comparing modalities (radiographs vs CT, HKA estimations for both observers showed the least maximum and mean differences while SFA observations were the least accurate. CONCLUSION: Radiographic estimation of HKA showed excellent intra- and inter-observer correlation and corresponds well with CT imaging. However, radiographic estimation of sagittal plane alignment was less reliably measured and correlated less with CT imaging. Plain radiography was found to be inferior to CT for estimation of biplanar prosthetic alignment following TKA.

Comparison of prostate contours between conventional stepping transverse imaging and Twister-based sagittal imaging in permanent interstitial prostate brachytherapy.

Science.gov (United States)

Kawakami, Shogo; Ishiyama, Hiromichi; Satoh, Takefumi; Tsumura, Hideyasu; Sekiguchi, Akane; Takenaka, Kouji; Tabata, Ken-Ichi; Iwamura, Masatsugu; Hayakawa, Kazushige

2017-08-01

To compare prostate contours on conventional stepping transverse image acquisitions with those on twister-based sagittal image acquisitions. Twenty prostate cancer patients who were planned to have permanent interstitial prostate brachytherapy were prospectively accrued. A transrectal ultrasonography probe was inserted, with the patient in lithotomy position. Transverse images were obtained with stepping movement of the transverse transducer. In the same patient, sagittal images were also obtained through rotation of the sagittal transducer using the "Twister" mode. The differences of prostate size among the two types of image acquisitions were compared. The relationships among the difference of the two types of image acquisitions, dose-volume histogram (DVH) parameters on the post-implant computed tomography (CT) analysis, as well as other factors were analyzed. The sagittal image acquisitions showed a larger prostate size compared to the transverse image acquisitions especially in the anterior-posterior (AP) direction ( p transverse image acquisitions was correlated to DVH parameters such as D 90 ( R = 0.518, p = 0.019), and V 100 ( R = 0.598, p = 0.005). There were small but significant differences in the prostate contours between the transverse and the sagittal planning image acquisitions. Furthermore, our study suggested that the differences between the two types of image acquisitions might correlated to dosimetric results on CT analysis.

Sagittal synostosis: II. Cranial morphology and growth after the modified pi-plasty

DEFF Research Database (Denmark)

Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

2006-01-01

The aim of this study was to characterise the postoperative cranial growth and morphology after a modified pi-plasty for sagittal synostosis. The shape of the skull of 82 patients with isolated premature synostosis of the sagittal suture ( SS group) operated on with a modified pi-plasty was studied...... developed by Kreiborg, which included the digitisation of 89 landmarks of the calvaria, cranial base, and orbit ( 43 in the lateral and 46 in the frontal projections), the production of mean shape plots for each group, and the intergroup comparison of a series of 78 variables ( linear distance between...... selected landmarks, and angles defined by groups of three landmarks). Paired and unpaired t tests were used to assess the differences between the variables studied. These were accepted as significant for values of p...

Bulky scalp metastasis and superior sagittal sinus thrombosis from a cervical adenocarcinoma: an unusual case

International Nuclear Information System (INIS)

Abhishek, A.; Ouseph, M. M.; Sharma, M.; Sharma, P.; Kamal, V.

2008-01-01

Distant cutaneous metastases from cervical malignancies are uncommon, with scalp metastases being exceptional events. We present the case of a 53-year-old postmenopausal lady with adenocarcinoma of the uterine cervix that metastasized to the scalp with superior sagittal sinus thrombosis 8 months after diagnosis. In contrast to the seven prior cases of scalp metastases of cervical squamous cell carcinoma reported in published reports, ours is the first documentation of such an occurrence in cervical adenocarcinoma. Superior sagittal sinus thrombosis has not been reported with this tumour in the past.

Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach.

Science.gov (United States)

Asopa, H S; Garg, M; Singhal, G G; Singh, L; Asopa, J; Nischal, A

2001-11-01

To explore the feasibility of applying a dorsal free graft to treat urethral stricture by the ventral sagittal urethrotomy approach without mobilizing the urethra. Twelve patients with long or multiple strictures of the anterior urethra were treated by a dorsal free full-thickness preputial or buccal mucosa graft. The urethra was not separated from the corporal bodies and was opened in the midline over the stricture. The floor of the urethra was incised, and an elliptical raw area was created over the tunica on which a free full-thickness graft of preputial or buccal mucosa was secured. The urethra was retubularized in one stage. After a follow-up of 8 to 40 months, one recurrence developed and required dilation. The ventral sagittal urethrotomy approach for dorsal free graft urethroplasty is not only feasible and successful, but is easy to perform.

WAVELET ANALYSIS AND NEURAL NETWORK CLASSIFIERS TO DETECT MID-SAGITTAL SECTIONS FOR NUCHAL TRANSLUCENCY MEASUREMENT

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Giuseppa Sciortino

2016-04-01

Full Text Available We propose a methodology to support the physician in the automatic identification of mid-sagittal sections of the fetus in ultrasound videos acquired during the first trimester of pregnancy. A good mid-sagittal section is a key requirement to make the correct measurement of nuchal translucency which is one of the main marker for screening of chromosomal defects such as trisomy 13, 18 and 21. NT measurement is beyond the scope of this article. The proposed methodology is mainly based on wavelet analysis and neural network classifiers to detect the jawbone and on radial symmetry analysis to detect the choroid plexus. Those steps allow to identify the frames which represent correct mid-sagittal sections to be processed. The performance of the proposed methodology was analyzed on 3000 random frames uniformly extracted from 10 real clinical ultrasound videos. With respect to a ground-truth provided by an expert physician, we obtained a true positive, a true negative and a balanced accuracy equal to 87.26%, 94.98% and 91.12% respectively.

CORRELATION BETWEEN CERVICAL SAGITTAL ALIGNMENT AND FUNCTIONAL CAPACITY IN CERVICAL SPONDYLOSIS

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Marcel Machado da Motta

Full Text Available ABSTRACT Objective: To correlate the radiographic parameters of sagittal cervical alignment with quality of life and functional capacity in patients with cervical spondylosis under conservative treatment. Methods: This is an observational and prospective study in patients with cervical spondylosis under conservative treatment and without indication for surgery. The 52 patients included were divided into three groups: axial pain, radiculopathy, and cervical myelopathy. The radiographic parameters considered were cervical lordosis (CL, cervical sagittal vertical axis (CSVA, T1 slope (TS and the discrepancy between TS and CL (TS-CL. Quality of life and functional capacity were evaluated by the Neck Disability Index (NDI questionnaire. Pain was assessed by the Visual Analogue Scale (VAS. The correlation between the radiographic parameters and the clinical scores was evaluated by the Pearson correlations coefficient. Results: There was no difference in cervical radiographic parameters between the three groups. In the total of the sample, the mean value of the CSVA was 17.8o (±8.3o, CL, 22.4° (± 8.8°; TS, 29.3° (±6.6°, and TS-CL, 7.0° (±7.4°. Significant inverse correlation (r= -0.3, p=0.039 was observed between NDI and CL, but there was no significant correlation between CL and VAS. CSVA (p=0.541, TS (p=0.287 and TS-CL (p=0.287 had no significantly correlated with NDI or VAS. Conclusion: Considering patients with cervical spondylosis not candidates for surgery, the only sagittal parameter that correlated with functional capacity was LC. In these patients, the correlation between cervical alignment and quality of life needs to be better characterized.

[Evaluation of the clinical results of non-surgical treatment for pediatric sagittal fracture of mandibular condyle].

Science.gov (United States)

Liu, Chang-kui; Tan, Xin-ying; Xu, Juan; Liu, Hua-wei; Liu, San-xia; Hu, Min

2013-11-01

To investigate the clinical results of occlusal splint in the treatment of sagittal fracture of mandibular condyle (SFMC) in children. Thirty-nine patients (48 condyles)aged 3-8 years with sagittal fracture of mandibular condyle were included in this study. All the patients were treated by occlusal splint.Slight open occlusion was maintained by occlusal splint for 3-6 months. Clinical and radiological examination was performed six mouths and every year after treatment. Good mandibular function was observed in 39 patients. Maximal mouth opening over 35 mm was achieved at 6 months. But 11 of the 39 patients presented with deviation on mouth opening at 6 months. The radiology showed an complete remodeling in 32 condyles (28 patients) and partial remodeling in 16 condyles (11 patients). Poor remodelling was not observed in any patients. Good clinical results can be obtained by using occlusal splint in the treatment of pediatric sagittal fracture of mandibular condyle.

A rare complication in a child undergoing chemotherapy for acute lymphoblastic leukemia: Superior sagittal sinus thrombosis

Directory of Open Access Journals (Sweden)

Ting-Yao Wang

2011-04-01

Full Text Available We report the case of a 4-year-old boy with acute lymphoblastic leukemia in high-risk group who suffered from generalized tonic-colonic seizure evolving into status epilepticus, and subsequent left hemiparesis during his first reinduction chemotherapy, consisting of dexamethasone, vincristine, l-asparaginase, and epirubicin. Superior sagittal sinus and cerebral venous thrombosis, predominantly in right side, were proved by brain magnetic resonance imaging. After aggressive treatment with low-molecular weight heparin (LMWH, left hemiparesis improved in 1 week. And he was fully ambulatory 3 weeks later. The second cycle of reinduction chemotherapy was conducted smoothly with the concomitant use of LMWH. This case illustrates the strong correlation of the rare thrombotic complication, superior sagittal sinus thrombosis, and hypercoagulable status secondary to combination use of l-asparaginase and corticosteroid. Early and vigilant recognition of superior sagittal sinus thrombosis and prompt anticoagulation with LMWH may prevent further neurological damage.

A comparison of economy and sagittal plane trunk movements among back-, back/front- and head-loading.

Science.gov (United States)

Hudson, Sean; Cooke, Carlton; Davies, Simeon; West, Sacha; Gamieldien, Raeeq; Low, Chris; Lloyd, Ray

2018-05-14

It has been suggested that freedom of movement in the trunk could influence load carriage economy. This study aimed to compare the economy and sagittal plane trunk movements associated with three load carriage methods that constrain posture differently. Eighteen females walked at 3 km.h -1 with loads of 0, 3, 6, 9, 12, 15 and 20 kg carried on the back, back/front and head. Load carriage economy was assessed using the Extra Load Index (ELI). Change in sagittal plane trunk forward lean and trunk angle excursion from unloaded to loaded walking were assessed. Results show no difference in economy between methods (p = 0.483), despite differences in the change in trunk forward lean (p = 0.001) and trunk angle excursion (p = 0.021) from unloaded to loaded walking. We conclude that economy is not different among the three methods of load carriage, despite significant differences in sagittal plane trunk movements.

Risk factors affecting somatosensory function after sagittal split osteotomy

DEFF Research Database (Denmark)

Thygesen, Torben Henrik; Jensen, Allan Bardow; Helleberg, M

2008-01-01

Purpose The aim of this study was to evaluate potential individual and intraoperative risk factors associated with bilateral sagittal split osteotomy (BSSO) and to correlate the findings with postoperative changes in somatosensory function. Patients and Methods A total of 18 men and 29 women (mean...... and free dissection of the inferior alveolar nerve during BSSO increased self-reported changes in lower lip sensation and lower lip tactile threshold after BSSO (P discrimination (P

Normal anatomy of the female pelvis in axial, coronal, and sagittal planes demonstrated with reformatted CT

International Nuclear Information System (INIS)

Constant, O.C.; Cooke, J.C.; Parsons, C.A.

1987-01-01

Axial CT is used in assessing gynecologic malignancies. Accurate delineation of local tumor extent in carcinoma of the cervix is important in initial staging and in planning subsequent management. A modified scanning technique produces reformatted coronal and sagittal images, which demonstrate additional valuable information about the cardinal ligaments, parametria, ureters, boundaries between the cervix, bladder, and rectum, and extension to vagina and uterus. This information is illustrated by representative axial, coronal, and sagittal scans. Familiarity with normal appearances is essential to allow correct interpretation of pathology

Is Postoperative Intensive Care Unit Care Necessary following Cranial Vault Remodeling for Sagittal Synostosis?

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Wolfswinkel, Erik M; Howell, Lori K; Fahradyan, Artur; Azadgoli, Beina; McComb, J Gordon; Urata, Mark M

2017-12-01

Of U.S. craniofacial and neurosurgeons, 94 percent routinely admit patients to the intensive care unit following cranial vault remodeling for correction of sagittal synostosis. This study aims to examine the outcomes and cost of direct ward admission following primary cranial vault remodeling for sagittal synostosis. An institutional review board-approved retrospective review was undertaken of the records of all patients who underwent primary cranial vault remodeling for isolated sagittal craniosynostosis from 2009 to 2015 at a single pediatric hospital. Patient demographics, perioperative course, and outcomes were recorded. One hundred ten patients met inclusion criteria with absence of other major medical problems. Average age at operation was 6.7 months, with a mean follow-up of 19.8 months. Ninety-eight patients (89 percent) were admitted to a general ward for postoperative care, whereas the remaining 12 (11 percent) were admitted to the intensive care unit for preoperative or perioperative concerns. Among ward-admitted patients, there were four (3.6 percent) minor complications; however, there were no major adverse events, with none necessitating intensive care unit transfers from the ward and no mortalities. Average hospital stay was 3.7 days. The institution's financial difference in cost of intensive care unit stay versus ward bed was $5520 on average per bed per day. Omitting just one intensive care unit postoperative day stay for this patient cohort would reduce projected health care costs by a total of $540,960 for the study period. Despite the common practice of postoperative admission to the intensive care unit following cranial vault remodeling for sagittal craniosynostosis, the authors suggest that postoperative care be considered on an individual basis, with only a small percentage requiring a higher level of care. Therapeutic, III.

Impact of Cervical Sagittal Alignment on Axial Neck Pain and Health-related Quality of Life After Cervical Laminoplasty in Patients With Cervical Spondylotic Myelopathy or Ossification of the Posterior Longitudinal Ligament: A Prospective Comparative Study.

Science.gov (United States)

Fujiwara, Hiroyasu; Oda, Takenori; Makino, Takahiro; Moriguchi, Yu; Yonenobu, Kazuo; Kaito, Takashi

2018-05-01

This is prospective observational study. To prospectively investigate the correlation among axial neck pain; a newly developed patient-based quality of life outcome measure, the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ); and cervical sagittal alignment after open-door laminoplasty for cervical myelopathy. Many studies have focused on postoperative axial neck pain after laminoplasty. However, the correlation among cervical sagittal alignment, neck pain, and JOACMEQ has not been investigated. In total, 57 consecutive patients treated by open-door laminoplasty for cervical myelopathy were included (mean age, 63.7 y; 15 women and 42 men) and divided into 2 groups according to diagnosis [cervical spondylotic myelopathy (CSM) group: 35 patients, and ossification of the posterior longitudinal ligament (OPLL) group: 22 patients]. JOA score, a subdomain of cervical spine function (CSF) in the JOACMEQ, and the visual analog scale for axial neck pain were assessed preoperatively and 12 months postoperatively. Radiographic cervical sagittal parameters were measured by C2 sagittal vertical axis (C2 SVA), C2-C7 lordosis, C7 sagittal slope (C7 slope), and range of motion. C2 SVA values in both groups shifted slightly anteriorly between preoperative and 12-month postoperative measurements (CSM: +19.7±10.9 mm; OPLL: +22.1±13.4 mm vs. CSM: +23.2±16.1 mm; OPLL: +28.7±15.4 mm, respectively). Postoperative axial neck pain in the OPLL group showed strong negative correlations with C2 SVA and C7 slope. Strong negative correlations were found between axial neck pain and CSF in both the preoperative CSM and OPLL groups (CSM: r=-0.45, P=0.01; OPLL: r=-0.61, Ppain and CSF in the postoperative OPLL group (r=-0.51, P=0.05). This study demonstrated a significant negative correlation between neck pain and CSF in both the CSM and OPLL groups preoperatively and in the OPLL group postoperatively. Radiographic cervical sagittal alignment

Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy

NARCIS (Netherlands)

van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.

2003-01-01

Distraction osteogenesis in 'common' surgical orthodontics is mentioned as an alternative for conventional sagittal split osteotomy. After a 'learning curve' in the surgical skills of distraction, the two techniques can be compared concerning time and cost aspects. Forty-seven patients (male n=28,

A Review Of Referral Patterns For Sagittal Synostosis In Ireland: 2008-2013

LENUS (Irish Health Repository)

Berney, M J

2018-01-01

Sagittal synostosis (SS) is the commonest form of craniosynostosis. Children with sagittal synostosis in Ireland are treated in the National Paediatric Craniofacial Centre (NPCC) in Temple Street Children’s University Hospital. This retrospective study analysed the correlation between referral patterns to the unit and age at operation. The notes of 81 patients referred over a 5 year period (April 2008 – April 2013) to the NPCC with non-syndromic SS were reviewed and demographics and referral information were recorded. Of 81 patients reviewed, 60 (74%) were referred before 6 months of age, while 21 (26%) had late referrals. Neonatologists referred 100% of infants before 6 months, paediatricians referred 71%, and GPs 64%. Later referral was associated with a more complex referral pathway, including multiple-steps of referral and unnecessary investigations. Improved clinician knowledge and emphasis on the importance of early referral may lead to a reduction in late referrals.

Zebrin II Is Expressed in Sagittal Stripes in the Cerebellum of Dragon Lizards (Ctenophorus sp.).

Science.gov (United States)

Wylie, Douglas R; Hoops, Daniel; Aspden, Joel W; Iwaniuk, Andrew N

2016-01-01

Aldolase C, also known as zebrin II (ZII), is a glycolytic enzyme that is expressed in cerebellar Purkinje cells of the vertebrate cerebellum. In both mammals and birds, ZII is expressed heterogeneously, such that there are sagittal stripes of Purkinje cells with high ZII expression (ZII+) alternating with stripes of Purkinje cells with little or no expression (ZII-). In contrast, in snakes and turtles, ZII is not expressed heterogeneously; rather all Purkinje cells are ZII+. Here, we examined the expression of ZII in the cerebellum of lizards to elucidate the evolutionary origins of ZII stripes in Sauropsida. We focused on the central netted dragon (Ctenophorus nuchalis) but also examined cerebellar ZII expression in 5 other dragon species (Ctenophorus spp.). In contrast to what has been observed in snakes and turtles, we found that in these lizards, ZII is heterogeneously expressed. In the posterior part of the cerebellum, on each side of the midline, there were 3 sagittal stripes consisting of Purkinje cells with high ZII expression (ZII+) alternating with 2 sagittal stripes with weaker ZII expression (ZIIw). More anteriorly, most of the Purkinje cells were ZII+, except laterally, where the Purkinje cells did not express ZII (ZII-). Finally, all Purkinje cells in the auricle (flocculus) were ZII-. Overall, the parasagittal heterogeneous expression of ZII in the cerebellum of lizards is similar to that in mammals and birds, and contrasts with the homogenous ZII+ expression seen in snakes and turtles. We suggest that a sagittal heterogeneous expression of ZII represents the ancestral condition in stem reptiles which was lost in snakes and turtles. © 2017 S. Karger AG, Basel.

Comparing the Effectiveness of Sagittal Balance, Foraminal Stenosis, and Preoperative Cord Rotation in Predicting Postoperative C5 Palsy.

Science.gov (United States)

Chugh, Arunit J S; Weinberg, Douglas S; Alonso, Fernando; Eubanks, Jason D

2017-11-01

Retrospective cohort review. To determine whether preoperative cord rotation is independently correlated with C5 palsy when analyzed alongside measures of sagittal balance and foraminal stenosis. Postoperative C5 palsy is a well-documented complication of cervical procedures with a prevalence of 4%-8%. Recent studies have shown a correlation with preoperative spinal cord rotation. There have been few studies, however, that have examined the role of sagittal balance and foraminal stenosis in the development of C5 palsy. A total of 77 patients who underwent cervical decompression-10 of whom developed C5 palsy-were reviewed. Sagittal balance was assessed using curvature angle and curvature index on radiographs and magnetic resonance image (MRI). Cord rotation was assessed on axial MRI. C4-C5 foraminal stenosis was assessed on sagittal MRI using area measurements and a grading scale. Demographics and information on surgical approach were gathered from chart review. Correlation with C5 palsy was performed by point-biserial, χ, and regression analyses. Point-biserial analysis indicated that only cord rotation showed significance (Pbalance did not correlate with presence of C5 palsy. Logistic regression model yielded cord rotation as the only significant independent predictor of C5 palsy. For every degree of axial cord rotation, the likelihood ratio for suffering a C5 palsy was 3.93 (95% confidence interval, 2.01-8.66; Ppoints to mechanisms other than direct compression as the etiology. In addition, the lack of correlation with postoperative changes in sagittal balance hints that measures of curvature angle and curvature index may not be appropriate to accurately predict this complication. Level 3.

Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.

Science.gov (United States)

Luo, Shufang; Li, Bo; Long, Xing; Deng, Mohong; Cai, Hengxing; Cheng, Yong

2011-07-01

The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment. Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height. Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis. The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Alignment in the transverse plane, but not sagittal or coronal plane, affects the risk of recurrent patella dislocation.

Science.gov (United States)

Takagi, Shigeru; Sato, Takashi; Watanabe, Satoshi; Tanifuji, Osamu; Mochizuki, Tomoharu; Omori, Go; Endo, Naoto

2017-11-17

Abnormalities of lower extremity alignment (LEA) in recurrent patella dislocation (RPD) have been studied mostly by two-dimensional (2D) procedures leaving three-dimensional (3D) factors unknown. This study aimed to three-dimensionally examine risk factors for RPD in lower extremity alignment under the weight-bearing conditions. The alignment of 21 limbs in 15 RPD subjects was compared to the alignment of 24 limbs of 12 healthy young control subjects by an our previously reported 2D-3D image-matching technique. The sagittal, coronal, and transverse alignment in full extension as well as the torsional position of the femur (anteversion) and tibia (tibial torsion) under weight-bearing standing conditions were assessed by our previously reported 3D technique. The correlations between lower extremity alignment and RPD were assessed using multiple logistic regression analysis. The difference of lower extremity alignment in RPD between under the weight-bearing conditions and under the non-weight-bearing conditions was assessed. In the sagittal and coronal planes, there was no relationship (statistically or by clinically important difference) between lower extremity alignment angle and RPD. However, in the transverse plane, increased external tibial rotation [odds ratio (OR) 1.819; 95% confidence interval (CI) 1.282-2.581], increased femoral anteversion (OR 1.183; 95% CI 1.029-1.360), and increased external tibial torsion (OR 0.880; 95% CI 0.782-0.991) were all correlated with RPD. The tibia was more rotated relative to femur at the knee joint in the RPD group under the weight-bearing conditions compared to under the non-weight-bearing conditions (p alignment parameters in the transverse plane related to the risk of RPD, while in the sagittal and coronal plane alignment parameters did not correlate with RPD. The clinical importance of this study is that the 3D measurements more directly, precisely, and sensitively detect rotational parameters associated with RPD and

The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

Directory of Open Access Journals (Sweden)

Pereira Marcelo P.

2015-12-01

Full Text Available Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during movement. In addition, the effects of two different vibration frequencies (80 and 120Hz were tested. Vibration was applied bilaterally on the tibialis anterior, rectus femoris and trapezius superior. The first step characteristics, ground reaction forces and CoP behaviour were assessed. Results. Vibration improved gait initiation performance regardless of the moment it was applied. CoP velocity during the initial phase of APA was increased by vibration only when it was applied before movement. When vibration was applied to disturb the movement, no effects on the CoP behaviour were observed. Manipulation of vibration frequency had no effects. Conclusions. Rather than proprioception manipulation, the results suggest that post-vibratory effects and attentional mechanisms were responsible for our results. Taken together, the results show that sagittal APA setting is robust to proprioception manipulation.

Chronic low back pain after lumbosacral fracture due to sagittal and frontal vertebral imbalance.

Science.gov (United States)

Boyoud-Garnier, L; Boudissa, M; Ruatti, S; Kerschbaumer, G; Grobost, P; Tonetti, J

2017-06-01

Over time, some patients with unilateral or bilateral lumbosacral injuries experience chronic low back pain. We studied the sagittal and frontal balance in a population with these injuries to determine whether mismatch in the pelvic and lumbar angles are associated with chronic low back pain. Patients with posterior pelvic ring fractures (Tile C1, C2, C3 and A3.3) that had healed were included. Foreign patients and those with an associated spinal or acetabular fracture or nonunion were excluded. The review consisted of subjective questionnaires, a clinical examination, and standing A/P and lateral stereoradiographic views. The pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), measured lumbar lordosis (LLm), T9 sagittal offset, leg discrepancy (LD) and lateral curvature (LC). The expected lumbar lordosis (LLe) was calculated using the formula LLe=PI+9°. We defined lumbopelvic mismatch (LPM) as the difference between LLm and LLe being equal or greater than 25% of LLe. Fifteen patients were reviewed after an average follow-up of 8.8 years [5.4-15]. There were four Tile C1, five Tile C2, five Tile C3 and one Tile A3.3 fracture. Ten of the 15 patients had low back pain. The mean angles were: LLm 49.6° and LLe 71.9° (P=0.002), PT 21.3°, SS 44.1°, PI 62.9° in patients with low back pain and LLm 57.4° and LLe 63.2° (P=0.55), PT 13°, SS 43.1°, PI 54.2° in those without. LPM was present in 9 patients, 8 of who had low back pain (P=0.02). Six patients, all of whom had low back pain, had a mean LC of 7.5° [4.5-23] (P=0.02). The mean LD was 0.77cm. The findings of this small study suggest that patients who experience low back pain after their posterior arch of the pelvic ring fracture has healed, have a lumbopelvic mismatch. Early treatment of these patients should aim to reestablish the anatomy of the pelvic base relative to the frontal and sagittal balance. IV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Sagittal balance in scoliosis associated with Marfan syndrome: a stereoradiographic three-dimensional analysis.

Science.gov (United States)

Glard, Yann; Pomero, Vincent; Collignon, Patrick; Skalli, Wafa; Jouve, Jean-Luc; Bollini, Gérard

2008-03-01

Marfan syndrome (MFS) is a genetic disease often marked by the presence of scoliosis. There is no three-dimensional analysis of the deformity in the literature. Our aim was to determine what kind of sagittal balance defines scoliosis associated with MFS, namely a flexion deformity, as it is in scoliosis associated with Chiari I or an extension deformity, as in adolescent idiopathic scoliosis (AIS). To address this issue, we compared the presence or absence of a thoracic scoliosis with the presence or absence of a segment in extension in the thoracic spine. In our series, 30 patients diagnosed with Marfan syndrome were prospectively included. In each patient, personalized three-dimensional reconstruction from T1 to L5 of the spine was made using stereoradiography. The patients were first separated based on the presence or absence of thoracic scoliosis, in order to compare this with the presence or absence of a segment in extension in the thoracic spine. They were then classified into two groups based on the presence or absence of the segment in extension (meaning containing negative values of inter-vertebral sagittal rotation) in the thoracic spine. Among scoliotic patients with a thoracic scoliosis (17 cases), there were 13 (76.5% cases) with a segment in extension in the thoracic spine and 4 with no segment in extension. Our results showed that scoliosis associated with MFS is somehow original, demonstrating a sagittal balance in extension (as AIS) in about 80% of thoracic curves, but without this characteristic feature in about 20%.

Prenatal MR imaging of Dandy-Walker complex: Midline sagittal area analysis

International Nuclear Information System (INIS)

Wong, Alex M.; Bilaniuk, Larissa T.; Zimmerman, Robert A.; Liu, P.L.

2012-01-01

Objective: To measure the mid-sagittal areas of vermis (VA) and of posterior fossa (PFA) and determine their differences among fetuses with various Dandy-Walker (DW) entities and control subjects. Methods: We reviewed data in 25 fetal patients with a MR diagnosis of DW complex including hypoplastic vermis (HV), HV with rotation (HVR), and mega cistern magna (MCM), and in 85 fetal controls with normal CNS. PFA and VA of each subject were manually traced on mid-sagittal MR images. Regarding each of VA and PFA, after age correction, we determined statistically significant differences among HVR, HV, MCM, and control groups. Results: The mean VA residue of MCM was greater than that of the control, which was in turn greater than those of HVR and HV. The mean PF residue of the control was smaller than all other groups. Conclusion: Fetuses with HVR or HV had smaller VA than fetuses with MCM or control subjects. Fetuses with MCM, HVR, or HV had larger PFA than control subjects. These results may be an early step leading to better understanding of the confusion about the PF anomalies in future.

Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

International Nuclear Information System (INIS)

Lee, Myoung Seok; Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup; Park, Joong Shin; Jun, Jong Kwan

2017-01-01

The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed. We compared the ultrasonography findings with postnatal findings in all fetuses. Alveolar defects were detected in 16 out of 17 cases with CP and four out of eight cases with CL. Alveolar malalignment and hard palate defects were detected in 11 out of 17 cases and 14 out of 17 cases with CP, respectively, but not detected in any cases with CL. Communicating flow through the palate defect was detected in 11 out of 17 cases of CL with CP. The accuracy of detection in axial scans of an alveolar defect and malalignment was 80% and 76%, respectively. Accuracy of detection of in mid-sagittal images of hard palate defect and flow was 80% and 86%, respectively. The overall diagnostic accuracy of combined axial and sagittal images with sagittal CDUS was 92%. Sagittal CDUS of the fetal hard palate is a feasible method to directly reveal hard palate bony defects and flow through defects, which may have additional value in the differential diagnosis of fetal CL and CP

Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

Energy Technology Data Exchange (ETDEWEB)

Lee, Myoung Seok [Dept. of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Joong Shin; Jun, Jong Kwan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

2017-01-15

The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed. We compared the ultrasonography findings with postnatal findings in all fetuses. Alveolar defects were detected in 16 out of 17 cases with CP and four out of eight cases with CL. Alveolar malalignment and hard palate defects were detected in 11 out of 17 cases and 14 out of 17 cases with CP, respectively, but not detected in any cases with CL. Communicating flow through the palate defect was detected in 11 out of 17 cases of CL with CP. The accuracy of detection in axial scans of an alveolar defect and malalignment was 80% and 76%, respectively. Accuracy of detection of in mid-sagittal images of hard palate defect and flow was 80% and 86%, respectively. The overall diagnostic accuracy of combined axial and sagittal images with sagittal CDUS was 92%. Sagittal CDUS of the fetal hard palate is a feasible method to directly reveal hard palate bony defects and flow through defects, which may have additional value in the differential diagnosis of fetal CL and CP.

Subjective alveolar nerve function after bilateral sagittal split osteotomy or distraction osteogenesis of mandible

NARCIS (Netherlands)

Baas, E.M.; Horsthuis, R.B.G.; de Lange, J.

2012-01-01

Purpose: The present retrospective cohort study compared the subjective inferior alveolar nerve (IAN) function after distraction osteogenesis (DOG) and bilateral sagittal split osteotomy (BSSO) in mandibular advancement surgery. Materials and Methods: Treatment consisted of correction of a

Subjective Alveolar Nerve Function After Bilateral Sagittal Split Osteotomy or Distraction Osteogenesis of Mandible

NARCIS (Netherlands)

Baas, Erik M.; Horsthuis, Roy B. G.; de Lange, Jan

2012-01-01

Purpose: The present retrospective cohort study compared the subjective inferior alveolar nerve (IAN) function after distraction osteogenesis (DOG) and bilateral sagittal split osteotomy (BSSO) in mandibular advancement surgery. Materials and Methods: Treatment consisted of correction of a

Central uplift of custom immobilization radiotherapy patients with lower limb overhead sagittal laser affected without mobile

International Nuclear Information System (INIS)

Velazquez Miranda, S.; Delgado Gil, M. M.; Ortiz Seidel, M.

2011-01-01

If you have a laser moving overhead sagittal or the location of tumors in the lower extremities is laborious, as to reference properly in the CT, is necessary before tattooing in the treatment table using their ability to relate the lateral midline with tattoos on the limb. For anatomical forms often happens that lasers are not displayed on the areas of our interest. The problem can be overcome if between the legs raise the bag or custom immobilizer above the height of the patient's abdomen, as this will have a central reference reliable and well designed lasers.

BMD measurements of the spine derived from sagittal reformations of contrast-enhanced MDCT without dedicated software

Energy Technology Data Exchange (ETDEWEB)

Baum, Thomas, E-mail: thbaum@gmx.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Mueller, Dirk, E-mail: dirk.mueller@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Dobritz, Martin, E-mail: dobritz@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Rummeny, Ernst J., E-mail: institut@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany); Link, Thomas M., E-mail: thomas.link@radiology.ucsf.edu [Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States); Bauer, Jan S., E-mail: jsb@roe.med.tum.de [Institut fuer Roentgendiagnostik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675 Muenchen (Germany)

2011-11-15

Purpose: To assess QCT equivalent BMD of the lumbar spine in sagittal reformations of routine abdominal contrast-enhanced MDCT with simple PACS measurement tools and to apply this method to MDCT datasets for differentiating patients with and without osteoporotic vertebral fractures. Materials and methods: Eight postmenopausal women (65 {+-} 5years) underwent standard QCT to assess BMD of L1-L3. Afterwards routine abdominal contrast-enhanced MDCT images of these women were obtained and apparent BMD of L1-L3 was measured using the sagittal reformations. The MDCT-to-QCT conversion equation for BMD was calculated with linear regression analysis. The conversion equation was applied to vertebral BMD datasets (L1-L3) of 75 postmenopausal women (66 {+-} 4years). Seventeen of the 75 patients had osteoporotic vertebral fractures. Results: BMD values of contrast-enhanced MDCT were on average 56 mg/ml higher than those of standard QCT. A correlation coefficient of r = 0.94 (p < 0.05) was calculated for the BMD values of MDCT and standard QCT with the conversion equation BMD{sub QCT} = 0.69 x BMD{sub MDCT} - 11 mg/ml. Accordingly converted BMD values of patients with vertebral fractures were significantly lower than those of patients without vertebral fractures (69 mg/ml vs. 85 mg/ml; p < 0.05). Using ROC analysis to differentiate patients with and without vertebral fractures, AUC = 0.72 was obtained for converted BMD values (p < 0.05). Short- and long-term reproducibility errors for BMD measurements in the sagittal reformations amounted 2.09% and 7.70%, respectively. Conclusion: BMD measurements of the spine could be computed in sagittal reformations of routine abdominal contrast-enhanced MDCT with minimal technical and time effort. Using the conversion equation, the acquired BMD data could differentiate patients with and without osteoporotic vertebral fractures.

Role of thoracoscopy for the sagittal correction of hypokyphotic adolescent idiopathic scoliosis patients.

Science.gov (United States)

Ferrero, E; Pesenti, S; Blondel, B; Jouve, J L; Mazda, K; Ilharreborde, B

2014-12-01

Thoracic adolescent idiopathic scoliosis (AIS) curves (Lenke 1-4) are often characterized by hypokyphosis. Sagittal alignment remains challenging to correct, even with recent posterior segmental instrumentation. Some authors recommend anterior endoscopic release (AER) to reduce anterior column height, and facilitate thoracic kyphosis correction. The aim of this study was to assess the contribution of AER to sagittal correction in hypokyphotic AIS. Fifty-six hypokyphotic (T4T12<20°) AIS patients were included. In group 1 (28 patients), patients first underwent AER, followed by posterior instrumentation and correction 5-7 days later. In group 2 (28 patients), patients underwent the same posterior procedure without AER. Posterior correction was performed in all cases using posteromedial translation and hybrid constructs consisting of lumbar pedicle screws and thoracic sublaminar bands. From radiological measurements performed using low-dose EOS radiographs, the correction of thoracic kyphosis was compared between the two groups. Groups 1 and 2 were comparable regarding demographic data and preoperative thoracic kyphosis (group 1: 11.7° ± 6.9° vs group 2: 12.1° ± 6.3°, p = 0.89). Postoperative thoracic kyphosis increase averaged 18.3° ± 13.6° in group 1 and 15.2° ± 9.0° in group 2. The benefit of anterior release was not statistically significant (p = 0.35). Although previous studies have suggested that thoracoscopic release improved correction compared to posterior surgery alone, the current study did not confirm this finding. Moreover, results of the current series showed that no significant benefit can be expected from AER in terms of sagittal plane improvement when the posteromedial translation technique is used, even in challenging hypokyphotic patients.

Association of baseline knee sagittal dynamic joint stiffness during gait and 2-year patellofemoral cartilage damage worsening in knee osteoarthritis.

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Chang, A H; Chmiel, J S; Almagor, O; Guermazi, A; Prasad, P V; Moisio, K C; Belisle, L; Zhang, Y; Hayes, K; Sharma, L

2017-02-01

Knee sagittal dynamic joint stiffness (DJS) describes the biomechanical interaction between change in external knee flexion moment and flexion angular excursion during gait. In theory, greater DJS may particularly stress the patellofemoral (PF) compartment and thereby contribute to PF osteoarthritis (OA) worsening. We hypothesized that greater baseline knee sagittal DJS is associated with PF cartilage damage worsening 2 years later. Participants all had OA in at least one knee. Knee kinematics and kinetics during gait were recorded using motion capture systems and force plates. Knee sagittal DJS was computed as the slope of the linear regression line for knee flexion moments vs angles during the loading response phase. Knee magnetic resonance imaging (MRI) scans were obtained at baseline and 2 years later. We assessed the association between baseline DJS and baseline-to-2-year PF cartilage damage worsening using logistic regression with generalized estimating equations (GEE). Our sample had 391 knees (204 persons): mean age 64.2 years (SD 10.0); body mass index (BMI) 28.4 kg/m 2 (5.7); 76.5% women. Baseline knee sagittal DJS was associated with baseline-to-2-year cartilage damage worsening in the lateral (OR = 5.35, 95% CI: 2.37-12.05) and any PF (OR = 2.99, 95% CI: 1.27-7.04) compartment. Individual components of baseline DJS (i.e., change in knee moment or angle) were not associated with subsequent PF disease worsening. Capturing the concomitant effect of knee kinetics and kinematics during gait, knee sagittal DJS is a potentially modifiable risk factor for PF disease worsening. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee.

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Obeid, Ibrahim; Hauger, Olivier; Aunoble, Stéphane; Bourghli, Anouar; Pellet, Nicolas; Vital, Jean-Marc

2011-09-01

It has become well recognised that sagittal balance of the spine is the result of an interaction between the spine and the pelvis. Knee flexion is considered to be the last compensatory mechanism in case of sagittal imbalance, but only few studies have insisted on the relationship between spino-pelvic parameters and lower extremity parameters. Correlation between the lack of lumbar lordosis and knee flexion has not yet been established. A retrospective study was carried out on 28 patients with major spinal deformities. The EOS system was used to measure spinal and pelvic parameters and the knee flexion angle; the lack of lumbar lordosis was calculated after prediction of lumbar lordosis with two different formulas. Correlation analysis between the different measured parameters was performed. Lumbar lordosis correlated with sacral slope (r = -0.71) and moderately with knee flexion angle (r = 0.42). Pelvic tilt correlated moderately with knee flexion angle (r = 0.55). Lack of lumbar lordosis correlated best with knee flexion angle (r = 0.72 and r = 0.63 using the two formulas, respectively). Knee flexion as a compensatory mechanism to sagittal imbalance was well correlated to the lack of lordosis and, depending on the importance of the former parameter, the best procedure to correct sagittal imbalance could be chosen.

Sagittal venous sinus thrombosis after cesarean section: a case report

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Farideh Keypour

2013-07-01

Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

Bilateral sagittal split osteotomy: Surgery first approach for correction of skeletal Class II

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Revathi Peddu

2018-01-01

Full Text Available Most of the skeletal malocclusions which require orthognathic surgeries are treated by traditional approach which requires time-consuming and unesthetic presurgical orthodontic phase. Surgery first approach (SFA avoids these disadvantages of the traditional approach. A 24-year-old female patient with skeletal and dental class II malocclusion due to retrognathic mandible was treated with SFA. Bilateral sagittal split osteotomy with mandibular advancement was done immediately after initial alignment and closure of the existing spaces in the maxillary arch. Angle's class I molar and canine relation was achieved after surgery. Bonding of the mandibular arch was done after 1 month of orthognathic surgery and treatment was completed within 13 months. A wrap-around retainer was placed in upper arch, and bonded lingual retainer was given in the lower arch.

An interactive tool for CT volume rendering and sagittal plane-picking of the prostate for radiotherapy treatment planning

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Jani, Ashesh B.; Pelizzari, Charles A.; Chen, George T.Y.; Grzezcszuk, Robert P.; Vijayakumar, Srinivasan

1997-01-01

Objective: Accurate and precise target volume and critical structure definition is a basic necessity in radiotherapy. The prostate, particularly the apex (an important potential site of recurrence in prostate cancer patients), is a challenging structure to define using any modality, including conventional axial CT. Invasive or expensive techniques, such as retrograde urethrography or MRI, could be avoided if localization of the prostate were possible using information already available on the planning CT. Our primary objective was to build a software tool to determine whether volume rendering and sagittal plane-picking, which are CT-based, noninvasive visualization techniques, were of utility in radiotherapy treatment planning for the prostate. Methods: Using AVS (Application Visualization System) on a Silicon Graphics Indigo 2 High Impact workstation, we have developed a tool that enables the clinician to efficiently navigate a CT volume and to use volume rendering and sagittal plane-picking to better define structures at any anatomic site. We applied the tool to the specific example of the prostate to compare the two visualization techniques with the current standard of axial CT. The prostate was defined on 80-slice CT scans (scanning thickness 4mm, pixel size 2mm x 2mm) of prostate cancer patients using axial CT images, volume-rendered CT images, and sagittal plane-picked images. Results: The navigation of the prostate using the different visualization techniques qualitatively demonstrated that the sagittal plane-picked images, and even more so the volume-rendered images, revealed the prostate (particularly the lower border) better in relationship to the surrounding regional anatomy (bladder, rectum, pelvis, and penile structures) than did the axial images. A quantitative comparison of the target volumes obtained by navigating using the different visualization techniques demonstrated that, when compared to the prostate volume defined on axial CT, a larger volume

Simultaneous display of MRA and MPR in detecting vascular compression for trigeminal neuralgia or hemifacial spasm: comparison with oblique sagittal views of MRI

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Arbab, A.S.; Aoki, S.; Yoshikawa, T.; Kumagai, H.; Araki, T.; Nishiyama, Y.; Nagaseki, Y.; Nukui, H.

2000-01-01

A new technique, simultaneous display of magnetic resonance angiography (MRA) and multiplanar reconstruction (MPR), was performed by a workstation to identify the involved vessels in patients with trigeminal neuralgia (TN) or hemifacial spasm (HFS), and the results were compared with those of oblique sagittal MRI technique. Twelve patients with either HFS or TN were prospectively assessed by simultaneous display of MRA and MPR, and oblique sagittal techniques, to point out the neurovascular compression and to identify the involved vessels. Three-dimensional (3D) time-of-flight (TOF) spoiled gradient-echo (SPGR) images were acquired to create MRA and MPR. Oblique sagittal views were also created and displayed on films. A total of 15 vessels in 12 patients were identified as compressing vessels during surgery. Simultaneous display of MRA and MPR technique pointed out the presence of vessels at and/or around root entry/exit zone (REZ) in all 12 patients, but proper identification by the name of the individual vessel was correct in 13 of 15 cases. However, oblique sagittal technique indicated the presence of vessels at and/or around REZ in 11 patients, but only 8 of 14 vessels were correctly identified. Our new method, simultaneous display of MRA-MPR, facilitated correct identification of the involved vessels compared with the oblique sagittal view method. (orig.)

Evolution of the postoperative sagittal spinal profile in early-onset scoliosis: is there a difference between rib-based and spine-based growth-friendly instrumentation?

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Chen, Zhonghui; Li, Song; Qiu, Yong; Zhu, Zezhang; Chen, Xi; Xu, Liang; Sun, Xu

2017-12-01

OBJECTIVE Although the vertical expandable prosthetic titanium rib (VEPTR) and growing rod instrumentation (GRI) encourage spinal growth via regular lengthening, they can create different results because of their different fixation patterns and mechanisms in correcting scoliosis. Previous studies have focused comparisons on coronal plane deformity with minimal attention to the sagittal profile. In this retrospective study, the authors aimed to compare the evolution of the sagittal spinal profile in early-onset scoliosis (EOS) treated with VEPTR versus GRI. METHODS The data for 11 patients with VEPTR and 22 with GRI were reviewed. All patients had more than 2 years' follow-up with more than 2 lengthening procedures. Radiographic measurements were performed before and after the index surgery and at the latest follow-up. The complications in both groups were recorded. RESULTS Patients in both groups had similar diagnoses, age at the index surgery, and number of lengthening procedures. The changes in the major coronal Cobb angle and T1-S1 spinal height were not significantly different between the 2 groups. Compared with the GRI group, the VEPTR group had less correction in thoracic kyphosis (23% ± 12% vs 44% ± 16%, p GRI: 8° ± 5°, p = 0.569), the incidence of proximal junctional kyphosis was relatively lower in the VEPTR group (VEPTR: 18.2% vs GRI: 22.7%). No significant changes in the spinopelvic parameters were observed, while the sagittal vertical axis showed a tendency toward a neutral position in both groups. The overall complication rate was higher in the VEPTR group than in the GRI group (72.7% vs 54.5%). CONCLUSIONS The VEPTR had coronal correction and spinal growth results similar to those with GRI. In the sagittal plane, however, the VEPTR was not comparable to the GRI in controlling thoracic kyphosis. Thus, for hyperkyphotic EOS patients, GRI is recommended over VEPTR.

Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males.

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Imagama, Shiro; Ito, Zenya; Wakao, Norimitsu; Seki, Taisuke; Hirano, Kenichi; Muramoto, Akio; Sakai, Yoshihito; Matsuyama, Yukihiro; Hamajima, Nobuyuki; Ishiguro, Naoki; Hasegawa, Yukiharu

2013-06-01

Risk factors for falling in elderly people remain uncertain, and the effects of spinal factors and physical ability on body balance and falling have not been examined. The objective of this study was to investigate how factors such as spinal sagittal alignment, spinal range of motion, body balance, muscle strength, and gait speed influence falling in the prospective cohort study. The subjects were 100 males who underwent a basic health checkup. Balance, SpinalMouse(®) data, grip strength, back muscle strength, 10-m gait time, lumbar lateral standing radiographs, body mass index, and fall history over the previous year were examined. Platform measurements of balance included the distance of movement of the center of pressure (COP) per second (LNG/TIME), the envelopment area traced by movement of the COP (E AREA), and the LNG/E AREA ratio. The thoracic/lumbar angle ratio (T/L ratio) and sagittal vertical axis (SVA) were used as an index of sagittal balance. LNG/TIME and E AREA showed significant positive correlations with age, T/L ratio, SVA, and 10-m gait time; and significant negative correlations with lumbar lordosis angle, sacral inclination angle, grip strength and back muscle strength. Multiple regression analysis showed significant differences for LNG/TIME and E AREA with T/L ratio, SVA, lumbar lordosis angle and sacral inclination angle (R (2) = 0.399). Twelve subjects (12 %) had experienced a fall over the past year. Age, T/L ratio, SVA, lumbar lordosis angle, sacral inclination angle, grip strength, back muscle strength, 10-m gait time, height of the intervertebral disc, osteophyte formation in radiographs and LNG/E AREA differed significantly between fallers and non-fallers. The group with SVA > 40 mm (n = 18) had a significant higher number of subjects with a single fall (6 single fallers/18: p = 0.0075) and with multiple falls (4 multiple fallers/18: p = 0.0095). Good spinal sagittal alignment, muscle strength and 10-m gait speed improve body balance

Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion

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Cevidanes, Lucia; Baccetti, Tiziano; Franchi, Lorenzo; McNamara, James A.; De Clerck, Hugo

2010-01-01

Objective To test the hypothesis that there is no difference in the active treatment effects for maxillary advancement induced by bone-anchored maxillary protraction (BAMP) and the active treatment effects for face mask in association with rapid maxillary expansion (RME/FM). Materials and Methods This is a study on consecutively treated patients. The changes in dentoskeletal cephalometric variables from start of treatment (T1) to end of active treatment (T2) with an average T1–T2 interval of about 1 year were contrasted in a BAMP sample of 21 subjects with a RME/FM sample of 34 patients. All subjects were prepubertal at T1. Statistical comparison was performed with t-tests for independent samples. Results The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy (with a difference of 2 mm to 3 mm). Mandibular sagittal changes were similar, while vertical changes were better controlled with BAMP. The sagittal intermaxillary relationships improved 2.5 mm more in the BAMP patients. Additional favorable outcomes of BAMP treatment were the lack of clockwise rotation of the mandible as well as a lack of retroclination of the lower incisors. Conclusions The hypothesis is rejected. The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy. PMID:20578848

X-linked hypophosphatemic rickets and sagittal craniosynostosis: three patients requiring operative cranial expansion: case series and literature review.

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Jaszczuk, Phillip; Rogers, Gary F; Guzman, Raphael; Proctor, Mark R

2016-05-01

A defect in a phosphate-regulating gene leads to the most common form of rickets: X-linked hypophosphatemic rickets (XLH) or vitamin D-resistant rickets (VDDR). XLH has been associated with craniosynostosis, the sagittal suture being the most commonly involved. We present three patients with rickets and symptomatic sagittal suture craniosynostosis all of whom presented late (>2 years of age). Two had a severe phenotype and papilledema, while the third presented with an osseous bulging near the anterior fontanel and experienced chronic headaches. All underwent successful cranial vault expansion. Rachitic patients with scaphocephaly should be screened for craniosynostosis.

Can a Single Sagittal Magnetic Resonance Imaging Slice Represent Whole Fatty Infiltration in Chronic Rotator Cuff Tears at the Supraspinatus?

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Lee, Yong-Beom; Yang, Cheol-Jung; Li, Cheng Zhen; Zhuan, Zhong; Kwon, Seung-Cheol; Noh, Kyu-Cheol

2018-03-01

This study aimed to investigate whether fatty infiltration (FI) measured on a single sagittal magnetic resonance imaging (MRI) slice can represent FI of the whole supraspinatus muscle. This study retrospectively reviewed the MRIs of 106 patients (age 50-79 years) divided into three rotator cuff tear-size groups: medium, large, and massive. Fat mass and muscle mass on all T1-weighted sagittal MRI scans (FA and MA) were measured. Of the total MRI scans, the Y-view was defined as the most lateral image of the junction of the scapular spine with the scapular body on the oblique sagittal T1-weighted image. Fat mass and muscle mass seen on this Y-view single slice were recorded as F1 and M1, respectively. Fat mass and muscle mass were also assessed on MRI scans lateral and medial to the Y-view. The means of fat mass and muscle mass on these three slices were recorded as F3 and M3, respectively. Average FI ratios (fat mass/muscle mass) of the three assessment methods (F1/M1, FA/MA, and F3/M3) were compared. Intraclass correlation coefficients (ICCs) were calculated for inter- and intraobserver reliability. ICCs showed higher reliability (> 0.8) for all measurements. F1/M1 values were not statistically different from FA/MA and F3/M3 values ( p > 0.05), except in males with medium and large tears. F3/M3 and FA/MA were not statistically different. The difference between F1/M1 and FA/MA did not exceed 2%. A single sagittal MRI slice can represent the whole FI in chronic rotator cuff tears, except in some patient groups. We recommend measurement of FI using a single sagittal MRI slice, given the effort required for repeated measurements.

Long-term Clinical and Radiographic Outcomes of Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance: Does Level of Proximal Fusion Affect the Outcome? Minimum 5-Year Follow-up.

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Yagi, Mitsuru; King, Akilah B; Cunningham, Matthew E; Boachie-Adjei, Oheneba

2013-03-01

Retrospective case series of surgically treated adult patients with fixed sagittal imbalance. To assess clinical and radiographic changes after pedicle subtraction osteotomy (PSO) to treat adult fixed sagittal imbalance. Although recent reports have shown favorable clinical outcomes for PSO, few reports have published long-term follow-up outcomes. It is also unknown whether long-term outcomes are correlated with the level of proximal fusion and the radiographic changes that are observed after PSO. We reviewed the charts, X-rays, and postoperative SRS-22 and Oswestry Disability Index (ODI) scores of 32 adult patients who presented with fixed sagittal imbalance and were treated with lumbar PSO. Long fusions were defined as those proximal to T6, and short fusions were defined as those below T8. Measured radiographic parameters included thoracic kyphosis, lumbar lordosis (LL), sacral slope, pelvic incidence, and sagittal balance (SVA). Statistical analysis included Student t test and chi-square test. A p value of imbalance, PSO provided good sagittal balance and maintained favorable clinical outcomes in both the short and long fusion groups despite a slight decrease in the SVA and a high complication rate. The data suggest that the loss of sagittal balance may be attributed to increase global and junctional kyphosis in short fusion groups, and should be monitored for long-term outcomes. Particular attention should be paid to the long-term deterioration of the SVA in adults who present with fixed sagittal imbalance after PSO. Copyright © 2013 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.

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Marouane, H; Shirazi-Adl, A; Adouni, M

2015-01-01

Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position-dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus-valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.

Effect of trunk sagittal attitude on shoulder, thorax and pelvis three-dimensional kinematics in able-bodied subjects during gait.

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Alberto Leardini

Full Text Available It has been shown that an original attitude in forward or backward inclination of the trunk is maintained at gait initiation and during locomotion, and that this affects lower limb loading patterns. However, no studies have shown the extent to which shoulder, thorax and pelvis three-dimensional kinematics are modified during gait due to this sagittal inclination attitude. Thirty young healthy volunteers were analyzed during level walking with video-based motion analysis. Reflecting markers were mounted on anatomical landmarks to form a two-marker shoulder line segment, and a four-marker thorax and pelvis segments. Absolute and relative spatial rotations were calculated, for a total of 11 degrees of freedom. The subjects were divided into two groups of 15 according to the median of mean thorax inclination angle over the gait cycle. Preliminary MANOVA analysis assessed whether gender was an independent variable. Then two-factor nested ANOVA was used to test the possible effect of thorax inclination on body segments, planes of motion and gait periods, separately. There was no significant difference in all anthropometric and spatio-temporal parameters between the two groups, except for subject mass. The three-dimensional kinematics of the thorax and pelvis were not affected by gender. Nested ANOVA revealed group effect in all segment rotations apart those at the pelvis, in the sagittal and frontal planes, and at the push-off. Attitudes in sagittal thorax inclination altered trunk segments kinematics during gait. Subjects with a backward thorax showed less thorax-to-pelvis motion, but more shoulder-to-thorax and thorax-to-laboratory motion, less motion in flexion/extension and in lateral bending, and also less motion during push-off. This contributes to the understanding of forward propulsion and sideways load transfer mechanisms, fundamental for the maintenance of balance and the risk of falling.

Sectional anatomy of the fetal brain in uterus at term on the sagittal plane

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Fan-Zhen Kong

2011-06-01

Conclusion: Through the comparison study between sagittal sections and corresponding MRI of fetal brain at term, we could obtain morphological anatomic structures and MRI of fetal brain, providing morphological demonstration of the intrauterine development of fetal brain and auxiliary diagnosis of ultrasound and MRI in pregnant woman.

Effect of Long Term Oral Warfarin Sodium Treatment on Bone Mineral Density Scores and Spinal Sagittal Alignment

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Kamil Eyvazov

2016-04-01

Full Text Available Objective: The aim of this study was to investigate the effect of long term oral warfarin sodium treatment on bone mineral density (BMD and spinal sagittal alignment. Materials and Methods: Sixty four participants were enrolled for this retrospective study. Participants were divided into two groups-participants who had taken warfarin sodium for at least two years (n=33 and participants who had never taken warfarin sodium (n=31. All of the individuals were evaluated at the same center. Dual X-ray absorptiometry (DXA was used for measuring BMD. Whole spine x-rays were obtained for sagittal assessment and the following parameters were measured: Cervical lordosis, thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope and sagittal vertical axis (SVA. Results: The mean BMD value was significantly higher in participants who had not taken warfarin sodium compared to participants who had taken warfarin sodium. The differences between the average values were 0.1552 g/cm2 in BMD; 2.1 in T scores; 1.4 in Z scores. On the radiological evaluation of the spine, cervical lordosis was 7.1 degrees lower, lumbar lordosis was 4.7 degrees lower and thoracic kyphosis was 5.3 degrees higher in the patients using drug. C7 plumb line was interchanged forward in the patients using drug. Conclusions: This study shows that warfarin sodium use worsens bone quality in the lumbar region and does not affect bone quality in the femoral region. Furthermore, warfarin sodium use also reduces physiological lordosis and enhances thoracic kyphosis. Consequences of these changes are the likely cause of sagittal spinal anterior imbalance. Long-term oral warfarin sodium use affect bone mineral density and spinal alignment. Our conclusion about giving clear message and show exactly mechanism we need prospective randomized multicentre studies in future. We strongly believe this study will be pioneer for future researches.

1975 Memorial Award Paper. Image generation and display techniques for CT scan data. Thin transverse and reconstructed coronal and sagittal planes.

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Glenn, W V; Johnston, R J; Morton, P E; Dwyer, S J

1975-01-01

The various limitations to computerized axial tomographic (CT) interpretation are due in part to the 8-13 mm standard tissue plane thickness and in part to the absence of alternative planes of view, such as coronal or sagittal images. This paper describes a method for gathering multiple overlapped 8 mm transverse sections, subjecting these data to a deconvolution process, and then displaying thin (1 mm) transverse as well as reconstructed coronal and sagittal CT images. Verification of the deconvolution technique with phantom experiments is described. Application of the phantom results to human post mortem CT scan data illustrates this method's faithful reconstruction of coronal and sagittal tissue densities when correlated with actual specimen photographs of a sectioned brain. A special CT procedure, limited basal overlap scanning, is proposed for use on current first generation CT scanners without hardware modification.

The influence of heel height on sagittal plane knee kinematics during landing tasks in recreationally active and athletic collegiate females.

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Lindenberg, Kelly M; Carcia, Christopher R; Phelps, Amy L; Martin, Robroy L; Burrows, Anne M

2011-09-01

To determine if heel height alters sagittal plane knee kinematics when landing from a forward hop or drop landing. Knee angles close to extension during landing are theorized to increase ACL injury risk in female athletes. Fifty collegiate females performed two single-limb landing tasks while wearing heel lifts of three different sizes (0, 12 & 24 mm) attached to the bottom of a sneaker. Using an electrogoniometer, sagittal plane kinematics (initial contact [KA(IC)], peak flexion [KA(Peak)], and rate of excursion [RE]) were examined. Repeated measures ANOVAs were used to determine the influence of heel height on the dependent measures. Forward hop task- KA(IC) with 0 mm, 12 mm, and 24 mm lifts were 8.88±6.5, 9.38±5.8 and 11.28±7.0, respectively. Significant differences were noted between 0 and 24 mm lift (psneaker significantly alters sagittal plane knee kinematics upon landing from a unilateral forward hop but not from a drop jump.

Clinical and radiological outcomes after treatment of sagittal fracture of mandibular condyle (SFMC) by using occlusal splint in children.

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Liu, Chang-Kui; Meng, Fan-Wen; Tan, Xin-Ying; Xu, Juan; Liu, Hua-Wei; Liu, San-Xia; Huang, Hai-Tao; Yan, Rong-Zeng; Hu, Min; Hu, Kai-Jin

2014-02-01

This study was designed to investigate the effects of occlusal splints in the treatment of sagittal fractures of the mandibular condyle in children. From January 1995 to December 2011, 37 sagittal fractures of the mandibular condyle in 30 patients aged 4-8 years old were included in this study. All the patients were treated with 1-2mm occlusal splints in the molar region. The mouths of the patients were kept slightly open by the occlusal splints for 3-6 months, and we reviewed the clinical and radiological remodelling of the affected condyles after treatment. Excellent (n=20) and good (n=10) clinical outcomes were achieved with full radiological remodelling seen in 19 and partial remodelling in 11. Treatment with occlusal splints is effective in delivering good results and function with minimal morbidity in children with sagittal fractures of the condyle, while permitting ongoing remodelling and growth in the short term. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Sagittal MR findings of L5 spondylolysis : changes of spinal canal

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Kim, Hyun Cheol; Choi, Woo Suk; Kim, Eui Jong; Ryu, Kyung Nam; Oh, Joo Hyeong; Kim, Ihn Sub; Yoon, Yup [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

1997-07-01

To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition(posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. Mean SCR value in 27 patients with L5 spondylolysis(1.22) was significantly greater than 100 control subjects(0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition(1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition(0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis(63%) than in control subjects(9%). The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted.

Sagittal MR findings of L5 spondylolysis : changes of spinal canal

International Nuclear Information System (INIS)

Kim, Hyun Cheol; Choi, Woo Suk; Kim, Eui Jong; Ryu, Kyung Nam; Oh, Joo Hyeong; Kim, Ihn Sub; Yoon, Yup

1997-01-01

To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition(posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. Mean SCR value in 27 patients with L5 spondylolysis(1.22) was significantly greater than 100 control subjects(0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition(1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition(0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis(63%) than in control subjects(9%). The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted

Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment.

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Hosseini, Pooria; Mundis, Gregory M; Eastlack, Robert K; Bagheri, Ramin; Vargas, Enrique; Tran, Stacie; Akbarnia, Behrooz A

2017-12-01

OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m 2 . The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p < 0.05). The changes in motion segment angle and intradiscal angle achieved in the ALIF-ACR group without osteotomy compared with the ALIF-ACR group with osteotomy

Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility.

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Williams, D S Blaise; Welch, Lee M

2015-01-01

Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females. To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners. Forty subjects (30.0±6.4 years) participated and were placed in one of 4 groups: flexible males (n=10), inflexible males (n=10), flexible females (n=10), and inflexible females (n=10). All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while subjects ran over ground across 2 force platforms. Sagittal plane joint angles and moments were calculated at the knee and hip and compared with a 2-way (sex X flexibility) ANOVA (α=0.05). Males exhibited greater peak knee extension moment than females (M=2.80±0.47, F=2.48±0.52 Nm/kg*m, p=0.05) and inflexible runners exhibited greater peak knee extension moment than flexible runners (In=2.83±0.56, Fl=2.44±0.51 Nm/kg*m, p=0.01). For hip flexion at initial contact, a significant interaction existed (pHamstring flexibility results in different mechanical profiles in males and females. Flexibility in the hamstrings may result in decreased moments via active or passive tension. These differences may have implications for performance and injury in flexible female runners.

A Proposal of New Reference System for the Standard Axial, Sagittal, Coronal Planes of Brain Based on the Serially-Sectioned Images

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Park, Jin Seo; Park, Hyo Seok; Shin, Dong Sun; Har, Dong-Hwan; Cho, Zang-Hee; Kim, Young-Bo; Han, Jae-Yong; Chi, Je-Geun

2010-01-01

Sectional anatomy of human brain is useful to examine the diseased brain as well as normal brain. However, intracerebral reference points for the axial, sagittal, and coronal planes of brain have not been standardized in anatomical sections or radiological images. We made 2,343 serially-sectioned images of a cadaver head with 0.1 mm intervals, 0.1 mm pixel size, and 48 bit color and obtained axial, sagittal, and coronal images based on the proposed reference system. This reference system consists of one principal reference point and two ancillary reference points. The two ancillary reference points are the anterior commissure and the posterior commissure. And the principal reference point is the midpoint of two ancillary reference points. It resides in the center of whole brain. From the principal reference point, Cartesian coordinate of x, y, z could be made to be the standard axial, sagittal, and coronal planes. PMID:20052359

Validity of a smartphone protractor to measure sagittal parameters in adult spinal deformity.

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Kunkle, William Aaron; Madden, Michael; Potts, Shannon; Fogelson, Jeremy; Hershman, Stuart

2017-10-01

Smartphones have become an integral tool in the daily life of health-care professionals (Franko 2011). Their ease of use and wide availability often make smartphones the first tool surgeons use to perform measurements. This technique has been validated for certain orthopedic pathologies (Shaw 2012; Quek 2014; Milanese 2014; Milani 2014), but never to assess sagittal parameters in adult spinal deformity (ASD). This study was designed to assess the validity, reproducibility, precision, and efficiency of using a smartphone protractor application to measure sagittal parameters commonly measured in ASD assessment and surgical planning. This study aimed to (1) determine the validity of smartphone protractor applications, (2) determine the intra- and interobserver reliability of smartphone protractor applications when used to measure sagittal parameters in ASD, (3) determine the efficiency of using a smartphone protractor application to measure sagittal parameters, and (4) elucidate whether a physician's level of experience impacts the reliability or validity of using a smartphone protractor application to measure sagittal parameters in ASD. An experimental validation study was carried out. Thirty standard 36″ standing lateral radiographs were examined. Three separate measurements were performed using a marker and protractor; then at a separate time point, three separate measurements were performed using a smartphone protractor application for all 30 radiographs. The first 10 radiographs were then re-measured two more times, for a total of three measurements from both the smartphone protractor and marker and protractor. The parameters included lumbar lordosis, pelvic incidence, and pelvic tilt. Three raters performed all measurements-a junior level orthopedic resident, a senior level orthopedic resident, and a fellowship-trained spinal deformity surgeon. All data, including the time to perform the measurements, were recorded, and statistical analysis was performed to

Early Outcomes of Minimally Invasive Anterior Longitudinal Ligament Release for Correction of Sagittal Imbalance in Patients with Adult Spinal Deformity

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Armen R. Deukmedjian

2012-01-01

Full Text Available The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR to improve sagittal imbalance. All cases were split into anterior and posterior stages, with mean estimated blood loss of 125 cc and 530 cc, respectively. Average hospital stay was 8.3 days, and mean follow-up time was 9.1 months. Comparing pre- and postoperative 36′′ standing X-rays, the authors discovered a mean increase in global lumbar lordosis of 24 degrees, increase in segmental lumbar lordosis of 17 degrees per level of ALL released, decrease in pelvic tilt of 7 degrees, and decrease in sagittal vertical axis of 4.9 cm. At the last followup, there was a mean improvement in VAS and ODI scores of 26.2% and 18.3%. Conclusions. In the authors’ early experience, release of the anterior longitudinal ligament using the minimally invasive lateral retroperitoneal transpsoas approach may be a feasible alternative in correcting sagittal deformity.

Sagittal lumbar and pelvic alignment in the standing and sitting positions.

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Endo, Kenji; Suzuki, Hidekazu; Nishimura, Hirosuke; Tanaka, Hidetoshi; Shishido, Takaaki; Yamamoto, Kengo

2012-11-01

The sitting position has become the most common posture in today's workplace. In relation to this position, kinematic analysis of the lumbar spine is helpful in understanding the causes of low back pain and its prevention. In this study, we investigated the relationship between sagittal lumbar alignment and pelvic alignment in the standing and sitting positions for 50 healthy adults. Lumbar lordotic angle (LLA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) were measured on lateral lumbar spine standing and sitting radiographs. Regarding changes from the standing to sitting positions, average LLA, SS, and PT were -16.6° (-49.8 %), -18.7° (-50.3 %), and 18.3° (284.8 %), respectively (P position, lumbar lordosis was reduced and pelvic rotation became posterior. This study showed that LLA decreased by approximately 50 % and PT increased by approximately 25 % in the sitting position compared with the standing position. No significant gender differences were observed for LLA, SS, and PT in the standing position. In the sitting position, however, LLA and SS were markedly larger for women.

Reliability and Validity Measurement of Sagittal Lumbosacral Quiet Standing Posture with a Smartphone Application in a Mixed Population of 183 College Students and Personnel

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George A. Koumantakis

2016-01-01

Full Text Available Accurate recording of spinal posture with simple and accessible measurement devices in clinical practice may lead to spinal loading optimization in occupations related to prolonged sitting and standing postures. Therefore, the purpose of this study was to establish the level of reliability of sagittal lumbosacral posture in quiet standing and the validity of the method in differentiating between male and female subjects, establishing in parallel a normative database. 183 participants (83 males and 100 females, with no current low back or pelvic pain, were assessed using the “iHandy Level” smartphone application. Intrarater reliability (3 same-day sequential measurements was high for both the lumbar curve (ICC2,1: 0.96, SEM: 2.13°, and MDC95%: 5.9° and the sacral slope (ICC2,1: 0.97, SEM: 1.61°, and MDC95%: 4.46° sagittal alignment. Data analysis for each gender separately confirmed equally high reliability for both male and female participants. Correlation between lumbar curve and sacral slope was high (Pearson’s r=0.86, p<0.001. Between-gender comparisons confirmed the validity of the method to differentiate between male and female lumbar curve and sacral slope angles, with females generally demonstrating greater lumbosacral values (p<0.001. The “iHandy Level” application is a reliable and valid tool in the measurement of lumbosacral quiet standing spinal posture in the sagittal plane.

Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy.

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Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto

2018-04-06

A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

The role of hyperthyroidism as the predisposing factor for superior sagittal sinus thrombosis.

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Hwang, Jong-Uk; Kwon, Ki-Young; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

2012-09-01

Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism.

Sagittal alignment of the cervical spine in adolescent idiopathic scoliosis treated by posteromedial translation.

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Ilharreborde, Brice; Vidal, Christophe; Skalli, Wafa; Mazda, Keyvan

2013-02-01

To analyze postoperative changes in the cervical sagittal alignment (CSA) of patients with AIS treated by posteromedial translation. 49 patients with thoracic AIS underwent posterior arthrodesis with hybrid constructs, combining lumbar pedicle screws and thoracic universal clamps. Posteromedial translation was the main correction technique used. 3D radiological parameters were measured from low-dose biplanar radiographs. CSA was assessed using the C2C6 angle, and the central hip vertical axis (CHVA) was used as a reference axis to evaluate patients' balance. Preoperatively, 58 % of patients had thoracic hypokyphosis, and 79 % had a kyphotic CSA. Significant correlation was found (r = 0.45, P = 0.01) between thoracic hypokyphosis and cervical kyphosis. Increase in T4-T12 thoracic kyphosis (average 14.5° ± 10°) was associated with significant decrease in cervical kyphosis in the early postoperative period. The CSA further improved spontaneously during follow-up by 7.6° (P < 0.0001). Significant positive correlation (r = 0.32, P = 0.03) was found between thoracic and cervical improvements. At latest follow-up, 94 % of the patients were normokyphotic and 67 % had a CSA in the physiological range. Sagittal balance of the thoracolumbar spine was not significantly modified postoperatively. However, the procedure significantly changed the position of C2 in regard to the CHVA (C2-CHVA), which reflects headposition (P = 0.012). At last follow-up, the patients sagittal imbalance was not significantly different from the preoperative imbalance (P = 0.34). Thoracic hypokyphosis and cervical hypolordosis, observed in AIS, can be improved postoperatively, when the posteromedial translation technique is used for correction. The cervical spine remains adaptable in most patients, but the proportion of patients with physiological cervical lordosis at final follow-up remained low (24.5 %).

Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection.

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Lee, Jung-Hee; Kim, Ki-Tack; Lee, Sang-Hun; Kang, Kyung-Chung; Oh, Hyun-Seok; Kim, Young-Jun; Jung, Hyuk

2016-08-01

To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD). Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5 years) who underwent surgical correction with a minimum 2-year follow-up were evaluated. Based on the difference between postoperative LL and ideal LL using the Korean version of Legaye's formula, we divided the 51 patients into two groups: overcorrection (degree of postoperative LL > ideal LL) and undercorrection (degree of postoperative LL < ideal LL). Our clinical series of patients comprised 24 in the overcorrection and 27 in the undercorrection group. No significant differences were found in preoperative pelvic incidence (PI 52.6° vs. 57.3°), sacral slope (SS 23.3° vs. 18.3°), LL (-6.9° vs. -2.3°), thoracic kyphosis (TK 4.7° vs. 4.9°) and SVA (140 vs. 139 mm) except pelvic tilt (PT 29.4° vs. 39.0°), between the two groups. All the patients in the overcorrection group and 16 in the undercorrection group achieved postoperative optimal sagittal balance based on SVA ≤ 50 mm. In addition, significant differences in PT (10.5° vs. 26.7°), SS (42.1° vs. 30.6°), LL (-64.3° vs. -37.1°), TK (22.6° vs. 15.8°), and SVA (-1 vs. 41 mm) between the two groups were observed postoperatively. Furthermore, four patients (16.7 %) in the overcorrection group and eight (50 %) in the undercorrection group had sagittal decompensation at the final follow-up. Our results showed that the difference between postoperative LL and ideal LL had a significant correlation with postoperative and final follow-up SVA in our clinical series. Overcorrection of LL is an effective treatment modality to maintain optimal sagittal alignment in patients with DLK; this suggests that it should be considered in preoperative planning for patients with ASD with sagittal imbalance.

Visibility of mandibular canal on panoramic radiograph after bilateral sagittal split osteotomy (BSSO).

OpenAIRE

Politis, Constantinus; Ramirez, Xiomara Botero; Sun, Yi; Lambrichts, Ivo; Heath, Neil; Agbaje, Jimoh Olubanwo

2013-01-01

PURPOSE: This study aimed to assess the visibility of the mandibular canal (MC) on panoramic radiographs after bilateral sagittal split osteotomy (BSSO), and to investigate what factors affect this MC visibility. METHODS: We assessed MC visibility on panoramic radiographs of 200 BSSO patients. Images were acquired preoperatively (T0), immediately postoperatively (T1), 6 months postoperatively (T2), and 1 year postoperatively (T3), from three diffe...

Cost of treating sagittal synostosis in the first year of life.

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Abbott, Megan M; Rogers, Gary F; Proctor, Mark R; Busa, Kathleen; Meara, John G

2012-01-01

Endoscopically assisted suturectomy (EAS) has been reported to reduce the morbidity and cost of treating sagittal synostosis when compared with traditional open cranial vault remodeling (CVR) procedures. Whereas the former claim is well substantiated and intuitive, the latter has not been validated by rigorous cost analysis. Patient medical records and financial database reports were culled retrospectively to determine the total cost associated with both EAS and CVR during 1 year of care. Recorded cost data included physician and hospital services, orthotic equipment and fittings, and indirect patient cost. Ten patients treated with CVR were compared with 10 patients who underwent EAS. The CVR patients incurred greater costs in nearly all categories studied, including overall 1-year costs, physician services, hospital services, supplies/equipment, medications/intravenous fluids, and laboratory and blood bank services. Postoperative costs were greater in the EAS group, primarily because of the cost associated with orthotic services and indirect patient costs for travel and lost work. However, overall indirect patient costs for the whole year did not differ between the groups. One-year median costs were $55,121 for CVR and $23,377 for EAS. Early clinical results were similar for the 2 groups. Cranial vault remodeling was more costly in the first year of treatment than EAS, although indirect patient costs were similar. The favorable cost of EAS compared with CVR provides further justification to consider this procedure as first-line treatment of sagittal synostosis in young infants.

The effects of the sagittal plane malpositioning of the patella and concomitant quadriceps hypotrophy on the patellofemoral joint: a finite element analysis.

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Aksahin, Ertugrul; Kocadal, Onur; Aktekin, Cem N; Kaya, Defne; Pepe, Murad; Yılmaz, Serdar; Yuksel, H Yalcin; Bicimoglu, Ali

2016-03-01

Anterior knee pain is a common symptom after intramedullary nailing in tibia shaft fracture. Moreover, patellofemoral malalignment is also known to be a major reason for anterior knee pain. Patellofemoral malalignment predisposes to increased loading in patellar cartilage. In the previous study, we have demonstrated the quadriceps atrophy and patellofemoral malalignment after intramedullary nailing due to tibia shaft fracture. In this study, our aim was to clarify the effects of quadriceps atrophy and patellofemoral malalignment with the pathologic loading on the joint cartilage. Mesh models of patellofemoral joint were constructed with CT images and integrated with soft tissue components such as menisci and ligaments. Physiological and sagittal tilt models during extension and flexion at 15°, 30° and 60° were created generating eight models. All the models were applied with 137 N force to present the effects of normal loading and 115.7 N force for the simulation of quadriceps atrophy. Different degrees of loading were applied to evaluate the joint contact area and pressure value with the finite element analysis. There was increased patellofemoral contact area in patellar tilt models with respect to normal models. The similar loading patterns were diagnosed in all models at 0° and 15° knee flexion when 137 N force was applied. Higher loading values were obtained at 30° and 60° knee flexions in sagittal tilt models. Furthermore, in the sagittal tilt models, in which the quadriceps atrophy was simulated, the loadings at 30° and 60° knee flexion were higher than in the physiological ones. Sagittal malalignment of the patellofemoral joint is a new concept that results in different loading patterns in the patellofemoral joint biomechanics. This malalignment in sagittal plane leads to increased loading values on the patellofemoral joint at 30° and 60° of the knee flexions. This new concept should be kept in mind during the course of diagnosis and treatment

Biomechanical analysis of the effect of occlusal force on osteosynthesis following sagittal split ramus osteotomy

International Nuclear Information System (INIS)

Okuda, Katsuya; Nakajima, Masahiro; Kakudo, Kenji

2009-01-01

Relapse is sometimes observed during the postoperative course following sagittal split ramus osteotomy which is widely used to correct jaw deformities. Relapse may be caused by biomechanical factors such as the postoperative occlusal force. We evaluated serial changes in the stress distribution associated with postoperative occlusal force and jaw-closing pressure on the mandible and osteosynthesis plate using three-dimensional finite element analysis. Based on CT data, we produced mandibular models 1, 3, 6, and 12 months after sagittal split ramus osteotomy, and subjected them to simulated occlusal force and jaw-closing pressure. Changes in equivalent stress in the proximal and distal segments, at the osteosynthesis site, and the fixation plate were evaluated by three-dimensional finite element analysis. The equivalent stresses in the proximal and distal segments slightly increased over time from 1 to 12 months after the operation. In particular, marked stress concentration was observed at the anterior border of the ramus at each measurement area. Stress at the osteosynthesis site increased from 1 to 6 months after the operation, but decreased after 12 months. As a result of postoperative occlusal forces and jaw-closing pressure, stress was concentrated at the anterior border of the ramus in the proximal segment. Between 3 and 6 months after the operation, tensile stress was concentrated at the upper and lower ends of the osteotomy line at the osteosynthesis site. These biomechanical findings indicate the application of clockwise stress on the distal segment up to 6 months after the operation. We concluded that sagittal split ramus osteotomy runs the risk of relapse between 3 and 6 months after the operation. (author)

The lumbar lordosis index: a new ratio to detect spinal malalignment with a therapeutic impact for sagittal balance correction decisions in adult scoliosis surgery.

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Boissière, Louis; Bourghli, Anouar; Vital, Jean-Marc; Gille, Olivier; Obeid, Ibrahim

2013-06-01

Sagittal malalignment is frequently observed in adult scoliosis. C7 plumb line, lumbar lordosis and pelvic tilt are the main factors to evaluate sagittal balance and the need of a vertebral osteotomy to correct it. We described a ratio: the lumbar lordosis index (ratio lumbar lordosis/pelvic incidence) (LLI) and analyzed its relationships with spinal malalignment and vertebral osteotomies. 53 consecutive patients with a surgical adult scoliosis had preoperative and postoperative full spine EOS radiographies to measure spino-pelvic parameters and LLI. The lack of lordosis was calculated after prediction of theoretical lumbar lordosis. Correlation analysis between the different parameters was performed. All parameters were correlated with spinal malalignment but LLI is the most correlated parameter (r = -0.978). It is also the best parameter in this study to predict the need of a spinal osteotomy (r = 1 if LLI <0.5). LLI is a statistically validated parameter for sagittal malalignment analysis. It can be used as a mathematical tool to detect spinal malalignment in adult scoliosis and guides the surgeon decision of realizing a vertebral osteotomy for adult scoliosis sagittal correction. It can be used as well for the interpretation of clinical series in adult scoliosis.

Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility

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Williams III, D. S. Blaise; Welch, Lee M.

2015-01-01

ABSTRACT Background: Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females. Objective: To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners. Method: Forty subjects (30.0±6.4 years) participated and were placed in one of 4 groups: flexible males (n=10), inflexible males (n=10), flexible females (n=10), and inflexible females (n=10). All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while subjects ran over ground across 2 force platforms. Sagittal plane joint angles and moments were calculated at the knee and hip and compared with a 2-way (sex X flexibility) ANOVA (α=0.05). Results: Males exhibited greater peak knee extension moment than females (M=2.80±0.47, F=2.48±0.52 Nm/kg*m, p=0.05) and inflexible runners exhibited greater peak knee extension moment than flexible runners (In=2.83±0.56, Fl=2.44±0.51 Nm/kg*m, p=0.01). For hip flexion at initial contact, a significant interaction existed (pHamstring flexibility results in different mechanical profiles in males and females. Flexibility in the hamstrings may result in decreased moments via active or passive tension. These differences may have implications for performance and injury in flexible female runners. PMID:26537812

The influence of elastic orthotic belt on sagittal profile in adolescent idiopathic thoracic scoliosis: a comparative radiographic study with Milwaukee brace

Directory of Open Access Journals (Sweden)

Qian Bangping

2010-09-01

Full Text Available Abstract Background The effectiveness of bracing on preventing curve progression in coronal plane for mild and moderate adolescent idiopathic scoliosis (AIS patients has been confirmed by previous radiographic researches. However, a hypokyphotic effect on the sagittal plane has been reported by a few studies. A relatively increasing number of AIS patients were noticed to wear a new kind of elastic orthotic belt for the treatments of scoliosis without doctors' instructions. We postulate the correcting mechanism of this new appliance may cause flattening of the spine. To our knowledge, no study has investigated the effects of this new orthosis on the sagittal profile of AIS patients. The aim of this study was to evaluate and compare the effects of elastic orthotic belt and Milwaukee brace on the sagittal alignment in AIS patients. Methods Twenty-eight female AIS patients with mild or moderate thoracic curves were included in this study. Standing full-length lateral radiographs were obtained in three conditions: natural standing posture without any treatment, with elastic orthotic belt and with Milwaukee brace. Thoracic kyphosis (TK, lumber lordosis (LL and pelvic incidence (PI were measured and compared between the above three conditions. Results Both elastic orthotic belt and Milwaukee brace can lead to significant decrease of TK, however, the decrease of TK after wearing elastic orthotic belt is significantly larger than that after wearing Milwaukee brace. Compared with no treatment, LL was found to be significantly smaller after wearing Milwaukee brace, however, such significant decrease was not noted after wearing elastic orthotic belt. No significant changes were observed for the PI between 3 conditions. Conclusions The elastic orthotic belt could lead to more severe thoracic hypokyphosis when compared with Milwaukee brace. This belt may not be a suitable conservative method for the treatment of mild and moderate AIS patients.

Altered brain connectivity in sagittal craniosynostosis.

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Beckett, Joel S; Brooks, Eric D; Lacadie, Cheryl; Vander Wyk, Brent; Jou, Roger J; Steinbacher, Derek M; Constable, R Todd; Pelphrey, Kevin A; Persing, John A

2014-06-01

Sagittal nonsyndromic craniosynostosis (sNSC) is the most common form of NSC. The condition is associated with a high prevalence (> 50%) of deficits in executive function. The authors employed diffusion tensor imaging (DTI) and functional MRI to evaluate whether hypothesized structural and functional connectivity differences underlie the observed neurocognitive morbidity of sNSC. Using a 3-T Siemens Trio MRI system, the authors collected DTI and resting-state functional connectivity MRI data in 8 adolescent patients (mean age 12.3 years) with sNSC that had been previously corrected via total vault cranioplasty and 8 control children (mean age 12.3 years) without craniosynostosis. Data were analyzed using the FMRIB Software Library and BioImageSuite. Analyses of the DTI data revealed white matter alterations approaching statistical significance in all supratentorial lobes. Statistically significant group differences (sNSC right supramarginal gyrus. Analysis of the resting-state seed in relation to whole-brain data revealed significant increases in negative connectivity (anticorrelations) of Brodmann area 8 to the prefrontal cortex (Montreal Neurological Institute [MNI] center of mass coordinates [x, y, z]: -6, 53, 6) and anterior cingulate cortex (MNI coordinates 6, 43, 14) in the sNSC group relative to controls. Furthermore, in the sNSC patients versus controls, the Brodmann area 7, 39, and 40 seed had decreased connectivity to left angular gyrus (MNI coordinates -31, -61, 34), posterior cingulate cortex (MNI coordinates 13, -52, 18), precuneus (MNI coordinates 10, -55, 54), left and right parahippocampus (MNI coordinates -13, -52, 2 and MNI coordinates 11, -50, 2, respectively), lingual (MNI coordinates -11, -86, -10), and fusiform gyri (MNI coordinates -30, -79, -18). Intrinsic connectivity analysis also revealed altered connectivity between central nodes in the default mode network in sNSC relative to controls; the left and right posterior cingulate cortices

Effects of fixed functional therapy on tongue and hyoid positions and posterior airway.

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Ozdemir, Fulya; Ulkur, Feyza; Nalbantgil, Didem

2014-03-01

To evaluate how therapy with a fixed functional appliance affects airway dimensions, dentoalveolar changes, and tongue and hyoid positions. A retrospective study was carried out on 46 pre- and posttreatment lateral cephalometric radiographs of 23 post-peak Class II patients (12 girls, 11 boys) treated with a Forsus Fatigue Resistant Device (FRD) appliance. The radiographies were taken at the start and at the end of Forsus FRD appliance therapy when a Class I or overcorrected Class I canine and molar relationship was achieved. The process took an average of 5 months 13 days ± 1 month 4 days. Skeletal and dental parameters were measured using Dolphin software, and the sagittal airway area was measured by AutoCAD software. Analyses of the pre- and posttreatment means revealed that there was no statistically significant skeletal correction of the sagittal malocclusion; increase of lower incisor inclination, decrease of upper incisor inclination, decrease of interincisal angle, and rotation of occlusal plane all contributed to the reduction of overjet. The tongue area and intermaxillary space area increased in response to these dentoalveolar changes; however, there was no statistically significant change in the hyoid position or the oropharyngeal area between the two time points. The dentoalveolar changes produced by Forsus FRD appliance did not cause any significant posterior airway changes in young adult patients.

The Role of Hyperthyroidism as the Predisposing Factor for Superior Sagittal Sinus Thrombosis

OpenAIRE

Hwang, Jong-Uk; Kwon, Ki-Young; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

2012-01-01

Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who devel...

Sagittal Abdominal Diameter: Application in Clinical Practice

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Thaís Da Silva-Ferreira

2014-05-01

Full Text Available Excess visceral fat is associated with cardiovascular risk factors. Sagittal abdominal diameter (SAD has recently been highlighted as an indicator of abdominal obesity, and also may be useful in predicting cardiovascular risk. The purpose of the present study was to review the scientific literature on the use of SAD in adult nutritional assessment. A search was conducted for scientific articles in the following electronic databases: SciELO , MEDLINE (PubMed and Virtual Health Library. SAD is more associated with abdominal fat (especially visceral, and with different cardiovascular risk factors, such as, insulin resistance, blood pressure, and serum lipoproteins than the traditional methods of estimating adiposity, such as body mass index and waist-to-hip ratio. SAD can also be used in association with other anthropometric measures. There are still no cut-off limits established to classify SAD as yet. SAD can be an alternative measure to estimate visceral adiposity. However, the few studies on this diameter, and the lack of consensus on the anatomical site to measure SAD, are obstacles to establish cut-off limits to classify it.

Patients with proximal junctional kyphosis requiring revision surgery have higher postoperative lumbar lordosis and larger sagittal balance corrections.

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Kim, Han Jo; Bridwell, Keith H; Lenke, Lawrence G; Park, Moon Soo; Song, Kwang Sup; Piyaskulkaew, Chaiwat; Chuntarapas, Tapanut

2014-04-20

Case control study. To evaluate risk factors in patients in 3 groups: those without proximal junctional kyphosis (PJK) (N), with PJK but not requiring revision (P), and then those with PJK requiring revision surgery (S). It is becoming clear that some patients maintain stable PJK angles, whereas others progress and develop severe PJK necessitating revision surgery. A total of 206 patients at a single institution from 2002 to 2007 with adult scoliosis with 2-year minimum follow-up (average 3.5 yr) were analyzed. Inclusion criteria were age more than 18 years and primary fusions greater than 5 levels from any thoracic upper instrumented vertebra to any lower instrumented vertebrae. Revisions were excluded. Radiographical assessment included Cobb measurements in the coronal/sagittal plane and measurements of the PJK angle at postoperative time points: 1 to 2 months, 2 years, and final follow-up. PJK was defined as an angle greater than 10°. The prevalence of PJK was 34%. The average age in N was 49.9 vs. 51.3 years in P and 60.1 years in S. Sex, body mass index, and smoking status were not significantly different between groups. Fusions extending to the pelvis were 74%, 85%, and 91% of the cases in groups N, P, and S. Instrumentation type was significantly different between groups N and S, with a higher number of upper instrumented vertebra hooks in group N. Radiographical parameters demonstrated a higher postoperative lumbar lordosis and a larger sagittal balance change, with surgery in those with PJK requiring revision surgery. Scoliosis Research Society postoperative pain scores were inferior in group N vs. P and S, and Oswestry Disability Index scores were similar between all groups. Patients with PJK requiring revision were older, had higher postoperative lumbar lordosis, and larger sagittal balance corrections than patients without PJK. Based on these data, it seems as though older patients with large corrections in their lumbar lordosis and sagittal balance

The advantage of the three dimensional computed tomographic (3 D-CT for ensuring accurate bone incision in sagittal split ramus osteotomy

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Coen Pramono D

2005-03-01

Full Text Available Functional and aesthetic dysgnathia surgery requires accurate pre-surgical planning, including the surgical technique to be used related with the difference of anatomical structures amongst individuals. Programs that simulate the surgery become increasingly important. This can be mediated by using a surgical model, conventional x-rays as panoramic, cephalometric projections and another sophisticated method such as a three dimensional computed tomography (3 D-CT. A patient who had undergone double jaw surgeries with difficult anatomical landmarks was presented. In this case the mandible foramens were seen highly relatively related to the sigmoid notches. Therefore, ensuring the bone incisions in sagittal split was presumed to be difficult. A 3D-CT was made and considered to be very helpful in supporting the pre-operative diagnostic.

Spinal sagittal balance substantially influences locomotive syndrome and physical performance in community-living middle-aged and elderly women.

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Muramoto, Akio; Imagama, Shiro; Ito, Zenya; Hirano, Kenichi; Ishiguro, Naoki; Hasegawa, Yukiharu

2016-03-01

Spinal sagittal imbalance has been well known risk factor of decreased quality of life in the field of adult spinal deformity. However, the impact of spinal sagittal balance on locomotive syndrome and physical performance in community-living elderly has not yet been clarified. The present study investigated the influence of spinal sagittal alignment on locomotive syndrome (LS) and physical performance in community-living middle-aged and elderly women. A total of 125 women between the age of 40-88 years (mean 66.2 ± 9.7 years) who completed the questionnaires, spinal mouse test, physical examination and physical performance tests in Yakumo study were enrolled in this study. Participants answered the 25-Question Geriatric Locomotive Function Scale (GLFS-25), the visual analog scale (VAS) for low back pain (LBP), knee pain. LS was defined as having a score of >16 points on the GLFS-25. Using spinal mouse, spinal inclination angle (SIA), thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacral slope angle (SSA), thoracic spinal range of motion (TSROM), lumbar spinal range of motion (LSROM) were measured. Timed-up-and-go test (TUG), one-leg standing time with eyes open (OLS), and maximum stride, back muscle strength were also measured. The relationship between spinal sagittal parameters and GLFS-25, VAS and physical performance tests were analyzed. 26 people were diagnosed as LS and 99 were diagnosed as non-LS. LBP and knee pain were greater, physical performance tests were poorer, SIA were greater, LLA were smaller in LS group compared to non-LS group even after adjustment by age. SIA significantly correlated with GLFS-25, TUG, OLS and maximum stride even after adjustment by age. The cutoff value of SIA for locomotive syndrome was 6°. People with a SIA of 6° or greater were grouped as "Inclined" and people with a SIA of less than 6° were grouped as "Non-inclined". 21 people were "Inclined" and 104 were "Non-inclined". Odds ratio to fall in LS of

Contributions of individual muscles to the sagittal- and frontal-plane angular accelerations of the trunk in walking.

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Klemetti, Rudolf; Steele, Katherine M; Moilanen, Petro; Avela, Janne; Timonen, Jussi

2014-07-18

This study was conducted to analyze the unimpaired control of the trunk during walking. Studying the unimpaired control of the trunk reveals characteristics of good control. These characteristics can be pursued in the rehabilitation of impaired control. Impaired control of the trunk during walking is associated with aging and many movement disorders. This is a concern as it is considered to increase fall risk. Muscles that contribute to the trunk control in normal walking may also contribute to it under perturbation circumstances, attempting to prevent an impending fall. Knowledge of such muscles can be used to rehabilitate impaired control of the trunk. Here, angular accelerations of the trunk induced by individual muscles, in the sagittal and frontal planes, were calculated using 3D muscle-driven simulations of seven young healthy subjects walking at free speed. Analysis of the simulations demonstrated that the abdominal and back muscles displayed large contributions throughout the gait cycle both in the sagittal and frontal planes. Proximal lower-limb muscles contributed more than distal muscles in the sagittal plane, while both proximal and distal muscles showed large contributions in the frontal plane. Along with the stance-limb muscles, the swing-limb muscles also exhibited considerable contribution. The gluteus medius was found to be an important individual frontal-plane control muscle; enhancing its function in pathologies could ameliorate gait by attenuating trunk sway. In addition, since gravity appreciably accelerated the trunk in the frontal plane, it may engender excessive trunk sway in pathologies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sci-Thur AM: YIS – 03: Combining sagittally-reconstructed 3D and live-2D ultrasound for high-dose-rate prostate brachytherapy needle segmentation

Energy Technology Data Exchange (ETDEWEB)

Hrinivich, Thomas; Hoover, Douglas; Surry, Kathleen; Edirisinghe, Chandima; D’Souza, David; Fenster, Aaron; Wong, Eugene [University of Western Ontario, London Regional Cancer Program/LHSC, London Regional Cancer Program/LHSC, Robarts Research Institute, London Regional Cancer Program/LHSC, Robarts Research Institute, University of Western Ontario (Canada)

2016-08-15

Ultrasound-guided high-dose-rate prostate brachytherapy (HDR-BT) needle segmentation is performed clinically using live-2D sagittal images. Organ segmentation is then performed using axial images, introducing a source of geometric uncertainty. Sagittally-reconstructed 3D (SR3D) ultrasound enables both needle and organ segmentation, but suffers from shadow artifacts. We present a needle segmentation technique augmenting SR3D with live-2D sagittal images using mechanical probe tracking to mitigate image artifacts and compare it to the clinical standard. Seven prostate cancer patients underwent TRUS-guided HDR-BT during which the clinical and proposed segmentation techniques were completed in parallel using dual ultrasound video outputs. Calibrated needle end-length measurements were used to calculate insertion depth errors (IDEs), and the dosimetric impact of IDEs was evaluated by perturbing clinical treatment plan source positions. The proposed technique provided smaller IDEs than the clinical approach, with mean±SD of −0.3±2.2 mm and −0.5±3.7mm respectively. The proposed and clinical techniques resulted in 84% and 43% of needles with IDEs within ±3mm, and IDE ranges across all needles of [−7.7mm, 5.9mm] and [−9.3mm, 7.7mm] respectively. The proposed and clinical IDEs lead to mean±SD changes in the volume of the prostate receiving the prescription dose of −0.6±0.9% and −2.0±5.3% respectively. The proposed technique provides improved HDR-BT needle segmentation accuracy over the clinical technique leading to decreased dosimetric uncertainty by eliminating the axial-to-sagittal registration, and mitigates the effect of shadow artifacts by incorporating mechanically registered live-2D sagittal images.

CHARACTERISTICS OF BODY POSTURE IN THE SAGITTAL PLANE AND FITNESS OF FIRST-FORM PUPILS FROM RURAL AREAS

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Hanna Żukowska

2014-07-01

Full Text Available Purpose: to find correlations between characteristics of body posture in the sagittal plane and fitness and endurance of first-form children from rural areas. Material: an analysis of more than 30 sources of scientific and educational literature. Results: the study involved 209 children, including 102 girls and 107 boys. They were children who lived in the country since they were born. To assess particular characteristics of body posture, the children were studied by means of the measuring equipment using the projection Moiré system. Motor skills were estimated using selected EUROFIT physical fitness tests (sitting forward bend, standing broad jump, handgrip, sit-and-reach, bent arm hang and 10 x 5 m shuttle run. The level of physical endurance was evaluated with the Harvard Step Test modified by Montoye. Conclusions: the conducted research reveals statistically significant correlations between the characteristics of body posture in the sagittal plane and selected EUROFIT physical fitness tests and physical endurance of the children involved in the study.

Cervical sagittal balance parameters after single-level anterior cervical discectomy and fusion: Correlations with clinical and functional outcomes

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Ioannis Siasios

2018-01-01

Conclusions: Single-level ACDF significantly increases upper cervical lordosis (C1–C2 without significantly changing lower cervical lordosis (C2–C7. The C7 slope is a significant marker of overall cervical sagittal alignment (P < 0.05.

A systematic review of the angular values obtained by computerized photogrammetry in sagittal plane: a proposal for reference values.

Science.gov (United States)

Krawczky, Bruna; Pacheco, Antonio G; Mainenti, Míriam R M

2014-05-01

Reference values for postural alignment in the coronal plane, as measured by computerized photogrammetry, have been established but not for the sagittal plane. The objective of this study is to propose reference values for angular measurements used for postural analysis in the sagittal plane for healthy adults. Electronic databases (PubMed, BVS, Cochrane, Scielo, and Science Direct) were searched using the following key words: evaluation, posture, photogrammetry, and software. Articles published between 2006 and 2012 that used the PAS/SAPO (postural assessment software) were selected. Another inclusion criterion was the presentation of, at least, one of the following measurements: head horizontal alignment, pelvic horizontal alignment, hip angle, vertical alignment of the body, thoracic kyphosis, and lumbar lordosis. Angle samples of the selected articles were grouped 2 by 2 in relation to an overall average, which made possible total average, variance, and SD calculations. Six articles were included, and the following average angular values were found: 51.42° ± 4.87° (head horizontal alignment), -12.26° ± 5.81° (pelvic horizontal alignment), -6.40° ± 3.86° (hip angle), and 1.73° ± 0.94° (vertical alignment of the body). None of the articles contained the measurements for thoracic kyphosis and lumbar lordosis. The reference values can be adopted as reference for postural assessment in future researches if the same anatomical points are considered. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Crecimiento sagital maxilar en fisurados unilaterales operados funcionalmente Sagittal maxillary growth in unilateral cleft lip and palate patients following functional surgery

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F. Donoso Hofer

2007-06-01

Full Text Available Objetivo. Comparar el crecimiento sagital maxilar en pacientes con fisura labio-máxilo-palatina unilateral operados a los 6 meses con criterio funcional con pacientes normales que tengan relación consanguínea directa con los anteriores. Diseño del estudio. Análisis arquitectural y craneofacial de Delaire en telerradiografías de perfil en ambos grupos de pacientes cuyas edades fluctúan actualmente entre los 7 y los 12 años, determinando el crecimiento sagital del maxilar a través de la medida del ángulo del pilar maxilar anterior (C1/F1, sometiendo las medidas al test T de Student con una significación del 99,5%. Resultados.Se determinó el valor real y esperado para el ángulo del pilar maxilar anterior en todos los casos. Al comparar estadísticamente los resultados, no se encontraron diferencias significativas en los valores promedios obtenidos. Conclusiones.El crecimiento sagital maxilar de los pacientes con fisura labio-máxilo-palatina unilateral operados a los 6 meses con criterio funcional no difiere del de aquellos pacientes normales.Objective. To compare the sagittal maxillary growth between unilateral cleft lip and palate patients operated under functional criterion at the age of 6 months and normal patients who were blood-related. Design. Delaire’s Architectural and Structural craniofacial analysis in conventional lateral radiographs of all the patients with an age range of 7-12 years, determining the sagittal maxillary growth by the anterior maxillary pillar angle (C1/F1. These measurements were analyzed using the T-test with a 99.5% significance. Results. The real and expected value of the anterior maxillary pillar angle was determined in all cases. By comparing the results statistically, no significant differences were found in the mean values obtained. Conclusion. Maxillary sagittal growth in unilateral cleft lip and palate patients operated at the age of 6 months under functional criterion, does not differ from the

Estimation and Perturbation of the Mid-Sagittal Plane and its Effects on Corpus Callosum Morphometry

DEFF Research Database (Denmark)

Skoglund, Karl; Stegmann, Mikkel Bille; Ryberg, Charlotte

2005-01-01

callosum (CC), the white-matter nervous tissue bridging the left and right cerebral hemisphere. A multitude of papers (e.g. [2]) report on measurements performed on the two-dimensional cross-section of the CC defined by the mid-sagittal plane (MSP) which separates the left hemisphere from the right......Brain morphometry is an important tool for detecting and monitoring brain pathologies such as epilepsy, dementia [1,2] and multiple sclerosis [3]. A common method is to delineate some well-defined area of the brain to yield a shape for interor intra-subject studies. One such structure is the corpus....... Differences in shape due to pathologies are often slight (e.g. [1]). This makes it imperative to define the MSP in an accurate and consistent manner. This work investigates the importance of proper MSP estimation by measuring relative area changes of the CC as a function of plane perturbation angle from...

Direct sagittal CT scanning in the diagnosis of pituitary fossa tumours and posterior fossa pathology

International Nuclear Information System (INIS)

Podlas, H.

1981-01-01

Two independent methods are presented for multidirectional CT scanning of the brain using the Philips Tomoscan 300. The advantages in scanning pituitary fossa tumours and pathology of the posterior fossa are discussed. No additional software or modifications are required. Direct sagittal scanning is particularly advantageous for accurate assessment of the size of pituitary tumours and intrasellar lesions requiring surgical intervention or radiation therapy. (Auth.)

Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility

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D. S. Blaise Williams III

2015-10-01

Full Text Available ABSTRACTBackground:Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females.Objective: To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners.Method: Forty subjects (30.0±6.4 years participated and were placed in one of 4 groups: flexible males (n=10, inflexible males (n=10, flexible females (n=10, and inflexible females (n=10. All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while subjects ran over ground across 2 force platforms. Sagittal plane joint angles and moments were calculated at the knee and hip and compared with a 2-way (sex X flexibility ANOVA (α=0.05.Results: Males exhibited greater peak knee extension moment than females (M=2.80±0.47, F=2.48±0.52 Nm/kg*m, p=0.05 and inflexible runners exhibited greater peak knee extension moment than flexible runners (In=2.83±0.56, Fl=2.44±0.51 Nm/kg*m, p=0.01. For hip flexion at initial contact, a significant interaction existed (p<0.05. Flexible females (36.7±7.4º exhibited more hip flexion than inflexible females (27.9±4.6º, p<0.01 and flexible males (30.1±9.5º, p<0.05. No differences existed for knee angle at initial contact, peak knee angle, peak hip angle, or peak hip moment.Conclusion: Hamstring flexibility results in different mechanical profiles in males and females. Flexibility in the hamstrings may result in decreased moments via active or passive tension. These differences may have implications for performance and injury in flexible female runners.

Sagittal Thoracic and Lumbar Spine Profiles in Upright Standing and Lying Prone Positions Among Healthy Subjects: Influence of Various Biometric Features.

Science.gov (United States)

Salem, Walid; Coomans, Ysaline; Brismée, Jean-Michel; Klein, Paul; Sobczak, Stéphane; Dugailly, Pierre-Michel

2015-08-01

A prospective study was performed on the assessment of both thoracic and lumbar spine sagittal profiles (from C7 to S1). To propose a new noninvasive method for measuring the spine curvatures in standing and lying prone positions and to analyze their relationship with various biometric characteristics. Modifications of spine curvatures (i.e. lordosis or kyphosis) are of importance in the development of spinal disorders. Studies have emphasized the development of new devices to measure the spine sagittal profiles using a noninvasive and low-cost method. To date, it has not been applied for analyzing both lumbar and thoracic alterations for various positioning. Seventy-five healthy subjects (mean 22.6 ± 4.3 yr) were recruited to participate in this study. Thoracic and lumbar sagittal profiles were assessed in standing and lying prone positions using a 3D digitizer. In addition, several biometric data were collected including maximal trunk isometric strength for flexion and extension movement. Statistical analysis consisted in data comparisons of spine profiles and a multivariate analysis including biometric features, to classify individuals considering low within- and high between-variability. Kyphosis and lordosis angles decreased significantly from standing to lying prone position by an average of 13.4° and 16.6°, respectively. Multivariate analysis showed a sample clustering of 3 homogenous subgroups. The first group displayed larger lordosis and flexibility, and had low data values for height, weight, and strength. The second group had lower values than the overall trend of the whole sample, whereas the third group had larger score values for the torques, height, weight, waist, body mass index, and kyphosis angle but a reduced flexibility. The present results demonstrate a significant effect of the positioning on both thoracic and lumbar spine sagittal profiles and highlight the use of cluster analysis to categorize subgroups after biometric characteristics

Evaluation of Andrews' Analysis as a Predictor of Ideal Sagittal Maxillary Positioning in Orthognathic Surgery.

Science.gov (United States)

Resnick, Cory M; Kim, Somi; Yorlets, Rachel R; Calabrese, Carly E; Peacock, Zachary S; Kaban, Leonard B

2018-03-22

There is no universally accepted method for determining the ideal sagittal position of the maxilla in orthognathic surgery. In "Element II" of "The Six Elements of Orofacial Harmony," Andrews used the forehead to define the goal maxillary position. The purpose of this study was to compare how well this analysis correlated with postoperative findings in patients who underwent bimaxillary orthognathic surgery planned using other guidelines. The authors hypothesized that the Andrews analysis would more consistently reflect clinical outcomes than standard angular and linear measurements. This is a retrospective cohort study of patients who had bimaxillary orthognathic surgery and achieved an acceptable esthetic outcome. Patients with no maxillary sagittal movement, obstructive sleep apnea, cleft or craniofacial diagnoses, or who were non-Caucasian were excluded. Treatment plans were developed using photographs, radiographs, and standard cephalometric measurements. The Andrews analysis, measuring the distance from the maxillary incisor to the goal anterior limit line, and standard measurements were applied to end-treatment records. The Andrews analysis was statistically compared with standard methods. There were 493 patients who had orthognathic surgery from 2007 through 2014, and 60 (62% women; mean age, 22.1 ± 6.8 yr) met the criteria for inclusion in this study. The mean Andrews distances were -4.8 ± 2.9 mm for women and -8.6 ± 4.6 mm for men preoperatively and -0.6 ± 2.1 mm for women and -1.9 ± 3.4 mm for men postoperatively. For women, the Andrews analysis was closer to the goal value (0 mm) postoperatively than any standard measurement (P Andrews analysis. The Andrews analysis correlated well with the final esthetic sagittal maxillary position in the present sample, particularly for women, and could be a useful tool for orthognathic surgical planning. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by

Agreement between fiber optic and optoelectronic systems for quantifying sagittal plane spinal curvature in sitting.

Science.gov (United States)

Cloud, Beth A; Zhao, Kristin D; Breighner, Ryan; Giambini, Hugo; An, Kai-Nan

2014-07-01

Spinal posture affects how individuals function from a manual wheelchair. There is a need to directly quantify spinal posture in this population to ultimately improve function. A fiber optic system, comprised of an attached series of sensors, is promising for measuring large regions of the spine in individuals sitting in a wheelchair. The purpose of this study was to determine the agreement between fiber optic and optoelectronic systems for measuring spinal curvature, and describe the range of sagittal plane spinal curvatures in natural sitting. Able-bodied adults (n = 26, 13 male) participated. Each participant assumed three sitting postures: natural, slouched (accentuated kyphosis), and extension (accentuated lordosis) sitting. Fiber optic (ShapeTape) and optoelectronic (Optotrak) systems were applied to the skin over spinous processes from S1 to C7 and used to measure sagittal plane spinal curvature. Regions of kyphosis and lordosis were identified. A Cobb angle-like method was used to quantify lordosis and kyphosis. Generalized linear model and Bland-Altman analyses were used to assess agreement. A strong correlation exists between curvature values obtained with Optotrak and ShapeTape (R(2) = 0.98). The mean difference between Optotrak and ShapeTape for kyphosis in natural, extension, and slouched postures was 4.30° (95% LOA: -3.43 to 12.04°), 3.64° (95% LOA: -1.07 to 8.36°), and 4.02° (95% LOA: -2.80 to 10.84°), respectively. The mean difference for lordosis, when present, in natural and extension postures was 2.86° (95% LOA: -1.18 to 6.90°) and 2.55° (95% LOA: -3.38 to 8.48°), respectively. In natural sitting, the mean ± SD of kyphosis values was 35.07 ± 6.75°. Lordosis was detected in 8/26 participants: 11.72 ± 7.32°. The fiber optic and optoelectronic systems demonstrate acceptable agreement for measuring sagittal plane thoracolumbar spinal curvature. Copyright © 2014 Elsevier B.V. All rights reserved.

An algorithm based on OmniView technology to reconstruct sagittal and coronal planes of the fetal brain from volume datasets acquired by three-dimensional ultrasound.

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Rizzo, G; Capponi, A; Pietrolucci, M E; Capece, A; Aiello, E; Mammarella, S; Arduini, D

2011-08-01

To describe a novel algorithm, based on the new display technology 'OmniView', developed to visualize diagnostic sagittal and coronal planes of the fetal brain from volumes obtained by three-dimensional (3D) ultrasonography. We developed an algorithm to image standard neurosonographic planes by drawing dissecting lines through the axial transventricular view of 3D volume datasets acquired transabdominally. The algorithm was tested on 106 normal fetuses at 18-24 weeks of gestation and the visualization rates of brain diagnostic planes were evaluated by two independent reviewers. The algorithm was also applied to nine cases with proven brain defects. The two reviewers, using the algorithm on normal fetuses, found satisfactory images with visualization rates ranging between 71.7% and 96.2% for sagittal planes and between 76.4% and 90.6% for coronal planes. The agreement rate between the two reviewers, as expressed by Cohen's kappa coefficient, was > 0.93 for sagittal planes and > 0.89 for coronal planes. All nine abnormal volumes were identified by a single observer from among a series including normal brains, and eight of these nine cases were diagnosed correctly. This novel algorithm can be used to visualize standard sagittal and coronal planes in the fetal brain. This approach may simplify the examination of the fetal brain and reduce dependency of success on operator skill. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

Reliability of the Radiographic Sagittal and Frontal Tibiotalar Alignment after Ankle Arthrodesis.

Science.gov (United States)

Willegger, Madeleine; Holinka, Johannes; Nemecek, Elena; Bock, Peter; Wanivenhaus, Axel Hugo; Windhager, Reinhard; Schuh, Reinhard

2016-01-01

Accurate measurement of the tibiotalar alignment is important in radiographic outcome assessment of ankle arthrodesis (AA). In studies, various radiological methods have been used to measure the tibiotalar alignment leading to facultative misinterpretation of results. However, to our knowledge, no previous study has investigated the reliability of tibiotalar alignment measurement in AA. We aimed to investigate the reliability of four different methods of measurement of the frontal and sagittal tibiotalar alignment after AA, and to further clarify the most reliable method for determining the longitudinal axis of the tibia. Thirty-eight weight bearing anterior to posterior and lateral ankle radiographs of thirty-seven patients who had undergone AA with a two screw fixation technique were selected. Three observers measured the frontal tibiotalar angle (FTTA) and the sagittal tibiotalar angle (STTA) using four different methods. The methods differed by the definition of the longitudinal tibial axis. Method A was defined by a line drawn along the lateral tibial border in anterior to posterior radiographs and along the posterior tibial border in lateral radiographs. Method B was defined by a line connecting two points in the middle of the proximal and the distal tibial shaft. Method C was drawn "freestyle"along the longitudinal axis of the tibia, and method D was defined by a line connecting the center of the tibial articular surface and a point in the middle of the proximal tibial shaft. Intra- and interobserver correlation coefficients (ICC) and repeated measurement ANOVA were calculated to assess measurement reliability and accuracy. All four methods showed excellent inter- and intraobserver reliability for the FTTA and the STTA. When the longitudinal tibial axis is defined by connecting two points in the middle of the proximal and the distal tibial shaft, the highest interobserver reliability for the FTTA (ICC: 0.980; CI 95%: 0.966-0.989) and for the STTA (ICC: 0

Reliability of the Radiographic Sagittal and Frontal Tibiotalar Alignment after Ankle Arthrodesis.

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Madeleine Willegger

Full Text Available Accurate measurement of the tibiotalar alignment is important in radiographic outcome assessment of ankle arthrodesis (AA. In studies, various radiological methods have been used to measure the tibiotalar alignment leading to facultative misinterpretation of results. However, to our knowledge, no previous study has investigated the reliability of tibiotalar alignment measurement in AA. We aimed to investigate the reliability of four different methods of measurement of the frontal and sagittal tibiotalar alignment after AA, and to further clarify the most reliable method for determining the longitudinal axis of the tibia.Thirty-eight weight bearing anterior to posterior and lateral ankle radiographs of thirty-seven patients who had undergone AA with a two screw fixation technique were selected. Three observers measured the frontal tibiotalar angle (FTTA and the sagittal tibiotalar angle (STTA using four different methods. The methods differed by the definition of the longitudinal tibial axis. Method A was defined by a line drawn along the lateral tibial border in anterior to posterior radiographs and along the posterior tibial border in lateral radiographs. Method B was defined by a line connecting two points in the middle of the proximal and the distal tibial shaft. Method C was drawn "freestyle"along the longitudinal axis of the tibia, and method D was defined by a line connecting the center of the tibial articular surface and a point in the middle of the proximal tibial shaft. Intra- and interobserver correlation coefficients (ICC and repeated measurement ANOVA were calculated to assess measurement reliability and accuracy.All four methods showed excellent inter- and intraobserver reliability for the FTTA and the STTA. When the longitudinal tibial axis is defined by connecting two points in the middle of the proximal and the distal tibial shaft, the highest interobserver reliability for the FTTA (ICC: 0.980; CI 95%: 0.966-0.989 and for the

Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

International Nuclear Information System (INIS)

Knirsch, Walter; Kurtz, Claudia; Langer, Mathias; Haeffner, Nicole; Kececioglu, Deniz

2005-01-01

The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

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Knirsch, Walter [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany); University Children' s Hospital Zurich, Division of Paediatric Cardiology, Zurich (Switzerland); Kurtz, Claudia; Langer, Mathias [University Hospital Freiburg, Department of Radiology, Freiburg (Germany); Haeffner, Nicole; Kececioglu, Deniz [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany)

2005-04-01

The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

Science.gov (United States)

Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

2016-01-01

A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Assessment of Normal Sagittal Alignment of the Spine and Pelvis in Children and Adolescents

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Hasan Ghandhari

2013-01-01

Full Text Available Aim. We aimed to determine spinopelvic balance in 8–19-year-old-people in order to assess pelvic and spinal parameters in sagittal view. Methods. Ninety-eight healthy students aged 8–19 years, who lived in the central parts of Tehran, were assessed. Demographic data, history of present and past diseases, height (cm, and weight (kg were collected. Each subject was examined by an orthopedic surgeon and spinal radiographs in lateral view were obtained. Eight spinopelvic parameters were measured by 2 orthopedic spine surgeons. Results. Ninety-eight subjects, among which 48 were girls (49% and 50 boys (51%, with a mean age of 13.6±2.9 years (range: 8–19 were evaluated. Mean height and weight of children were 153.6±15.6 cm and 49.9±13.1 kgs, respectively. Mean TK, LL, TT, LT, and PI of subjects were 37.1 ± 9.9°, 39.6 ± 12.4°, 7.08 ± 4.9°, 12.0 ± 5.9°, and 45.37 ± 10.7°, respectively. Conclusion. Preoperation planning for spinal fusion surgeries via applying PI seems reasonable. Predicating “abnormal” to lordosis and kyphosis values alone without considering overall sagittal balance is incorrect. Mean of SS and TK in our population is slightly less than that in Caucasians.

Magnetic resonance imaging of skeletal muscle in patients with Duchenne muscular dystrophy; Serial axial and sagittal section studies

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Nagao, Hideo (Ehime Univ., Matsuyama (Japan). Faculty of Education); Morimoto, Takehiko; Sano, Nozomi; Takahashi, Mitsugi; Nagai, Hironao; Tawa, Ritsuko; Yoshimatsu, Makoto; Woo Young-Jong; Matsuda, Hiroshi

1991-01-01

Magnetic resonance imaging of skeletal muscles in thirteen patients with Duchenne muscular dystrophy was performed to estimate pathological changes. Serial axial and sagittal sections of the right lower extremity were recorded. In the early stage, the T{sub 1} values of gastrocnemius and soleus muscles were slightly lower than the control values, and in the late stage, the values were much lower in all muscles examined. In sagittal sections, the gastrocnemius muscle in the early stage showed a high density area at the distal region adjacent to soleus muscle, and the soleus muscle showed a high density area adjacent to the gestrocnemius muscle. In serial axial sections, high density areas of the anterior and posterior tibialis muscles appeared first at their proximal and peripheral regions. It was concluded that the sequence of appearance of pathological changes was different not only among individual muscles but also among various regions of each muscle; the high density changes appeared first at myotendon junctions. (author).

Sagittal otolith morphogenesis asymmetry in marine fishes.

Science.gov (United States)

Mille, T; Mahe, K; Villanueva, M C; De Pontual, H; Ernande, B

2015-09-01

This study investigated and compared asymmetry in sagittal otolith shape and length between left and right inner ears in four roundfish and four flatfish species of commercial interest. For each species, the effects of ontogenetic changes (individual age and total body length), sexual dimorphism (individual sex) and the otolith's location on the right or left side of the head, on the shape and length of paired otoliths (between 143 and 702 pairs according to species) were evaluated. Ontogenetic changes in otolith shape and length were observed for all species. Sexual dimorphism, either in otolith shape and length or in their ontogenetic changes, was detected for half of the species, be they round or flat. Significant directional asymmetry in otolith shape and length was detected in one roundfish species each, but its inconsistency across species and its small average amplitude (6·17% for shape and 1·99% for length) suggested that it has barely any biological relevance. Significant directional asymmetry in otolith shape and length was found for all flatfish species except otolith length for one species. Its average amplitude varied between 2·06 and 17·50% for shape and between 0·00 and 11·83% for length and increased significantly throughout ontogeny for two species, one dextral and one sinistral. The longer (length) and rounder otolith (shape) appeared to be always on the blind side whatever the species. These results suggest differential biomineralization between the blind and ocular inner ears in flatfish species that could result from perturbations of the proximal-distal gradient of otolith precursors in the endolymph and the otolith position relative to the geometry of the saccular epithelium due to body morphology asymmetry and lateralized behaviour. The fact that asymmetry never exceeded 18% even at the individual level suggests an evolutionary canalization of otolith shape symmetry to avoid negative effects on fish hearing and balance. Technically

Preoperative cervical sagittal alignment parameters and their impacts on myelopathy in patients with cervical spondylotic myelopathy: a retrospective study

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Wei Yuan

2017-11-01

Full Text Available Background Cervical sagittal alignment plays an important role in the pathogenesis of cervical spondylotic myelopathy (CSM, but there are limited studies on the cervical sagittal parameters in CSM patients and their correlations with myelopathy. The aim of this study is to investigate the correlations among the preoperative cervical sagittal alignment parameters and their correlations with the development of myelopathy in patients with CSM. Methods We retrospectively collected 212 patients with CSM who underwent surgical interventions. Gender, age, modified Japanese Orthopedic Association score (mJOA, cervical lordosis (CL, C2–C7 sagittal vertical axis (C2–C7 SVA, T1 slope (T1S, neck tilt (NT and thoracic inlet angle (TIA were collected before operation. Interobserver and intraobserver reliability were calculated for all measurements (intraclass correlation coefficient, ICC. Data were analyzed with Pearson and Spearman correlation tests and multiple linear regression analysis. Results A total of 212 patients with CSM were included in this study (male: 136, female: 76 with an average age of 54.5 ± 10.1 years old. Intraobserver and interobserver reliability for all included radiographic parameters presented good to excellent agreement (ICC > 0.7. No significant differences in demographic and radiological parameters have been observed between males and females (P > 0.05. We found statistically significant correlations among the following parameters: age with CL (r = 0.135, P = 0.049, age with T1S (r = 0.222, P = 0.001, CL with T1S (r = 0.291, P < 0.001, CL with C2-C7 SVA (r =  − 0.395, P < 0.001, mJOA with age (r =  − 0.274, P < 0.001, mJOA with C2–C7 SVA (r =  − 0.219, P < 0.001 and mJOA with T1S(r =  − 0.171, p = 0.013. Linear regression analysis showed that C2–C7 SVA was the predictor of CL (adjusted R2 = 0.152, P < 0.001 and multiple linear regression showed that age combined with C

Normal development of brainstem in childhood. Measurement of the area on mid-sagittal MR imaging

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Kutomi, Kimiko [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

2005-05-01

Developmental abnormality of brainstem is shown in pediatric patients with mental retardation, autism, periventricular leukomalacia, neurodegenerative disease, and so on. Our purpose here is to clarify the normal developmental pattern of the brainstem. We measured the area of tectum, midbrain tegmentum, pons, basis pontis and pontine tegmentum on mid-sagittal MR images in 111 children (newborn to 20 year old). Different growth patterns were shown in all parts of the brainstem. Tectum showed a subtle increase in area from the newborn to adult period, while midbrain tegmentum and pontine tegmenturn showed a mild and gradual increase in area. Pons and pontine tegmentum showed a rapid and prominent increase in area from newborn to infant period and gradual increase in area until the adult period. These different growth patterns seemed to be consistent with differences in the myelination cycles of the neuronal fibers, maturation of the nuclei and proliferation of glial cells in each part of the brainstem. Mid-sagittal MR imaging of the head is accurate and reproducible and is used conveniently in routine head MR study, making it very useful for the diagnosis of many central nervous diseases and anomalies. We believe that this new milestone provided in this study will be helpful in distinguishing normal children from those that have neurodegenerative disorders. (author)

Normal development of brainstem in childhood. Measurement of the area on mid-sagittal MR imaging

International Nuclear Information System (INIS)

Kutomi, Kimiko

2005-01-01

Developmental abnormality of brainstem is shown in pediatric patients with mental retardation, autism, periventricular leukomalacia, neurodegenerative disease, and so on. Our purpose here is to clarify the normal developmental pattern of the brainstem. We measured the area of tectum, midbrain tegmentum, pons, basis pontis and pontine tegmentum on mid-sagittal MR images in 111 children (newborn to 20 year old). Different growth patterns were shown in all parts of the brainstem. Tectum showed a subtle increase in area from the newborn to adult period, while midbrain tegmentum and pontine tegmenturn showed a mild and gradual increase in area. Pons and pontine tegmentum showed a rapid and prominent increase in area from newborn to infant period and gradual increase in area until the adult period. These different growth patterns seemed to be consistent with differences in the myelination cycles of the neuronal fibers, maturation of the nuclei and proliferation of glial cells in each part of the brainstem. Mid-sagittal MR imaging of the head is accurate and reproducible and is used conveniently in routine head MR study, making it very useful for the diagnosis of many central nervous diseases and anomalies. We believe that this new milestone provided in this study will be helpful in distinguishing normal children from those that have neurodegenerative disorders. (author)

Incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone in six horses

International Nuclear Information System (INIS)

Watt, B.C.; Foerner, J.J.; Haines, G.R.

1998-01-01

To describe incomplete oblique sagittal dorsal cortical fractures of the equine third metacarpal bone, their surgical repair, and subsequent performance of the horses. Retrospective examination of medical records and racing performance. Six Thoroughbred race horses, 2 to 4 years of age. Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery. Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery. Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis. Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures

Anterior or posterior sagittal anorectoplasty without colostomy for low-type anorectal malformation: how to get a better outcome?

NARCIS (Netherlands)

Kuijper, Caroline F.; Aronson, Daniel C.

2010-01-01

Background/Purpose: Usually, anorectal malformations (ARM) are treated in 2 or 3 stages for fear of disturbed wound healing and subsequent damage to the anal sphincter complex. The aim of this study was to assess the feasibility, safety, advantages, and follow-up of an anterior or posterior sagittal

Anterior or posterior sagittal anorectoplasty without colostomy for low-type anorectal malformation: how to get a better outcome?

NARCIS (Netherlands)

Kuijper, C.F.; Aronson, D.C.

2010-01-01

BACKGROUND/PURPOSE: Usually, anorectal malformations (ARM) are treated in 2 or 3 stages for fear of disturbed wound healing and subsequent damage to the anal sphincter complex. The aim of this study was to assess the feasibility, safety, advantages, and follow-up of an anterior or posterior sagittal

Reproducibility and repeatability of a new computerized software for sagittal spinopelvic and scoliosis curvature radiologic measurements: Keops(®).

Science.gov (United States)

Maillot, C; Ferrero, E; Fort, D; Heyberger, C; Le Huec, J-C

2015-07-01

The purpose of this study was to evaluate the inter- and intra-observer variability of the computerized radiologic measurements using Keops(®) and to determine the bias between the software and the standard paper measurement. Four individuals measured all frontal and sagittal variables on the 30 X-rays randomly selected on two occasions (test and retest conditions). The Bland-Altman plot was used to determine the degree of agreement between the measurement on paper X-ray and the measurement using Keops(®) for all reviewers and for the two measures; the intraclass correlation coefficient (ICC) was calculated for each pair of analyses to assess interobserver reproducibility among the four reviewers for the same patient using either paper X-ray or Keops(®) measurement and finally, concordance correlation coefficient (rc) was calculated to assess intraobserver repeatability among the same reviewer for one patient between the two measure using the same method (paper or Keops(®)). The mean difference calculated between the two methods was minimal at -0, 4° ± 3.41° [-7.1; 6.4] for frontal measurement and 0.1° ± 3.52° [-6.7; 6.8] for sagittal measurement. Keops(®) has a better interobserver reproducibility than paper measurement for determination of the sagittal pelvic parameter (ICC = 0.9960 vs. 0.9931; p = 0.0001). It has a better intraobserver repeatability than paper for determination of Cobbs angle (rc = 0.9872 vs. 0.9808; p rc = 0.9981 vs. 0.9953; p plane and that the use of this software can be recommended for clinical application. Diagnostic, level III.

Extensive cranioplasty for sagittal synostosis in young children by preserving cranial bone flaps adhered to the dura mater.

Science.gov (United States)

Nan, Bao; Bo, Yang; Yun-Hai, Song; Cheng, Chen; Xiong-Zheng, Mu

2015-03-01

This study aimed to evaluate extensive cranioplasty involving the frontal, parietal, occipital, and temporal bones without removing the floating bone flaps in the treatment of sagittal synostosis. Sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. Patients were followed up 1-5 years. Skull growth was excellent in all patients, the anteroposterior diameter was shortened, the transverse diameter was increased, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis. Surgery without removing bone flaps is less traumatic and results in no massive bleeding. It can effectively relieve brain compression and promotes transversal expansion of the brain during surgery and subsequent normal brain development. The skull of young children is relatively thin and early surgery can easily achieve satisfactory bone reshaping. Our surgical technique is not only safe and effective but also can avoid subsequent psychological disorders caused by skull deformity.

Relationship between anthropometric measures and sagittal spinal curvatures in adult male handball players

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Ameer Mariam Abdul-Moneem

2017-12-01

Full Text Available Purpose. Increasing anthropometric measures bring considerable spinal loads during sports practice, which inversely affects the adaptation abilities of the spinal structures; this in turn influences the spinal curvatures. The study was conducted to explore the relationship between anthropometric measures and sagittal spinal curvatures in handball players. Method. The total of 83 male handball players were divided into 2 groups, depending on their body height: group 1 (age, 23.62 ± 2.07 years consisted of 40 handball players with height above average, group 2 (age, 24.63 ± 2.58 years consisted of 43 handball players with height below average. The thoracic and lumbar curvatures and trunk height were measured with the Formetric III 4D spine and posture analysis system. Results. The thoracic kyphosis of group 1 was significantly higher than that of group 2 (p = 0.038, without a significant difference in lumbar lordosis (p = 0.312, and significant difference in the coefficient of compensation between thoracic kyphosis and lumbar lordosis (p = 0.026. Group 1 showed strong positive correlation between body height and kyphotic angle (r = 0.897, and moderate positive correlation with lordosis angle (r = 0.496. In group 2, there was weak positive correlation with kyphotic angle (r = 0.381, and weak negative correlation with lumbar lordosis angle (r = -0.355. Conclusions. Increasing body height of handball players is associated with bigger kyphotic and lordotic angles. Owing to frequent sagittal asymmetric overloading of the spine during handball training, exercises that help maintain good posture and correct the thoracic kyphosis are required, especially for taller players.

Sagittal abdominal diameter shows better correlation with cardiovascular risk factors than waist circumference and BMI

OpenAIRE

de Souza, Natalia Cavalheri; de Oliveira, Erick Prado

2013-01-01

Background Obesity (abdominal adiposity) is a risk factor for cardiovascular diseases and the most used methods to measure the adiposity are body mass index (BMI), waist circumference (WC), and sagittal abdominal diameter (SAD). Objective To correlate BMI, WC, and SAD with biochemical parameters and blood pressure in adults. Methods A non-experimental exploratory/descriptive and cross sectional study was developed and it was assessed 133 subjects (59 men and 74 women) aging between 18 and 87?...

Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls.

Science.gov (United States)

Ishikawa, Yoshinori; Miyakoshi, Naohisa; Kasukawa, Yuji; Hongo, Michio; Shimada, Yoichi

2013-06-01

Spinal deformities reportedly affect postural instability or falls. To prevent falls in clinical settings, the determination of a cut-off angle of spinal sagittal contour associated with increase risk for falls would be useful for screening for high-risk fallers. The purpose of this study was to calculate the spinal sagittal contour angle associated with increased risk for falls during medical checkups in community dwelling elders. The subjects comprised 213 patients (57 men, 156 women) with a mean age of 70.1 years (range, 55-85 years). The upright and flexion/extension thoracic kyphosis and lumbar lordosis angles, and the spinal inclination were evaluated with SpinalMouse(®). Postural instability was evaluated by stabilometry, using the total track length (LNG), enveloped areas (ENV), and track lengths in the lateral and anteroposterior directions (X LNG and Y LNG, respectively). The back extensor strength (BES) was measured using a strain-gauge dynamometer. The relationships among the parameters were analyzed statistically. Age, lumbar lordosis, spinal inclination, LNG, X LNG, Y LNG, and BES were significantly associated with falls (Pfalls about lumbar lordosis angles revealed that angles of 3° and less were significant for falls. The present findings suggest that increased age, spinal inclination, LNG, X LNG, Y LNG, and decreased BES and lumbar lordosis, are associated with falls. An angle of lumbar lordosis of 3° or less was associated with falls in these community-dwelling elders. Copyright © 2012 Elsevier B.V. All rights reserved.

Rat brain sagittal organotypic slice cultures as an ex vivo dopamine cell loss system.

Science.gov (United States)

McCaughey-Chapman, Amy; Connor, Bronwen

2017-02-01

Organotypic brain slice cultures are a useful tool to study neurological function as they provide a more complex, 3-dimensional system than standard 2-dimensional in vitro cell cultures. Building on a previously developed mouse brain slice culture protocol, we have developed a rat sagittal brain slice culture system as an ex vivo model of dopamine cell loss. We show that rat brain organotypic slice cultures remain viable for up to 6 weeks in culture. Using Fluoro-Gold axonal tracing, we demonstrate that the slice 3-dimensional cytoarchitecture is maintained over a 4 week culturing period, with particular focus on the nigrostriatal pathway. Treatment of the cultures with 6-hydroxydopamine and desipramine induces a progressive loss of Fluoro-Gold-positive nigral cells with a sustained loss of tyrosine hydroxylase-positive nigral cells. This recapitulates the pattern of dopaminergic degeneration observed in the rat partial 6-hydroxydopamine lesion model and, most importantly, the progressive pathology of Parkinson's disease. Our slice culture platform provides an advance over other systems, as we demonstrate for the first time 3-dimensional cytoarchitecture maintenance of rat nigrostriatal sagittal slices for up to 6 weeks. Our ex vivo organotypic slice culture system provides a long term cellular platform to model Parkinson's disease, allowing for the elucidation of mechanisms involved in dopaminergic neuron degeneration and the capability to study cellular integration and plasticity ex vivo. Copyright © 2017 Elsevier B.V. All rights reserved.

Upper midbrain profile sign and cingulate sulcus sign. MRI findings on sagittal images in idiopathic normal-pressure hydrocephalus, Alzheimer's disease, and progressive supranuclear palsy

International Nuclear Information System (INIS)

Adachi, Michito; Ohshima, Fumi; Kawanami, Toru; Kato, Takeo

2006-01-01

On magnetic resonance imaging (MRI) sagittal sections, we sometimes encounter abnormal aspects of the superior profile of the midbrain and the cingulate sulcus in patients with dementia. In this preliminary study, we refer to these findings as the ''upper midbrain profile sign'' and the cingulate sulcus sign.'' We prospectively evaluated the usefulness of these signs for the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH), Alzheimer's disease (AD) and progressive supranuclear palsy (PSP). We evaluated the upper midbrain profile sign and the cingulate sulcus sign on MRI sagittal images obtained from 21 people with headaches but no neurological deficit (controls), 10 iNPH patients, 11 AD patients, and 5 PSP patients. The upper midbrain profile sign indicated a concave shape to the superior profile of the midbrain on mid-sagittal images, and the cingulate sulcus sign indicated a narrow, tight aspect of the posterior part of the cingulate sulcus on paramedian-sagittal images. These signs were never seen in any images from the controls. The upper midbrain profile sign was seen in 7 of 10 patients with iNPH, 5 of 11 with AD, and 3 of 5 with PSP. The cingulate sulcus sign was seen in all 10 patients with iNPH but was never seen in any patient with AD or PSP. The upper midbrain profile sign could support a diagnosis of PSP but cannot discriminate among iNPH, AD, and PSP. In contrast, the cingulate sulcus sign has a very high sensitivity for iNPH and should facilitate the distinction of iNPH from other dementias. In the clinical setting, it is momentous to evaluate these signs easily by one simple MRI sequence. (author)

Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome

International Nuclear Information System (INIS)

Del-Rio Camacho, G.; Leal Orozco, A.; Camino Lopez, M.; Ruiz-Moreno, M.; Perez-Higueras, A.; Al-Assir, I.

2001-01-01

A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy. (orig.)

Emergency surgical management of traumatic superior sagittal sinus injury: An unusual case

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Sudhansu Sekhar Mishra

2012-01-01

Full Text Available Head injuries following fall of heavy objects are not very uncommon in developing countries. However, compound depressed skull fracture with superior sagittal sinus (SSS laceration caused by a flying asbestos fragment in a stormy afternoon is an unusual mode of head injury. We report such an unusual case of compound depressed skull fracture by an asbestos fragment injuring the middle third of SSS and its successful surgical management in a 14-year-old child. The role of computed tomography (CT scan of head with 3D reconstruction is highlighted. Early steps taken in this case to check the profuse bleeding, which helped save the life of this boy is interesting to note.

Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager

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P. O. Okunola

2012-01-01

Full Text Available Cerebral venous sinus (sinovenous thrombosis (CSVT is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST. We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.

MR angiography of the carotid arteries in 3 D TOF-technique with sagittal ''double-slab'' acquisition using a new head-neck coil

International Nuclear Information System (INIS)

Link, J.; Mueller-Huelsbeck, S.; Heller, M.

1996-01-01

Purpose: The aim of the study was to assess the value of MR angiography (MRA) in sagittal technique compared to DSA in the evaluation of carotid artery stenosis. Methods: 80 Carotid arteries in 40 symptomatic patients were prospectively studied with DSA and MRA. MRA was carried out by means of 3D time-of-flight technique with a FISP sequence (T E 6 ms/T R 80 ms, flip angle 25 , FOV 240x210 mm, matrix 157x256 mm, in-plane resolution 1.34x0.94 mm, partition thickness 1.32 mm, slab thickness 45 mm, acquisition time 7 min) using a new head-neck coil. Data acquisition was performed in sagittal orientation with the 'double-slab' technique. Imaging quality of the extracranial carotid arteries and correctness of quantification of stenosis was performed. Results: Imaging quality was good at the origin of the carotid arteries in 65%, at the bifurcation region in 98% and near the skull base in 81%. The agreement of DSA and MRA was 96% of the normal arteries (24/25), 90% of the severe stenoses (28/31) and 100% of the occluded arteries (9/9). Conclusion: MRA in sagittal 'double-slab' technique is a noninvasive technique allowing to detect normal arteries and candidates for surgery with high degree of certainity. (orig.) [de

EMG Analysis and Sagittal Plane Kinematics of the Two-Handed and Single-Handed Kettlebell Swing: A Descriptive Study.

Science.gov (United States)

Van Gelder, Leonard H; Hoogenboom, Barbara J; Alonzo, Bryan; Briggs, Dayna; Hatzel, Brian

2015-11-01

Kettlebell (KB) swing exercises have been proposed as a possible method to improve hip and spinal motor control as well as improve power, strength, and endurance. To describe electromyographic (EMG) and sagittal plane kinematics during two KB exercises: the two-handed KB swing (THKS) and the single-handed KB swing (SHKS). In addition, the authors sought to investigate whether or not hip flexor length related to the muscular activity or the kinematics of the exercise. Twenty-three healthy college age subjects participated in this study. Demographic information and passive hip flexor length were recorded for each subject. A maximum voluntary isometric contraction (MVIC) of bilateral gluteus maximus (GMAX), gluteus medius (GMED), and biceps femoris (BF) muscles was recorded. EMG activity and sagittal plane video was recorded during both the THKS and SHKS in a randomized order. Normalized muscular activation of the three studied muscles was calculated from EMG data. During both SHKS and THKS, the average percent of peak MVIC for GMAX was 75.02% ± 55.38, GMED 55.47% ± 26.33, and BF 78.95% ± 53.29. Comparisons of the mean time to peak activation (TTP) for each muscle showed that the biceps femoris was the first muscle to activate during the swings. Statistically significant (p < .05), moderately positive correlations (r = .483 and .417) were found between passive hip flexor length and % MVIC for the GMax during the SHKS and THKS, respectively. The THKS and SHKS provide sufficient muscular recruitment for strengthening of all of the muscles explored. This is the first study to show significant correlations between passive hip flexor length and muscular activation of hip extensors, particularly the GMax. Finally, the BF consistently reached peak activity before the GMax and GMed during the SHKS. Level 3.

The transverse ligament as a landmark for tibial sagittal insertions of the anterior cruciate ligament: a cadaveric study.

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Kongcharoensombat, Wirat; Ochi, Mitsuo; Abouheif, Mohamed; Adachi, Nobuo; Ohkawa, Shingo; Kamei, Goki; Okuhara, Atushi; Shibuya, Hoyatoshi; Niimoto, Takuya; Nakasa, Tomoyuki; Nakamae, Atsuo; Deie, Masataka

2011-10-01

The purpose of this study was to determine the relation between the position of the transverse ligament, the anterior edge of the anterior cruciate ligament (ACL) tibial footprint, and the center of the ACL tibial insertion. We used arthroscopy for localization of the anatomic landmarks, followed by insertions of guide pins under direct visualization, and then the position of these guide pins was checked on plain lateral radiographs. The transverse ligament and the anterior aspect of the ACL tibial footprint were identified by arthroscopy in 20 unpaired cadaveric knees (10 left and 10 right). Guide pins were inserted with tibial ACL adapter drill guides under direct observation at the transverse ligament, the anterior aspect of the tibial footprint, and the center of tibial insertion of the ACL. Then, plain lateral radiographs of specimens were taken. The Amis and Jakob line was used to define the attachment of the ACL tibial insertion and the transverse ligament. A sagittal percentage of the location of the insertion point was determined and calculated from the anterior margin of the tibia in the anteroposterior direction. The transverse ligament averaged 21.20% ± 4.1%, the anterior edge of the ACL tibial insertion averaged 21.60% ± 4.0%, and the center of the ACL tibial insertion averaged 40.30% ± 4.8%. There were similar percent variations between the transverse ligament and the anterior edge of the ACL tibial insertion, with no significant difference between them (P = .38). Intraobserver and interobserver reliability was high, with small standard errors of measurement. This study shows that the transverse ligament coincides with the anterior edge of the ACL tibial footprint in the sagittal plane. The transverse ligament can be considered as a new landmark for tibial tunnel positioning during anatomic ACL reconstruction. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Sagittal spino-pelvic adjustment in severe Lenke 1 hypokyphotic adolescent idiopathic scoliosis patients.

Science.gov (United States)

Vidal, Christophe; Mazda, Keyvan; Ilharreborde, Brice

2016-10-01

The human standing position requires permanent reciprocal spino-pelvic adjustments to obtain a dynamic and economic posture. This study focuses on a hypokyphotic Lenke 1 adolescent idiopathic scoliosis (AIS) patients cohort and points out their particular lumbo-pelvic adaptive mechanisms to maintain a neutral sagittal balance. Preoperative retrospective analysis of prospectively collected data on a monocentric cohort of 455 AIS patients planned for corrective surgery. Radiological low-dose system coupled with a validated clinical routine software allowed to obtain data from eighty-four hypokyphotic [thoracic kyphosis (TK) <20°] Lenke 1 patients and were separately analyzed. Bilateral Student and one-way ANOVAs were conducted for statistical analysis. Mean Cobb angle was 46.3° (±7.2), TK was 11° (±7.1), sagittal vertical axis (SVA) was -10.1 mm (±30.9), pelvic incidence (PI) was 55.7° (±12.9). Fifty percents of patients were posteriorly imbalanced. Among them, patients with a low PI used an anteversion of their pelvis [indicated by a high pelvic tilt (PT) angle] but were not able to increase their lumbar lordosis (LL) to minimize the posterior spinal shift. Hypokyphotic Lenke 1 AIS patients use lumbo-pelvic compensatory mechanisms to maintain their global balance with a poor effectiveness. Subjects with a low PI have a restricted range of LL adaptation. Attention should be paid during surgical planning not to overcorrect lordosis in the instrumented levels in case of non-selective fusion, that may induce posterior shift of the fusion mass and expose to junctional syndromes and poor functional outcomes in this particular patients.

Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part I. Clinical parameters.

NARCIS (Netherlands)

Borstlap, W.A.; Stoelinga, P.J.W.; Hoppenreijs, T.J.M.; Hof, M.A. van 't

2004-01-01

The principal aim of this study was to assess the postoperative stability of bilateral sagittal split osteotomies (BSSO) using two miniplates. Part I reports on the clinical results including treatment characteristics, nerve functions, TMJ function, occlusional relapse and patient satisfaction. This

How does sagittal imbalance affect the appropriateness of surgical indications and selection of procedure in the treatment of degenerative scoliosis? Findings from the RAND/UCLA Appropriate Use Criteria study.

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Daubs, Michael D; Brara, Harsimran S; Raaen, Laura B; Chen, Peggy Guey-Chi; Anderson, Ashaunta T; Asch, Steven M; Nuckols, Teryl K

2018-05-01

Degenerative lumbar scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. The goals of this article were to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present. This study included a literature review and an expert panel using the RAND/University of California at Los Angeles (UCLA) Appropriateness Method. To develop appropriate use criteria for DLS, researchers at the RAND Corporation recently employed the RAND/UCLA Appropriateness Method, which involves a systematic review of the literature and multidisciplinary expert panel process. Experts reviewed a synopsis of published literature and rated the appropriateness of five common operative approaches for 260 different clinical scenarios. In the present work, we updated the literature review and compared panelists' ratings in scenarios where imbalance was present versus absent. This work was funded by the Collaborative Spine Research Foundation, a group of surgical specialty societies and device manufacturers. On the basis of 13 eligible studies that examined sagittal imbalance and outcomes in patients with DLS, imbalance was associated with worse functional status in the absence of surgery and worse symptoms and complications postoperatively. Panelists' ratings demonstrated a consistent pattern across the diverse clinical scenarios. In general, when imbalance was present, surgery was more likely to be appropriate or necessary, including in some situations where surgery would otherwise be inappropriate. For patients with moderate to severe symptoms and imbalance, a deformity correction procedure was usually appropriate

Subjective and objective image qualities: a comparison of sagittal T2 weighted spin-echo and turbo-spin-eco sequences in magnetic resonance imaging of the spine by use of a subjective ranking system

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Goerres, G. [Institut fuer diagnostische Radiologie, Departement Radiologie, Universitaetskliniken, Kantonsspital Basel (Switzerland); Mader, I. [Radiologische Gemeinschaftspraxis Dres. Siems, Grossmann, Bayreuth (Germany); Proske, M. [Klinikum Rosenheim (Germany). Inst. fuer Diagnostische Radiologie

1998-12-31

We evaluated the subjective image impression of two different magnetic resonance (MR) sequences by using a subjective ranking system. This ranking system was based on 20 criteria describing several tissue characteristics such as the signal intensity of normal anatomical structures and the changes of signal intensities and shape of lesions as well as artefacts. MR of the vertebral spine was performed in 48 female and 52 male patients (mean age 44.8 years) referred consecutively for investigation of a back problem. Ninety-six pathologies were found in 82 patients. Sagittal and axial T1 weighted spin-echo before and after administration of Gadolinium (Gd-DOTA), and sagittal T2 weighted spin-echo (T2wSE) and Turbo-spin-echo (TSE) sequences were performed by means of surface coils. Using the subjective ranking system the sagittal T2wSE and sagittal TSE were compared. Both sequences were suitable for identification of normal anatomy and pathologic changes and there was no trend for increased detection of disease by one imaging sequence over the other. We found that sagittal TSE sequences can replace sagittal T2wSE sequences in spinal MR and that artefacts at the cervical and lumbar spine are less frequent using TSE, thus confirming previous studies. In this study, our ranking system reveiled, that there are differences between the subjective judgement of image qualities and objective measurement of SNR. However, this approach may not be helpful to compare two different MR sequences as it is limited to the anatomical area investigated and is time consuming. The subjective image impression, i.e. the quality of images, may not always be represented by physical parameters such as a signal-to-noise ratio (SNR), radiologists should try to define influences of image quality also by subjective parameters. (orig.)

Os acromiale: evaluation of markers for identification on sagittal and coronal oblique MR images

Energy Technology Data Exchange (ETDEWEB)

Uri, D.S. [University of Michigan, Dept. of Radiology, Ann Arbor, MI (United States)]|[Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia (United States); Kneeland, J.B. [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia (United States); Herzog, R. [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia (United States)

1997-01-01

An os acromiale is a developmental abnormality of ossification involving the anterior acromion which may contribute to impingement and rotator cuff disease. When axial MR sections do not include the acromioclavicular joint, the diagnosis of this often subtle abnormality will rest on its recognition on oblique coronal and sagittal images where it mimics the acromioclavicular joint. The identification of this anomaly is important as it frequently alters the type of surgical procedure utilized in symptomatic patients. We evaluate several imaging features which may be used to diagnose an os acromiale in these cases. (orig.). With 5 figs.

Os acromiale: evaluation of markers for identification on sagittal and coronal oblique MR images

International Nuclear Information System (INIS)

Uri, D.S.; Kneeland, J.B.; Herzog, R.

1997-01-01

An os acromiale is a developmental abnormality of ossification involving the anterior acromion which may contribute to impingement and rotator cuff disease. When axial MR sections do not include the acromioclavicular joint, the diagnosis of this often subtle abnormality will rest on its recognition on oblique coronal and sagittal images where it mimics the acromioclavicular joint. The identification of this anomaly is important as it frequently alters the type of surgical procedure utilized in symptomatic patients. We evaluate several imaging features which may be used to diagnose an os acromiale in these cases. (orig.). With 5 figs

The significance of faint visualization of the superior sagittal sinus in brain scintigraphy for the diagnosis of brain death

International Nuclear Information System (INIS)

Bisset, R.; Sfakianakis, G.; Ihmedian, I.; Holzman, B.; Curless, R.; Serafini, A.

1985-01-01

Brain death is associated with cessation of blood flow to the brain. Tc-99m brain flow studies are used as a laboratory confirmatory test for the establishment of the diagnosis of brain death. Criteria for the diagnosis of cessation of blood flow to the brain are 1) visualization of carotid artery activity in the neck of the patient and 2) no visualization of activity in the distribution of the anterior and middle cerebral arteries. The authors noticed that in a significant number of patients, although there was no visualization of arterial blood flow to the brain the static images demonstrated faint accumulation of activity in the region of the superior sagittal sinus (SSS). In a four year period 212 brain flow studies were performed in 154 patients for diagnosis of brain death; of them 137 studies (65%) showed no evidence of arterial flow. In 103 out of the 137 studies (75%) there was no visualization of the SSS; in the remaining 34 studies (3l patients) however three patterns of faint activity attributed to partial and or faint visualization of the SSS could be recognized at the midline of the immediate anterior static view: a) linear from the cranial vault floor up b) disk shaped at the apex of the vault and c) disk shaped at the apex tailing caudad. All of the 3l patients in this group satisfied brain death criteria within four days of the last study which showed faint visualization of the superior sagittal sinus. The authors conclude that even in the presence of a faint visualization of the superior sagittal sinus on static post brain flow scintigraphy, the diagnosis of cessation of blood flow to the brain can be made if there is no evidence of arterial blood flow

Dorsal buccal mucosal graft urethroplasty by a ventral sagittal urethrotomy and minimal-access perineal approach for anterior urethral stricture.

Science.gov (United States)

Gupta, N P; Ansari, M S; Dogra, P N; Tandon, S

2004-06-01

To present the technique of dorsal buccal mucosal graft urethroplasty through a ventral sagittal urethrotomy and minimal access perineal approach for anterior urethral stricture. From July 2001 to December 2002, 12 patients with a long anterior urethral stricture had the anterior urethra reconstructed, using a one-stage urethroplasty with a dorsal onlay buccal mucosal graft through a ventral sagittal urethrotomy. The urethra was approached via a small perineal incision irrespective of the site and length of the stricture. The penis was everted through the perineal wound. No urethral dissection was used on laterally or dorsally, so as not to jeopardize the blood supply. The mean (range) length of the stricture was 5 (3-16) cm and the follow-up 12 (10-16) months. The results were good in 11 of the 12 patients. One patient developed a stricture at the proximal anastomotic site and required optical internal urethrotomy. Dorsal buccal mucosal graft urethroplasty via a minimal access perineal approach is a simple technique with a good surgical outcome; it does not require urethral dissection and mobilization and hence preserves the blood supply.

Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging. An agreement study

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Ahn, Y.; Jeong, T.S. [Gachon University Gil Medical Center, Department of Neurosurgery, Incheon (Korea, Republic of); Lim, T.; Jeon, J.Y. [Gachon University Gil Medical Center, Department of Radiology, Incheon (Korea, Republic of)

2018-01-15

Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH. We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics. The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620). The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures. (orig.)

Increased detection rate of syringomyelia by whole spine sagittal magnetic resonance images: Based on the data from military conscription of Korean young males

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Lee, Myoung Seok; Oh, Chang Hyun [Seoul Regional Military Manpower Administration, Seoul (Korea, Republic of); Yoon, Seung Hwan; Park, Hyeong Chun; Park, Chong Oon; Kim, Yeo Ju [Inha Univ. Hospital/College of Medicine/Inha Univ., Incheon (Korea, Republic of)

2012-09-15

We compared the detection rate of syringomyelia according to the type of magnetic resonance (MR) images among the Korean military conscription. Among the total of 238910 examinees (males aged 18 to 32 years old) from January 2008 to December 2011, the examinees with conventional single lesion MR images (cervical, thoracic, and lumbar) with and without whole spine sagittal T2 weighted MR images (WSST2I) totaled 1206 cases, and syringomyelia was observed in 24 cases. The detection rate of syringomyelia according to the MR protocol (the presence of WSST2I or not) was done through analysis by annually and the clinical characters of syringomyelia was reviewed. The estimated prevalence of syringomyelia was approximately 10.0 cases per 100000 people. The detection rate was increased annually when the WSST2I proportion was increased (from 3.4 to 14.9 cases per 100000 persons, r = 0.939, p = 0.018). Clinical character of syringomyelia was ambiguous with other spinal diseases. The most affected spinal level was C5 to C7 (83%), and most cases were non communicating syringomyelia with benign central canal widening (79%). Whole spine sagittal MR image is useful to detect coexisting spinal diseases such as syringomyelia, and most syringomyelia in young males was benign hydromyelia. A whole spine sagittal MR image is recommended to increase the detection of syringomyelia.

Influence of a variation in the position of the arms on the sagittal connection of the gravity line with the spinal structures.

Science.gov (United States)

Legaye, Jean; Duval-Beaupere, Ginette

2017-11-01

To evaluate the influence of the position of the arms on the location of the body's gravity line. The sagittal balance of the pelvi-spinal unit is organized so that the gravity line is localized in a way that limits the mechanical loads and the muscle efforts. This position of the gravity line was analyzed in vivo, in standing position, the arms dangling, by the barycentremeter, a gamma rays scanner. Then, several teams had the same purpose but using a force platform combined with radiographies. Their results differed significantly among themselves and with the data of the barycentremetry. However, in these studies, the positions of the arms varied noticeably, either slightly bent forwards on a support, or the fingers on the clavicles or on the cheeks. We estimated, for each varied posture of the arms, the sagittal coordinates of the masses of the upper limbs and their influence on the anatomical position of the gravity line of the whole body. Using a simple equation and the data of the barycentremeter, we observed that the variations in the location of the gravity line were proportionally connected to the changes of the sagittal position of the mass of the upper limbs induced by the various positions of the arms. We conclude in a validation of the data of the barycentremeter, as well as of the data obtained by the force platforms as long as the artifact of the position of the arms is taken into account.

Sagittal spino-pelvic alignment in adults: The Wakayama Spine Study.

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Yoshiki Asai

Full Text Available To establish the normal values of spino-pelvic alignment and to clarify the effect of age-related changes using large, community-based cohorts.In this study, data from 1461 participants (466 men, 995 women were analyzed. On lateral standing radiographs, the following parameters were measured: thoracic kyphosis (TK, lumbar lordosis (LL, pelvic tilt (PT, pelvic incidence (PI, and C7 sagittal vertical axis (SVA. All values are expressed as the mean±standard deviation. The Spearman rank correlation coefficient was used to examine correlations between variables of spino-pelvic parameters. Finally, we analyzed the relationship between age and spino-pelvic parameters. Therefore, we entered values for the body mass index (BMI, SVA, TK, and PI-LL into a multiple regression model to adjust for potential confounding factors.The SVA, TK, and PT increased with age, and LL decreased with age. Regarding sex differences, the TK was statistically significantly larger in men than in women, and LL, PT, and PI were statistically significantly smaller in men than in women. Correlation coefficients between the SVA and TK, between the SVA and PI-LL, and between TK and PI-LL were none, strong, and weak, respectively. Results of multiple regression analysis between age and spino-pelvic parameters showed that the standardized partial regression coefficients for the SVA, TK, and PI-LL were 0.17, 0.30, and 0.23, respectively, in men and 0.29, 0.32, and 0.23, respectively, in women.We found that all parameters were significantly associated with age in men and women. The SVA, TK, and PT increased with age, and LL decreased with age. Results of multiple regression analysis also demonstrated that the SVA, TK, and PI-LL are related to age. Indeed, the PI-LL value increased with age. In this study, a more excessive PI-LL mismatch was shown, indicating an increased risk of spinal malalignment. Differences in the absolute values of spino-pelvic parameters in each sex were small

REPRODUCIBILITY AND EQUIVALENCE OF COBBMETER APPLICATION IN THE SAGITTAL EVALUATION OF THE SPINE

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Luis Marchi

Full Text Available ABSTRACT Objective: This study aims to evaluate the reliability and equivalency of using the Cobbmeter application for iPhone compared to the manual measurement method in the analysis of the sagittal spinal alignment. Methods: Cross-sectional, prospective, single-center study that had 20 panoramic radiographs of the spine in lateral view, in a neutral standing position, analyzed blindly and randomly by three independent examiners in three different times. The parameters were pelvic incidence (PI, pelvic tilt (PT and lumbar lordosis (LL. The statistical analysis was performed to measure the intraclass correlation coefficient (ICC between the two measurement methods, in addition to measuring the intra and inter-evaluators reliability. Results: For reproducibility analysis, the intra-evaluators ICC using the application resulted in a Kappa (K of 0.975 for the evaluation of pelvic incidence (PI evaluation. For pelvic tilt (PT, the K value obtained was 0.981 and the K measured for lumbar lordosis (LL analysis was 0.987. The inter-evaluators evaluation of reproducibility using the application resulted in a K value of 0.917 for PI, 0.930 for PT and 0.951 for LL. For the assessment of equivalency of methods, comparing the application to the standard method, with a goniometer and dermographic pencil, the K value found for PI was 0.873, for PV was 0.939 and for LL was 0.914. All values were significant (p<0.001 against the null hypothesis. Conclusion: This smartphone application is a valid and reliable instrument for measuring the angle involved in the sagittal balance of the spine. Furthermore, the results show that its applicability is not inferior to the manual method with goniometer and dermographic pencil.

Three-dimensional computed tomographic evaluation of bilateral sagittal split osteotomy lingual fracture line and le fort I pterygomaxillary separation in orthognathic surgery using cadaver heads: ultrasonic osteotome versus conventional saw.

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Dammous, Sophie; Dupont, Quentin; Gilles, Roland

2015-06-01

The purpose of this study was to observe the quality of the fracture line on the lingual side of the mandible after sagittal split osteotomy and the quality of pterygomaxillary separation after Le Fort I osteotomy using the BoneScalpel ultrasonic osteotome. Bimaxillary procedures, according to the standard protocol, were performed using 10 fresh cadaver heads. The ultrasonic osteotome was used in the study group, and a reciprocating saw was used in the control group. Three-dimensional reconstructions of postoperative computed tomographic scans were obtained. The lingual ramus fracture pattern and the pterygomaxillary separation pattern were observed, classified, and compared. Postoperative dissections of the skulls were performed to assess the integrity of the infra-alveolar nerve and the descending palatine artery. No significant differences were found in the cutting time of bone between the BoneScalpel and the sagittal saw. Of the sagittal split osteotomies in the study group, 90% showed a good pattern (vertical pattern of fracture line extending to the inferior border of the mandible running behind the mandibular canal) compared with 50% of the sagittal split osteotomies in the control group. Ideal separation of the pterygoid plates without fractures was observed in 80% of the Le Fort I osteotomies in the study group compared with 50% of the osteotomies in the control group. High-level fractures occurred in 30% of cases in the control group compared with none in the study group. The integrities of the infra-alveolar nerve and the descending palatine artery were preserved in all cases. Use of the ultrasonic BoneScalpel did not require more time than the conventional method. An improved pattern of lingual fracture lines in mandibular sagittal split osteotomy procedures and the pattern of pterygomaxillary separation in Le Fort I osteotomy procedures were observed. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc

Observation of sagittal X-ray diffraction by surface acoustic waves in Bragg geometry.

Science.gov (United States)

Vadilonga, Simone; Zizak, Ivo; Roshchupkin, Dmitry; Evgenii, Emelin; Petsiuk, Andrei; Leitenberger, Wolfram; Erko, Alexei

2017-04-01

X-ray Bragg diffraction in sagittal geometry on a Y-cut langasite crystal (La 3 Ga 5 SiO 14 ) modulated by Λ = 3 µm Rayleigh surface acoustic waves was studied at the BESSY II synchrotron radiation facility. Owing to the crystal lattice modulation by the surface acoustic wave diffraction, satellites appear. Their intensity and angular separation depend on the amplitude and wavelength of the ultrasonic superlattice. Experimental results are compared with the corresponding theoretical model that exploits the kinematical diffraction theory. This experiment shows that the propagation of the surface acoustic waves creates a dynamical diffraction grating on the crystal surface, and this can be used for space-time modulation of an X-ray beam.

Task-level strategies for human sagittal-plane running maneuvers are consistent with robotic control policies.

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Mu Qiao

Full Text Available The strategies that humans use to control unsteady locomotion are not well understood. A "spring-mass" template comprised of a point mass bouncing on a sprung leg can approximate both center of mass movements and ground reaction forces during running in humans and other animals. Legged robots that operate as bouncing, "spring-mass" systems can maintain stable motion using relatively simple, distributed feedback rules. We tested whether the changes to sagittal-plane movements during five running tasks involving active changes to running height, speed, and orientation were consistent with the rules used by bouncing robots to maintain stability. Changes to running height were associated with changes to leg force but not stance duration. To change speed, humans primarily used a "pogo stick" strategy, where speed changes were associated with adjustments to fore-aft foot placement, and not a "unicycle" strategy involving systematic changes to stance leg hip moment. However, hip moments were related to changes to body orientation and angular speed. Hip moments could be described with first order proportional-derivative relationship to trunk pitch. Overall, the task-level strategies used for body control in humans were consistent with the strategies employed by bouncing robots. Identification of these behavioral strategies could lead to a better understanding of the sensorimotor mechanisms that allow for effective unsteady locomotion.

Spine evaluation: Determination of the relationship between thoracic spinal deformity and sagittal curves by a noninvasive method DOI: 10.5007/1980-0037.2010v12n4p282

Directory of Open Access Journals (Sweden)

Dalva Minonroze Albuquerque Ferreira

2010-01-01

Full Text Available The objectives of this study were to compare sagittal plane alignment between subjects with spinal deformities and a group presenting no changes; to test the reliability of the tool used, and to determine the existence of correlations between spinal deformity and sagittal curvature measures. Forty young subjects were divided into two groups: a control group (n=20 presenting no changes or spinal deformity less than 0.5 cm in the dorsal curvature and 0.7 cm in the lumbar curvature, and an experimental group (n=20 with spinal deformities greater than those described for the control group. Spinal deformity and sagittal plane curvatures were measured using a water level-based tool and by the Adams test. Data were collected from the two groups on two distinct occasions. The Mann-Whitney test showed no difference between sampling times. A significant difference between the two groups was only observed in terms of cervical curvature. Spearman’s test revealed a linear correlation between dorsal curvature and dorsal spinal deformity in the control group, between dorsal and lumbar curves in the two groups, and between dorsal spinal deformity and lumbar and sacral curves and between sacral curvature and dorsal and lumbar curves in the experimental group. In conclusion, spinal deformity measurement is associated with sagittal plane curvatures. The method proposed here is reliable, simple and accessible and can be reproduced without high costs and damage to the patient’s health.

Anesthetic management of a patient with Bartter′s syndrome undergoing bilateral sagittal split osteotomy

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Nasser Nooh

2012-01-01

Full Text Available Bartter′s syndrome is an unusual (estimated incidence is 1.2 per million people but important congenital form of secondary hyperaldosteronism; due to abnormalities in renal handling of electrolytes. It is associated with hypertrophy and hyperplasia of the juxtaglomerular cells, normal blood pressure, and hypokalemic alkalosis withoutedema.We present a 22-year-old woman with Bartter′s syndrome underwent bilateral sagittal split osteotomy to correct mandibular prognathic. The anesthetic management of Bartter′s syndrome should be relevant to the pathophysiology of the syndrome. Therefore, it should be directed toward maintaining cardiovascular stability, control of associated fluid, electrolyte and acid-base derangements, and the prevention of renal damage.

Changes in superior sagittal sinus blood velocities due to postural alterations and pressure on the head of the newborn infant.

Science.gov (United States)

Cowan, F; Thoresen, M

1985-06-01

A pulsed Doppler bidirectional ultrasound system has been used to measure alterations in the blood velocities in the superior sagittal sinus of the healthy term newborn infant in response to unilateral and bilateral jugular venous occlusion. These maneuvers were performed with the baby lying in different positions: supine, prone, and on the side (both left and right), the neck flexed or extended, and with the head in the midline or turned 90 degrees to the side (both left and right). Transfontanel pressure was also measured in these positions during occlusions. Results show that turning the head effectively occludes the jugular vein on the side to which the head is turned and that occluding the other jugular vein does not force blood through this functional obstruction. The effect of different forms of external pressure to the head on the superior sagittal sinus velocities was also examined. Alterations in velocities were frequently profound although they varied considerably from baby to baby. This work shows how readily large fluctuations in cranial venous velocities and pressures can occur in the course of normal handling of babies.

Short Lingual Osteotomy Using a Piezosurgery Ultrasonic Bone-Cutting Device During Sagittal Split Ramus Osteotomy.

Science.gov (United States)

Kawase-Koga, Yoko; Mori, Yoshiyuki; Kanno, Yuki; Hoshi, Kazuto; Takato, Tsuyoshi

2015-10-01

Short lingual osteotomy is a useful method for the performance of sagittal split ramus osteotomy involving interference between the proximal and distal bone fragments when lateral differences exist in the setback distance. However, this procedure occasionally results in abnormal fracture and nerve injury; expert surgical skill is thus required. We herein describe a novel technique involving the use of an ultrasonic bone-cutting device (Piezosurgery; Mectron Medical Technology, Carasco, Italy) for vertical osteotomy posterior to the mandibular foramen. Successful short lingual osteotomy was performed using this technique with avoidance of abnormal fracture and neurovascular bundle damage.

Correlation between Sagittal Spinopelvic Parametersand Oswestry Disability Indexafter Thoracal and Lumbar Spine Stabilization and Fusion

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Yudistira Prama Tirta

2017-04-01

Full Text Available Spinopelvic parameter consists of sagittal vertical axis (SVA, pelvic incidence (PI, pelvic tilt (PT, sacral slope (SS which are measured by whole-spine-lateral-view radiograph in standing position. Measurement of the separameters is pivotalas the land mark analysis toachieve correct sagittal balance. The objective of the study is to analyze the correlation between PI, PT, SVA and SSwith theclinical outcomes which was measured usingOswestry Disability Index (ODI scoring system.This is a cross-sectional study involving 19 patients who underwent thoracal and lumbar fusion surgery in our centerduring 2012-2014. Radiographi cevaluation of SVA, PI, PT, and SS and ODI score were performed 1 year after surgery. Pearson test was conducted to determine the correlation between SVA, PI, PT, and SS with ODI score.There wasa strong correlation between ODI withSVA and PI (p<0.001,r=0.866; p=0.006; r=0.603, respectively. There was no correlation between other parameters with ODI.Based on this study, spinopelvic parameters that can represent the clinical outcome after thoracal and lumbar fusion and stabilization surgeries are SVA and PI. Keywords: spinopelvic parameter, post operation, vertebrae fusion.   Korelasi antara Parameter Luaran Spinopelvik Sagital dengan Oswestry Disability Index pasca Stabilisasi dan Fusi Vertebra Torakal dan Lumbar   Abstrak Parameter spinopelvis terdiri atas sagittal vertical axis (SVA, pelvic incidence (PI, pelvic tilt (PT, sacral slope (SS dan diukur menggunakan X-ray seluruh tulang belakang lateral yang diambil pada posisi berdiri. Pengukuran parameter ini penting sebagai dasar analisis keseimbangan sagital pada operasi rekonstruksi vertebra. Tujuan penelitian ini adalah untuk menganalisis korelasi antara PI, PT, SVA, dan SS pada luaran klinis berdasarkan sistem skoring oswestry disability index (ODI. Studi ini adalah studi potong lintang dengan 19 subjek yang menjalani fusi dan stabilisasi torakal dan lumbal di center kami

Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients.

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Mensink, Gertjan; Verweij, Jop P; Frank, Michael D; Eelco Bergsma, J; Richard van Merkesteyn, J P

2013-09-01

An unfavourable fracture, known as a bad split, is a common operative complication in bilateral sagittal split osteotomy (BSSO). The reported incidence ranges from 0.5 to 5.5%/site. Since 1994 we have used sagittal splitters and separators instead of chisels for BSSO in our clinic in an attempt to prevent postoperative hypoaesthesia. Theoretically an increased percentage of bad splits could be expected with this technique. In this retrospective study we aimed to find out the incidence of bad splits associated with BSSO done with splitters and separators. We also assessed the risk factors for bad splits. The study group comprised 427 consecutive patients among whom the incidence of bad splits was 2.0%/site, which is well within the reported range. The only predictive factor for a bad split was the removal of third molars at the same time as BSSO. There was no significant association between bad splits and age, sex, class of occlusion, or the experience of the surgeon. We think that doing a BSSO with splitters and separators instead of chisels does not increase the risk of a bad split, and is therefore safe with predictable results. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects.

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Baccetti, Tiziano; Franchi, Lorenzo; Mucedero, Manuela; Cozza, Paola

2010-06-01

The purpose of this cephalometric study was to analyse the treatment and post-treatment craniofacial effects of a facemask (FM) combined with a bite block (BB) with specific regard to the sagittal pharyngeal dimensions in subjects with a Class III malocclusion when compared with an untreated Class III control group. The FM/BB group (22 subjects, 12 females and 10 males) had a mean age pre-treatment (T1) of 8.9 +/- 1.5 years, at the end of active treatment (T2) of 10.5 +/- 1.3 years, and post-treatment (T3) of 12.6 +/- 1.9 years. The treated group was compared with a control group of 14 subjects (6 females and 8 males) with untreated Class III malocclusions that matched the FM/BB group as to age at T1, T2, and T3, observation periods and skeletal maturation. Comparisons of the T2-T1 and T3-T1 changes between the two groups were analysed with the Mann-Whitney test. Significant favourable skeletal changes in the maxilla and mandible were observed in the treated group both after Ts2 and T3. No significant short- or long-term changes in the sagittal oropharyngeal and nasopharyngeal airway dimensions were induced by maxillary protraction in subjects with a Class III malocclusion when compared with untreated controls.

Anorectal anomaly with rectovestibular fistula: a historical comparison of neonatal anterior sagittal anorectoplasty without covering colostomy and postoperative anal dilatation to the classical three-stage posterior sagittal anorectoplasty

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Abdul Aziz DA

2017-08-01

Full Text Available Dayang Anita Abdul Aziz,1 Ramamoorthy Velayutham,2 Marjmin Osman,1 Zarina Abdul Latiff,3 Felicia SK Lim,4 Mahmud Mohd Nor1 1Department of Surgery, UKM Medical Centre, Kuala Lumpur, 2Department of Surgery, Hospital Raja Permaisuri Bainun, Ipoh, 3Department of Paediatrics, 4Department of Anaesthesia, UKM Medical Centre, Kuala Lumpur, Malaysia Background: Traditional three-stage posterior sagittal anorectoplasty (PSARP is a widely used operational technique for rectovestibular fistula (RVF which includes creation of stoma, definitive surgery, and subsequent closure of stoma. Three-stage PSARP is usually completed during infancy. Many pediatric surgeons across the world have embarked on anterior sagittal anorectoplasty (ASARP as an alternative technique to reduce pelvic floor dissection and the need to operate with patients in the prone position. ASARP is performed with the patient lying in supine position and it can be performed as one-stage repair during the neonatal period. Early reports from many centers are showing promising results. An outcome comparison of both techniques is vital to help surgeons consider this new approach in the repair of RVF.Patients and methods: This is a retrospective historical comparison study. Nine neonates with RVF underwent primary ASARP without postoperative anal dilatation and were compared to 25 patients with RVF who underwent three-stage PSARP with postoperative anal dilatation. Immediate surgical outcome was reviewed from the records and follow-up sheets of individual patients and functional outcome was assessed by interviewing the parents. Results were compared statistically; P-value ≤0.05 was considered significant.Results: The immediate surgical complications were higher in the PSARP group (40% compared to the ASARP group (22%. Functional outcome showed overall better outcome in ASARP compared to PSARP. Patients from both groups did not develop stenosis, although only the PSARP group was subjected to daily

Evaluation of force degradation characteristics of orthodontic latex elastics in vitro and in vivo.

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Wang, Tong; Zhou, Gang; Tan, Xianfeng; Dong, Yaojun

2007-07-01

To evaluate the characteristics of force degradation of latex elastics in clinical applications and in vitro studies. Samples of 3/16-inch latex elastics were investigated, and 12 students between the ages of 12 and 15 years were selected for the intermaxillary and intramaxillary tractions. The elastics in the control groups were set in artificial saliva and dry room conditions and were stretched 20 mm. The repeated-measure two-way analysis of variance and nonlinear regression analysis were used to identify statistical significance. Overall, there were statistically significant differences between the different methods and observation intervals. At 24- and 48-hour time intervals, the force decreased during in vivo testing and in artificial saliva (P .05). In intermaxillary traction the percentage of initial force remaining after 48 hours was 61%. In intramaxillary traction and in artificial saliva the percentage of initial force remaining was 71%, and in room conditions 86% of initial force remained. Force degradation of latex elastics was different according to their environmental conditions. There was significantly more force degradation in intermaxillary traction than in intramaxillary traction. The dry room condition caused the least force loss. There were some differences among groups in the different times to start wearing elastics in intermaxillary traction but no significant differences in intramaxillary traction.

[Extensive cranioplasty for sagittal synostosis in young children by preserving multiple cranial bone flaps adhered to the dura mater: experience with 63 cases].

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Bao Nan; Chu Jun; Wang Xue; Yang, Bo; Song, Yunhai; Cai, Jinjing

2016-01-01

This study aimed to evaluate the effort of applying frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater in the treatment of sagittal synostosis. From April 2008 to June 2013, sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. The CT images showed that both sides of the parietal bone of artificial sagittal groove gradually merged postoperative 1 year, and skull almost completely normal healing after operation 2 or 3 years, without deformity recurrence within 5 years. Among them all, 61 children's intelligence is normal and 2 children's lagged behind normal level, no further improvement. Patients were followed up 1 - 5 years (an average of 43 months). Skull growth was excellent in all patients, the anteroposterior diameter was shortened by 14.6 mm averagely, the transverse diameter was increased by 12.3 mm averagely, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis. The application of frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater can be used in the treatment of sagittal

Lumbar Sagittal Shape Variation vis-à-vis Gender During Growth: A Three-Year Follow-Up Mri Study in Children from the General Population

DEFF Research Database (Denmark)

Masharawi, Y; Kjaer, P; Manniche, C

2012-01-01

ABSTRACT: Study Design. A longitudinal descriptive MRI study on the changes of the supine lumbar lordosis (SLL), supine sacral slope (SSS), and sagittal wedging of the vertebral body (VB) and intervertebral discs (IVD) in children from the general population.Objective. To compare the shape...

Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

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Zylfije Hundozi

2016-12-01

Full Text Available Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS thrombosis (SSST developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

A comparison of standard definitions and sagittal abdominal ...

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Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of componen

Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

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Paolo Ronchi

2013-06-01

Full Text Available Objectives: The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods: 15 adult sleep apnea syndrome (OSAS patients diagnosed by polysomnography (PSG and treated with maxillomandubular advancement (MMA were included in this study. Pre- (T1 and postsurgical (T2 PSG studies assessing the apnea/hypopnea index (AHI and the lowest oxygen saturation (LSAT level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog, the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H, and the posterior airway space (PAS.Results: Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001. The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001. All the patients in our study were successfully treated (AHI < 20 or reduced by 50%. Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01. The overall mean SNA increase was 6°.Conclusions: Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.

Comprehensive Analysis of Mandibular Residual Asymmetry after Bilateral Sagittal Split Ramus Osteotomy Correction of Menton Point Deviation.

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Lin, Han; Zhu, Ping; Lin, Qiuping; Huang, Xiaoqiong; Xu, Yue; Yang, Xiaoping

2016-01-01

Facial asymmetry often persists even after mandibular deviation corrected by the bilateral sagittal split ramus osteotomy (BSSRO) operation, since the reference facial sagittal plane for the asymmetry analysis is usually set up before the mandibular menton (Me) point correction. Our aim is to develop a predictive and quantitative method to assess the true asymmetry of the mandible after a midline correction performed by a virtual BSSRO, and to verify its availability by evaluation of the post-surgical improvement. A retrospective cohort study was conducted at the Hospital of Stomatology, Sun Yat-sen University (China) of patients with pure hemi-mandibular elongation (HE) from September 2010 through May 2014. Mandibular models were reconstructed from CBCT images of patients with pre-surgical orthodontic treatment. After mandibular de-rotation and midline alignment with virtual BSSRO, the elongation hemi-mandible was virtually mirrored along the facial sagittal plane. The residual asymmetry, defined as the superimposition and boolean operation of the mirrored elongation side on the normal side, was calculated, including the volumetric differences and the length of transversal and vertical asymmetry discrepancy. For more specific evaluation, both sides of the hemi-mandible were divided into the symphysis and parasymphysis (SP), mandibular body (MB), and mandibular angle (MA) regions. Other clinical variables include deviation of Me point, dental midline and molar relationship. The measurement of volumetric discrepancy between the two sides of post-surgical hemi-mandible were also calculated to verify the availability of virtual surgery. Paired t-tests were computed and the P value was set at .05. This study included 45 patients. The volume differences were 407.8±64.8 mm3, 2139.1±72.5 mm3, and 422.5±36.9 mm3; residual average transversal discrepancy, 1.9 mm, 1.0 mm, and 2.2 mm; average vertical discrepancy, 1.1 mm, 2.2 mm, and 2.2 mm (before virtual surgery). The

Surgical and nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses: 32 cases (1991-2001).

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Kraus, Beth M; Ross, Michael W; Boston, Raymond C

2005-03-15

To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. Retrospective study. 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. 22 (69%) horses raced at least once after treatment of the fracture. All 7 horses treated by means of interfragmentary compression raced after treatment, and horses that underwent interfragmentary compression had significantly higher earnings per start after the injury than did horses treated without surgery. Eight of 9 horses treated by means of arthroscopic debridement of the damaged cartilage and bone raced after treatment, but only 7 of 16 horses treated without surgery (ie, stall rest) were able to return to racing after treatment. Results suggest that racehorses with sagittal slab fractures of the third carpal bone have a favorable prognosis for return to racing after treatment. Horses treated surgically were more likely to race after treatment than were horses treated without surgery.

The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

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Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

2012-06-01

The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ. Copyright © 2011. Published by Elsevier Ltd.

A modified sagittal spine postural classification and its relationship to deformities and spinal mobility in a chinese osteoporotic population.

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Hua-Jun Wang

Full Text Available BACKGROUND: Abnormal posture and spinal mobility have been demonstrated to cause functional impairment in the quality of life, especially in the postmenopausal osteoporotic population. Most of the literature studies focus on either thoracic kyphosis or lumbar lordosis, but not on the change of the entire spinal alignment. Very few articles reported the spinal alignment of Chinese people. The purpose of this study was threefold: to classify the spinal curvature based on the classification system defined by Satoh consisting of the entire spine alignment; to identify the change of trunk mobility; and to relate spinal curvature to balance disorder in a Chinese population. METHODOLOGY/PRINCIPAL FINDINGS: 450 osteoporotic volunteers were recruited for this study. Spinal range of motion and global curvature were evaluated noninvasively using the Spinal-Mouse® system and sagittal postural deformities were characterized. RESULTS: We found a new spine postural alignment consisting of an increased thoracic kyphosis and decreased lumbar lordosis which we classified as our modified round back. We did not find any of Satoh's type 5 classification in our population. Type 2 sagittal alignment was the most common spinal deformity (38.44%. In standing, thoracic kyphosis angles in types 2 (58.34° and 3 (58.03° were the largest and lumbar lordosis angles in types 4 (13.95° and 5 (-8.61° were the smallest. The range of flexion (ROF and range of flexion-extension (ROFE of types 2 and 3 were usually greater than types 4 and 5, with type 1 being the largest. CONCLUSIONS/SIGNIFICANCE: The present study classified and compared for the first time the mobility, curvature and balance in a Chinese population based on the entire spine alignment and found types 4 and 5 to present the worst balance and mobility. This study included a new spine postural alignment classification that should be considered in future population studies.

Associations of anthropometry since birth with sagittal posture at age 7 in a prospective birth cohort: the Generation XXI Study.

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Araújo, Fábio A; Lucas, Raquel; Simpkin, Andrew J; Heron, Jon; Alegrete, Nuno; Tilling, Kate; Howe, Laura D; Barros, Henrique

2017-07-26

Adult sagittal posture is established during childhood and adolescence. A flattened or hypercurved spine is associated with poorer musculoskeletal health in adulthood. Although anthropometry from birth onwards is expected to be a key influence on sagittal posture design, this has never been assessed during childhood. Our aim was to estimate the association between body size throughout childhood with sagittal postural patterns at age 7. Prospective cohort study. A subsample of 1029 girls and 1101 boys taking part in the 7-year-old follow-up of the birth cohort Generation XXI (Porto, Portugal) was included. We assessed the associations between anthropometric measurements (weight, height and body mass index) at birth, 4 and 7 years of age and postural patterns at age 7. Postural patterns were defined using latent profile analysis, a probabilistic model-based technique which allows for simultaneously including anthropometrics as predictors of latent profiles by means of logistic regression. Postural patterns identified were sway, flat and "neutral to hyperlordotic"in girls, and "sway to neutral", flat and hyperlordotic in boys; with flat and hyperlordotic postures representing a straightened and a rounded spine, respectively. In both girls and boys, higher weight was associated with lower odds of a flat pattern compared with a sway/"sway to neutral"pattern, with stronger associations at older ages: for example, ORs were 0.68 (95% CI 0.53 to 0.88) per SD increase in birth weight and 0.36 (95% CI 0.19 to 0.68) per SD increase in weight at age 7 in girls, with similar findings in boys. Boys with higher ponderal index at birth were more frequently assigned to the hyperlordotic pattern (OR=1.44 per SD; p=0.043). Our findings support a prospective sculpting role of body size and therefore of load on musculoskeletal spinopelvic structures, with stronger associations as children get older. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

OpenAIRE

Oh, Young Min; Choi, Ha Young; Eun, Jong Pil

2013-01-01

Objective To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each...

Class III Malocclusion Surgical-Orthodontic Treatment

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Bruna Alves Furquim

2014-01-01

Full Text Available The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.

Is the Lingual Fracture Line Influenced by the Mandibular Canal or the Mylohyoid Groove During a Bilateral Sagittal Split Osteotomy? A Human Cadaveric Study

NARCIS (Netherlands)

Mensink, Gertjan; Gooris, Peter J. J.; Bergsma, Eelco J.; Frank, Michael H.; van Gemert, Jan T. M.; van Merkesteyn, J. P. Richard

2014-01-01

Purpose: Although the bilateral sagittal split osteotomy (BSSO) is a routinely performed procedure, exact control of the lingual fracture line remains problematic. The purpose of this study was to determine the various lingual splitting patterns in cadaveric human mandibles after a BSSO and the

MR findings of facial nerve on oblique sagittal MRI using TMJ surface coil: normal vs peripheral facial nerve palsy

International Nuclear Information System (INIS)

Park, Yong Ok; Lee, Myeong Jun; Lee, Chang Joon; Yoo, Jeong Hyun

2000-01-01

To evaluate the findings of normal facial nerve, as seen on oblique sagittal MRI using a TMJ (temporomandibular joint) surface coil, and then to evaluate abnormal findings of peripheral facial nerve palsy. We retrospectively reviewed the MR findings of 20 patients with peripheral facial palsy and 50 normal facial nerves of 36 patients without facial palsy. All underwent oblique sagittal MRI using a T MJ surface coil. We analyzed the course, signal intensity, thickness, location, and degree of enhancement of the facial nerve. According to the angle made by the proximal parotid segment on the axis of the mastoid segment, course was classified as anterior angulation (obtuse and acute, or buckling), straight and posterior angulation. Among 50 normal facial nerves, 24 (48%) were straight, and 23 (46%) demonstrated anterior angulation; 34 (68%) showed iso signal intensity on T1W1. In the group of patients, course on the affected side was either straight (40%) or showed anterior angulation (55%), and signal intensity in 80% of cases was isointense. These findings were similar to those in the normal group, but in patients with post-traumatic or post-operative facial palsy, buckling, of course, appeared. In 12 of 18 facial palsy cases (66.6%) in which contrast materials were administered, a normal facial nerve of the opposite facial canal showed mild enhancement on more than one segment, but on the affected side the facial nerve showed diffuse enhancement in all 14 patients with acute facial palsy. Eleven of these (79%) showed fair or marked enhancement on more than one segment, and in 12 (86%), mild enhancement of the proximal parotid segment was noted. Four of six chronic facial palsy cases (66.6%) showed atrophy of the facial nerve. When oblique sagittal MR images are obtained using a TMJ surface coil, enhancement of the proximal parotid segment of the facial nerve and fair or marked enhancement of at least one segment within the facial canal always suggests pathology of

LINK BETWEEN SKELETAL RELATIONS AND ROOT RESORPTION IN ORTHODONTIC PATIENTS

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Cristina Teodora Preoteasa

2011-09-01

Full Text Available External root resorption is one of the possible complications of the orthodontic treatment, severe cases presenting a higher frequency. The aim of the present study was to test the existence of a relation between the severity of root resorption and the sagittal or vertical skeletal relations. A cross-sectional study was conducted on a group of 55 patients with fixed orthodontic devices, applied bimaxillarily for at least 6 months. The sample presented mostly mild or moderate apical root resorption, with an average value of 1.31 mm (standard deviation 0.60. Patients with abnormal sagittal skeletal relations presented a more severe root resorption compared to those with a normal pattern. The tendency towards more severe external root resorption was also noticed in cases with mandibular clockwise rotation and hiperdivergent facial pattern. A good knowledge on the variables associated to severe root resorption is essential for the identification of the high risk patients, as well as for the selection of the best suited treatment alternative in terms of low probability of root resorption occurrence.

Effect of Acute Alterations in Foot Strike Patterns during Running on Sagittal Plane Lower Limb Kinematics and Kinetics

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Kevin A. Valenzuela, Scott K. Lynn, Lisa R. Mikelson, Guillermo J. Noffal, Daniel A. Judelson

2015-03-01

Full Text Available subjects were identified through slow motion video playback (n = 21, age = 22.8±2.2 years, mass = 73.1±14.5 kg, height 1.75 ± 0.10 m. On day two, subjects performed five overground run trials in both their natural and unnatural strike patterns while motion and force data were collected. Data were collected over two days so that foot strike videos could be analyzed for group placement purposes. Several 2 (Foot Strike Pattern –forefoot strike [FFS], rearfoot strike [RFS] x 2 (Group – PFFG, PRFG mixed model ANOVAs (p < 0.05 were run on speed, active peak vertical ground reaction force (VGRF, peak early stance and mid stance sagittal ankle moments, sagittal plane hip and knee moments, ankle dorsiflexion ROM, and sagittal plane hip and knee ROM. There were no significant interactions or between group differences for any of the measured variables. Within subject effects demonstrated that the RFS condition had significantly lower (VGRF (RFS = 2.58 ± .21 BW, FFS = 2.71 ± 0.23 BW, dorsiflexion moment (RFS = -2.6 1± 0.61 Nm·kg-1, FFS = -3.09 ± 0.32 Nm·kg-1, and dorsiflexion range of motion (RFS = 17.63 ± 3.76°, FFS = 22.10 ± 5.08°. There was also a significantly higher peak plantarflexion moment (RFS = 0.23 ± 0.11 Nm·kg-1, FFS = 0.01 ± 0.01 Nm·kg-1, peak knee moment (RFS = 2.61 ± 0.54 Nm·kg-1, FFS = 2.39 ± 0.61 Nm·kg-1, knee ROM (RFS = 31.72 ± 2.79°, FFS = 29.58 ± 2.97°, and hip ROM (RFS = 42.72 ± 4.03°, FFS = 41.38 ± 3.32° as compared with the FFS condition. This research suggests that acute changes in foot strike patterns during shod running can create alterations in certain lower limb kinematic and kinetic measures that are not dependent on the preferred foot strike pattern of the individual. This research also challenges the contention that the impact transient spike in the vertical ground reaction force curve is only present during a rear foot strike type of running gait.

Association of achondroplasia with sagittal synostosis and scaphocephaly in two patients, an underestimated condition?

Science.gov (United States)

Accogli, Andrea; Pacetti, Mattia; Fiaschi, Pietro; Pavanello, Marco; Piatelli, Gianluca; Nuzzi, Daniele; Baldi, Maurizia; Tassano, Elisa; Severino, Maria Savina; Allegri, Anna; Capra, Valeria

2015-03-01

We report on two patients with an unusual combination of achondroplasia and surgically treated sagittal synostosis and scaphocephaly. The most common achondroplasia mutation, p.Gly380Arg in fibroblast growth factor receptor 3 (FGFR3), was detected in both patients. Molecular genetic testing of FGFR1, FGFR2, FGFR3 and TWIST1 genes failed to detect any additional mutations. There are several reports of achondroplasia with associated craniosynostosis, but no other cases of scaphocephaly in children with achondroplasia have been described. Recently it has been demonstrated that FGFR3 mutations affect not only endochondral ossification but also membranous ossification, providing new explanations for the craniofacial hallmarks in achondroplasia. Our report suggests that the association of isolated scaphocephaly and other craniosynostoses with achondroplasia may be under recognized. © 2015 Wiley Periodicals, Inc.

Lumbar Sagittal Shape Variation Vis-à-Vis Sex During Growth: A 3-Year Follow-up Magnetic Resonance Imaging Study in Children From the General Population

DEFF Research Database (Denmark)

Masharawi, Y; Kjær, Per; Manniche, C

2012-01-01

ABSTRACT: Study Design. A longitudinal descriptive MRI study on the changes of the supine lumbar lordosis (SLL), supine sacral slope (SSS), and sagittal wedging of the vertebral body (VB) and intervertebral discs (IVD) in children from the general population.Objective. To compare the shape...

Reliability and measurement error of sagittal spinal motion parameters in 220 patients with chronic low back pain using a three-dimensional measurement device.

Science.gov (United States)

Mieritz, Rune M; Bronfort, Gert; Jakobsen, Markus D; Aagaard, Per; Hartvigsen, Jan

2014-09-01

A basic premise for any instrument measuring spinal motion is that reliable outcomes can be obtained on a relevant sample under standardized conditions. The purpose of this study was to assess the overall reliability and measurement error of regional spinal sagittal plane motion in patients with chronic low back pain (LBP), and then to evaluate the influence of body mass index, examiner, gender, stability of pain, and pain distribution on reliability and measurement error. This study comprises a test-retest design separated by 7 to 14 days. The patient cohort consisted of 220 individuals with chronic LBP. Kinematics of the lumbar spine were sampled during standardized spinal extension-flexion testing using a 6-df instrumented spatial linkage system. Test-retest reliability and measurement error were evaluated using interclass correlation coefficients (ICC(1,1)) and Bland-Altman limits of agreement (LOAs). The overall test-retest reliability (ICC(1,1)) for various motion parameters ranged from 0.51 to 0.70, and relatively wide LOAs were observed for all parameters. Reliability measures in patient subgroups (ICC(1,1)) ranged between 0.34 and 0.77. In general, greater (ICC(1,1)) coefficients and smaller LOAs were found in subgroups with patients examined by the same examiner, patients with a stable pain level, patients with a body mass index less than below 30 kg/m(2), patients who were men, and patients in the Quebec Task Force classifications Group 1. This study shows that sagittal plane kinematic data from patients with chronic LBP may be sufficiently reliable in measurements of groups of patients. However, because of the large LOAs, this test procedure appears unusable at the individual patient level. Furthermore, reliability and measurement error varies substantially among subgroups of patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Indocyanine green videoangiography (ICGV)-guided surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS).

Science.gov (United States)

d'Avella, Elena; Volpin, Francesco; Manara, Renzo; Scienza, Renato; Della Puppa, Alessandro

2013-03-01

Maximal safe resection is the goal of correct surgical treatment of parasagittal meningiomas, and it is intimately related to the venous anatomy both near and directly involved by the tumor. Indocyanine green videoangiography (ICGV) has already been advocated as an intra-operative resourceful technique in brain tumor surgery for the identification of vessels. The aim of this study was to investigate the role of ICGV in surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS). In this study, we prospectively analyzed clinical, radiological and intra-operative findings of patients affected by parasagittal meningioma occluding the SSS, who underwent ICGV assisted-surgery. Radiological diagnosis of complete SSS occlusion was pre-operatively established in all cases. ICGV was performed before dural opening, before and during tumor resection, at the end of the procedure. Five patients were included in our study. In all cases, ICGV guided dural opening, tumor resection, and venous management. The venous collateral pathway was easily identified and preserved in all cases. Radical resection was achieved in four cases. Surgery was uneventful in all cases. Despite the small number of patients, our study shows that ICG videoangiography could play a crucial role in guiding surgery of parasagittal meningioma occluding the SSS. Further studies are needed to define the role of this technique on functional and oncological outcome of these patients.

Evaluation of T2-weighted versus short-tau inversion recovery sagittal sequences in the identification and localization of canine intervertebral disc extrusion with low-field magnetic resonance imaging.

Science.gov (United States)

Housley, Daniel; Caine, Abby; Cherubini, Giunio; Taeymans, Olivier

2017-07-01

Sagittal T2-weighted sequences (T2-SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short-tau inversion recovery sequences (STIR-SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR-SAG would provide higher sensitivity than T2-SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2-SAG and STIR-SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2-SAG and STIR-SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2-SAG and STIR-SAG during the identification of intervertebral disc extrusion (T2-SAG: 92.7%, STIR-SAG: 94.5%, P = 0.752). Nevertheless, STIR-SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2-SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2-SAG and STIR-SAG series provided a significantly higher sensitivity than T2-SAG in isolation, during the identification of intervertebral disc extrusion (T2-SAG: 78.2%, paired T2-SAG, and STIR-SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2-SAG: 92.7%, paired T2-SAG, and STIR-SAG = 97.3%, P = 0.392). We therefore conclude that STIR-SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2-SAG, and that STIR-SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc

Hybrid fixation in the bilateral sagittal split osteotomy for lower jaw advancement

Directory of Open Access Journals (Sweden)

Felipe Ladeira Pereira

2010-02-01

Full Text Available Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.

Conical geometry for sagittal focusing as applied to X rays from synchrotrons

International Nuclear Information System (INIS)

Ice, G.E.; Sparks, C.J.

1993-06-01

The authors describe a method for simultaneously focusing and monochromatization of X rays from a fan of radiation having up to 15 mrad divergence in one dimension. This geometry is well suited to synchrotron radiation sources at magnifications of one-fifth to two and is efficient for X-ray energies between 3 and 40 keV (0.48 and 6.4 fJ). The method uses crystals bent to part of a cone for sagittal focusing and allows for the collection of a larger divergence with less mixing of the horizontal into the vertical divergence than is possible with X-ray mirrors. They describe the geometry required to achieve the highest efficiency when a conical crystal follows a flat crystal in a nondispersive two-crystal monochromator. At a magnification of one-third, the geometry is identical to a cylindrical focusing design described previously. A simple theoretical calculation is shown to agree well with ray-tracing results. Minimum aberrations are observed at magnifications near one. Applications of the conical focusing geometry to existing and future synchrotron radiation facilities are discussed

Accuracy and reliability of coronal and sagittal spinal curvature data based on patient-specific three-dimensional models created by the EOS 2D/3D imaging system.

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Somoskeöy, Szabolcs; Tunyogi-Csapó, Miklós; Bogyó, Csaba; Illés, Tamás

2012-11-01

reconstructions and automatic measurements were performed two times by each examiner. Means comparison t test, Pearson bivariate correlation analysis, reliability analysis by intraclass correlation coefficients for intraobserver reproducibility and interrater reliability were performed using SPSS v16.0 software (IBM Corp., Armonk, NY, USA). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article. In comparison with manual 2D methods, only small and nonsignificant differences were detectable in sterEOS 3D-based curvature data. Intraobserver reliability was excellent for both methods, and interrater reproducibility was consistently higher for sterEOS 3D methods that was found to be unaffected by the magnitude of coronal curves or sagittal plane deviations. This is the first clinical report on EOS 2D/3D system (EOS Imaging, Paris, France) and its sterEOS 3D software, documenting an excellent capability for accurate, reliable, and reproducible spinal curvature measurements. Copyright © 2012 Elsevier Inc. All rights reserved.

The Effects of Frontal- and Sagittal-Plane Plyometrics on Change-of-Direction Speed and Power in Adolescent Female Basketball Players.

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McCormick, Brian T; Hannon, James C; Newton, Maria; Shultz, Barry; Detling, Nicole; Young, Warren B

2016-01-01

Plyometrics is a popular training modality for basketball players to improve power and change-of-direction speed. Most plyometric training has used sagittal-plane exercises, but improvements in change-of-direction speed have been greater in multi-direction programs. To determine the benefits of a 6-wk frontal-plane plyometric (FPP) training program compared with a 6-wk sagittal-plane plyometric (SPP) training program with regard to power and change-of-direction speed. Fourteen female varsity high school basketball players participated in the study. Multiple 2 × 2 repeated-measures ANOVAs were used to determine differences for the FPP and SPP groups from preintervention to postintervention on 4 tests of power and 2 tests of change-of-direction speed. There was a group main effect for time in all 6 tests. There was a significant group × time interaction effect in 3 of the 6 tests. The SPP improved performance of the countermovement vertical jump more than the FPP, whereas the FPP improved performance of the lateral hop (left) and lateral-shuffle test (left) more than the SPP. The standing long jump, lateral hop (right), and lateral-shuffle test (right) did not show a significant interaction effect. These results suggest that basketball players should incorporate plyometric training in all planes to improve power and change-of-direction speed.

Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects?

Science.gov (United States)

Moustafa, Ibrahim Moustafa; Diab, Aliaa Attiah Mohamed; Hegazy, Fatma A; Harrison, Deed E

2017-01-01

To test the hypothesis that improvement of cervical lordosis in cervical spondylotic radiculopathy (CSR) will improve cervical spine flexion and extension end range of motion kinematics in a population suffering from CSR. Thirty chronic lower CSR patients with cervical lordosis lordosis (p lordosis in the study group was associated with significant improvement in the translational and rotational motions of the lower cervical spine. This finding provides objective evidence that cervical flexion/extension is partially dependent on the posture and sagittal curve orientation. These findings are in agreement with several other reports in the literature; whereas ours is the first post treatment analysis identifying this relationship.

Contemporary occurrence of hydrocephalus and Chiari I malformation in sagittal craniosynostosis. Case report and review of the literature.

Science.gov (United States)

Sgulò, Francesco Giovanni; Spennato, Pietro; Aliberti, Ferdinando; Di Martino, Giuliana; Cascone, Daniele; Cinalli, Giuseppe

2017-01-01

Chiari malformation type I (CM-I) and hydrocephalus are often associated with complex craniosynostosis. On the contrary, their simultaneous occurrence in monosutural synostosis is extremely rare. The pathophysiological hypothesis is that they may alter posterior fossa growth and lead to cerebellar tonsil herniation also without skull base primary involvement. Hydrocephalus is multifactorial and may be secondary to fourth ventricle outlet obstruction. The management of these cases is quite complex and not well defined. Cranial vault remodeling should be the only treatment when CM-I is asymptomatic and not related to syringomyelia. Suboccipital decompression should be reserved only in complicated CM-I, usually as a second surgical step following the correction of the supratentorial deformity. In our opinion, the associated hydrocephalus should be treated first in order to normalize intracranial hypertension before opening the cranial sutures. We report the case of a 26-month-old child that presented with sagittal craniosynostosis, hydrocephalus, and CM-I. He was managed by performing endoscopic third ventriculostomy (ETV) first and cranial vault remodeling thereafter. Clinico-radiological outcome was very satisfying. Concerning literature is reviewed; physiopathology and surgical management are discussed.

Sagittal spinal alignment in asymptomatic patients over 30 years old in the Korean population.

Science.gov (United States)

Sohn, Seil; Chung, Chun Kee; Kim, Yongjung Jay; Han, Inbo; Kang, Su Min; Yoon, Ji Won; Kim, Hyejin

2017-06-01

We aim to provide sagittal and pelvic parameters according to different age groups in an asymptomatic population all over 30 years old and to investigate the possible causes of changes in these parameters. Whole-spine, standing lateral radiographs were taken in 128 asymptomatic Korean people over 30 years old. The spinal parameters (the total thoracic kyphosis (TTK), maximal lumbar lordosis (MLL), total lumbar lordosis (TLL), lower lumbar lordosis (LLL), thoracolumbar junctional angle (TLJA), and lumbar inclination (LI)), pelvic parameters (pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT)), and spinal balance parameters (spinal balance, sacropelvic balance, and spinopelvic balance) were measured. The body mass index, body protein mass, waist line, skeletal muscle mass, and body fat mass were also measured for potential causes. TTK and TLJA were significantly increased in the group over 70 years of age compared to the other age groups (p = 0.0002, values were similar to PI even in over 70-year age group. LLL did not differ in the group over 70 years of age (p = 0.29), gradually increasing with an increase in age. SS was significantly decreased and PT was significantly increased in the group over 70 years of age as compared to the other age groups (p = 0.049, 0.049, respectively). PI was similar in all age groups (p = 0.75). Spinal balance was significantly decreased in the group over 70 years of age (p = mass and skeletal muscle mass (p = 0.01, 0.001, respectively). Body protein mass and skeletal muscle mass were significantly lower in the group over 70 years of age (p = 0.02, 0.02) and were possible causes. Several sagittal and pelvic parameters are different in asymptomatic adults over 70 years of age. Decreased body protein mass and skeletal muscle mass are possible causes of these changes.

Assessment of Gender Dimorphism on Sagittal Cephalometry in Pakistani Population

International Nuclear Information System (INIS)

Qamruddin, I.; Shahid, F.; Tanveer, S.; Mukhtiar, M.; Asim, Z.; Alam, M. K.

2016-01-01

Objective: To determine and compare the cephalometric values among Pakistani males and females using commonly used sagittal skeletal measurements (ANB, Wits appraisal, Beta-angle) and newly developed cephalometric analyses (Yen-angle and W-angle). Study Design: Observational, cross-sectional study. Place and Duration of Study: Orthodontic Department of Baqai Medical University, Karachi, Pakistan, from August to October 2013. Methodology: A total of 209 pre-treatment lateral cephalometric radiographs of orthodontic patients were selected from departmental records, comprised of 92 males and 117 females. Radiographs were traced for measurements of ANB, Wits appraisal, Beta-angle, W-angle and Yen-angle. Patients were categorized into skeletal classes I, II, and III on the basis of performed measurements, incisor classification, and profile recorded from their records. Descriptive analysis was used to obtain median interquartile range in both the genders and Mann-Whitney U-test was used to observe gender dimorphism. Result: Skeletal class II was the most prevalent type of malocclusion. There were no difference in the obtained measurements between males and females except the Wits appraisal and Beta-angle in class II patients, which showed significant difference in values (p < 0.05). Conclusion: Pakistani population has no significant different difference in the craniofacial morphology of males and females, with the exception of Wits-appraisal and Beta-angle in class II cases. (author)

Comparison of 2D-3D Measurements of Hallux and First Ray Sagittal Motion in Patients With and Without Hallux Valgus.

Science.gov (United States)

Swanson, Jessica E; Stoltman, Matthew G; Oyen, Cheyenne R; Mohrbacher, Jessica A; Orandi, Atefeh; Olson, Jeff M; Glasoe, Ward M

2016-02-01

Clinicians base treatment decisions on measures of hallux and first ray motion in the management of first metatarsophalangeal joint disorders. Women account for a majority of the patients. This study assessed the reliability of a 2D approach for the measurements of sagittal motion, and compared the result to a Cardan (3D) angle criterion standard and evaluated how hallux valgus (bunion) deformity affected the comparisons. Twenty-nine women (controls n = 10; bunion n = 19) were examined using a retrospective repeated measures design. Weightbearing magnetic resonance (MR) images were acquired to replicate the position of the foot during the stance phase of gait. The images were reconstructed into virtual bone models using computer processes, whereby measures of hallux and first ray motion were represented by 2D and 3D methods of measurement. An examiner measured 2D motion on the image data sets using a goniometer, and reliability was assessed. The 3D Cardan angle result was derived from a matrix calculation. The 2D-3D comparison of measurements was evaluated with an analysis of variance (ANOVA) model across gait conditions, run separate for groups. The 2D measurement was reliable (ICC ≥ 0.98, SEM ≤ 0.89 degrees). There was no method-by-condition interaction (F ≤ 1.37, P ≥ .25) between variables. No significant difference was detected between the 2D-3D measurements in the control group (F ≤ 1.24, P ≥ .30), but the measurements were statistically different (F ≥ 4.46, P ≤ .049) in the bunion group. This study described a reliable 2D approach for measuring hallux and first ray sagittal motion from weightbearing images. The 2D measurements were comparable to a Cardan angle component motion result in controls, but not in women with bunion. Joint motion measurements may augment clinical decision making. These results suggest that a 2D image-based approach may be adequate to estimate hallux and first ray sagittal motion, although bunion deformity creates out

Gender differences of sagittal knee and ankle biomechanics during stair-to-ground descent transition.

Science.gov (United States)

Hong, Yoon No Gregory; Shin, Choongsoo S

2015-12-01

Falls on stairs often result in severe injury and occur twice as frequently in women. However, gender differences in kinetics and kinematics during stair descent are unknown. Thus, this study aimed to determine whether gender differences of knee and ankle biomechanics exist in the sagittal plane during the stair-to-ground descending transition. It was hypothesized that 1) women would reveal higher ground-toe-trochanter angle and lower ground-toe length during stair-to-ground descent transition than men; and 2) women would reveal lower peak knee extension moment during stair-to-ground descent transition than men. Fifteen men and fifteen women were recruited and performed a stair descent activity. Kinetic and kinematic data were obtained using a force plate and motion capture system. The women performed the stair descent with a lower peak knee extension moment and a peak knee power at the early weight acceptance phase. The women also revealed a higher ground-toe-trochanter angle and a lower ground-toe length, which indicated a more forward position of the lower extremity relative to the toe contact point at both the initial contact and at the time of peak kinematic and kinetic events. This study found that knee and ankle kinematics and kinetics differed significantly between the genders due to differences in ground-toe-trochanter angle. Women have a different stair descending strategy that reduces the demand of the lower extremity muscle function, but this strategy seems to increase the risk of falls. Copyright © 2015 Elsevier Ltd. All rights reserved.

Central uplift of custom immobilization radiotherapy patients with lower limb overhead sagittal laser affected without mobile; Elevacion central de inmovilizacion personalizada de pacientes radioterapicos con extremidades inferiores afectas sin laser sagital cenital movil

Energy Technology Data Exchange (ETDEWEB)

Velazquez Miranda, S.; Delgado Gil, M. M.; Ortiz Seidel, M.

2011-07-01

If you have a laser moving overhead sagittal or the location of tumors in the lower extremities is laborious, as to reference properly in the CT, is necessary before tattooing in the treatment table using their ability to relate the lateral midline with tattoos on the limb. For anatomical forms often happens that lasers are not displayed on the areas of our interest. The problem can be overcome if between the legs raise the bag or custom immobilizer above the height of the patient's abdomen, as this will have a central reference reliable and well designed lasers.

Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

Directory of Open Access Journals (Sweden)

Ashok Kumar Talapaneni

2011-01-01

Full Text Available Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual.

Frank-ter Haar syndrome associated with sagittal craniosynostosis and raised intracranial pressure.

Science.gov (United States)

Bendon, Charlotte L; Fenwick, Aimée L; Hurst, Jane A; Nürnberg, Gudrun; Nürnberg, Peter; Wall, Steven A; Wilkie, Andrew O M; Johnson, David

2012-11-09

Frank-ter Haar syndrome is a rare disorder associated with skeletal, cardiac, ocular and craniofacial features including hypertelorism and brachycephaly. The most common underlying genetic defect in Frank-ter Haar syndrome appears to be a mutation in the SH3PXD2B gene on chromosome 5q35.1. Craniosynostosis, or premature fusion of the calvarial sutures, has not previously been described in Frank-ter Haar syndrome. We present a family of three affected siblings born to consanguineous parents with clinical features in keeping with a diagnosis of Frank-ter Haar syndrome. All three siblings have a novel mutation caused by the deletion of exon 13 of the SH3PXD2B gene. Two of the three siblings also have non-scaphocephalic sagittal synostosis associated with raised intracranial pressure. The clinical features of craniosynostosis and raised intracranial pressure in this family with a confirmed diagnosis of Frank-ter Haar syndrome expand the clinical spectrum of the disease. The abnormal cranial proportions in a mouse model of the disease suggests that the association is not coincidental. The possibility of craniosynostosis should be considered in individuals with a suspected diagnosis of Frank-ter Haar syndrome.

Palate Fracture Repair With Light-Cured Resin Splint: Technical Note.

Science.gov (United States)

Waldrop, Jimmy; Dale, Elizabeth L; Halsey, Jordan; Sargent, Larry A

2015-10-01

Palate fractures are rare, and their treatment is a matter of debate. Although some investigators have favored rigid plate fixation, others have reported successful treatment without it. Sagittal split and comminuted fractures can require rigid fixation to reduce the maxillary width; however, additional stabilization is needed. Also, palate repair without a splint is complicated by prolonged intermaxillary fixation (IMF), causing stiffness to the temporomandibular joint. We introduce a technique using a rapid light-cured resin (TRIAD TranSheet) frequently used by orthodontists for making dental retainers. Its use is similar to the splints traditionally created preoperatively, but obviates the need for making impressions, a model, and a molded splint. A series of 13 patients treated with this technique during a 5-year period is presented. The average duration of IMF was 4.7 weeks (range 3 to 6). The average duration of the palate splint was 8.4 weeks (range 5 to 12). One patient had malocclusion, but none had malunion, infection, or oronasal fistula. Our series has demonstrated a simple, cost-effective, and successful technique. It can be used alone or combined with rigid fixation and allows for a shortened duration of maxillomandibular fixation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Neuromuscular strategies for lumbopelvic control during frontal and sagittal plane movement challenges differ between people with and without low back pain.

Science.gov (United States)

Nelson-Wong, E; Poupore, K; Ingvalson, S; Dehmer, K; Piatte, A; Alexander, S; Gallant, P; McClenahan, B; Davis, A M

2013-12-01

Observation-based assessments of movement are a standard component in clinical assessment of patients with non-specific low back pain. While aberrant motion patterns can be detected visually, clinicians are unable to assess underlying neuromuscular strategies during these tests. The purpose of this study was to compare coordination of the trunk and hip muscles during 2 commonly used assessments for lumbopelvic control in people with low back pain (LBP) and matched control subjects. Electromyography was recorded from hip and trunk muscles of 34 participants (17 with LBP) during performance of the Active Hip Abduction (AHAbd) and Active Straight Leg Raise (ASLR) tests. Relative muscle timing was calculated using cross-correlation. Participants with LBP demonstrated a variable strategy, while control subjects used a consistent proximal to distal activation strategy during both frontal and sagittal plane movements. Findings from this study provide insight into underlying neuromuscular control during commonly used assessment tests for patients with LBP that may help to guide targeted intervention approaches. Copyright © 2013 Elsevier Ltd. All rights reserved.

Surgical Management of Laterognathia in Orthofacial Surgery.

Science.gov (United States)

García Y Sánchez, J M; Gómez Rodríguez, C L; Romero Flores, J

2017-09-01

Each year around the world, various surgical procedures are carried out with the goal of correcting laterognathia; both the intraoral vertical ramus osteotomy (IVRO) and bilateral sagittal split ramus osteotomy (OSB) have been the most used techniques in mandibular surgery. These techniques have advantages and disadvantages; for example the advantages of the OSB include: increased coefficient of friction between bony segments, for both the forward and the retroposition, as well as decrease in the time of intermaxillary fixation (IMF). Disadvantages include injury to the inferior alveolar nerve (IAN), hemorrhage, bad split, among others. The advantages of IVRO include decrease of possibility of injury to the IAN, ease of implementation of the technique, a lower incidence of hemorrhage and the short duration of the surgical procedure. Their disadvantages include: lower coefficient of friction between bony segments, requires a relatively long period of IMF. The combination between the techniques of mandibular osteotomy for the correction of minor 10 mm laterognathia is the ideal treatment, since it avoids potential recurrence. We describe two cases of patients with laterognathia greater than 6 mm associated with maxilla deformity, which were treated with combined osteotomies. At Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, we describe the advantages and disadvantages, pre and postoperative nosocomial, by comparing them with the reports of the literature. The combination of techniques in the correction of laterognathias greater than 4 mm (smaller than 10 mm) is the ideal treatment, eliminating problems of articular compression, recurrence and damage to the alveolar nerve.

Satisfactory rate of post-processing visualization of fetal cerebral axial, sagittal, and coronal planes from three-dimensional volumes acquired in routine second trimester ultrasound practice by sonographers of peripheral centers.

Science.gov (United States)

Rizzo, Giuseppe; Pietrolucci, Maria Elena; Capece, Giuseppe; Cimmino, Ernesto; Colosi, Enrico; Ferrentino, Salvatore; Sica, Carmine; Di Meglio, Aniello; Arduini, Domenico

2011-08-01

The aim of this study was to evaluate the feasibility to visualize central nervous system (CNS) diagnostic planes from three-dimensional (3D) brain volumes obtained in ultrasound facilities with no specific experience in fetal neurosonography. Five sonographers prospectively recorded transabdominal 3D CNS volumes starting from an axial approach on 500 consecutive pregnancies at 19-24 weeks of gestation undergoing routine ultrasound examination. Volumes were sent to the referral center (Department of Obstetrics and Gynecology, Università Roma Tor Vergata, Italy) and two independent reviewers with experience in 3D ultrasound assessed their quality in the display of axial, coronal, and sagittal planes. CNS volumes were acquired in 491/500 pregnancies (98.2%). The two reviewers acknowledged the presence of satisfactory images with a visualization rate ranging respectively between 95.1% and 97.14% for axial planes, 73.72% and 87.16% for coronal planes, and 78.41% and 94.29% for sagittal planes. The agreement rate between the two reviewers as expressed by Cohen's kappa coefficient was >0.87 for axial planes, >0.89 for coronal planes, and >0.94 for sagittal planes. The presence of a maternal body mass index >30 alters the probability of achieving satisfactory CNS views, while existence of previous maternal lower abdomen surgery does not affect the quality of the reconstructed planes. CNS volumes acquired by 3D ultrasonography in peripheral centers showed a quality high enough to allow a detailed fetal neurosonogram.

Determination of a sagittal plane axis of rotation for a dynamic office chair.

Science.gov (United States)

Bauer, C M; Rast, F M; Böck, C; Kuster, R P; Baumgartner, D

2018-10-01

This study investigated the location of the axis of rotation in sagittal plane movement of the spine in a free sitting condition to adjust the kinematics of a mobile seat for a dynamic chair. Dynamic office chairs are designed to avoid continuous isometric muscle activity, and to facilitate increased mobility of the back during sitting. However, these chairs incorporate increased upper body movement which could distract office workers from the performance of their tasks. A chair with an axis of rotation above the seat would facilitate a stable upper back during movements of the lower back. The selection of a natural kinematic pattern is of high importance in order to match the properties of the spine. Twenty-one participants performed four cycles of flexion and extension of the spine during an upper arm hang on parallel bars. The location of the axis of rotation relative to the seat was estimated using infrared cameras and reflective skin markers. The median axis of rotation across all participants was located 36 cm above the seat for the complete movement and 39 cm for both the flexion and extension phases, each with an interquartile range of 20 cm. There was no significant effect of the movement direction on the location of the axis of rotation and only a weak, non-significant correlation between body height and the location of the axis of rotation. Individual movement patterns explained the majority of the variance. The axis of rotation for a spinal flexion/extension movement is located above the seat. The recommended radius for a guide rail of a mobile seat is between 36 cm and 39 cm. Copyright © 2018 Elsevier Ltd. All rights reserved.

Prophylactic single-dose administration of 600 mg clindamycin versus 4-time administration of 600 mg clindamycin in orthognathic surgery: A prospective randomized study in bilateral mandibular sagittal ramus osteotomies

NARCIS (Netherlands)

Lindeboom, Jerôme A. H.; Baas, Eric M.; Kroon, Frans H. M.

2003-01-01

Objective. The purpose of this study was to compare a single 600-mg dose of preoperative intravenously administered clindamycin with a 24-hour 600-mg regimen of clindamycin as prophylaxis for postoperative infections in bilateral sagittal ramus osteotomies. Study design. Seventy patients were

Sagittal tibiotalar translation and clinical outcomes in mobile and fixed-bearing total ankle replacement.

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Usuelli, Federico G; Manzi, Luigi; Brusaferri, Giovanni; Neher, Robert E; Guelfi, Matteo; Maccario, Camilla

2017-06-01

Sagittal implant malalignment after total ankle replacement (TAR) has been considered to be a possible cause for premature implant failure. In a prior study, the change over time of the tibiotalar ratio (T-T ratio), which is the ratio between the posterior longitudinal talar length and the full longitudinal talar length, was assessed in 66 TARs where an unconstrained, mobile-bearing implant was implanted. The analysis documented an increase in the T-T ratio between 2 and 6 months post-surgery (on average from 34.6% to 37.2%). We hypothesized that this change might have been related to the presence of a mobile-bearing insert. In order to test our hypothesis, we designed a study to compare the translation of the talus in TARs performed with an unconstrained, mobile-bearing implant (designated the "Mobile ankle") and those performed with a semi-constrained, fixed-bearing implant (designated the "Fixed ankle"). The study included 71 consecutive patients (71 ankles) who underwent TAR with the Mobile ankle and 24 consecutive patients (24 ankles) who received the Fixed ankle from May 2011 to December 2014. Patients were assessed clinically and radiologically preoperatively (T 0 ), at 6 months (T 2 ) and 12 months (T 3 ) post-surgery. There was also a radiological assessment at 2 months post-surgery (T 1 ). The comparison of the T-T ratio between the two implant groups and over time indicated an interaction between time and group, therefore the changes of the T-T ratio over time were affected by the implant type factor (Pbearing interface. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study

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Eitzen Ingrid

2012-12-01

Full Text Available Abstract Background Existent biomechanical studies on hip osteoarthritic gait have primarily focused on the end stage of disease. Consequently, there is no clear consensus on which specific gait parameters are of most relevance for hip osteoarthritis patients with mild to moderate symptoms. The purpose of this study was to explore sagittal plane gait characteristics during the stance phase of gait in hip osteoarthritis patients not eligible for hip replacement surgery. First, compared to healthy controls, and second, when categorized into two subgroups of radiographic severity defined from a minimal joint space of ≤/>2 mm. Methods Sagittal plane kinematics and kinetics of the hip, knee and ankle joint were calculated for total joint excursion throughout the stance phase, as well as from the specific events initial contact, midstance, peak hip extension and toe-off following 3D gait analysis. In addition, the Western Ontario and McMaster Universities Osteoarthritis Index, passive hip range of motion, and isokinetic muscle strength of hip and knee flexion and extension were included as secondary outcomes. Data were checked for normality and differences evaluated with the independent Student’s t-test, Welch’s t-test and the independent Mann–Whitney U-test. A binary logistic regression model was used in order to control for velocity in key variables. Results Fourty-eight hip osteoarthritis patients and 22 controls were included in the final material. The patients walked significantly slower than the controls (p=0.002, revealed significantly reduced joint excursions of the hip (pp=0.011, and a reduced hip flexion moment at midstance and peak hip extension (p2 mm suggested that the observed deviations were more pronounced in patients with greater radiographic severity. The biomechanical differences were, however, not reflected in self-reported symptoms or function. Conclusions Reduced gait velocity, reduced sagittal plane joint excursion, and

Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging

DEFF Research Database (Denmark)

Gideon, P; Thomsen, C; Gjerris, F

1996-01-01

PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic...

Clinical validation of coronal and sagittal spinal curve measurements based on three-dimensional vertebra vector parameters.

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Somoskeöy, Szabolcs; Tunyogi-Csapó, Miklós; Bogyó, Csaba; Illés, Tamás

2012-10-01

� (Group 4; n=49), and above 75° (Group 5; n=22). All study subjects were examined by EOS 2D imaging, resulting in anteroposterior (AP) and lateral (LAT) full spine, orthogonal digital X-ray images, in standing position. Conventional coronal and sagittal curvature measurements including sagittal L5 vertebra wedges were determined by 3 experienced examiners, using traditional Cobb methods on EOS 2D AP and LAT images. Vertebra vector-based measurements were performed as published earlier, based on computer-assisted calculations of corresponding spinal curvature. Vertebra vectors were generated by dedicated software from sterEOS 3D spine models reconstructed from EOS 2D images by the same three examiners. Manual measurements were performed by each examiner, thrice for sterEOS 3D reconstructions and twice for vertebra vector-based measurements. Means comparison t test, Pearson bivariate correlation analysis, reliability analysis by intraclass correlation coefficients for intraobserver reproducibility and interrater reliability were performed using SPSS v16.0 software. In comparison with manual 2D methods, only small and nonsignificant differences were detectable in vertebra vector-based curvature data for coronal curves and thoracic kyphosis, whereas the found difference in L1-L5 lordosis values was shown to be strongly related to the magnitude of corresponding L5 wedge. Intraobserver reliability was excellent for both methods, and interrater reproducibility was consistently higher for vertebra vector-based methods that was also found to be unaffected by the magnitude of coronal curves or sagittal plane deviations. Vertebra vector-based angulation measurements could fully substitute conventional manual 2D measurements, with similar accuracy and higher intraobserver reliability and interrater reproducibility. Vertebra vectors represent a truly 3D solution for clear and comprehensible 3D visualization of spinal deformities while preserving crucial parametric information for

Assessment of CSF dynamics and venous flow in the superior sagittal sinus by MRI in idiopathic intracranial hypertension: a preliminary study

DEFF Research Database (Denmark)

Gideon, P; Sørensen, P S; Thomsen, C

1994-01-01

A velocity-sensitive magnetic resonance imaging (MRI) phase-mapping method was used for non-invasive study of cerebrospinal fluid (CSF) flow in the cerebral aqueduct, for indirect calculation of supratentorial CSF production, and for measurement of blood flow in the superior sagittal sinus (SSS......, the MRI measurements suggested CSF hypersecretion in three patients, whereas increased transependymal passage of CSF could have been the cause of negative calculated CSF production rates in two others. A tendency towards lower mean blood flow in the SSS (mean 345 ml/min) in the patients than...

Treatment and post-treatment effects of functional therapy on the sagittal pharyngeal dimensions in Class II subjects.

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Pavoni, Chiara; Cretella Lombardo, Elisabetta; Franchi, Lorenzo; Lione, Roberta; Cozza, Paola

2017-10-01

To evaluate the craniofacial changes induced by functional appliances with special regard to the oro and nasopharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions when compared with an untreated Class II control group immediately after therapy and at long-term observation. A group of 40 patients (21 females and 19 males) with Class II malocclusion treated consecutively either with a Bionator or an Activator followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.4 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation at the end of growth (mean age: 18.2 ± 2.1 years). Statistical comparisons were performed with independent sample t tests at T1 (baseline characteristics) and for the T1-T2, T2-T3, and T1-T3 changes. During active treatment the treated group showed a significant increment in lower airway dimension (PNS-AD1), as well as a significant improvement in the upper airway dimension (PNS-AD2). A significant decrease in the upper adenoid size (AD2-H) was also found. In the longterm evaluation, a significant increase in both lower and upper airway thickness (PNS-AD1; PNS-AD2) and a significant decrease in the upper adenoid thickness were still present in the treated group. The treatment with functional appliances produced significant favorable changes during active treatment in the oro- and nasopharyngeal sagittal airway dimensions in dentoskeletal Class II subjects when compared with untreated controls, and these changes were stable in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.

The role of intraoperative positioning of the inferior alveolar nerve on postoperative paresthesia after bilateral sagittal split osteotomy of the mandible: prospective clinical study

Czech Academy of Sciences Publication Activity Database

Hanzelka, T.; Foltán, R.; Pavlíková, G.; Horká, E.; Šedý, Jiří

2011-01-01

Roč. 40, č. 9 (2011), s. 901-906 ISSN 0901-5027 R&D Projects: GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant - others:GA MŠk(CZ) 1M0538 Program:1M Institutional research plan: CEZ:AV0Z50390703 Keywords : orthognathic surgery * paresthesia * bilateral sagittal split osteotomy Subject RIV: FJ - Surgery incl. Transplants; FH - Neurology (UEM-P) Impact factor: 1.506, year: 2011

Interpolated sagittal and coronal reconstruction of CT images in the screening of neck abnormalities

International Nuclear Information System (INIS)

Koga, Issei

1983-01-01

Recontructed sagittal and coronal images were analyzed for their usefulness during clinical applications and to determine the correct use of recontruction techniques. Recontructed stereoscopic images can be formed by continuous or interrupted image reconstruction using interpolation. This study showed that lesions less than 10 mm in diameter should be made continuously and recontructed with uninterrupted technique. However, 5 mm interrupted distances are acceptable for interpolated reconstruction except in cases of lesions less than 10 mm in diameter. Clinically, interpolated reconstruction is not adequated for semicircular lesions less than 10 mm. Blood vessels and linear lesions are good condiated for the application of interpolated recontruction. Reconstruction of images using interrupted interpolation is therefore recommended for screening and for demonstrating correct stereoscopic information, except cases of small lesions less than 10 mm in diameter. Results of this study underscore the fact that obscure information in transverse CT images should be routinely utilized by interporating recontruction techniques, if transverse images are not made continuously. Interpolated recontruction may be helpful in obtaining stereoscopic information. (author)

Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy.

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Aarabi, Mohammadali; Tabrizi, Reza; Hekmat, Mina; Shahidi, Shoaleh; Puzesh, Ayatollah

2014-12-01

A bad split is a troublesome complication of the sagittal split osteotomy (SSO). The aim of this study was to evaluate the relation between the occurrence of a bad split and mandibular anatomy in SSO using cone-beam computed tomography. The authors designed a cohort retrospective study. Forty-eight patients (96 SSO sites) were studied. The buccolingual thickness of the retromandibular area (BLR), the buccolingual thickness of the ramus at the level of the lingula (BLTR), the height of the mandible from the alveolar crest to the inferior border of the mandible, (ACIB), the distance between the sigmoid notch and the inferior border of the mandible (SIBM), and the anteroposterior width of the ramus (APWR) were measured. The independent t test was applied to compare anatomic measurements between the group with and the group without bad splits. The receiver operating characteristic (ROC) test was used to find a cutoff point in anatomic size for various parts of the mandible related to the occurrence of bad splits. The mean SIBM was 47.05±6.33 mm in group 1 (with bad splits) versus 40.66±2.44 mm in group 2 (without bad splits; P=.01). The mean BLTR was 5.74±1.11 mm in group 1 versus 3.19±0.55 mm in group 2 (P=.04). The mean BLR was 14.98±2.78 mm in group 1 versus 11.21±1.29 mm in group 2 (P=.001). No statistically significant difference was found for APWR and ACIB between the 2 groups. The ROC test showed cutoff points of 10.17 mm for BLR, 36.69 mm for SIBM, and 4.06 mm for BLTR. This study showed that certain mandibular anatomic differences can increase the risk of a bad split during SSO surgery. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Posterior sagittal anorectoplasty in vestibular fistula: with or without colostomy.

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Karakus, Suleyman Cuneyt; User, Idil Rana; Akcaer, Vedat; Ceylan, Haluk; Ozokutan, Bulent Hayri

2017-07-01

The aim of this study is to compare the results and complications of one- and three-stage repairs in females with vestibular fistula (VF) and make contribution to the discussion of whether the disadvantages outweigh the protective effect of a colostomy from wound infection and wound dehiscence following posterior sagittal anorectoplasty (PSARP). Patients with a diagnosis of VF who underwent PSARP between October 2009 and November 2015 were retrospectively reviewed. The patients were divided into two groups: Group 1-patients treated by one-stage procedure (n = 30); Group 2-patients treated by three-stage procedure (n = 16). There were no statistically significant differences between the groups with respect to wound infection, recurrence of fistula and rectal mucosal prolapse. Minor wound dehiscence occurred slightly more common in Group 1, even if p value is not significant. No wound dehiscence has been observed since we switched to the protocol of keeping the child nil per oral for 5 postoperative days and loperamide (0.1 mg/kg) administration for 7 postoperative days. The mean time before resuming oral intake was 2.87 ± 1.7 and 1.19 ± 0.4 days in Group 1 and Group 2, respectively (p = 0.001). None developed major wound disruption or anal stenosis in either group. There were no statistical differences between the groups in terms of voluntary bowel movements, soiling and constipation. PSARP performed without a protective colostomy in patients with VF has low morbidity, good continence rates and obvious advantages for both the patients and their parents.

Osteosynthesis techniques used for mandibular sagittal split osteotomy – history of orthognathic procedures and modern practice.

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Nowak, Rafał; Trybek, Grzegorz

Choosing an appropriate fixation technique after maxillary or mandibular osteotomy is one of the key factors affecting the success of orthognathic surgery. In line with the development of new surgical methods and techniques, the surgeons’ approach to the fixation of bone fragments has evolved accordingly, varying from non-fusion to different osteosynthesis techniques. Advances in medical sciences and medical technologies, have changed our attitudes to bone fragment reduction in orthopaedics and traumatology, and also in maxillofacial surgery. The pivotal underlying principle which determines bone healing – that is proper positioning so as to ensure appropriate contact area and immobilisation so as to ensure osteosynthesis – has remained unchanged for centuries. However, over the years, patient comfort and the predictability of treatment outcomes have vastly improved. The paper provides an overview of the techniques and methods used for the fixation of osteotomized fragments after bilateral sagittal split osteotomy since its introduction by Hugo Obwegeser up to the present day.

Surgical treatment on displaced and dislocated sagittal fractures of the mandibular condyle.

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Jing, Jie; Han, Yu; Song, Yu; Wan, Yingbiao

2011-06-01

The purpose of this study was to evaluate the effect of surgical treatment on displaced and dislocated sagittal fractures of the mandibular condyle (SFMC). Twenty-four patients with 28 displaced and dislocated SFMCs were distinguished into type M, type C, and type L fractures according the location of the fracture line. The fractured fragment was reduced and fixated with two 0.6-mm 4-hole micro-plates via a preauricular temporal incision. The fragment was extirpated when it was too small to be fixated. The postoperative position and profile of the fragment was examined by orthopantomogram radiograph or computed tomography (CT). The function of the temporal and zygomatic branches of the facial nerve was inspected. The occluding relation was surveyed, the interincisal distance at maximum mouth opening was measured, and the deviation from the midline during mouth opening was recorded. Twenty-three condyles (82%) suffered dislocated fractures with the condylar fragment out of the glenoid fossa. Five condyles (18%) were displaced, but not dislocated. There were 2 (7%) type M, 19 (68%) type C (3 comminuted), and 7 (25%) type L fractures (1 comminuted), respectively. Twenty-one (75%) fractured fragments received free-graft procedures with 2 micro-plates. Four (14%) fragments were reduced and fixated without being dissected free of their attachments. Three (11%) fragments were extirpated. There were no permanent facial never branch injuries. Micro-plate removal was necessary because of postoperative infection and necrosis of the fractured fragment in 1 condylar process. No other patients could be found with obvious postoperative bone resorption. The average postoperative maximum mouth opening and deviation at 6 months were improved significantly. The postoperative occlusion was good in 22 cases. Access with the preauricular incision, and the dislocated and displaced fragment can be reduced and fixated to its normal position easily. Free-graft procedure is a suitable

A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

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Paulo Alvim Borges

Full Text Available OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation.

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Köhnke, Robert; Kolk, Andreas; Kluwe, Lan; Ploder, Oliver

2017-09-01

To evaluate piezosurgery for bilateral sagittal split osteotomy (BSSO) for its duration and inferior alveolar nerve (IAN) perturbation. In this prospective randomized study, the authors evaluated 100 BSSO procedures in 50 patients. Piezoelectric (group I) and conventional (group II) osteotomies were carried out on each side of the mandible of a patient by 2 specialists. The surgeons had at least 1 year of experience using piezosurgery. The period from incision to complete splitting of the mandibular bone was recorded (ie, procedure duration). The intraoperative status (visibility and relocation) of the IAN also was recorded. The neurosensory function of the IAN was measured by the 2-point discrimination threshold and static light touch methods before surgery and postoperatively (1, 3, and 6 weeks and 6 and 12 months). Parameters were compared between the test groups by the paired t, nonparametric Wilcoxon, or χ 2 test. Intergroup comparison showed the mean duration of osteotomy was significantly shorter for group I (17 ± 6 vs 25 ± 9 minutes; P < .001). The rate of intraoperative exposures of the IAN was slightly lower for group I (68%) compared with group II (81%). However, the difference was not relevant. Neurosensory disturbance and recovery of the IAN did not differ between groups. Piezoelectric osteotomy requires considerably less time than conventional mechanical approaches, but shows no advantage in preventing neurosensory perturbation. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Control of lower incisor inclination with a completely customized lingual appliance for dentoalveolar compensation of class III malocclusion.

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Lossdörfer, Stefan; Schwestka-Polly, Rainer; Wiechmann, Dirk

2013-09-01

Bracket slots and orthodontic archwires offering high dimensional precision are needed for fully customized lingual appliances. We aimed to investigate whether high-precision appliances of this type enable dentoalveolar compensation of class III malocclusion so that lower incisor inclination at the end of treatment will closely match the anticipated situation as defined in a pretreatment setup. This retrospective study included a total of 34 consecutive patients who had worn a fully customized lingual appliance to achieve dentoalveolar compensation for class III malocclusion by intermaxillary elastics, or proximal enamel reduction, or extraction of teeth in one or both jaws. Casts fabricated at different points in time were three-dimensionally scanned to analyze how precisely the lower incisor inclinations envisioned in the setup were implemented in clinical practice. Aside from minor deviations of ±3.75°, the lower incisor inclinations were clinically implemented as planned even in patients with major sagittal discrepancies. Treatment goals predefined in a setup of dentoalveolar compensation for class III malocclusion can be very precisely achieved via a customized lingual appliance. Correct planning can prevent undesirable lingual tipping of the lower incisors. This finding should not encourage a more liberal use of dentoalveolar compensation, but it should heighten clinicians' awareness of how essential it is to sufficiently consider the individual anatomy of the dentoalveolar complex during treatment planning.

Stability of biodegradable metal (Mg-Ca-Zn alloy) screws compared with absorbable polymer and titanium screws for sagittal split ramus osteotomy of the mandible using the finite element analysis model.

Science.gov (United States)

Lee, Jee-Ho; Han, Hyung-Seop; Kim, Yu-Chan; Lee, Jin-Yong; Lee, Bu-Kyu

2017-10-01

Mg-Ca-Zn alloy has been suggested for the application of fixation materials during maxillofacial surgery. We investigated the stability of Mg-Ca-Zn alloy for clinical application during orthognathic surgery. The finite element model for the fixation of sagittal split ramus osteotomy was constructed. In the bicortical screw fixation of the mandible setback condition, the stress distributions of Mg-Ca-Za alloy, polylactic acid polymer, and titanium were evaluated using the virtual model with occlusal loading of 132 N. The deformations of the three different materials of fixation screw were observed according to masticatory force ranging from 132 to 1,000 N. When comparing the stress distribution placed on cortical bone between the polymer and magnesium alloy groups, the magnesium alloy screws could bear more stress, thereby decreasing the stress, which might be distributed to other biologic components, such as the condyle and cortical ramus of the mandible. Deformations of the screws according to functional load were minimal, and the deformation remained stability of sagittal split ramus osteotomy setback surgery. Copyright © 2017. Published by Elsevier Ltd.

Evaluation of higher brain function by MRI. Flow measurement in the superior sagittal sinus using phase contrast method

International Nuclear Information System (INIS)

Ono, Mototsugu

1997-01-01

To assess the higher brain function, flow measurement in the superior sagittal sinus (SSS) was performed noninvasively using a phase contrast MRI in 76 patients with suspicious of impaired higher brain function including dementias (senile dementia of Alzheimer type; SDAT and multi-infarct dementia; MID), strokes, and others. Thirty-one normal controls were consisted of 18 healthy volunteers and 13 patients with tension headache whose higher brain function was proved be normal. Mean flow velocity was measured in the distal portion of the SSS adjoining to the occipital lobes and was multiplied by cross-sectional area of the SSS at the measuring point to obtain mean flow volume. For intellectual index, cross-cultural cognitive examination (CCCE) was applied to all cases excluding volunteers. Normal value of SSS flow volume measured by MRI was 6.92±0.66 ml/s. Significant differences in both SSS flow and CCCE score from normal controls were found in SDAT group, MID group, and non-dementia group. No substantial differences between SDAT group and MID group were noted in both CCCE score and SSS flow. In normal controls, there was no correlation between SSS flow and age, whereas, significant inverse correlation of SSS flow with age was found in all cases. Between CCCE score and SSS flow, there were nearly linear relationships in all cases, SDAT group, MID group, and non-dementia group. Significant but relatively poor correlation was found in normals. (K.H.)

Effects of altered sagittal trunk orientation on kinetic pattern in able-bodied walking on uneven ground

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Soran Aminiaghdam

2017-07-01

Full Text Available Studies of disturbed human locomotion often focus on the dynamics of the gait when either posture, movement or surface is perturbed. Yet, the interaction effects of variation of trunk posture and ground level on kinetic behaviour of able-bodied gait have not been explored. For 12 participants we investigated the kinetic behaviour, as well as velocity and contact time, across four steps including an unperturbed step on level ground, pre-perturbation, perturbation (10-cm drop and post-perturbation steps while walking with normal speed with four postures: regular erect, with 30°, 50° and maximal sagittal trunk flexion (70°. Two-way repeated measures ANOVAs detected significant interactions of posture×step for the second peak of the vertical ground reaction force (GRF, propulsive impulse, contact time and velocity. An increased trunk flexion was associated with a systematic decrease of the second GRF peak during all steps and with a decreased contact time and an increased velocity across steps, except for the perturbation step. Pre-adaptations were more pronounced in the approach step to the drop in regular erect gait. With increased trunk flexion, walking on uneven ground exhibited reduced changes in GRF kinetic parameters relative to upright walking. It seems that in trunk-flexed gaits the trunk is used in a compensatory way during the step-down to accommodate changes in ground level by adjusting its angle leading to lower variations in centre of mass height. Exploitation of this mechanism resembles the ability of small birds in adjusting their zig-zag-like configured legs to cope with changes in ground level.

Intrinsic and Extrinsic Contributions to Seated Balance in the Sagittal and Coronal Planes: Implications for Trunk Control After Spinal Cord Injury.

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Audu, Musa L; Triolo, Ronald J

2015-08-01

The contributions of intrinsic (passive) and extrinsic (active) properties of the human trunk, in terms of the simultaneous actions about the hip and spinal joints, to the control of sagittal and coronal seated balance were examined. Able-bodied (ABD) and spinal-cord-injured (SCI) volunteers sat on a moving platform which underwent small amplitude perturbations in the anterior-posterior (AP) and medial-lateral (ML) directions while changes to trunk orientation were measured. A linear parametric model that related platform movement to trunk angle was fit to the experimental data by identifying model parameters in the time domain. The results showed that spinal cord injury leads to a systematic reduction in the extrinsic characteristics, while most of the intrinsic characteristics were rarely affected. In both SCI and ABD individuals, passive characteristics alone were not enough to maintain seated balance. Passive stiffness in the ML direction was almost 3 times that in the AP direction, making more extrinsic mechanisms necessary for balance in the latter direction. Proportional and derivative terms of the extrinsic model made the largest contribution to the overall output from the active system, implying that a simple proportional plus derivative (PD) controller structure will suffice for restoring seated balance after spinal cord injury.

Relationship between flexion contractures of the joints of the lower extremities and the sagittal profile of the spine in patients with cerebral palsy: a preliminary report

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Valery V. Umnov

2016-11-01

Full Text Available Background. The considerable incidence of kyphosis in patients with cerebral palsy (CP causes back pain and aggravates movement disorders. However, few studies have investigated the pathogenesis of this condition. Aim. To identify the relationship between patient motor abilities, the severity of flexion contractures of the knee and hip joints and spinal sagittal profile changes, and the impact on the latter by surgical correction of flexion contracture of the knee joint. Material and methods. The study cohort included 17 pediatric CP patients (11 boys and 6 girls with a mean age of 13.1 ± 1.3 (range, 10–16 years and level 2–4 spastic diplegia according to the Gross Motor Function Classification System. The relationship between radiological indicators of the spine sagittal profile and motor abilities of children, as well as the severity of flexion contractures at the hip and knee, and the degree of insufficiency of the active extension of the knee were investigated. Of these 17 patients, 12 underwent surgery to correct flexion contracture of the knee, which involved lengthening of leg flexors, to analyze the impact of contracture on the sagittal profile of the spine. The following radiological indicators were assessed: angle of thoracic kyphosis (CC, lordosis angle (UL of the lumbar spine, and sacral inclination angle (SS. The study included patients with a CC of at least 30°. Results. Results of an X-ray study showed that the severity of kyphosis was 50.7° ± 2.1°, lordosis was 30.3° ± 4.3°, and SS was 30.5° ± 3.3°. There was a significant association between kyphosis and flexion contracture of the knee joint, as well as between lordosis and insufficient active extension of the knee joint. After elimination of the flexion contracture of the knee, the degree of severity of the CC (thoracic kyphosis was unchanged, while UL (lordosis angle and SS (sacral inclination angle increased by approximately 10°. Conclusion. The severity of

Reliability and reproducibility analysis of the Cobb angle and assessing sagittal plane by computer-assisted and manual measurement tools.

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Wu, Weifei; Liang, Jie; Du, Yuanli; Tan, Xiaoyi; Xiang, Xuanping; Wang, Wanhong; Ru, Neng; Le, Jinbo

2014-02-06

Although many studies on reliability and reproducibility of measurement have been performed on coronal Cobb angle, few results about reliability and reproducibility are reported on sagittal alignment measurement including the pelvis. We usually use SurgimapSpine software to measure the Cobb angle in our studies; however, there are no reports till date on its reliability and reproducible measurements. Sixty-eight standard standing posteroanterior whole-spine radiographs were reviewed. Three examiners carried out the measurements independently under the settings of manual measurement on X-ray radiographies and SurgimapSpine software on the computer. Parameters measured included pelvic incidence, sacral slope, pelvic tilt, Lumbar lordosis (LL), thoracic kyphosis, and coronal Cobb angle. SPSS 16.0 software was used for statistical analyses. The means, standard deviations, intraclass and interclass correlation coefficient (ICC), and 95% confidence intervals (CI) were calculated. There was no notable difference between the two tools (P = 0.21) for the coronal Cobb angle. In the sagittal plane parameters, the ICC of intraobserver reliability for the manual measures varied from 0.65 (T2-T5 angle) to 0.95 (LL angle). Further, for SurgimapSpine tool, the ICC ranged from 0.75 to 0.98. No significant difference in intraobserver reliability was found between the two measurements (P > 0.05). As for the interobserver reliability, measurements with SurgimapSpine tool had better ICC (0.71 to 0.98 vs 0.59 to 0.96) and Pearson's coefficient (0.76 to 0.99 vs 0.60 to 0.97). The reliability of SurgimapSpine measures was significantly higher in all parameters except for the coronal Cobb angle where the difference was not significant (P > 0.05). Although the differences between the two methods are very small, the results of this study indicate that the SurgimapSpine measurement is an equivalent measuring tool to the traditional manual in coronal Cobb angle, but is advantageous in spino

Progression of spinal deformity in wheelchair-dependent patients with Duchenne muscular dystrophy who are not treated with steroids: coronal plane (scoliosis) and sagittal plane (kyphosis, lordosis) deformity.

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Shapiro, F; Zurakowski, D; Bui, T; Darras, B T

2014-01-01

We determined the frequency, rate and extent of development of scoliosis (coronal plane deformity) in wheelchair-dependent patients with Duchenne muscular dystrophy (DMD) who were not receiving steroid treatment. We also assessed kyphosis and lordosis (sagittal plane deformity). The extent of scoliosis was assessed on sitting anteroposterior (AP) spinal radiographs in 88 consecutive non-ambulatory patients with DMD. Radiographs were studied from the time the patients became wheelchair-dependent until the time of spinal fusion, or the latest assessment if surgery was not undertaken. Progression was estimated using a longitudinal mixed-model regression analysis to handle repeated measurements. Scoliosis ≥ 10° occurred in 85 of 88 patients (97%), ≥ 20° in 78 of 88 (89%) and ≥ 30° in 66 of 88 patients (75%). The fitted longitudinal model revealed that time in a wheelchair was a highly significant predictor of the magnitude of the curve, independent of the age of the patient (p lordosis (16 (27%) abnormal and seven (11%) normal). This study provides a baseline to assess the effects of steroids and other forms of treatment on the natural history of scoliosis in patients with DMD, and an approach to assessing spinal deformity in the coronal and sagittal planes in wheelchair-dependent patients with other neuromuscular disorders.

A morphometric investigation on breed-specific features affecting sagittal rotational and lateral bending mobility in the canine cervical spine (c3-c7).

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Breit, S; Künzel, W

2004-08-01

Vertebral and inter-vertebral parameters obtained in large breeds (n = 74), small breeds (n = 35), and Dachshunds (n = 30) were compared to reveal potential differences in the range of motion of the cervical spine between these three groups of breeds. Body size normalized dimensions of vertebral and inter-vertebral parameters and correlations between these indicate large canine breeds to have a tendency towards higher range of motion in sagittal rotation and lateral bending compared with Dachshunds and small breeds. Higher mobility in large breeds is based on significantly (P inter-vertebral discs, wider but shorter cranial and caudal articular surfaces, larger differences in width between caudal and cranial joining facets (compared with Dachshunds from C3/4 to C6/7, compared with small breeds from C4/5 to C5/6), and larger differences in length between caudal and cranial joining facets. Large differences in width between caudal and cranial joining facets were associated with small distances between the most medial (C3/4 to C6/7) and lateral (C3/4 to C5/6) aspects of the articular surfaces as well as with small differences in length between caudal and cranial joining facets (C3/4 to C5/6). This suggests that from C3/4 to C5/6 a higher range of motion in lateral bending is coupled to a lower range of motion in sagittal rotation. The present findings contribute also to explain the higher incidence of degenerative lesions of the cervical spine in large dogs.

Reliability of sagittal plane hip, knee, and ankle joint angles from a single frame of video data using the GAITRite camera system.

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Ross, Sandy A; Rice, Clinton; Von Behren, Kristyn; Meyer, April; Alexander, Rachel; Murfin, Scott

2015-01-01

The purpose of this study was to establish intra-rater, intra-session, and inter-rater, reliability of sagittal plane hip, knee, and ankle angles with and without reflective markers using the GAITRite walkway and single video camera between student physical therapists and an experienced physical therapist. This study included thirty-two healthy participants age 20-59, stratified by age and gender. Participants performed three successful walks with and without markers applied to anatomical landmarks. GAITRite software was used to digitize sagittal hip, knee, and ankle angles at two phases of gait: (1) initial contact; and (2) mid-stance. Intra-rater reliability was more consistent for the experienced physical therapist, regardless of joint or phase of gait. Intra-session reliability was variable, the experienced physical therapist showed moderate to high reliability (intra-class correlation coefficient (ICC) = 0.50-0.89) and the student physical therapist showed very poor to high reliability (ICC = 0.07-0.85). Inter-rater reliability was highest during mid-stance at the knee with markers (ICC = 0.86) and lowest during mid-stance at the hip without markers (ICC = 0.25). Reliability of a single camera system, especially at the knee joint shows promise. Depending on the specific type of reliability, error can be attributed to the testers (e.g. lack of digitization practice and marker placement), participants (e.g. loose fitting clothing) and camera systems (e.g. frame rate and resolution). However, until the camera technology can be upgraded to a higher frame rate and resolution, and the software can be linked to the GAITRite walkway, the clinical utility for pre/post measures is limited.

Bony contact area and displacement of the temporomandibular joint after high-oblique and bilateral sagittal split osteotomy: a computer-simulated comparison.

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Möhlhenrich, Stephan Christian; Kamal, Mohammad; Peters, Florian; Fritz, Ulrike; Hölzle, Frank; Modabber, Ali

2016-04-01

The most common way to move the mandible during orthognathic surgery is by bilateral sagittal split osteotomy (BSSO). The high-oblique sagittal split osteotomy (HSSO) is an alternative, although its use is limited by potential complications, mainly to do with the position of the condyle and reduced contact with bone. The aim of this study was to find out the optimal intercondylar distance and area of contact with the surface of the bone for mandibular advancement and setback in BSSO and HSSO. Data from computed tomographic (CT) images from 40 patients were loaded into special planning software, and virtual operations done for mandibular advancement and setback at 3, 5, 8, and 10mm using BSSO and HSSO, which resulted in 640 individual mandibular displacements. The resultant area of bony contact and intercondylar distance were calculated by the software. The mean (SD) areas of contact with the bony surface after 10mm advancement for HSSO and BSSO were 193.94 (63.76) mm(2) and 967.92 (229.21) mm(2), respectively, and after 10mm setback 202.64 (62.30) mm(2) and 1108.86 (247.38) mm(2). The mean corresponding intercondylar distance after maximum advancement were 86.76 (6.40) mm and 86.59 (6.24) mm, and after maximum setback 74.90 (5.73) mm and 73.06 (6.06) mm. There were significant differences between the two for the area of contact with the surface at each displacement distance (parea of bony contact can be expected at any displacement distance for BSSO, so the changes in intercondylar distance should not be considered when deciding which osteotomy to select. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Reliable sagittal plane kinematic gait assessments are feasible using low-cost webcam technology.

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Saner, Robert J; Washabaugh, Edward P; Krishnan, Chandramouli

2017-07-01

Three-dimensional (3-D) motion capture systems are commonly used for gait analysis because they provide reliable and accurate measurements. However, the downside of this approach is that it is expensive and requires technical expertise; thus making it less feasible in the clinic. To address this limitation, we recently developed and validated (using a high-precision walking robot) a low-cost, two-dimensional (2-D) real-time motion tracking approach using a simple webcam and LabVIEW Vision Assistant. The purpose of this study was to establish the repeatability and minimal detectable change values of hip and knee sagittal plane gait kinematics recorded using this system. Twenty-one healthy subjects underwent two kinematic assessments while walking on a treadmill at a range of gait velocities. Intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values were calculated for commonly used hip and knee kinematic parameters to demonstrate the reliability of the system. Additionally, Bland-Altman plots were generated to examine the agreement between the measurements recorded on two different days. The system demonstrated good to excellent reliability (ICC>0.75) for all the gait parameters tested on this study. The MDC values were typically low (gait assessments using webcam technology can be reliably used for clinical and research purposes. Copyright © 2017 Elsevier B.V. All rights reserved.

Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

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Yasuhiro Homma

2014-01-01

Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

Koreksi gigitan terbalik posterior dan anterior dengan alat cekat rapid maxillary expansion dan elastik intermaksila

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Retno Dewati

2014-06-01

Full Text Available Background: Children with anterior and posterior crossbite usually have a complaint in aesthetic and masticatory function. It could caused by bad habits and hereditary factors which made worse condition. Purpose: The purpose of this case report was to report the use of orthodontic appliance rapid maxillary expansion (RPE and intermaxillary elastic to correct posterior and anterior crossbite in teenage patient. Case: A fourteen years-old teenage female patient came to Dental Hospital Dentistry Universitas Airlangga with case of anterior posterior cross bite and unerupted permanent teeth. Case management: The case was treated using orthodontic fixed appliance rapid maxillary expansion (RPE and followed by intermaxillary elastics. The posterior cross bite treatment took 4 weeks used of orthodontic fixed appliance RPE, while, treatment of anterior cross bite which used intermaxillary elactic was done within three month to achieved normal occlusion. Conclusion: This case report showed that the orthodontic appliance rapid maxillary expansion (RPE and intermaxillary elastic could be used to correct posterior and anterior crossbite.Latar belakang: Anak dengan gigitan terbalik anterior dan posterior pada umumnya mempunyai keluhan dalam hal estetik dan fungsi pengunyahan. Kondisi gigitan terbalik biasanya disebabkan oleh adanya kebiasaan buruk dan faktor keturunan yang semakin memperparah keadaan tersebut. Tujuan: Laporan kasus ini melaporkan pemakaian alat cekat rapid maxillary expansion (RPE dan elastik intermaksila untuk mengkoreksi gigitan terbalik posterior dan anterior pada anak remaja. Kasus: Pasien remaja perempuan berusia 14 tahun datang ke Rumah Sakit Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Airlangga Surabaya dengan kasus gigitan terbalik anterior posterior dan terdapat gigi permanen yang tidak tumbuh. Tatalaksana kasus: Perawatan yang dilakukan adalah koreksi gigitan terbalik dengan menggunakan alat ortodonsia cekat rapid maxillary

Assessing delay and lag in sagittal trunk control using a tracking task.

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Reeves, N Peter; Luis, Abraham; Chan, Elizabeth C; Sal Y Rosas, Victor G; Tanaka, Martin L

2018-05-17

Slower trunk muscle responses are linked to back pain and injury. Unfortunately, clinical assessments of spine function do not objectively evaluate this important attribute, which reflects speed of trunk control. Speed of trunk control can be parsed into two components: (1) delay, the time it takes to initiate a movement, and (2) lag, the time it takes to execute a movement once initiated. The goal of this study is to demonstrate a new approach to assess delay and lag in trunk control using a simple tracking task. Ten healthy subjects performed four blocks of six trials of trunk tracking in the sagittal plane. Delay and lag were estimated by modeling trunk control for predictable and unpredictable (control mode) trunk movements in flexion and extension (control direction) at movement amplitudes of 2°, 4°, and 6° (control amplitude). The main effect of control mode, direction, and amplitude of movement were compared between trial blocks to assess secondary influencers (e.g., fatigue). Only control mode was consistent across trial blocks with predictable movements being faster than unpredictable for both delay and lag. Control direction and amplitude effects on delay and lag were consistent across the first two trial blocks and less consistent in later blocks. Given the heterogeneity in the presentation of back pain, clinical assessment of trunk control should include different control modes, directions, and amplitudes. To reduce testing time and the influence of fatigue, we recommend six trials to assess trunk control. Copyright © 2018 Elsevier Ltd. All rights reserved.

Global tilt and lumbar lordosis index: two parameters correlating with health-related quality of life scores-but how do they truly impact disability?

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Boissière, Louis; Takemoto, Mitsuru; Bourghli, Anouar; Vital, Jean-Marc; Pellisé, Ferran; Alanay, Ahmet; Yilgor, Caglar; Acaroglu, Emre; Perez-Grueso, Francisco Javier; Kleinstück, Frank; Obeid, Ibrahim

2017-04-01

Many radiological parameters have been reported to correlate with patient's disability including sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL). European literature reports other parameters such as lumbar lordosis index (LLI) and the global tilt (GT). If most parameters correlate with health-related quality of life scores (HRQLs), their impact on disability remains unclear. This study aimed to validate these parameters by investigating their correlation with HRQLs. It also aimed to evaluate the relationship between each of these sagittal parameters and HRQLs to fully understand the impact in adult spinal deformity management. A retrospective review of a multicenter, prospective database was carried out. The database inclusion criteria were adults (>18 years old) presenting any of the following radiographic parameters: scoliosis (Cobb ≥20°), SVA ≥5 cm, thoracic kyphosis ≥60° or PT ≥25°. All patients with complete data at baseline were included. Health-related quality of life scores, demographic variables (DVs), and radiographic parameters were collected at baseline. Differences in HRQLs among groups of each DV were assessed with analyses of variance. Correlations between radiographic variables and HRQLs were assessed using the Spearman rank correlation. Multivariate linear regression models were fitted for each of the HRQLs (Oswestry Disability Index [ODI], Scoliosis Research Society-22 subtotal score, or physical component summaries) with sagittal parameters and covariants as independent variables. A p<.05 value was considered statistically significant. Among a total of 755 included patients (mean age, 52.1 years), 431 were non-surgical candidates and 324 were surgical candidates. Global tilt and LLI significantly correlated with HRQLs (r=0.4 and -0.3, respectively) for univariate analysis. Demographic variables such as age, gender, body mass index, past surgery, and surgical or non-surgical candidate

Pneumatized articular eminence in a cohort of orthodontic patients with different sagittal skeletal anomalies. A retrospective cone beam computed tomography study

International Nuclear Information System (INIS)

Miloglu, O.; Celikoglu, M.; Yildirim, E.; Yilmaz, A.B.; Demirtas, O.

2010-01-01

The aim of this study was to determine the prevalence and characteristics of pneumatized articular eminence (PAE) in dental patients using cone beam computed tomography (CBCT) with respect to age, sex, and type of skeletal anomaly. The results were then compared to prevalence studies regarding PAE in the literature. A retrospective study of 603 orthodontic patients aged between 6 and 24 years was performed using sagittal and coronal CBCT images at the Department of Oral and Maxillofacial Radiology (Erzurum, Turkey). The age, gender, skeletal anomaly, and lateral were recorded for all patients, and the types were noted for cases of PAE. The chi-squared test was used for statistical analyses. Sixty-four PAEs were found in 39 orthodontic patients, representing a prevalence of 6.47%. No significant differences in sex (p=0.153), age (before and after puberty, p=0.389), and type of skeletal anomaly were observed (p=0.271). A higher frequency of PAE was detected among dental patients aged 6-24 years when compared to previous studies, most likely because of the use of CBCT images. No significant relation was observed between PAE and the type of skeletal anomalies. One, however, must be aware of these structures to avoid complications in cases for which surgical treatment is planned due to the occlusion and recognize its role in the onset or perpetuation of temporomandibular joint dysfunction. (author)

Pediatric mandibular fractures: a free hand technique.

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Davison, S P; Clifton, M S; Davison, M N; Hedrick, M; Sotereanos, G

2001-01-01

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition. To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues. A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.). Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did. We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

Effects of mid-foot contact area ratio on lower body kinetics/kinematics in sagittal plane during stair descent in women.

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Lee, Jinkyu; Hong, Yoon No Gregory; Shin, Choongsoo S

2016-07-01

The mid-foot contact area relative to the total foot contact area can facilitate foot arch structure evaluation. A stair descent motion consistently provides initial fore-foot contact and utilizes the foot arch more actively for energy absorption. The purpose of this study was to compare ankle and knee joint angle, moment, and work in sagittal plane during stair descending between low and high Mid-Foot-Contact-Area (MFCA) ratio group. The twenty-two female subjects were tested and classified into two groups (high MFCA and low MFCA) using their static MFCA ratios. The ground reaction force (GRF) and kinematics of ankle and knee joints were measured while stair descending. During the period between initial contact and the first peak in vertical GRF (early absorption phase), ankle negative work for the low MFCA ratio group was 33% higher than that for the high MFCA ratio group (pcontact and peak dorsiflexion angle (early absorption phase+late absorption phase). The peak ankle dorsiflexion angle was smaller in the low MFCA ratio group (p<0.05). Our results suggest that strategy of energy absorption at the ankle and foot differs depending upon foot arch types classified by MFCA. The low MFCA ratio group seemed to absorb more impact energy using strain in the planar fascia during early absorption phase, whereas the high MFCA ratio group absorbed more impact energy using increased dorsiflexion during late absorption phase. Copyright © 2016 Elsevier B.V. All rights reserved.

Comparing preseason frontal and sagittal plane plyometric programs on vertical jump height in high-school basketball players.

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King, Jeffrey A; Cipriani, Daniel J

2010-08-01

The primary purpose of this study was to evaluate whether frontal plane (FP) plyometrics, which are defined as plyometrics dominated with a lateral component, would produce similar increases in vertical jump height (VJH) compared to sagittal plane (SP) Plyometrics. Thirty-two junior varsity and varsity high-school basketball players participated in 6 weeks of plyometric training. Players participated in either FP or SP plyometrics for the entire study. Vertical jump height was measured on 3 occasions: preintervention (baseline), at week 3 of preparatory training, and at week 6 of training. Descriptive statistics were calculated for VJH. A 2-way analysis of variance (ANOVA) with repeated measures was used to test the difference in mean vertical jump scores using FP and SP training modalities. Results showed a significant effect over time for vertical jump (p training did not have a significant effect on VJH and significant improvement in VJH was seen in subjects participating in SP plyometrics thus reinforcing the specificity principle of training. However, coaches should implement both types of plyometrics because both training modalities can improve power and quickness among basketball players.

Does Knee Osteoarthritis Differentially Modulate Proprioceptive Acuity in the Frontal and Sagittal Planes of the Knee?

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Cammarata, Martha L; Schnitzer, Thomas J; Dhaher, Yasin Y

2012-01-01

Objective Impaired proprioception may alter joint loading and contribute to the progression of knee osteoarthritis (OA). Though frontal plane loading at the knee contributes to OA, proprioception and its modulation with OA in this direction have not been examined. The aim of this study was to assess knee proprioceptive acuity in the frontal and sagittal planes in knee OA and healthy participants. We hypothesized that proprioceptive acuity will be decreased in the OA population in both planes of movement. Methods Thirteen persons with knee OA and fourteen healthy age-matched subjects participated. Proprioceptive acuity was assessed in varus, valgus, flexion, and extension using the threshold to detection of passive movement (TDPM). Repeated measures analysis of variance was used to assess differences in TDPM between subject groups and across movement directions. Linear regression analyses were performed to assess the correlation of TDPM between and within planes of movement. Results TDPM was found to be significantly higher (Pplanes of movement were only weakly correlated, especially in the OA group. Conclusions Consistent differences in TDPM between the OA and control groups across all movement directions suggest a global, not direction-specific, reduction in sensation in knee OA patients. PMID:21547895

PROXIMAL JUNCTIONAL KYPHOSIS IN ADULT RECONSTRUCTIVE SPINE SURGERY RESULTS FROM INCOMPLETE RESTORATION OF THE LUMBAR LORDOSIS RELATIVE TO THE MAGNITUDE OF THE THORACIC KYPHOSIS

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Mendoza-Lattes, Sergio; Ries, Zachary; Gao, Yubo; Weinstein, Stuart L

2011-01-01

Proximal junctional kyphosis developed in those patients where the thoracic kyphosis remained greater in magnitude relative to the lumbar lordosis, and where the sagittal balance seemed corrected, but part of thise correction was secondary to pelvic retroversion. Level of Evidence Prognostic case-control study – Level III. PMID:22096442

Neonatal posterior sagittal anorectoplasty for a subset of males with high anorectal malformations

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Nilesh G Nagdeve

2011-01-01

Full Text Available Aim: To assess the results of primary posterior sagittal anorectoplasty (PSARP in male neonates with high anorectal malformations (ARM who on invertogram showed well descended rectum. Materials and Methods: Twelve full-term male neonates with high ARM over a period of one and half years were selected for primary PSARP based on the findings of invertogram. Primary PSARP was performed in all neonates with lower limit of rectal gas bubble at or below the ossified fifth sacral vertebra. The patients were followed-up for a period between three to four and half years. The clinical evaluation of fecal continence was performed using Pena′s criteria for assessment of continence. Results: All neonates underwent PSARP on second to fourth postnatal day. The fistula with urinary tract was found in 11 patients (seven had fistula to bulbar urethra and four to prostatic urethra. Rectal tapering was not required in any neonate. No patient had urinary problems after removal of catheter. Most of the neonates were discharged by ninth day. Postoperatively, two patients had superficial wound infection of anoplasty without any disruption or bowel retraction. Two patients had severe perianal excoriation. No patient had anorectal stenosis. Nine of twelve patients on follow-up had good voluntary bowel movements. Of the three patients who had grade I soiling two had recto-prostatic urethral fistula. No patient had constipation. All patients had good urinary stream. Conclusions: Repair of high ARM in male neonates with a well descended rectum is feasible without significant morbidity and good continence.

Topography of the inferior alveolar nerve in relation to cystic processes of the mandible in dental MRI

International Nuclear Information System (INIS)

Kress, B.; Stippich, C.; Sartor, K.

2003-01-01

Purpose: Cystic processes are changing the course of the inferior alveolar nerve in the mandible. This study evaluates the possibility of demonstrating the relationship between space-occupying processes and the course of the neurovascular bundle. Materials and Methods: Thirteen patients with cystic processes in the mandible (9 keratocystic lesions, 1 eosinophilic granuloma, 1 plasmocytoma, 2 adamantinomas) were examined by MRI (1.5-T magnet, 8-cm surface coil, PD-gradient-echo-sequences in sagittal and coronal orientation, without enhancement) and the results retrospectively evaluated. Results: The entire course of the nerve could be delineated in all patients. In six patients with minor cystic processes, the nerve was identified in both sagittal and coronal orientation. In seven patients with major cystic lesions, only parts of the nerve were detected in either image orientation, but the nerve could be visualized in its entire length by evaluating coronal and sagittal images side by side. Conclusion: It is possible to delineate the inferior alveolar nerve in its entirety along pathologic mandibular lesions. For large cystic lesions, this requires the evaluation of both coronal and sagittal sections of multidirectional MRI. (orig.) [de

The dural entrance of cerebral bridging veins into the superior sagittal sinus: an anatomical comparison between cadavers and digital subtraction angiography

International Nuclear Information System (INIS)

Han, Hui; Tao, Wei; Zhang, Ming

2007-01-01

Intracranial venous structures have received increasing attention due to improved neuroimaging techniques and increased awareness of cerebral venous disease. To date, few studies have attempted to investigate the dural entrance of the cerebral bridging vein (BV). The aim of this study was to use the superior sagittal sinus (SSS) as an example to identify anatomical features of the dural entrance of the BVs into the SSS in both human cadavers and digital subtraction angiography (DSA) images. A total of 30 adult and 7 fetal human cadavers and 36 patients were examined with anatomical dissections, vascular casting and DSA. The number, diameter and angle of the BVs entering the SSS were measured and compared between the cadavers and DSA images. The results demonstrated that (1) the way a BV entered the SSS varied in three dimensions, and thus the BV dural entrance was difficult to precisely localize by DSA, (2) the distribution pattern of the dural entrance of the BVs into the SSS was relatively constant and a nontributary segment of the SSS was centered at the coronal suture and was identifiable by DSA, and (3) nearly all the BVs (97%, 561/581) entered the SSS at an angle opposite to the direction of blood flow. Unique anatomical features of the dural entrance of a BV into the SSS should be considered in neuroimaging interpretation of the sinus and its associated veins. (orig.)

Size, shape and age-related changes of the mandibular condyle during childhood

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Karlo, Christoph A. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Stolzmann, Paul [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Habernig, Sandra; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Mueller, Lukas [University of Zurich, Clinics for Orthodontics and Paediatric Dentistry, Zurich (Switzerland); Saurenmann, Traudel [University Children' s Hospital Zurich, Department of Rheumatology, Zurich (Switzerland)

2010-10-15

To determine age-related differences in the size and shape of the mandibular condyle in children to establish anatomical reference values. A total of 420 mandibular condyles in 210 children (mean age, 7 years) were retrospectively analysed by using computed tomography (CT) imaging. The greatest left-right (LRD) and anterior-posterior (APD) diameters and the anteversion angles (AA) were measured by two readers. An APD/LRD ratio was calculated. The shape of the condyles was graded into three types on sagittal images. Correlations of parameters with the children's age were assessed by using Pearson's correlation analyses. The LRD (mean, 14.1 {+-} 2.4 mm), APD (mean, 7.3 {+-} 1.0 mm) and LRD/APD ratio (mean, 1.9 {+-} 0.3) increased (r{sub LRD} = 0.70, p < 0.01; r{sub APD} = 0.56, p < 0.01; r{sub rat} = 0.28, p < 0.01) while the AA (mean, 27 {+-} 7 ) decreased significantly (r{sub antang} = -0.26, p < 0.001) with age. The condylar shape as determined on sagittal images correlated significantly with age (r = 0.69, p < 0.05). Boys had significantly higher anteversion angles (p < 0.01), greater LRDs (p < 0.05) and greater mean ratios (p < 0.05). The mandibular condyle is subject to significant age-related changes in size and shape during childhood. As the size of the condyles increases with age, the anteversion angles decrease and the shape of the condyle turns from round to oval. (orig.)

Characterization and Management of Mandibular Fractures: Lessons Learned from Iraq and Afghanistan

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2013-03-01

interdental splints and intermaxillary fixation.4 Thomas Brian Gunning4 showed the importance of dentistry in treating these fractures by restoring occlusion...Fractures in children with developing dentitionsdAvoiding damage to the developing teeth is key. If placement of arch bars is impossible

Sagittal and Vertical Craniofacial Growth Pattern and Timing of Circumpubertal Skeletal Maturation: A Multiple Regression Study

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Giuseppe Perinetti

2016-01-01

Full Text Available The knowledge of the associations between the timing of skeletal maturation and craniofacial growth is of primary importance when planning a functional treatment for most of the skeletal malocclusions. This cross-sectional study was thus aimed at evaluating whether sagittal and vertical craniofacial growth has an association with the timing of circumpubertal skeletal maturation. A total of 320 subjects (160 females and 160 males were included in the study (mean age, 12.3±1.7 years; range, 7.6–16.7 years. These subjects were equally distributed in the circumpubertal cervical vertebral maturation (CVM stages 2 to 5. Each CVM stage group also had equal number of females and males. Multiple regression models were run for each CVM stage group to assess the significance of the association of cephalometric parameters (ANB, SN/MP, and NSBa angles with age of attainment of the corresponding CVM stage (in months. Significant associations were seen only for stage 3, where the SN/MP angle was negatively associated with age (β coefficient, −0.7. These results show that hyperdivergent and hypodivergent subjects may have an anticipated and delayed attainment of the pubertal CVM stage 3, respectively. However, such association remains of little entity and it would become clinically relevant only in extreme cases.

Sagittal and Vertical Craniofacial Growth Pattern and Timing of Circumpubertal Skeletal Maturation: A Multiple Regression Study

Science.gov (United States)

Rosso, Luigi; Riatti, Riccardo

2016-01-01

The knowledge of the associations between the timing of skeletal maturation and craniofacial growth is of primary importance when planning a functional treatment for most of the skeletal malocclusions. This cross-sectional study was thus aimed at evaluating whether sagittal and vertical craniofacial growth has an association with the timing of circumpubertal skeletal maturation. A total of 320 subjects (160 females and 160 males) were included in the study (mean age, 12.3 ± 1.7 years; range, 7.6–16.7 years). These subjects were equally distributed in the circumpubertal cervical vertebral maturation (CVM) stages 2 to 5. Each CVM stage group also had equal number of females and males. Multiple regression models were run for each CVM stage group to assess the significance of the association of cephalometric parameters (ANB, SN/MP, and NSBa angles) with age of attainment of the corresponding CVM stage (in months). Significant associations were seen only for stage 3, where the SN/MP angle was negatively associated with age (β coefficient, −0.7). These results show that hyperdivergent and hypodivergent subjects may have an anticipated and delayed attainment of the pubertal CVM stage 3, respectively. However, such association remains of little entity and it would become clinically relevant only in extreme cases. PMID:27995136

Relation of the measuring values in cephalometric radiographs and TMJ tomographs

Energy Technology Data Exchange (ETDEWEB)

Han, Jin Woo [Kangnung National Univ. College of Dentistry, Kangnung (Korea, Republic of)

2007-03-15

To examine whether the maxillofacial skeletal morphology correlates with the condylar position and the anatomic characteristics of articular eminence using measurements of lateral cephalometric radiographs and individualized sagittal temporomandibular joint (TMJ) tomographs. I compared measurements of 202 TMJs of 101 orthodontic patients of Kangnung National University Dental Hospital. I used Pearson's correlation for comparison of the measuring values in lateral cephalometric radiographs and individualized sagittal TMJ tomographs. Large occlusal plane angle tendency showed decreased width of posterior eminence slope, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large mandibular plane angle tendency showed decreased superior joint space, decreased superior joint space, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large genial angle tendency showed decreased depth of articular fossa, decreased posterior slope angle of eminence and anterior position of comdylar head. Large anterior facial height and large posterior facial height tendency showed increased width of posterior position of condylar head. Maxillofacial skeletal morphology has correlation with the anatomic characteristics of TMJ. Individualized sagittal TMJ tomographs can provide useful information for anatomical analysis of TMJ.

Observer variation in target volume delineation of lung cancer related to radiation oncologist-computer interaction: A 'Big Brother' evaluation

International Nuclear Information System (INIS)

Steenbakkers, Roel J.H.M.; Duppen, Joop C.; Fitton, Isabelle; Deurloo, Kirsten E.I.; Zijp, Lambert; Uitterhoeve, Apollonia L.J.; Rodrigus, Patrick T.R.; Kramer, Gijsbert W.P.; Bussink, Johan; Jaeger, Katrien De; Belderbos, Jose S.A.; Hart, Augustinus A.M.; Nowak, Peter J.C.M.; Herk, Marcel van; Rasch, Coen R.N.

2005-01-01

Background and purpose: To evaluate the process of target volume delineation in lung cancer for optimization of imaging, delineation protocol and delineation software. Patients and methods: Eleven radiation oncologists (observers) from five different institutions delineated the Gross Tumor Volume (GTV) including positive lymph nodes of 22 lung cancer patients (stages I-IIIB) on CT only. All radiation oncologist-computer interactions were recorded with a tool called 'Big Brother'. For each radiation oncologist and patient the following issues were analyzed: delineation time, number of delineated points and corrections, zoom levels, level and window (L/W) settings, CT slice changes, use of side windows (coronal and sagittal) and software button use. Results: The mean delineation time per GTV was 16 min (SD 10 min). The mean delineation time for lymph node positive patients was on average 3 min larger (P=0.02) than for lymph node negative patients. Many corrections (55%) were due to L/W change (e.g. delineating in mediastinum L/W and then correcting in lung L/W). For the lymph node region, a relatively large number of corrections was found (3.7 corr/cm 2 ), indicating that it was difficult to delineate lymph nodes. For the tumor-atelectasis region, a relative small number of corrections was found (1.0 corr/cm 2 ), indicating that including or excluding atelectasis into the GTV was a clinical decision. Inappropriate use of L/W settings was frequently found (e.g. 46% of all delineated points in the tumor-lung region were delineated in mediastinum L/W settings). Despite a large observer variation in cranial and caudal direction of 0.72 cm (1 SD), the coronal and sagittal side windows were not used in 45 and 60% of the cases, respectively. For the more difficult cases, observer variation was smaller when the coronal and sagittal side windows were used. Conclusions: With the 'Big Brother' tool a method was developed to trace the delineation process. The differences between

The value of three-dimensional photogrammetry in isolated sagittal synostosis: Impact of age and surgical technique on intracranial volume and cephalic index─a retrospective cohort study.

Science.gov (United States)

Mertens, Christian; Wessel, Eline; Berger, Moritz; Ristow, Oliver; Hoffmann, Jürgen; Kansy, Katinka; Freudlsperger, Christian; Bächli, Heidrun; Engel, Michael

2017-12-01

The aim of this study was to compare the outcome of intracranial volume (ICV) and cephalic index (CI) between two different techniques for surgical therapy of sagittal synostosis. Between 2011 and 2015, all patients scheduled for surgical therapy of sagittal synostosis were consecutively enrolled. All patients younger than 6 months underwent early extended strip craniectomy (ESC group), and patients older than 6 months underwent late modified pi-procedure (MPP group). To measure ICV and CI, data acquisition was performed via three-dimensional photogrammetry, 1 day before (T0) and between 10 and 12 weeks after surgery (T1). Results were compared with an age-matched reference group of healthy children. Perioperative parameters, as duration of surgery and the amount of blood loss of both surgical procedures were analyzed. A total of 85 patients were enrolled. Of the patients, 48 underwent an extended strip craniotomy with parietal osteotomies and biparietal widening and 37 patients underwent a late modified pi-procedure. There was no significant difference between the ESC group and the MPP group regarding the efficacy of improving CI (p > 0.05). Both techniques were able to normalize CI and to improve head shape. ICV was normal compared to age-matched norm-groups with both techniques, pre- and postoperatively. However, duration of the surgical procedure and calculated blood loss were significantly lower in the ESC group (p photogrammetry is a valid method to objectively evaluate patients before and after surgery without exposing pediatric patients to ionizing radiation. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects

NARCIS (Netherlands)

van den Bergh, B.; de Mol van Otterloo, J.J.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

2015-01-01

Objective Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study

IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: Quality of life aspects

NARCIS (Netherlands)

van den Bergh, B.; van Otterloo, J.J.D.M.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

2015-01-01

Objective Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study

Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea

Energy Technology Data Exchange (ETDEWEB)

Guimaraes, Carolina V.A. [Medical Center, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Donnelly, Lane F. [Medical Center, Department of Radiology, Cincinnati, OH (United States); Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Shott, Sally R. [Medical Center, Division of Otolaryngology, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States); Amin, Raouf S.; Kalra, Maninder [Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital, OH (United States)

2008-10-15

Children with Down syndrome are described as having macroglossia as well as midface hypoplasia. We reviewed anatomic parameters on MRI to determine whether adolescents with Down syndrome have true macroglossia or relatively large tongues compared to the small size of their oral cavity. This has implications for the treatment of obstructive sleep apnea, which occurs at a relatively high rate among patients with Down syndrome. To determine whether adolescents with Down syndrome have relative rather than true macroglossia. On sagittal and axial MR images, parameters for tongue size (area in sagittal midline), the bony craniofacial confines of the retroglossal pharynx (distance between the mandibular rami and distance between the posterior aspect of the mental mandible and the anterior aspect of the spine), and the size of the tongue relative to the craniofacial bony parameters [tongue area/(transverse diameter x anterior-to-posterior diameter)] were compared between 16 patients with Down syndrome and 16 age- and gender-matched controls. The tongue area was significantly smaller in patients with Down syndrome (2,432 mm{sup 2}) than in the control patients (2,767 mm{sup 2}; P=0.02). The craniofacial bony parameters were also smaller in patients with Down syndrome than in the controls (left-right 69.8 vs. 80.1 mm, P<0.001; anterior-posterior 64.2 vs. 74.9 mm, P<0.001). However, the size of the tongue relative to the craniofacial parameters was larger in the patients with Down syndrome (0.54) than in the controls (0.46; P<0.001). Children with Down syndrome do not have true macroglossia but have relatively large tongues compared to the bony confines of the oral cavity. (orig.)

Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea

International Nuclear Information System (INIS)

Guimaraes, Carolina V.A.; Donnelly, Lane F.; Shott, Sally R.; Amin, Raouf S.; Kalra, Maninder

2008-01-01

Children with Down syndrome are described as having macroglossia as well as midface hypoplasia. We reviewed anatomic parameters on MRI to determine whether adolescents with Down syndrome have true macroglossia or relatively large tongues compared to the small size of their oral cavity. This has implications for the treatment of obstructive sleep apnea, which occurs at a relatively high rate among patients with Down syndrome. To determine whether adolescents with Down syndrome have relative rather than true macroglossia. On sagittal and axial MR images, parameters for tongue size (area in sagittal midline), the bony craniofacial confines of the retroglossal pharynx (distance between the mandibular rami and distance between the posterior aspect of the mental mandible and the anterior aspect of the spine), and the size of the tongue relative to the craniofacial bony parameters [tongue area/(transverse diameter x anterior-to-posterior diameter)] were compared between 16 patients with Down syndrome and 16 age- and gender-matched controls. The tongue area was significantly smaller in patients with Down syndrome (2,432 mm 2 ) than in the control patients (2,767 mm 2 ; P=0.02). The craniofacial bony parameters were also smaller in patients with Down syndrome than in the controls (left-right 69.8 vs. 80.1 mm, P<0.001; anterior-posterior 64.2 vs. 74.9 mm, P<0.001). However, the size of the tongue relative to the craniofacial parameters was larger in the patients with Down syndrome (0.54) than in the controls (0.46; P<0.001). Children with Down syndrome do not have true macroglossia but have relatively large tongues compared to the bony confines of the oral cavity. (orig.)

Management of Mandibular Fracture in a Peripheral Health Setting ...

African Journals Online (AJOL)

Hp 630 Dual Core

and immobilization using intermaxillary fixation (IMF) to the more invasive surgical sopens reduction with internal ... normal anatomic positions7, and prevention of movement by immobilization (fixation) of the fractured bone thereby ... Appearance of the patient after healing of fracture occurred intra orally. Due to the limited ...

Orthodontic treatment of a patient with hypoglossia.

Science.gov (United States)

Ogawa, Takuya; Sato, Chiemi; Kawakubo, Naomi; Moriyama, Keiji

2015-01-01

The aim of this case study was to provide a detailed report of the orthodontic approach used in treating a Japanese patient with congenital hypoglossia. The patient was a 6-year-old girl with hypoglossia, micrognathia, congenital absence of three incisors, and a telescopic occlusion accompanied by an extremely narrow lower arch. She had no limb anomalies, and her speech was normal. Bite opening and mandibular widening from the early mixed dentition dramatically improved the extremely constricted mandible and telescopic occlusion. Cephalometric tracings taken from the beginning to the end of active treatment revealed substantial forward and downward growth in the mandible over time, which may have contributed to correction of the intermaxillary relationship. Treatment of telescopic occlusion by bite opening and mandibular widening from the early mixed dentition may be effective in facilitating mandibular growth acceleration. An acceptable intermaxillary occlusal relationship and improvement of profile were achieved by an orthodontic approach in this case.

Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors.

Science.gov (United States)

Steenen, S A; van Wijk, A J; Becking, A G

2016-08-01

An unfavourable and unanticipated pattern of the bilateral sagittal split osteotomy (BSSO) is generally referred to as a 'bad split'. Patient factors predictive of a bad split reported in the literature are controversial. Suggested risk factors are reviewed in this article. A systematic review was undertaken, yielding a total of 30 studies published between 1971 and 2015 reporting the incidence of bad split and patient age, and/or surgical technique employed, and/or the presence of third molars. These included 22 retrospective cohort studies, six prospective cohort studies, one matched-pair analysis, and one case series. Spearman's rank correlation showed a statistically significant but weak correlation between increasing average age and increasing occurrence of bad splits in 18 studies (ρ=0.229; Pbad split among the different splitting techniques. A meta-analysis pooling the effect sizes of seven cohort studies showed no significant difference in the incidence of bad split between cohorts of patients with third molars present and concomitantly removed during surgery, and patients in whom third molars were removed at least 6 months preoperatively (odds ratio 1.16, 95% confidence interval 0.73-1.85, Z=0.64, P=0.52). In summary, there is no robust evidence to date to show that any risk factor influences the incidence of bad split. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Sagittal spinopelvic parameters in children with achondroplasia: identification of 2 distinct groups.

Science.gov (United States)

Karikari, Isaac O; Mehta, Ankit I; Solakoglu, Can; Bagley, Carlos A; Ain, Michael C; Gottfried, Oren N

2012-07-01

Spinopelvic parameters in children with achondroplasia have not been described. Because they observed a unique sagittal spinopelvic phenotype in some achondroplastic children with very horizontal sacrums, the authors sought to quantify the spinopelvic parameters in a pediatric patient population. A retrospective review was performed to identify all children (age range 1 month-10 years) with a diagnosis of achondroplasia between 2004 and 2009. Clinical and radiographic data were analyzed for age, sex, lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). Differences among these variables were analyzed using a 2-tailed, unpaired Student t-test. Forty children, 23 males and 17 females, with achondroplasia were identified during the study period. The mean age was 2.6 years. Two groups of patients were identified based on PT (that is, negative or positive tilt and horizontal or not horizontal sacrum). A negative PT was identified in all children with an extremely horizontal sacrum. Seventeen children had a negative PT (mean -16.6°), and the mean parameters in this group were 65.4° for LL, 31.7° for TLK, 18.5° for TK, 43.3° for SS, and 26.4° for PI. Twenty-three children had a positive PT (mean 17.9°), and the mean parameters in this group were 53.4° for LL, 41.5° for TLK, 9.6° for TK, 30.8° for SS, and 43.8° for PI. A statistically significant difference was observed for LL (p = 0.01), TLK (p = 0.05), SS (p = 0.006), PT (p = 0.006), and PI (0.0002). Spinopelvic parameters in achondroplasia are potentially dichotomous. The future implications of this observation are not known and will need to be explored in future long-term studies that follow pediatric patients with achondroplasia through adulthood.

Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion.

Science.gov (United States)

Franchi, Lorenzo; Pavoni, Chiara; Faltin, Kurt; McNamara, James A; Cozza, Paola

2013-03-01

To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances. A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey's post hoc tests. Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (∼3.0-3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty. Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty.

Relative strength of tailor's bunion osteotomies and fixation techniques.

Science.gov (United States)

Haddon, Todd B; LaPointe, Stephan J

2013-01-01

A paucity of data is available on the mechanical strength of fifth metatarsal osteotomies. The present study was designed to provide that information. Five osteotomies were mechanically tested to failure using a materials testing machine and compared with an intact fifth metatarsal using a hollow saw bone model with a sample size of 10 for each construct. The osteotomies tested were the distal reverse chevron fixated with a Kirschner wire, the long plantar reverse chevron osteotomy fixated with 2 screws, a mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, the mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, and an additional cerclage wire and a transverse closing wedge osteotomy fixated with a box wire technique. Analysis of variance was performed, resulting in a statistically significant difference among the data at p chevron was statistically the strongest construct at 130 N, followed by the long plantar osteotomy at 78 N. The chevron compared well with the control at 114 N, and they both fractured at the proximal model to fixture interface. The other osteotomies were statistically and significantly weaker than both the chevron and the long plantar constructs, with no statistically significant difference among them at 36, 39, and 48 N. In conclusion, the chevron osteotomy was superior in strength to the sagittal and transverse plane osteotomies and similar in strength and failure to the intact model. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Maintaining neutral sagittal cervical alignment after football helmet removal during emergency spine injury management.

Science.gov (United States)

Decoster, Laura C; Burns, Matthew F; Swartz, Erik E; Murthi, Dinakar S; Hernandez, Adam E; Vailas, James C; Isham, Linda L

2012-04-15

Descriptive laboratory study. To determine whether the placement of padding beneath the occiput after helmet removal is an effective intervention to maintain neutral sagittal cervical spine alignment in a position comparable with the helmeted condition. Current on-field recommendations for managing football athletes with suspected cervical spine injuries call for face mask removal, rather than helmet removal, because the combination of helmet and shoulder pads has been shown to maintain neutral cervical alignment. Therefore, in cases when helmet removal is required, recommendations also call for shoulder pad removal. Because removal of equipment causes motion, any technique that postpones the need to remove the shoulder pads would reduce prehospital motion. Four lateral radiographs of 20 male participants were obtained (age = 23.6 ± 2.7 years). Radiographs of participants wearing shoulder pads and helmet were first obtained. The helmet was removed and radiographs of participants with occipital padding were obtained immediately and 20 minutes later and finally without occipital padding. Cobb angle measurements for C2-C6 vertebral segments were determined by an orthopedic spine surgeon blinded to the study's purpose. Intraobserver reliability was determined using intraclass coefficient analysis. Measurements were analyzed using a 1×4 repeated-measures analysis of variance and post hoc pairwise comparisons with Bonferroni correction. Intraobserver analysis showed excellent reliability (intraclass correlation = 1.0; 95% confidence interval [CI], 0.999-1.0). Repeated-measures analysis of variance detected significant differences (F(3,17) = 13.34; P football helmet in the field, occipital padding (along with full body/head immobilization techniques) may be used to limit cervical lordosis, allowing safe delay of shoulder pad removal.

Sagittal abdominal diameter shows better correlation with cardiovascular risk factors than waist circumference and BMI.

Science.gov (United States)

de Souza, Natalia Cavalheri; de Oliveira, Erick Prado

2013-01-01

Obesity (abdominal adiposity) is a risk factor for cardiovascular diseases and the most used methods to measure the adiposity are body mass index (BMI), waist circumference (WC), and sagittal abdominal diameter (SAD). To correlate BMI, WC, and SAD with biochemical parameters and blood pressure in adults. A non-experimental exploratory/descriptive and cross sectional study was developed and it was assessed 133 subjects (59 men and 74 women) aging between 18 and 87 years. It was registered the patients' weight (kg), height (m), BMI (kg/m(2)), WC (cm) and SAD (cm), and these parameters were correlated with glycemia, triglycerides, total cholesterol, HDL-c, LDL-c and blood pressure. After adjustment for gender and age, it was observed a positive correlation between SAD and systolic arterial blood pressure (r = 0.20), glycemia (r = 0.20), triglycerides (r = 0.32), LDL (r = 0.26), total cholesterol (TC) (r = 0.33), and a negative correlation with HDL-c (r = -0.21) (p correlation between WC and systolic arterial blood pressure (r = 0.14), triglycerides (r = 0.31), total cholesterol (r = 0.21), and a negative correlation with HDL-c (r = -0.24) (p correlation with systolic arterial blood pressure (r = 0.22), total cholesterol (r = 0.20), and triglycerides (r = 0.23) (p correlated with almost all the cardiovascular risk factors analyzed and it might be considered the best predictor of abdominal fat and cardiovascular risk.

The Effect of Sagittal Plane Deformities after Tibial Plateau Fractures to Functions and Instability of Knee Joint.

Science.gov (United States)

Erdil, M; Yildiz, F; Kuyucu, E; Sayar, Ş; Polat, G; Ceylan, H H; Koçyiğit, F

2016-01-01

The objective of this study is to evaluate the effect of posterior tibial slope after fracture healing on antero-posterior knee laxity, functional outcome and patient satisfaction. 126 patients who were treated for tibial plateau fractures between 2008-2013 in the orthopedics and traumatology department of our institution were evaluated for the study. Patients were treated with open reduction and internal fixation, arthroscopy assisted minimally invasive osteosynthesis or conservative treatment. Mean posterior tibial slope after the treatment was 6.91 ± 5.11 and there was no significant difference when compared to the uninvolved side 6.42 ± 4,21 (p = 0.794). Knee laxity in anterior-posterior plane was 6.14 ± 2.11 and 5.95 ± 2.25 respectively on healthy and injured side. The difference of mean laxity in anterior-posterior plane between two sides was statistically significant. In this study we found no difference in laxity between the injured and healthy knees. However Tegner score decreased significantly in patients who had greater laxity difference between the knees. We did not find significant difference between fracture type and laxity, IKDC functional scores independent of the ligamentous injury. In conclusion despite coronal alignment is taken into consideration in treatment of tibial plateau fractures, sagittal alignment is reasonably important for stability and should not be ignored.

Utility of two types of MR cisternography for patency evaluation of aqueduct and third ventriculostomy site: Three dimentsional sagittal fast spin echo sequence and steady-state coherent fast gradient echo sequence

Energy Technology Data Exchange (ETDEWEB)

Park, Jung Hyun; Kim, Eun Hee; Park, Jong Bin; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheol Kyu; Bae, Yun Jung; Lee, Kyung Mi [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2015-07-15

We aimed to evaluate the utility of two types of MR cisternography [fast spin echo sequence and steady-state coherent gradient echo (GRE) sequence] in addition to phase contrast-cine imaging (PC-cine), for assessing patency at the aqueduct and third ventriculostomy site. 43 patients (35 patients with suspected aqueductal stenosis and 8 patients with third ventriculostomy) were retrospectively analyzed. PC-cine, 3 dimensional sagittal fast spin echo sequence [driven-equilibrium imaging (DRIVE) or volumetric isotrophic T2-weighted acquisition (T2 VISTA)] and steady-state coherent fast GRE sequence (balanced turbo field echo; bTFE) imaging were performed in all patients. The patency of the aqueduct or third ventriculostomy site was scored. Some pitfalls of each sequence were also analyzed in individual cases. 93% of all cases showed consistent scores in PC-cine, DRIVE/T2 VISTA, and bTFE imaging. DRIVE/T2 VISTA imaging provided functional information of cerebrospinal fluid flow with flow-related artifacts, while bTFE imaging allowed direct visualization of the aqueduct or ventriculostomy site. However, evaluation of anatomical structures was difficult in three cases with strong flow-related artifacts on DRIVE/T2 VISTA and in 2 cases with susceptibility artifacts on bTFE. Both DRIVE/T2 VISTA and bTFE imaging have complementary roles in evaluating the patency of the aqueduct and 3rd ventriculostomy site.

Utility of two types of MR cisternography for patency evaluation of aqueduct and third ventriculostomy site: Three dimentsional sagittal fast spin echo sequence and steady-state coherent fast gradient echo sequence

International Nuclear Information System (INIS)

Park, Jung Hyun; Kim, Eun Hee; Park, Jong Bin; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheol Kyu; Bae, Yun Jung; Lee, Kyung Mi

2015-01-01

We aimed to evaluate the utility of two types of MR cisternography [fast spin echo sequence and steady-state coherent gradient echo (GRE) sequence] in addition to phase contrast-cine imaging (PC-cine), for assessing patency at the aqueduct and third ventriculostomy site. 43 patients (35 patients with suspected aqueductal stenosis and 8 patients with third ventriculostomy) were retrospectively analyzed. PC-cine, 3 dimensional sagittal fast spin echo sequence [driven-equilibrium imaging (DRIVE) or volumetric isotrophic T2-weighted acquisition (T2 VISTA)] and steady-state coherent fast GRE sequence (balanced turbo field echo; bTFE) imaging were performed in all patients. The patency of the aqueduct or third ventriculostomy site was scored. Some pitfalls of each sequence were also analyzed in individual cases. 93% of all cases showed consistent scores in PC-cine, DRIVE/T2 VISTA, and bTFE imaging. DRIVE/T2 VISTA imaging provided functional information of cerebrospinal fluid flow with flow-related artifacts, while bTFE imaging allowed direct visualization of the aqueduct or ventriculostomy site. However, evaluation of anatomical structures was difficult in three cases with strong flow-related artifacts on DRIVE/T2 VISTA and in 2 cases with susceptibility artifacts on bTFE. Both DRIVE/T2 VISTA and bTFE imaging have complementary roles in evaluating the patency of the aqueduct and 3rd ventriculostomy site

The Effect of Local Fatigue Induced at Proximal and Distal Muscles of Lower Extremity in Sagittal Plane on Visual Dependency in Quiet Standing Postural Stability of Healthy Young Females

Directory of Open Access Journals (Sweden)

Manijeh Soleymani-Far

2007-10-01

Full Text Available Objective: The purpose of the present study was to assess the effect of local muscle fatigue induced at proximal and distal segments of lower extremity on sagittal plane mover on visual dependency in quiet standing postural stability. Materials & Methods: In this Quasi–experimental study (before – after comparison sagittal plane prime movers of the ankle and hip musculature were fatigued using isokinetic contractions at two test sessions with a randomized order and one week interval. Twenty five healthy young female students were َselected by using non probability selection and sample of convenience and asked to maintain single leg upright posture as immobile as possible. RMS and SD of Center of Pressure displacements were assessed in 30 seconds and consequently, the eyes were closed after 15 seconds. A analysis of variance (ANOVA for repeated measures was used to analyze the effect of the following factors over two periods of 5 seconds immediately before and after eye closure: (1 fatigue, (2 vision, (3 segment of fatigue. Results: The main effects of each within-subject factors (fatigue, vision and segment of fatigue were significant (P<0.05. The analysis of RMS and SD of Center of Pressure demonstrated a significant interaction between fatigue and vision, and fatigue and segment of fatigue so that the effects of Fatigue on Proximal segment and eye closed conditions were increased. Conclusion: The visual dependency for control of postural stability incremented following muscle fatigue. Proximal muscle fatigue lead to exaggeration of visual dependency for control of postural stability. Based on the present results, emphasis on the proprioception of proximal segment of lower extremity may be recommended for postural stability training.

Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis

Science.gov (United States)

Makirov, Serik K.; Jahaf, Mohammed T.; Nikulina, Anastasia A.

2015-01-01

Goal of the study This study intends to develop a method of quantitative sagittal balance parameters assessment, based on a geometrical model of lumbar spine and sacrum. Methods One hundred eight patients were divided into 2 groups. In the experimental group have been included 59 patients with lumbar spinal stenosis on L1-5 level. Forty-nine healthy volunteers without history of any lumbar spine pathlogy were included in the control group. All patients have been examined with supine MRI. Lumbar lordosis has been adopted as circular arc and described either anatomical (lumbar lordosis angle), or geometrical (chord length, circle segment height, the central angle, circle radius) parameters. Moreover, 2 sacral parameters have been assessed for all patients: sacral slope and sacral deviation angle. Both parameters characterize sacrum disposition in horizontal and vertical axis respectively. Results Significant correlation was observed between anatomical and geometrical lumbo-sacral parameters. Significant differences between stenosis group and control group were observed in the value of the “central angle” and “sacral deviation” parameters. We propose additional parameters: lumbar coefficient, as ratio of the lordosis angle to the segmental angle (Kl); sacral coefficient, as ratio of the sacral tilt (ST) to the sacral deviation (SD) angle (Ks); and assessment modulus of the mathematical difference between sacral and lumbar coefficients has been used for determining lumbosacral balance (LSB). Statistically significant differences between main and control group have been obtained for all described coefficients (p = 0.006, p = 0.0001, p = 0.0001, accordingly). Median of LSB value of was 0.18 and 0.34 for stenosis and control groups, accordingly. Conclusion Based on these results we believe that that spinal stenosis is associated with an acquired deformity that is measureable by the described parameters. It's possible that spinal stenosis occurs in patients with an

Finite element analysis of sagittal balance in different morphotype: Forces and resulting strain in pelvis and spine.

Science.gov (United States)

Filardi, Vincenzo; Simona, Portaro; Cacciola, Giorgio; Bertino, Salvatore; Soliera, Luigi; Barbanera, Andrea; Pisani, Alessandro; Milardi, Demetrio; Alessia, Bramanti

2017-06-01

In humans, vertical posture acquisition caused several changes in bones and muscles which can be assumed as verticalization. Pelvis, femur, and vertebral column gain an extension position which decreases muscular work by paravertebral muscles in the latter. It's widely known that six different morphological categories exist; each category differs from the others by pelvic parameters and vertebral column curvatures. Both values depend on the Pelvic Incidence, calculated as the angle between the axes passing through the rotation centre of the two femur heads and the vertical axis passing through the superior plate of the sacrum. The aim of this study is to evaluate the distribution of stress and the resulting strain along the axial skeleton using finite element analysis. The use of this computational method allows performing different analyses investigating how different bony geometries and skeletal structures can behavior under specific loading conditions. A computerized tomography (CT) of artificial bones, carried on at 1.5 mm of distance along sagittal, coronal and axial planes with the knee at 0° flexion (accuracy 0.5 mm), was used to obtain geometrical data of the model developed. Lines were imported into a commercial code (Hypermesh by Altair ® ) in order to interpolate main surfaces and create the solid version of the model. In particular six different models were created according Roussoly's classification, by arranging geometrical position of the skeletal components. Loading conditions were obtained by applying muscular forces components to T1 till to L5, according to a reference model (Daniel M. 2011), and a fixed constrain was imposed on the lower part of the femurs. Materials were assumed as elastic with an Elastic modulus of 15 GPa, a Shear Modulus of 7 GPa for bony parts, and an Elastic modulus of 6 MPa, a Shear Modulus of 3 MPa for cartilaginous parts. Six different simulations have been carried out in order to evaluate the mechanical behavior

Harvey Cushing's Meningiomas text and the historical origin of resectability criteria for the anterior one third of the superior sagittal sinus.

Science.gov (United States)

Shrivastava, Raj K; Segal, Salomao; Camins, Martin B; Sen, Chandranath; Post, Kalmon D

2003-10-01

The search for the origin of the commonly held principle in current neurosurgery regarding the resectability of the anterior one third of the superior sagittal sinus unravels the many fascinating developments that occurred in neurosurgery during the early 20th century. All these occurrences can be traced back to, and are uniquely contextualized in, Harvey Cushing's seminal text, Meningiomas, Their Classification, Regional Behaviour, Life History, and Surgical End Results. Written with Louise Eisenhardt and published in 1938, Meningiomas is a monograph of incredible description and detail. The meticulous categorization of meningiomas, their presentation, clinical outcome, and surgical therapies are even further supplemented by Cushing's personal commentary, questions, and recollections. Cushing's genius was evident in his ability not only to make insightful clinical observations, but also to synthesize these ideas within the neurosurgical context of his era. As he says in Meningiomas, "Thus the pathological curiosity of one day becomes in its proper time a commonplace... most of which are one and the same disorder--had, for their interpretation, to await the advent of the Neurosurgeon."

Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing.

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Kuemmerle, Jan M; Auer, Jörg A; Rademacher, Nathalie; Lischer, Christoph J; Bettschart-Wolfensberger, Regula; Fürst, Anton E

2008-02-01

To describe short incomplete sagittal fractures of the proximal phalanx (type Ia P1 fractures) in horses not used for racing and report outcome. Retrospective study. Horses (n=10) with type Ia P1 fractures. Retrieved data of horses with type Ia P1 fractures were signalment, history and results of orthopedic examination. Radiographs were re-evaluated for position and length of the fracture line, presence of osteoarthritis or subchondral cystic lesions (SCL), periosteal new bone formation and subchondral sclerosis. Conservative treatment (n=4) included box confinement for 2 months followed by 1 month of hand walking. Surgical therapy (n=6) consisted of internal fixation by screws inserted in lag fashion in 5 horses. Concurrent SCL were debrided by curettage via a transcortical drilling approach. In 1 horse, only SCL curettage but not internal fixation was performed. Outcome was assessed on a clinical and radiographic follow-up examination in all horses. Mean follow-up time was 27 months (median, 13.5 months; range, 9 months to 9 years). All horses treated with internal fixation were sound at follow-up and had radiographic fracture healing. Of the 4 horses managed conservatively, 3 remained lame and only 1 horse had radiographic evidence of fracture healing. Catastrophic fracture propagation occurred in 2 horses not treated by internal fixation, 20 and 30 months after diagnosis, respectively. Horses with a type Ia P1 fracture treated surgically had a better outcome than those managed conservatively and lack of fracture healing seemingly increases the risk of later catastrophic fracture. Surgical repair of type Ia P1 fractures should be considered to optimize healing and return to athletic use.

Motor intensive anti-gravity training improves performance in dynamic balance related tasks in persons with Parkinson's disease

DEFF Research Database (Denmark)

Malling, Anne Sofie Bøgh; Jensen, Bente Rona

2016-01-01

, the aim was to study the effect of motor intensive training performed in a safe anti-gravity environment using lower-body positive pressure (LBPP) technology on performance during dynamic balance related tasks. Thirteen male PDP went through an 8-week control period followed by 8 weeks of motor intensive...... antigravity training. Seventeen healthy males constituted a control group (CON). Performance during a five repetition sit-to-stand test (STS; sagittal plane) and a dynamic postural balance test (DPB; transversal plane) was evaluated. Effect measures were completion time, functional rates of force development...

Sagittal Abdominal Diameter as a Surrogate Marker of Insulin Resistance in an Admixtured Population--Brazilian Metabolic Syndrome Study (BRAMS).

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Vasques, Ana Carolina J; Cassani, Roberta S L; Forti, Adriana C e; Vilela, Brunna S; Pareja, José Carlos; Tambascia, Marcos Antonio; Geloneze, Bruno

2015-01-01

Sagittal abdominal diameter (SAD) has been proposed as a surrogate marker of insulin resistance (IR). However, the utilization of SAD requires specific validation for each ethnicity. We aimed to investigate the potential use of SAD, compared with classical anthropometrical parameters, as a surrogate marker of IR and to establish the cutoff values of SAD for screening for IR. A multicenter population survey on metabolic disorders was conducted. A race-admixtured sample of 824 adult women was assessed. The anthropometric parameters included: BMI, waist circumference (WC), waist-to-hip ratio and SAD. IR was determined by a hyperglycemic clamp and the HOMA-IR index. After adjustments for age and total body fat mass, SAD (r = 0.23 and r = -0.70) and BMI (r = 0.20 and r = -0.71) were strongly correlated with the IR measured by the HOMA-IR index and the clamp, respectively (p < 0.001). In the ROC analysis, the optimal cutoff for SAD in women was 21.0 cm. The women with an increased SAD presented 3.2 (CI 95%: 2.1-5.0) more likelihood of having IR, assessed by the HOMA-IR index compared with those with normal SAD (p < 0.001); whereas women with elevated BMI and WC were 2.1 (95% CI: 1.4-3.3) and 2.8 (95% CI: 1.7-4.5) more likely to have IR (p < 0.001), respectively. No statistically significant results were found for waist-to-hip ratio. SAD can be a suitable surrogate marker of IR. Understanding and applying routine and simplified methods is essential because IR is associated with an increased risk of obesity-related diseases even in the presence of normal weight, slight overweight, as well as in obesity. Further prospective analysis will need to verify SAD as a determinant of clinical outcomes, such as type 2 diabetes and cardiovascular events, in the Brazilian population.

The population distribution of the sagittal abdominal diameter (SAD) and SAD/height ratio among Finnish adults.

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Kahn, H S; Rissanen, H; Bullard, K M; Knekt, P

2014-12-01

Sagittal abdominal diameter (SAD; 'abdominal height' measured in supine position) may improve upon conventional anthropometry for predicting incident cardiometabolic diseases. However, the SAD is used infrequently by practitioners and epidemiologists. A representative survey of Finnish adults in 2000-2001 collected body measurements including SAD (by sliding-beam calliper) using standardized protocols. Sampled non-pregnant adults (ages 30+ years; 79% participation) provided 6123 SAD measurements from 80 health centre districts. Through stratified, complex survey design, these data represented 2.86 million adults at ages 30+ years. SAD ranged from 13.5 to 38.0 cm, with a population mean (standard error) of 21.7 (0.05) cm and median (interquartile range) of 21.0 (19.1-23.4). Median SAD was higher at ages 50+ years compared with ages 30-49 both for men (22.4 [20.5-24.6] vs. 20.8 [19.3-22.7]) and women (21.7 [19.6-23.9] vs. 19.4 [17.8-21.4]). The SAD/height ratio was similar (0.118) for both sexes at 30-39 years, rising more steeply with age for women than men. Attaining only a basic education, compared with a high level, was associated with increased mean (95% confidence interval) SADs for men (22.6 [22.3-22.8] vs. 22.0 [21.7-22.2]) and women (21.8 [21.5-22.0] vs. 20.6 [20.4-20.8]). Finland's early experience with nationally representative SAD measurements provides normative reference values and physiological insights useful for investigations of cardiometabolic risk. © 2014 World Obesity.

Comparison of vertebral morphometry in the lumbar vertebrae by T1-weighted sagittal MRI and radiograph

International Nuclear Information System (INIS)

Tomomitsu, Tatsushi; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

2005-01-01

Purpose: In this study, we investigated the usefulness of T1-weighted sagittal MR images at the lumbar vertebrae in the vertebral morphometry, in comparison with lateral radiographs. Subjects and methods: The subjects were 42 men (mean age: 53.0 years) and 41 women (mean age: 57.9 years). Both MRI and radiography of the lumbar spine were performed within 1 month. The vertebral body heights and their ratios were measured by the semi-automatic measuring system. The frequency of a vertebral fracture and the absolute value of vertebral body height in both morphometry were compared. Results: Based on the criteria for prevalent vertebral fracture using vertebral height ratios, the vertebrae were classified into four groups. Group 1 was defined as the vertebrae without fracture (n = 347 vertebrae). Groups 2-4 were defined as the vertebrae with fracture; Group 2 by both MRI and X-ray morphometry (n = 17), Group 3 by MRI morphometry alone (n = 17), and Group 4 by X-ray morphometry alone (n = 4). The rate of prevalent vertebral fracture diagnosed by MRI morphometry (8.8%) was higher than that by X-ray morphometry (5.5%). In Group 1, the values of anterior and posterior vertebral height obtained by MRI morphometry were greater than those obtained by X-ray morphometry. On the other hand, the values of central vertebral height obtained by MRI morphometry were smaller than those obtained by X-ray morphometry. Conclusion: Severe biconcave deformity of vertebra can be detected by both MRI and X-ray morphometry, although mild biconcave deformity can be detected only by MRI morphometry

DESCRIPTIVE STUDY ON SAGITTAL LUMBAR SPINE CHANGES IN STUDENTS OF THE FEDERAL EDUCATIONAL SYSTEM OF FLORIANÓPOLIS.

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Group, Susane; Santos, Saray Giovana Dos; Moro, Antônio Renato Pereira

2010-01-01

The purpose of this study was to assess the prevalence of sagittal lumbar spine postural abnormalities and associated factors among students in the federal educational system in Florianópolis. 288 adolescents (156 males and 132 females), aged from 15 to 18 years, who were students in the federal educational system in Florianópolis, Santa Catarina, were evaluated. To gather data, photogrammetry was used following a specific protocol for postural assessment, and a questionnaire was used to identify the prevalence and frequency of pain, and the activities that triggered the problem. In the data analysis, descriptive statistics, Student's t-test for independent samples, chi-square test and Poisson's regression were used, with the significance level set at p<0.05 for all the tests. The prevalence of low back pain was 49.3%, with weekly frequency in 43.1% of the sample. The prevalence of deviation was 53.8%, and 90.9% corresponded to rectification of lumbar curvature, and this affected males more frequently. A significant difference in lumbar angle was found between the sexes; higher prevalence ratios of postural deviations were found in the male group. The prevalences of low back pain and lumbar postural deviation were high, but the relationship between these variables did not present significance. The main causes of the lumbar pain were sports practice or vigorous activities and remaining in a seated position for extended periods of time.

Lumbar segmental instability: a criterion-related validity study of manual therapy assessment

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Chapple Cathy

2005-11-01

Full Text Available Abstract Background Musculoskeletal physiotherapists routinely assess lumbar segmental motion during the clinical examination of a patient with low back pain. The validity of manual assessment of segmental motion has not, however, been adequately investigated. Methods In this prospective, multi-centre, pragmatic, diagnostic validity study, 138 consecutive patients with recurrent or chronic low back pain (R/CLBP were recruited. Physiotherapists with post-graduate training in manual therapy performed passive accessory intervertebral motion tests (PAIVMs and passive physiological intervertebral motion tests (PPIVMs. Consenting patients were referred for flexion-extension radiographs. Sagittal angular rotation and sagittal translation of each lumbar spinal motion segment was measured from these radiographs, and compared to a reference range derived from a study of 30 asymptomatic volunteers. Motion beyond two standard deviations from the reference mean was considered diagnostic of rotational lumbar segmental instability (LSI and translational LSI. Accuracy and validity of the clinical assessments were expressed using sensitivity, specificity, and likelihood ratio statistics with 95% confidence intervals (CI. Results Only translation LSI was found to be significantly associated with R/CLBP (p Conclusion This study provides the first evidence reporting the concurrent validity of manual tests for the detection of abnormal sagittal planar motion. PAIVMs and PPIVMs are highly specific, but not sensitive, for the detection of translation LSI. Likelihood ratios resulting from positive test results were only moderate. This research indicates that manual clinical examination procedures have moderate validity for detecting segmental motion abnormality.

Hemimandibulektomi dengan Rekonstruksi Mandibula dan Fiksasi Intermaksila sebagai Penatalaksanaan Ameloblastoma Mandibula Sinistra

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Indria Nehriasari

2012-12-01

Full Text Available Latar belakang. Ameloblastoma adalah tumor odontogenik yang jarang terjadi. Walaupun jinak tetapi bersifat merusak dan mempunyai tingkat kekambuhan yang tinggi. Hemimandibulektomy adalah salah satu tindakan yang dipilih jika lesi patologis telah melibatkan processus coronoideus dan condyle walaupun efek dari tindakan tersebut adalah terjadinya defek wajah dan deviasi mandibula. Tujuan. Melaporkan tindakan hemimandibulektomy dengan rekonstruksi bridging plate dan traksi intermaksila pada ameloblastoma mandibula sebelah kiri yang dilakukan untuk mengurangi deviasi dan defek wajah. Kasus dan perawatan. Laki-laki umur 46 tahun datang ke klinik bedah mulut dan maksilofacial RS Dr Sardjito Yogyakarta dengan keluhan utama adanya pembengkakan pada sisi kiri rahang bawah di area pipi. Keadaan tersebut dirasakan sejak 4 tahun yang lalu, tidak sakit, keras, warna sesuai dengan jaringan sekitar. Diagnosa yang ditegakkan Ameloblastoma mandibula. Perawatan dari kasus ini adalah hemimandibulektomy dengan rekonstruksi bridging plate dengan anestesi umum. Enam minggu dengan kawat dan 3 bulan dengan traksi elastic digunakan untuk mengurangi deviasi mandibula setelah tulang rahang direseksi. Kesimpulan. Hemimandibulektomi dilakukan untuk mengambil lesi patologi secara radikal untuk mencegah rekurensi. Bridging plate digunakan sebagai tindakan rekontruksi mandibula. Traksi intermaksila merupakan salah satu cara yang bisa digunakan untuk mengurangi deviasi mandibula setelah hemimandibulektomy.   Background. Ameloblastoma is an odontogenic tumor which rarely happened. Although it is benign, it can be destructive and has a high recurrency rate. Hemimandibulectomy is one kind of treatments which can be choosed if pathologic fracture has involved coronoid processus and condyle, eventhough its effect can cause mandible deviation and facial defect. Purpose. Reported a hemimandibulectomy with bridging plate reconstruction and intermaxillary function on the left mandible

Trombosis del seno sagital en un neonato Sagittal sinus thrombosis in a newborn

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Lisett Hernández León

2012-12-01

Full Text Available La trombosis de los senos venosos durales es una rara y devastadora enfermedad. Se presenta generalmente en mujeres y ancianos, y no es frecuente en niños, aunque se reconoce ya como una causa de morbilidad y mortalidad en la población pediátrica. Se han reportado pocos casos en el mundo de neonatos afectados por esta entidad, en su mayoría fatales e insuficientemente investigados. A continuación se presenta el caso de un recién nacido con una trombosis del seno sagital que sobrevivió. Los factores predisponentes para la aparición de la enfermedad en este caso fueron la asfixia neonatal, la deshidratación severa unida al uso de una línea venosa central, y la inmovilización prolongada. Aunque la TAC contrastada no es el estudio ideal para su diagnóstico, permitió realizarlo oportunamente en este caso. El tratamiento temprano con anticoagulantes permitió una rápida recuperación y favoreció la recanalización venosa del seno involucrado. Hasta el momento no se han detectado secuelas neurológicas y el paciente tiene buen desarrollo psicomotor.Dural venous sinus thrombosis is a rare devastating disease. It is generally found in females and old people, but is infrequent in children; however, it is already recognized as a morbidity and mortality cause in the pediatric population. Few cases of newborns with this disease have been reported worldwide; most of them were poorly studied and had fatal outcomes. Here is the presentation of a newborn with sagittal sinus thrombosis, who managed to survive. The predisposing factors for the disease were neonatal asphyxia, severe dehydration together with the use of central venous line and extended immobilization. Although contrast CAT is not the ideal study, it helped to promptly arrive at the right diagnosis in this case. The early treatment based on anticoagulants allowed rapid recovery and facilitated venous retaking of the involved venous sinus. No neurological sequels have been so far

Cone Beam Computed Tomographic Analyses of the Position and Course of the Mandibular Canal: Relevance to the Sagittal Split Ramus Osteotomy

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Ahmet Ercan Sekerci

2014-01-01

Full Text Available Purpose. The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. Methods. The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. Results. The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. Conclusion. Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities.

The Influence of the “Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility

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Dariusz Czaprowski

2017-01-01

Full Text Available Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH instructed with “straighten your back” command (SYB. Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS, lumbar lordosis (LL, global thoracic kyphosis (TK, lower thoracic kyphosis (LK, and upper thoracic kyphosis (UK were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting and after the SYB. Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P<0.01, with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5 versus 21.0° (SD 15.5, P<0.001 below the standards proposed in the literature (30–40° and flattening of its lower part (P<0.001. The same changes were observed in the control group. Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.

Grizzly bear (Ursus arctos horribilis) locomotion: forelimb joint mechanics across speed in the sagittal and frontal planes.

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Shine, Catherine L; Robbins, Charles T; Nelson, O Lynne; McGowan, Craig P

2017-04-01

The majority of terrestrial locomotion studies have focused on parasagittal motion and paid less attention to forces or movement in the frontal plane. Our previous research has shown that grizzly bears produce higher medial ground reaction forces (lateral pushing from the animal) than would be expected for an upright mammal, suggesting frontal plane movement may be an important aspect of their locomotion. To examine this, we conducted an inverse dynamics analysis in the sagittal and frontal planes, using ground reaction forces and position data from three high-speed cameras of four adult female grizzly bears. Over the speed range collected, the bears used walks, running walks and canters. The scapulohumeral joint, wrist and the limb overall absorb energy (average total net work of the forelimb joints, -0.97 W kg -1 ). The scapulohumeral joint, elbow and total net work of the forelimb joints have negative relationships with speed, resulting in more energy absorbed by the forelimb at higher speeds (running walks and canters). The net joint moment and power curves maintain similar patterns across speed as in previously studied species, suggesting grizzly bears maintain similar joint dynamics to other mammalian quadrupeds. There is no significant relationship with net work and speed at any joint in the frontal plane. The total net work of the forelimb joints in the frontal plane was not significantly different from zero, suggesting that, despite the high medial ground reaction forces, the forelimb acts as a strut in that plane. © 2017. Published by The Company of Biologists Ltd.

A Comparative Study of Dorsal Buccal Mucosa Graft Substitution Urethroplasty by Dorsal Urethrotomy Approach versus Ventral Sagittal Urethrotomy Approach

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Mrinal Pahwa

2013-01-01

Full Text Available Objectives. To compare the outcome of dorsal buccal mucosal graft (BMG substitution urethroplasty by dorsal urethrotomy approach with ventral urethrotomy approach in management of stricture urethra. Methods and Materials. A total of 40 patients who underwent dorsal BMG substitution urethroplasty were randomized into two groups. 20 patients underwent dorsal onlay BMG urethroplasty as described by Barbagli, and the other 20 patients underwent dorsal BMG urethroplasty by ventral urethrotomy as described by Asopa. Operative time, success rate, satisfaction rate, and complications were compared between the two groups. Mean follow-up was 12 months (6–24 months. Results. Ventral urethrotomy group had considerably lesser operative time although the difference was not statistically significant. Patients in dorsal group had mean maximum flow rate of 19.6 mL/min and mean residual urine of 27 mL, whereas ventral group had a mean maximum flow rate of 18.8 and residual urine of 32 mL. Eighteen out of twenty patients voided well in each group, and postoperative imaging study in these patients showed a good lumen with no evidence of leak or extravasation. Conclusion. Though ventral sagittal urethrotomy preserves the blood supply of urethra and intraoperative time was less than dorsal urethrotomy technique, there was no statistically significant difference in final outcome using either technique.

A Comparative Study of Dorsal Buccal Mucosa Graft Substitution Urethroplasty by Dorsal Urethrotomy Approach versus Ventral Sagittal Urethrotomy Approach.

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Pahwa, Mrinal; Gupta, Sanjeev; Pahwa, Mayank; Jain, Brig D K; Gupta, Manu

2013-01-01

Objectives. To compare the outcome of dorsal buccal mucosal graft (BMG) substitution urethroplasty by dorsal urethrotomy approach with ventral urethrotomy approach in management of stricture urethra. Methods and Materials. A total of 40 patients who underwent dorsal BMG substitution urethroplasty were randomized into two groups. 20 patients underwent dorsal onlay BMG urethroplasty as described by Barbagli, and the other 20 patients underwent dorsal BMG urethroplasty by ventral urethrotomy as described by Asopa. Operative time, success rate, satisfaction rate, and complications were compared between the two groups. Mean follow-up was 12 months (6-24 months). Results. Ventral urethrotomy group had considerably lesser operative time although the difference was not statistically significant. Patients in dorsal group had mean maximum flow rate of 19.6 mL/min and mean residual urine of 27 mL, whereas ventral group had a mean maximum flow rate of 18.8 and residual urine of 32 mL. Eighteen out of twenty patients voided well in each group, and postoperative imaging study in these patients showed a good lumen with no evidence of leak or extravasation. Conclusion. Though ventral sagittal urethrotomy preserves the blood supply of urethra and intraoperative time was less than dorsal urethrotomy technique, there was no statistically significant difference in final outcome using either technique.

Inferior alveolar nerve function after sagittal split osteotomy by reciprocating saw or piezosurgery instrument: prospective double-blinded study.

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Monnazzi, Marcelo Silva; Real Gabrielli, Mario Francisco; Passeri, Luis Augusto; Cabrini Gabrielli, Marisa Aparecida; Spin-Neto, Rubens; Pereira-Filho, Valfrido Antonio

2014-06-01

The aim of this prospective study was to objectively evaluate inferior alveolar nerve (IAN) sensory disturbances in patients who underwent sagittal split ramus osteotomy (SSRO) by comparing 1 side treated with a reciprocating saw with the other side treated with a piezosurgery device. Clinical evaluation of IAN sensory disturbance was undertaken preoperatively and at 1 week, 4 weeks, 2 months, and 6 months postoperatively in 20 patients who underwent SSRO at the Division of Oral and Maxillofacial Surgery, Araraquara Dental School, São Paulo State University. The 20 patients were examined at all periods for IAN functionality by Semmes-Weinstein testing; neither the patients nor the examiner knew which side was treated using piezosurgery or a reciprocating saw. The mean age of the patients was 28.4 years (range, 20 to 48 yr). Before surgery, no patient had impaired function of the IAN in any of the 8 zones in the mental and inferior lip areas. All patients reported feeling the first monofilament at the time of the preoperative test. Seven days postoperatively, all patients reported some kind of altered sensitivity in at least 1 zone evaluated. The results of this study suggest there was no statistically significant difference in the sensitivity of the labiomental area regarding the instrument used to perform the osteotomy. Future studies will focus on enlarging the sample and evaluating the results. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Comparative study of postoperative stability between conventional orthognathic surgery and a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy for skeletal class III correction.

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Mah, Deuk-Hyun; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Jung, Seo-Yun; Kim, Won-Gi; Yu, Kyung-Hwan

2017-02-01

The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO). The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding). The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was 2.23±0.92 mm ( P surgery-first orthognathic approach group from T1 to T2 was 3.49±1.71 mm ( P surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.

Pilot study: relative dose of the TLD, OSL and Radiochromic film applied in CT exams dosimetry

International Nuclear Information System (INIS)

Kikuti, C.F.; Maia, R.S.I.; Romano, R.F.T.; Daros, K. A.C.

2015-01-01

At DDI/UNIFESP, the abdomen and chest CT exams correspond to 38% of the exams, becoming the focus of studies. The aim of this study is to assess the relative dose using TLDs, OSLs and RF for the evaluation of the dose distribution in the skin in abdomen CT exams. The simulation of the CT exam was performed in an anthropomorphic phantom, using a CT scanner Philips, Brilliance/64 and TLDs, OSLs and RF fixed along the sagittal axis of the phantom. The OSLs showed similar performance to the TLDs and RF shows low accuracy, resulting in an average value (0.927±0.022). (author)

Pilot study: relative dose of the TLD, OSL and Radiochromic film applied in CT exams dosimetry

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Kikuti, C.F. [Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS (Brazil). Hospital Universitario Maria Aparecida Pedrossian; Maia, R.S.I.; Romano, R.F.T.; Daros, K. A.C., E-mail: daros.kellen@unifesp.br [Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Departamento de Diagnostico por Imagem

2015-07-01

At DDI/UNIFESP, the abdomen and chest CT exams correspond to 38% of the exams, becoming the focus of studies. The aim of this study is to assess the relative dose using TLDs, OSLs and RF for the evaluation of the dose distribution in the skin in abdomen CT exams. The simulation of the CT exam was performed in an anthropomorphic phantom, using a CT scanner Philips, Brilliance/64 and TLDs, OSLs and RF fixed along the sagittal axis of the phantom. The OSLs showed similar performance to the TLDs and RF shows low accuracy, resulting in an average value (0.927±0.022). (author)

[Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

Science.gov (United States)

Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

1997-07-01

A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.

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Bai, Rong-Jie; Zhang, Hui-Bo; Zhan, Hui-Li; Qian, Zhan-Hua; Wang, Nai-Li; Liu, Yue; Li, Wen-Ting; Yin, Yu-Ming

2018-05-05

Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. Sports

Preventing posterior sagittal anoplasty ′cripples′ in areas with limited medical resources: A few modifications to surgical approach in anorectal malformations

Directory of Open Access Journals (Sweden)

Claudio Olivieri

2012-01-01

Full Text Available Background: Anorectal malformations (ARM are the most common neonatal emergencies in Sub-Saharan Africa countries. Late presentation, lack of pediatric facilities and trained paediatric surgeons influence the outcome of these patients. This study reports a 5-year of experience in the management of ARM at the Orotta Referral Hospital in Asmara (Eritrea and proposes some modified surgical approaches to minimize the risk of complications and the length of hospital stay. Materials and Methods: We reviewed the records of 38 patients with ARM observed between September 2006 and April 2011. Since 2009 a modification of original posterior sagittal anorectoplasty (PSARP was introduced, consisting in a long rectal stump (3 cms closed and left at the perineal level, to be trimmed after two weeks. This avoided mucous spillage on the wound and prevented contamination. Post-operative course and outcome were evalued in the two group of patients divided according the type of surgical technique (Group A: Standard PSARP; Group B: Modified PSARP. Results: There were 21 boys and 17 girls aged 4 days to 9 years (median age 182 days. Of the 38 patients, 2 infants died before surgery and 3 refused preliminary colostomy. Previously confectioned colostomies often required revision or redoing due to severe prolapse or malposition. When possible, primary sigmoid colostomy was performed. There were 15 patients in Group A and 18 in Group B. Wound infection or disruption were recorded in 7 cases (46% in Group A and in 2 (11% in Group B. Late complications were related to anal stenosis, which required long term dilatations. Three cases needed a PSARP redo (2 in Group A, 1 Group B. Conclusions: We believe that our simple modification of original PSARP technique could be of help lowering post-operative complications rate and reducing hospital stay. Family compliance is mandatory for long-term surgical success. A relevant time must be spent in training to stoma care and post

Occurrence of a 'bad' split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients.

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Posnick, J C; Choi, E; Liu, S

2016-10-01

The purpose of this study was to assess the prevalence of a 'bad' split after sagittal ramus osteotomies (SRO) and report the results of initial mandibular healing. A retrospective cohort study derived from patients treated by a single surgeon at one institution between 2004 and 2013 was performed. An index group consisting of a series of subjects with a spectrum of bimaxillary dentofacial deformities also involving the chin and symptomatic chronic obstructive nasal breathing was identified. The SRO design, bicortical screw fixation technique, and perioperative management were consistent. Outcome variables included the occurrence of a 'bad' split and the success of initial SRO healing. Two hundred sixty-two subjects undergoing 524 SROs met the inclusion criteria. Their average age was 25 years (range 13-63 years) and 134 were female (51%). Simultaneous removal of a third molar was performed during 209 of the SROs (40%). There were no 'bad' splits. All subjects achieved successful bone union, the planned occlusion, and return to a chewing diet and physical activities by 5 weeks after surgery. The presence of a third molar removed during SRO was not associated with an increased frequency of a 'bad' split or delayed mandibular healing. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Malunited fracture of the body and condyle of the mandible : A Case Report

OpenAIRE

Ramakrishna Yeluri; Sudhindra Baliga; Autar Krishen Munshi

2010-01-01

Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, develop...

A conservative approach to pediatric mandibular fracture management: Outcome and advantages

OpenAIRE

Amit Khatri; Namita Kalra

2011-01-01

Pediatric mandibular fractures are rare and their treatment remains controversial. Management is extremely complicated in mixed dentition as it is inherently dynamic and unstable. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. This case report describes and evaluates the conservative technique of acr...

The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander (MARPE) and the novel N2 mini-implant-a finite element study.

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Moon, Won; Wu, Kimberley W; MacGinnis, Matthew; Sung, Jay; Chu, Howard; Youssef, George; Machado, Andre

2015-01-01

Maxillary protraction with the novel N2 mini-implant- and micro-implant-assisted rapid palatal expander (MARPE) can potentially provide significant skeletal effects without surgery, even in older patients where conventional facemask therapy has limited skeletal effects. However, the skeletal effects of altering the location and direction of force from mini-implant-assisted maxillary protraction have not been extensively analyzed. In this study, the application of the novel N2 mini-implant as an orthopedic anchorage device is explored in its ability to treat patients with class III malocclusions. A 3D cranial mesh model with associated sutures was developed from CT images and Mimics modeling software. Utilizing ANSYS simulation software, protraction forces were applied at different locations and directions to simulate conventional facemask therapy and seven maxillary protraction protocols utilizing the novel N2 mini-implant. Stress distribution and displacement were analyzed. Video animations and superimpositions were created. By changing the vector of force and location of N2 mini-implant, the maxilla was displaced differentially. Varying degrees of forward, downward, and rotational movements were observed in each case. For brachyfacial patients, anterior micro-implant-supported protraction at -45° or intermaxillary class III elastics at -45° are recommended. For dolicofacial patients, either anterior micro-implants at -15° or an intermaxillary spring at +30° is recommended. For mesofacial patients with favorable vertical maxillary position, palatal micro-implants at -30° are recommended; anterior micro-implants at -30° are preferred for shallow bites. For patients with a severe mid-facial deficiency, intermaxillary class III elastics at -30° are most effective in promoting anterior growth of the maxilla. By varying the location of N2 mini-implants and vector of class III mechanics, clinicians can differentially alter the magnitude of forward, downward, and

A constrained extended Kalman filter for the optimal estimate of kinematics and kinetics of a sagittal symmetric exercise.

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Bonnet, V; Dumas, R; Cappozzo, A; Joukov, V; Daune, G; Kulić, D; Fraisse, P; Andary, S; Venture, G

2017-09-06

This paper presents a method for real-time estimation of the kinematics and kinetics of a human body performing a sagittal symmetric motor task, which would minimize the impact of the stereophotogrammetric soft tissue artefacts (STA). The method is based on a bi-dimensional mechanical model of the locomotor apparatus the state variables of which (joint angles, velocities and accelerations, and the segments lengths and inertial parameters) are estimated by a constrained extended Kalman filter (CEKF) that fuses input information made of both stereophotogrammetric and dynamometric measurement data. Filter gains are made to saturate in order to obtain plausible state variables and the measurement covariance matrix of the filter accounts for the expected STA maximal amplitudes. We hypothesised that the ensemble of constraints and input redundant information would allow the method to attenuate the STA propagation to the end results. The method was evaluated in ten human subjects performing a squat exercise. The CEKF estimated and measured skin marker trajectories exhibited a RMS difference lower than 4mm, thus in the range of STAs. The RMS differences between the measured ground reaction force and moment and those estimated using the proposed method (9N and 10Nm) were much lower than obtained using a classical inverse dynamics approach (22N and 30Nm). From the latter results it may be inferred that the presented method allows for a significant improvement of the accuracy with which kinematic variables and relevant time derivatives, model parameters and, therefore, intersegmental moments are estimated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of the sagittal sinus cross-sectional area between patients with multiple sclerosis, hydrocephalus, intracranial hypertension and spontaneous intracranial hypotension: a surrogate marker of venous transmural pressure?

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Bateman, Grant A; Lechner-Scott, Jeannette; Copping, Ross; Moeskops, Christopher; Yap, Swee Leong

2017-07-06

There is evidence that patients with multiple sclerosis (MS) and hydrocephalus share some common pathophysiological mechanisms. Alterations in CSF pressure are known to affect cerebral venous sinus geometry. To further explore these mechanisms, we measured the superior sagittal sinus (SSS) cross-sectional area 3 cm above the torcular using T2 images in 20 MS, 10 spontaneous intracranial hypotension (SIH), 21 hydrocephalus and 20 idiopathic intracranial hypertension (IIH) patients and compared with 20 matched controls. The SSS area was reduced by 25% in hydrocephalus (p = 0.0008), increased by 22% (p = 0.037) in SIH and unchanged in IIH compared to matched controls. In MS there was a 16% increase in SSS area (p = 0.01).The findings suggest that changes in SSS cross-sectional are common between MS and SIH patients, while in hydrocephalus and IIH these are different.

The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

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Oh, Young Min; Choi, Ha Young

2013-01-01

Objective To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each subject. Pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis angle, sacral inclination, lumbosacral angle, and sacral table angle were measured in both groups. A comparative study of the spinopelvic parameters of these two groups was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA). Results Among the aforementioned spinopelvic parameters, PI, SS and STA were significantly different between patients with spondylolysis and those without spondylolysis. PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Conclusion PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Patients with spondylolysis have low STA at birth, which remains constant during growth; a low STA translates into high SS. As a result, PI is also increased in accordance with SS. Therefore, we suggest that STA is an important etiologic factor in young adult patients with L5 spondylolysis. PMID:24278649

Endplates Changes Related to Age and Vertebral Segment

Directory of Open Access Journals (Sweden)

Carlos Fernando P. S. Herrero

2014-01-01

Full Text Available Endplate separations are defined as the presence of a space between the hyaline cartilage and the cortical bone of the adjacent vertebral body. This study evaluates endplate separations from the vertebral body and intervertebral discs and verifies if endplate separation is related to age and the spinal level. Groups were formed based on age (20–40 and 41–85 years old and the vertebral segment (T7-T8 and L4-L5 segments. Histological analysis included assessment of the length of the vertebral endplates, the number and dimensions of the separations, and orientation of the collagen fibers, in the mid-sagittal slice. Two indexes were created: the separation index (number of separations/vertebral length and separation extension index (sum of all separations/vertebral length. The results of the study demonstrated a direct relationship between the density of separations in the endplate and two variables: age and spinal level.

Rotation of intramedullary alignment rods affects distal femoral cutting plane in total knee arthroplasty.

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Maderbacher, Günther; Matussek, Jan; Keshmiri, Armin; Greimel, Felix; Baier, Clemens; Grifka, Joachim; Maderbacher, Hermann

2018-02-17

Intramedullary rods are widely used to align the distal femoral cut in total knee arthroplasty. We hypothesised that both coronal (varus/valgus) and sagittal (extension/flexion) cutting plane are affected by rotational changes of intramedullary femoral alignment guides. Distal femoral cuts using intramedullary alignment rods were simulated by means of a computer-aided engineering software in 4°, 6°, 8°, 10°, and 12° of valgus in relation to the femoral anatomical axis and 4° extension, neutral, as well as 4°, 8°, and 12° of flexion in relation to the femoral mechanical axis. This reflects the different angles between anatomical and mechanical axis in coronal and sagittal planes. To assess the influence of rotation of the alignment guide on the effective distal femoral cutting plane, all combinations were simulated with the rod gradually aligned from 40° of external to 40° of internal rotation. Rotational changes of the distal femoral alignment guides affect both the coronal and sagittal cutting planes. When alignment rods are intruded neutrally with regards to sagittal alignment, external rotation causes flexion, while internal rotation causes extension of the sagittal cutting plane. Simultaneously the coronal effect (valgus) decreases resulting in an increased varus of the cutting plane. However, when alignment rods are intruded in extension or flexion partly contradictory effects are observed. Generally the effect increases with the degree of valgus preset, rotation and flexion. As incorrect rotation of intramedullary alignment guides for distal femoral cuts causes significant cutting errors, exact rotational alignment is crucial. Coronal cutting errors in the distal femoral plane might result in overall leg malalignment, asymmetric extension gaps and subsequent sagittal cutting errors.

Case-related factors affecting cutting errors of the proximal tibia in total knee arthroplasty assessed by computer navigation.

Science.gov (United States)

Tsukeoka, Tadashi; Tsuneizumi, Yoshikazu; Yoshino, Kensuke; Suzuki, Mashiko

2018-05-01

The aim of this study was to determine factors that contribute to bone cutting errors of conventional instrumentation for tibial resection in total knee arthroplasty (TKA) as assessed by an image-free navigation system. The hypothesis is that preoperative varus alignment is a significant contributory factor to tibial bone cutting errors. This was a prospective study of a consecutive series of 72 TKAs. The amount of the tibial first-cut errors with reference to the planned cutting plane in both coronal and sagittal planes was measured by an image-free computer navigation system. Multiple regression models were developed with the amount of tibial cutting error in the coronal and sagittal planes as dependent variables and sex, age, disease, height, body mass index, preoperative alignment, patellar height (Insall-Salvati ratio) and preoperative flexion angle as independent variables. Multiple regression analysis showed that sex (male gender) (R = 0.25 p = 0.047) and preoperative varus alignment (R = 0.42, p = 0.001) were positively associated with varus tibial cutting errors in the coronal plane. In the sagittal plane, none of the independent variables was significant. When performing TKA in varus deformity, careful confirmation of the bone cutting surface should be performed to avoid varus alignment. The results of this study suggest technical considerations that can help a surgeon achieve more accurate component placement. IV.

Manometric findings in relation to functional outcomes in different types of anorectal malformations.

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Kyrklund, Kristiina; Pakarinen, Mikko P; Rintala, Risto J

2017-04-01

To compare anorectal manometry (AM) in patients with different types of anorectal malformations (ARMs) in relation to functional outcomes. A single-institution, cross-sectional study. After ethical approval, all patients ≥7years old treated for anterior anus (AA), perineal fistula (PF), vestibular fistula (VF), or rectourethral fistula (RUF) from 1983 onwards were invited to answer the Rintala bowel function score (BFS) questionnaire and to attend anorectal manometry (AM). Patients with mild ARMs (AA females and PF males) had been treated with minimally invasive perineal procedures. Females with VF/PF and males with RUF had undergone internal-sphincter saving sagittal repairs. 55 of 132 respondents (42%; median age 12 (7-29) years; 42% male) underwent AM. Patients with mild ARMs displayed good anorectal function after minimally invasive treatments. The median anal resting and squeeze pressures among patients with mild ARMs (60 cm H2O and 116 cm H2O respectively) were significantly higher than among patients with more severe ARMs (50 cm H2O, and 80cm H2O respectively; p≤0.002). The rectoanal inhibitory reflex was preserved in 100% of mild ARMs and 83% of patients with more severe malformations after IAS-saving sagittal repair. The functional outcome was poor in 4/5 patients with an absent RAIR (BFS≤11 or antegrade continence enema-dependence). Rectal sensation correlated significantly with the BFS. Our findings support the appropriateness of our minimally invasive approaches to the management of mild ARMs, and IAS-saving anatomical repairs for patients with more severe malformations. III. Copyright © 2017 Elsevier Inc. All rights reserved.

Use of orthodontic brackets for intermaxillary fixation for management of mandibular fracture in a pediatric patient

OpenAIRE

Rajeev Pandey; Anit Khatri; Rajat Gupta; Nitin Bhagat

2017-01-01

Fracture of mandible is relatively less common in pediatric population when compared to adults. Management of pediatric mandibular fracture is a very complex issue and requires accurate and early treatment. Although the general principles of treatment remain the same as adult but various factors which influence the choice of management: age, dentition status, site involved, amount of displacement, number of fractures, and socioeconomic status. This case report describes a conservative way of ...

Trunk response and stability in standing under sagittal-symmetric pull-push forces at different orientations, elevations and magnitudes.

Science.gov (United States)

El Ouaaid, Z; Shirazi-Adl, A; Plamondon, A

2018-03-21

To reduce lifting and associated low back injuries, manual material handling operations often involve pulling-pushing of carts at different weights, orientations, and heights. The loads on spine and risk of injury however need to be investigated. The aim of this study was to evaluate muscle forces, spinal loads and trunk stability in pull-push tasks in sagittal-symmetric, static upright standing posture. Three hand-held load magnitudes (80, 120 and 160 N) at four elevations (0, 20, 40 and 60 cm to the L5-S1) and 24 force directions covering all pull/push orientations were considered. For this purpose, a musculoskeletal finite element model with kinematics measured earlier were used. Results demonstrated that peak spinal forces occur under inclined pull (lift) at upper elevations but inclined push at the lowermost one. Minimal spinal loads, on the other hand, occurred at and around vertical pull directions. Overall, spinal forces closely followed variations in the net external moment of pull-push forces at the L5-S1. Local lumbar muscles were most active in pulls while global extensor muscles in lifts. The trunk stability margin decreased with load elevation except at and around horizontal push; it peaked under pulls and reached minimum at vertical lifts. It also increased with antagonist activity in muscles and intra-abdominal pressure. Results provide insight into the marked effects of variation in the load orientation and elevation on muscle forces, spinal loads and trunk stability and hence offer help in rehabilitation, performance enhancement training and design of safer workplaces. Copyright © 2017 Elsevier Ltd. All rights reserved.

The anterior sagittal transrectal approach (ASTRA) for cases associated with rectal implantation of the urethra: A retrospective review of six cases.

Science.gov (United States)

Macedo, A; Silva, M I S; Pompermaier, J A; Ottoni, S L; de Castro, R; Leal da Cruz, M

2017-12-01

Severe genital abnormalities such as urogenital sinus and urethral duplication with ectopic urethra in the rectum represent a major challenge in reconstructive urology. We aimed to review our cases presenting with functional ectopic urethra implanted in the rectum that were treated through an ASTRA approach. We reviewed the medical records of all patients who had undergone an ASTRA approach from 2005-2016. We collected data with interest to primary diagnosis, clinical presentation, additional procedure, immediate clinical outcome, complications, bowel habits after surgery, voiding and bladder emptying pattern and long term follow-up. Since 2005, we treated 6 cases using this method, consisting of 3 patients with congenital aphallia and 3 with Y-type urethral duplication. Two aphallia patients underwent De Castro's neophalloplasty with simultaneous anastomosis of proximal urethra to a tubed buccal mucosa neourethra and one had a neophalloplasty with transverse skin flaps and primary perineal urethrostomy. Two patients with Y-type urethral duplication had a complete urethroplasty performed (one end-to-end anastomosis and a two-stage repair). Last patient had a definitive perineal urethrostomy. At mean follow-up of 83.5 meses, only one patient voids through the urethra, four have a Mitrofanoff channel and two have a perineal urethrostomy. Immediate follow-up was uneventful and none of our patients had any bowel complications nor fecal incontinence. Domini et al. were the first proponents of the anterior sagittal transanorectal approach (ASTRA) as an alternative to classic Peña approach. Later, De Castro popularized specifically this technique as a relevant part of his neophalloplasty procedure to treat congenital aphallia. We did not find in this series any complications related to ASTRA technique in regards to bowel habits, fecal incontinence or infection but most of cases we tried to create a new anterior urethra and connect to the proximal stump failed. Moreover

The facial nerve in the temporal bone as visualised via thin-layer paratransversal and sagittal MR tomographic images by means of T1 spin-echo and FLASH sequences

International Nuclear Information System (INIS)

Mueller-Lisse, U.; Jaeger, L.J.E.; Bruegel, F.J.; Grevers, G.; Reiser, M.F.

1995-01-01

It is difficult to effect visualization and delineation of the facial nerve and its neighbouring structures in the temporal bone with conventional MRI examination protocols. We tested temporal bone MRI with 2 mm slices and compared T 1 -weighted FLASH (T R =400 ms, T E =10 ms, 90 flip angle) and spin-echo (T R =540 ms, T E =15 ms) sequences. 5 volunteers and 14 patients were examined with the head coil of a 1.0 T whole body MRI scanner (Impact, Siemens, Erlangen) with para-transversal images orientated parallel to the inferior outline of the clivus and sagittal images orientated along the brainstem. The facial nerve and its neighbouring structures could be reliably visualized and differentiated along its entire course. The FLASH sequence was superior to the spin-echo sequence. 8 of 11 patients with peripheral facial nerve palsy showed contrast enhancement. In two patients, local swelling of the affected facial nerve was evident. (orig./MG) [de

An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture

OpenAIRE

Kumar, Naresh; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

2015-01-01

Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable ...

In vitro comparison of the force degradation of orthodontic intramural elastic from different compositions

OpenAIRE

Vieira, Camilla Ivini Viana [UNESP; Oliveira, Cibele Braga de [UNESP; Ribeiro, Alexandre Antonio [UNESP; Caldas, Sergei Godeiro Fernandes Rabelo [UNESP; Martins, Lídia Parsekian [UNESP; Gandini Júnior, Luiz Gonzaga [UNESP; Santos-Pinto, Ary dos [UNESP

2013-01-01

Introduction and Objective: The synthetic intermaxillary elastic emerged as an alternative for clinical use in patients with latex sensitivity. However, there are disagreements about this elastic protocol use according to the force degradation. The aim of this study was to evaluate, in vitro, the forces generated by latex and synthetic elastics over time. Material and methods: Sample size of 840 elastics were used (420 latex and 420 synthetic), delivering medium strength (Dental Morelli®) wit...

In vitro comparison of the force degradation of orthodontic intraoral elastics from different compositions

OpenAIRE

Vieira, Camila Ivini Viana [UNESP; Oliveira, Cibele Braga [UNESP; Ribeiro, Alexandre Antonio [UNESP; Caldas, Sergei Godeiro Fernandes Rabelo [UNESP; Martins, Lídia Parsekian [UNESP; Gandini Júnior, Luiz Gonzaga [UNESP; Santos-Pinto, Ary dos [UNESP

2013-01-01

Introduction and Objective: The synthetic intermaxillary elastic emerged as an alternative for clinical use in patients with latex sensitivity. However, there are disagreements about this elastic protocol use according to the force degradation. The aim of this study was to evaluate, in vitro, the forces generated by latex and synthetic elastics over time. Material and methods: Sample size of 840 elastics were used (420 latex and 420 synthetic), delivering medium strength (Dental Morelli®) wi...

Orthopedic surgery-related benign uptake on FDG-PET. Case examples and pitfalls

International Nuclear Information System (INIS)

Liu, Y.

2009-01-01

Orthopedic surgical procedures often create some special postoperative complications, which may demonstrate abnormally increased or focal uptake for an extended period of time on fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT images. The distinction of normal from pathologic, benign from malignant uptake is very important to minimize the number of false positive results. To date, very little data have been published regarding surgical-related benign musculoskeletal uptake on PET-CT imaging. In this paper, we present to the readers some case examples of FDG PET-CT imaging for postoperative fracture, infection or osteomyelitis, metallic implants, aggressive bone edge, heterotopic ossification, granuloma and neuroma. We also discuss potential pitfalls to recognize these orthopedic surgery-related complications and identify benign nature of increased FDG uptake. In all cases, the patient's medical and surgical history would be of paramount importance to the radiologists/nuclear medicine physicians who interprets the scan. It is also crucial to carefully correlate FDG uptake with the anatomy on the co-registered CT images in all transaxial, coronal and sagittal views in order to identify the location and pattern of uptake. (author)

Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

Directory of Open Access Journals (Sweden)

Jan Rustemeyer

2011-07-01

Full Text Available Objectives: We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods.Material and Methods: Twenty-six patients (mean age 25.5, standard deviation (SD 5.2 years with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded.Results: Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007; and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043 compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039.Conclusions: Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

Science.gov (United States)

Martin, Alice

2011-01-01

ABSTRACT Objectives We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods. Material and Methods Twenty-six patients (mean age 25.5, standard deviation (SD) 5.2 years) with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years) who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded. Results Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007;) and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043) compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039). Conclusions Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another. PMID:24421994

Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls.

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Ishikawa, Yoshinori; Miyakoshi, Naohisa; Hongo, Michio; Kasukawa, Yuji; Kudo, Daisuke; Shimada, Yoichi

2017-03-01

Spinal deformities can affect quality of life (QOL) and risk of falling, but no studies have explored the relationships of spinal mobility and sagittal alignment of spine and the lower extremities simultaneously. Purpose of this study is to clarify the relationship of those postural parameters to QOL and risk of falling. The study evaluated 110 subjects (41 men, 69 women; mean age, 73 years). Upright and flexion and extension angles for thoracic kyphosis, lumbar lordosis, and spinal inclination were evaluated with SpinalMouse ® . Total-body inclination and hip and knee flexion angles in upright position were measured from lateral photographs. Subjects were divided into Fallers (n=23, 21%) and Non-fallers (n=87, 79%) based on past history of falls. QOL was assessed using the Short Form 36 Health Survey (SF-36 ® ). Age, total-body inclination, spinal inclination upright and in extension, thoracic kyphosis in flexion, lumbar lordosis upright and in extension, and knee flexion correlated significantly with the SF-36. Multiple regression analysis revealed total-body inclination and knee flexion to have the most significant relationships with the SF-36. SF-36, total-body inclination, spinal inclination in extension, thoracic kyphosis in flexion, lumbar lordosis upright and in extension, and hip and knee flexion angles differed significantly between Fallers and Non-fallers (Pfalling (P=0.038). Forward-stooped posture and knee-flexion deformity could be important indicator of lower QOL. Moreover, limited extension in the lumbar spine could be a useful screening examination for fall prevention in the elderly. Copyright © 2017 Elsevier B.V. All rights reserved.

Hard and Soft Tissue Changes Following Maxillary Distraction Osteogenesis and Mandibular Setback with Bilateral Sagittal Split Osteotomy.

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Bawane, Shilpa S; Andrade, Neelam N

2016-12-01

(1) To highlight the role of intraoral submerged device in distraction osteogenesis (DO) of patients requiring two jaw surgeries for the correction of severe developmental maxillary hypoplasia (MH) and mandibular prognathism (MP) (2) To analyse the hard and soft tissue changes following maxillary DO and mandibular setback with bilateral sagittal split osteotomy (BSSO) in patients with severe MH and MP requiring two jaw surgeries. During the period Jan 2004 to Dec 2006, five patients with severe developmental MH along with MP were treated. In 1st stage maxillary distraction was done. Distraction started on 6th postoperative day, 1 mm distraction was carried out for 10-15 days on either side. Serial radiographs were taken immediate postoperative period for baseline comparison, post-distraction and at the end of distraction. After a period of 3-4 months of distraction 2nd stage was done. In 2nd stage, mandibular setback was done with BSSO and distractors were removed under general anesthesia. Radiographs were taken immediately and at 4 months post-operatively. Cephalometric tracings were carried out preoperatively, post DO and finally after mandibular setback with BSSO. The mean horizontal movement of maxilla was 11.4 mm at ANS and 9.6 mm at A point. Upper incisor edge was advanced by 8.8 mms. SNA increased by 8.4° and SNB decreased by 4.6°. Nasal projection advanced by 4°. Nasolabial angle normalized in all patients, mean change achieved was 10.8°. Upper lip moved forward by 5.4 mm. Lower lip moved backward by 5.4 mm. Mandible positioned backward by 4 mm at B point. No vertical change occurred in the position of A, ANS and upper incisor edges. Mean increase in skeletal angle of convexity was 26.4°. Concave profile was significantly changed to convex in all patients. Maxillary DO and mandibular setback with BSSO was associated with improved facial balance and esthetics.

The conservative treatment of pediatric mandibular fracture with prefabricated surgical splint: a case report.

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Kocabay, Ceyda; Ataç, Mustafa Sancar; Oner, Burak; Güngör, Nadir

2007-08-01

The use of rigid fixation in children is controversial and may cause growth retardation along cranial suture lines. Intermaxillary fixation for mandibular fractures should be used cautiously as bony ankylosis in the temporomandibular joint (TMJ) and trismus may develop. The high osteogenic potential of the pediatric mandible allows non-surgical management to be successful in younger patients with conservative approaches. In this case, successful conservative treatment of mandibular fracture of a 3-year-old patient is presented.

Estimation of Vertical Ground Reaction Forces and Sagittal Knee Kinematics During Running Using Three Inertial Sensors

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Frank J. Wouda

2018-03-01

Full Text Available Analysis of running mechanics has traditionally been limited to a gait laboratory using either force plates or an instrumented treadmill in combination with a full-body optical motion capture system. With the introduction of inertial motion capture systems, it becomes possible to measure kinematics in any environment. However, kinetic information could not be provided with such technology. Furthermore, numerous body-worn sensors are required for a full-body motion analysis. The aim of this study is to examine the validity of a method to estimate sagittal knee joint angles and vertical ground reaction forces during running using an ambulatory minimal body-worn sensor setup. Two concatenated artificial neural networks were trained (using data from eight healthy subjects to estimate the kinematics and kinetics of the runners. The first artificial neural network maps the information (orientation and acceleration of three inertial sensors (placed at the lower legs and pelvis to lower-body joint angles. The estimated joint angles in combination with measured vertical accelerations are input to a second artificial neural network that estimates vertical ground reaction forces. To validate our approach, estimated joint angles were compared to both inertial and optical references, while kinetic output was compared to measured vertical ground reaction forces from an instrumented treadmill. Performance was evaluated using two scenarios: training and evaluating on a single subject and training on multiple subjects and evaluating on a different subject. The estimated kinematics and kinetics of most subjects show excellent agreement (ρ>0.99 with the reference, for single subject training. Knee flexion/extension angles are estimated with a mean RMSE <5°. Ground reaction forces are estimated with a mean RMSE < 0.27 BW. Additionaly, peak vertical ground reaction force, loading rate and maximal knee flexion during stance were compared, however, no significant

Performance Indicators Related to Points Scoring and Winning in International Rugby Sevens

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Dean G. Higham, Will G. Hopkins, David B. Pyne, Judith M. Anson

2014-06-01

Full Text Available The aim of the study was to assess the differences in maximal isometric trunk extension and flexion strength during standing, sitting and kneeling. Additionally, we were interested in correlations between the maximal strength in sagittal, frontal and transverse plane, measured in the sitting position. Sixty healthy subjects (24 male, 36 female; age 41.3 ± 15.1 yrs; body height 1.70 ± 0.09 m; body mass 72.7 ± 13.3 kg performed maximal voluntary isometric contractions of the trunk flexor and extensor muscles in standing, sitting and kneeling position. The subjects also performed lateral flexions and rotations in the sitting position. Each task was repeated three times and average of maximal forces was used for data analysis. RANOVA with post-hoc testing was applied to the flexion and extension data. The level of statistical significance was set to p < 0.05. Overall, in both genders together, the highest average force for trunk extension was recorded in sitting posture (910.5 ± 271.5 N, followed by kneeling (834.3 ± 242.9 N and standing (504.0 ± 165.4 N, compared with flexion, where we observed the opposite trend (508.5 ± 213.0 N, 450.9 ± 165.7 N and 443.4 ± 153.1 N, respectively. Post-hoc tests showed significant differences in all extension positions (p < 0.0001 and between sitting/standing (p = 0.018 and kneeling/standing (p = 0.033 flexion exertions. The extension/flexion ratio for sitting was 2.1 ± 0.4, for kneeling 1.9 ± 0.4, followed by standing, where motion forward approximately equals motion backward (1.1 ± 0.6. Trunk sagittal-transverse strength showed the strongest correlation, followed by frontal-transverse and sagittal-frontal plane correlation pairs (R2 = 0.830, 0.712 and 0.657. The baseline trunk isometric strength data provided by this study should help further strength diagnostics, more precisely, the prevention of low back disorders.

Agreement Between Visual Assessment and 2-Dimensional Analysis During Jump Landing Among Healthy Female Athletes.

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Rabin, Alon; Einstein, Ofira; Kozol, Zvi

2018-04-01

  Altered movement patterns, including increased frontal-plane knee movement and decreased sagittal-plane hip and knee movement, have been associated with several knee disorders. Nevertheless, the ability of clinicians to visually detect such altered movement patterns during high-speed athletic tasks is relatively unknown.   To explore the association between visual assessment and 2-dimensional (2D) analysis of frontal-plane knee movement and sagittal-plane hip and knee movement during a jump-landing task among healthy female athletes.   Cross-sectional study.   Gymnasiums of participating volleyball teams.   A total of 39 healthy female volleyball players (age = 21.0 ± 5.2 years, height = 172.0 ± 8.6 cm, mass = 64.2 ± 7.2 kg) from Divisions I and II of the Israeli Volleyball Association.   Frontal-plane knee movement and sagittal-plane hip and knee movement during jump landing were visually rated as good, moderate, or poor based on previously established criteria. Frontal-plane knee excursion and sagittal-plane hip and knee excursions were measured using free motion-analysis software and compared among athletes with different visual ratings of the corresponding movements.   Participants with different visual ratings of frontal-plane knee movement displayed differences in 2D frontal-plane knee excursion ( P < .01), whereas participants with different visual ratings of sagittal-plane hip and knee movement displayed differences in 2D sagittal-plane hip and knee excursions ( P < .01).   Visual ratings of frontal-plane knee movement and sagittal-plane hip and knee movement were associated with differences in the corresponding 2D hip and knee excursions. Visual rating of these movements may serve as an initial screening tool for detecting altered movement patterns during jump landings.

Relative mobility of the pelvis and spine during trunk axial rotation in chronic low back pain patients: A case-control study.

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Masashi Taniguchi

Full Text Available Trunk axial rotation is a risk factor for chronic low back pain (CLBP. The characteristics of rotational mobility in the pelvis and spine among CLBP patients are not fully understood.The purpose of this study was to examine three-dimensional kinematic changes, and to compare the differences of rotational mobility and coupled motion, in patients with and without CLBP.Fifteen patients with CLBP and 15 age and sex matched healthy subjects participated in this study. Each subject performed trunk rotation to maximum range of motion (ROM in a standing position. The kinematics data was collected using a three-dimensional motion analysis system. The outcomes measured were the rotational ROM and the spine/pelvis ratio (SPR in transvers plane at both maximum and 50% rotation position. The coupled angles in sagittal and frontal planes were also measured.No significant differences in rotational ROM of the thorax, pelvis, and spine were observed between two groups at maximum rotation position. However, there was a significant interaction between groups and rotational ROM of pelvis and spine (F = 4.57, p = 0.04, and the SPR in CLBP patients was significantly greater than that of the healthy subjects (CLBP; 0.50 ± 0.10 Control; 0.41 ± 0.12, p = 0.04. The results at 50% rotation position were similar to that at maximum rotation. This indicates a relative increase in spinal rotation in the CLBP patients during trunk rotation. Moreover, the CLBP patients exhibited a significantly higher anterior tilt of the pelvis and extension of the spine in the sagittal plane coupled with rotation.CLBP patients had relative hyper rotational mobility of the spine as well as excessive spinal extension coupled with trunk rotation. These results suggest that uncoordinated trunk rotation might be a functional failure associated with CLBP.

Determination of the most appropriate stress distribution by Finite Element Analysis in fixation with resorbable screws after Bilateral Sagittal Split Ramus Osteotomy surgery

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Sarkarat F.

2009-12-01

Full Text Available "nBackground and Aim: Due to the complications associated with fixation by Titanium screws and plates in Bilateral Sagittal Split Ramus Osteotomy (BSSRO surgery, the use of resorbable polymers has been increasingly recommended. Since there are not enough studies on this issue, this study aimed to assess the most appropriate stress distribution in fixation with resorbable screws after BSSRO surgery by Fnite Element Analysis (FEA."nMaterials and Methods: This experimental study was performed on simulated human mandible using Ansys and Catia softwares. The osteotomy line was applied to the simulated model and experimental loads of 75, 135 and 600 N were respectively exerted according to the natural direction of occlusal force. The distribution pattern of stress was assessed and compared for fixation with one resorbable screw, two resorbable screws in vertical pattern, two resorbable screws in horizontal pattern, three resorbable screws in L pattern and three resorbable screws in inverted backward L pattern using Ansys software."nResults: Among the four simulated fixations, L pattern showed the highest primary stability. Two screws in vertical pattern were also associated with sufficient primary stability and less trauma and cost for patients. One screw did not provide enough stability under 600 N."nConclusion: Polymer-based resorbable screws (polyglycolic acid and D, L polylactide acid provided satisfactory primary stability in BSSRO surgery.

Demonstrating optical aberrations in the laboratory

CSIR Research Space (South Africa)

Naidoo, Darryl

2009-07-01

Full Text Available THE TANGENTIAL AND SAGITTAL FOCI DO NOT COINCIDE AND THE SYSTEM APPEARS TO HAVE 2 POINTS OF FOCUS SAGITTAL PLANE TANGENTIAL PLANE TANGENTIAL IMAGE OPTICAL AXIS OBJECT POINT SAGITTAL IMAGE ASTIGMATISM © CSIR 2008 www....csir.co.za ASTIGMATISM ARISES WHEN THE TANGENTIAL AND SAGITTAL FOCI DO NOT COINCIDE AND THE SYSTEM APPEARS TO HAVE 2 POINTS OF FOCUS SAGITTAL PLANE TANGENTIAL PLANE TANGENTIAL IMAGE OPTICAL AXIS OBJECT POINT SAGITTAL IMAGE FOCAL PLANE COMA IMAGE A B θ COMA...

Valoración de la disposición sagital del raquis en gimnastas especialistas en trampolín. (Assessment of the sagittal plane of the spine in trampoline gymnasts.

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Pilar Sainz de Baranda

2009-07-01

Full Text Available ResumenSe valoró la disposición sagital de la columna vertebral en gimnastas especialistas en la modalidad de trampolín. Se realizó un estudio transversal, en el que participaron 69 gimnastas de trampolín (35 mujeres y 34 varones con una edad media de 14.97 + 4.77 años, y de 6.61+4 años de entrenamiento. La valoración se realizó en tres posiciones: bipedestación relajada, sedentación relajada y flexión máxima del tronco. En todas las posiciones se diferenció la curva dorsal y la lumbar. Para la cuantificación de los grados se utilizó un inclinómetro ISOMED Unilevel-95. En bipedestación la cifosis dorsal media fue 44.96º+8.23º, la lordosis lumbar fue de 36.25º+10.1º. En máxima flexión del tronco desde la bipedestación posición test dedos suelo (FMT-DDS los grados de la curvatura dorsal y lumbar fueron de 51.55º+11º y 29.29º+7.89º. En máxima flexión del tronco desde la sedentación test dedos planta (FMT-DDP los grados de la curvatura dorsal y lumbar fueron de 57.94º+15º y 27.72º+7.51º. En sedentación relajada los grados de la curvatura dorsal y lumbar fueron de 50.28º+10º y 17.48º+9.6º respectivamente. Los valores medios del plano sagital de los gimnastas especialistas en trampolín muestran en bipedestación valores de hipercifosis para la curva dorsal, con una lordosis lumbar normal. En la flexión máxima del tronco se observan valores normales para la cifosis dorsal y valores hipercifóticos para la curva lumbar. En sedentación se observan valores hipercifóticos tanto en la curva dorsal como en la lumbar. Los gimnastas presentan tendencia a una mayor cifosis dorsal en bipedestación y en flexión de tronco. Las gimnastas presentan tendencia a una mayor lordosis en bipedestación y menor cifosis lumbar en flexióny sedentación.Abstract The sagittal plane of the spine was measured in trampoline gymnasts. In this cross-sectional study, 69 club-level trampoline gymnasts (35 females and 34 males

Advantages and Disadvantages of Adult Spinal Deformity Surgery and Its Impact on Health-Related Quality of Life.

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Yoshida, Go; Boissiere, Louis; Larrieu, Daniel; Bourghli, Anouar; Vital, Jean Marc; Gille, Olivier; Pointillart, Vincent; Challier, Vincent; Mariey, Remi; Pellisé, Ferran; Vila-Casademunt, Alba; Perez-Grueso, Francisco Javier Sánchez; Alanay, Ahmet; Acaroglu, Emre; Kleinstück, Frank; Obeid, Ibrahim

2017-03-15

Prospective multicenter study of adult spinal deformity (ASD) surgery. To clarify the effect of ASD surgery on each health-related quality of life (HRQOL) subclass/domain. For patients with ASD, surgery offers superior radiological and HRQOL outcomes compared with nonoperative care. HRQOL may, however, be affected by surgical advantages related to corrective effects, yielding adequate spinopelvic alignment and stability or disadvantages because of long segment fusion. The study included 170 consecutive patients with ASD from a multicenter database with more than 2-year follow-up period. We analyzed each HRQOL domain/subclass (short form-36 items, Oswestry Disability Index, Scoliosis Research Society-22 [SRS-22] questionnaire), and radiographic parameters preoperatively and at 1 and 2 years postoperatively. We divided the patients into two groups each based on lowest instrumented vertebra (LIV; above L5 or S1 to ilium) or surgeon-determined preoperative pathology (idiopathic or degenerative). Improvement rate (%) was calculated as follows: 100 × |pre.-post.|/preoperative points (%) (+, advantages; -, disadvantages). The scores of all short form-36 items and SRS-22 subclasses improved at 1 and 2 years after surgery, regardless of LIV location and preoperative pathology. Personal care and lifting in Oswestry Disability Index were, however, not improved after 1 year. These disadvantages were correlated to sagittal modifiers of SRS-Schwab classification similar to other HRQOL. The degree of personal care disadvantage mainly depended on LIV location and preoperative pathology. Although personal care improved after 2 years postoperatively, no noticeable improvements in lifting were recorded. HRQOL subclass analysis indicated two disadvantages of ASD surgery, which were correlated to sagittal radiographic measures. Fusion to the sacrum or ilium greatly restricted the ability to stretch or bend, leading to limited daily activities for at least 1 year postoperatively

Eruption of the maxillary canines in relation to skeletal maturity.

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Baccetti, Tiziano; Franchi, Lorenzo; De Lisa, Simona; Giuntini, Veronica

2008-05-01

Our aim in this study was to assess the relationship between the eruption of the permanent maxillary canines and skeletal maturity in subjects with different skeletal relationships in the sagittal and vertical planes. A sample of 152 subjects (63 boys, 89 girls) with erupting permanent maxillary canines was analyzed. On the lateral cephalograms, the stage of cervical vertebral maturation was assessed. Then the subjects were divided into prepeak (before the pubertal growth spurt, cervical stage [CS]1 and CS2), peak (during the pubertal growth spurt, CS3 and CS4), and postpeak (after the pubertal growth spurt, CS5 and CS6) groups. Skeletal relationships in the sagittal and vertical planes were evaluated, and relationships to timing of canine eruption were tested statistically. The prepeak group comprised 86 subjects, the peak group 66 subjects, and the postpeak group 0 subjects. The differences in prevalence rates between either the prepeak or peak groups and the postpeak group were statistically significant (P < 0.001). The prevalence rate for hyperdivergent subjects showing eruption of the permanent maxillary canine in the prepeak group (37.2%) was significantly higher than in the reference orthodontic population (21%). The eruption of the permanent maxillary canine can occur at any stage in skeletal maturation before the end the pubertal growth spurt (CS1-CS4), with hyperdivergent subjects more frequently having prepubertal canine eruption.

The role of intraoperative positioning of the inferior alveolar nerve on postoperative paresthesia after bilateral sagittal split osteotomy of the mandible: prospective clinical study.

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Hanzelka, T; Foltán, R; Pavlíková, G; Horká, E; Sedý, J

2011-09-01

Bilateral sagittal split osteotomy (BSSO) aims to correct congenital or acquired mandibular abnormities. Temporary or permanent neurosensory disturbance is the most frequent complication of BSSO. To evaluate the influence of IAN handling during osteotomy, the authors undertook a prospective study in 290 patients who underwent BSSO. The occurrence and duration of paresthesia was evaluated 4 weeks, 3 months, 6 months, and 1 year after surgery. Paresthesia developed immediately after surgery in almost half of the patients. Most cases of paresthesia resolved within 1 year after surgery. A significantly higher prevalence of paresthesia was observed on the left side. The authors found a correlation between the type of IAN position between the left and right side. The type of split (and IAN exposure) did not have a significant effect on the occurrence or duration of neurosensory disturbance of the IAN. The authors did not find a correlation between the occurrence and duration of paresthesia and the direction of BSSO. Mandibular hypoplasia or mandibular progenia did not represent a predisposition for the development of paresthesia. In the development of IAN paresthesia, the type of IAN exposure and the split is less important than the side on which the split is carried out. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Mid-callosal plane determination using preferred directions from diffusion tensor images

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Costa, André L.; Rittner, Letícia; Lotufo, Roberto A.; Appenzeller, Simone

2015-03-01

The corpus callosum is the major brain structure responsible for inter{hemispheric communication between neurons. Many studies seek to relate corpus callosum attributes to patient characteristics, cerebral diseases and psychological disorders. Most of those studies rely on 2D analysis of the corpus callosum in the mid-sagittal plane. However, it is common to find conflicting results among studies, once many ignore methodological issues and define the mid-sagittal plane based on precary or invalid criteria with respect to the corpus callosum. In this work we propose a novel method to determine the mid-callosal plane using the corpus callosum internal preferred diffusion directions obtained from diffusion tensor images. This plane is analogous to the mid-sagittal plane, but intended to serve exclusively as the corpus callosum reference. Our method elucidates the great potential the directional information of the corpus callosum fibers have to indicate its own referential. Results from experiments with five image pairs from distinct subjects, obtained under the same conditions, demonstrate the method effectiveness to find the corpus callosum symmetric axis relative to the axial plane.

Association of body mass index, sagittal abdominal diameter and waist-hip ratio with cardiometabolic risk factors and adipocytokines in Arab children and adolescents

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Al-Attas Omar S

2012-08-01

Full Text Available Abstract Background Sagittal abdominal diameter (SAD is a novel anthropometric measure hypothesized to be a surrogate measure of visceral abdominal obesity in adults. This study aims to determine whether SAD is superior to other anthropometric measures such as body mass index (BMI and waist to hip ratio (WHR in terms of association to cardiometabolic risk and circulating adipocytokine concentrations in a cohort of Saudi children and adolescents. Methods A total of 948 (495 boys and 453 girls apparently healthy children with varying BMI, aged 10–17 years, were included in this cross sectional study. Fasting glucose, lipid profile, leptin, adiponectin, resistin, insulin, TNF-α and aPAI-1 were measured in serum and HOMA-IR was calculated. MetS components were defined according to the International Diabetes Federation (IDF criteria. Results BMI was superior to SAD as well as WHR, and had the highest number of significant associations to MetS components and adipocytokines even after adjustment for age and gender, including blood pressure, lipids, glucose and leptin. Conclusion In conclusion, while SAD is significantly associated with components of MetS among children and adolescents, it is not superior to BMI. The use of SAD therefore may not be practical for use in the pediatric clinical setting. Follow-up studies are needed to determine whether SAD has clinical significance in terms of harder outcomes such as predicting diabetes mellitus or cardiovascular diseases.

Relative brain displacement and deformation during constrained mild frontal head impact.

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Feng, Y; Abney, T M; Okamoto, R J; Pless, R B; Genin, G M; Bayly, P V

2010-12-06

This study describes the measurement of fields of relative displacement between the brain and the skull in vivo by tagged magnetic resonance imaging and digital image analysis. Motion of the brain relative to the skull occurs during normal activity, but if the head undergoes high accelerations, the resulting large and rapid deformation of neuronal and axonal tissue can lead to long-term disability or death. Mathematical modelling and computer simulation of acceleration-induced traumatic brain injury promise to illuminate the mechanisms of axonal and neuronal pathology, but numerical studies require knowledge of boundary conditions at the brain-skull interface, material properties and experimental data for validation. The current study provides a dense set of displacement measurements in the human brain during mild frontal skull impact constrained to the sagittal plane. Although head motion is dominated by translation, these data show that the brain rotates relative to the skull. For these mild events, characterized by linear decelerations near 1.5g (g = 9.81 m s⁻²) and angular accelerations of 120-140 rad s⁻², relative brain-skull displacements of 2-3 mm are typical; regions of smaller displacements reflect the tethering effects of brain-skull connections. Strain fields exhibit significant areas with maximal principal strains of 5 per cent or greater. These displacement and strain fields illuminate the skull-brain boundary conditions, and can be used to validate simulations of brain biomechanics.

Differences in male and female spino-pelvic alignment in asymptomatic young adults: a three-dimensional analysis using upright low-dose digital biplanar X-rays.

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Janssen, Michiel M A; Drevelle, Xavier; Humbert, Ludovic; Skalli, Wafa; Castelein, René M

2009-11-01

A three-dimensional analysis of spino-pelvic alignment in 60 asymptomatic young adult males and females. To analyze the differences in sagittal spino-pelvic alignment in a group of asymptomatic young adult males and females and describe gender specific reference values. Several spinal disorders like idiopathic scoliosis and Scheuermann's disease have a well-known sex-related prevalence ratio. As spino-pelvic alignment plays an important role in spinal biomechanics, it is imperative to analyze possible differences between the male and female spino-pelvic alignment. Furthermore, in spinal fusion surgery, normal sagittal balance should be recreated as closely as possible. An innovative biplanar ultra low-dose radiographic technique was used to obtain three-dimensional reconstructions of the spine (T1-L5), sacrum, and pelvis in a freestanding position of 30 asymptomatic young male and 30 young female adults. Values were calculated for thoracic kyphosis (T4-T12), lumbar lordosis (L1-S1), total and regional lumbopelvic lordosis (PRT12, PRL2, PRL4, and PRL5), sagittal plumb line of T1, T4, and T9 (HAT1, HAT4, and HAT9), T1-L5 sagittal spinal inclination, T9 sagittal offset, and pelvic parameters (pelvic tilt, sacral slope, and pelvic incidence). In addition, vertebral inclination in the sagittal plane of each vertebra was measured. Differences in spino-pelvic alignment between the sexes were analyzed. The female spine was more dorsally inclined (11 degrees vs. 8 degrees ; P = 0.003). High thoracic and thoracolumbar vertebrae were more dorsally inclined in women than in men. Thoracic kyphosis, lumbar lordosis, regional lumbopelvic lordosis, sagittal plumb lines, T9 sagittal offset, and pelvic parameters were not statistically different between the sexes. These results indicate that the female spine is definitely different from the male spine. The spine as whole and individual vertebrae in certain regions of the normal spine is more backwardly inclined in females than in

Orthodontic treatment in a patient with unilateral open-bite and Becker muscular dystrophy. A 5-year follow-up

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Juan Fernando Aristizabal

2014-12-01

Full Text Available INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite.METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead.RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period.

Synchronization in primate cerebellar granule cell layer local field potentials: Basic anisotropy and dynamic changes during active expectancy

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Richard Courtemanche

2009-07-01

Full Text Available The cerebellar cortex is remarkable for its organizational regularity, out of which task-related neural networks should emerge. So, in Purkinje cells, both complex and simple spike network patterns are evident in sensorimotor behavior. However, task-related patterns of activity in the granule cell layer (GCL have been less studied. We recorded local field potential (LFP activity simultaneously in pairs of GCL sites in monkeys performing an active expectancy (lever-press task, in passive expectancy, and at rest. LFP sites were selected when they showed strong 10-25 Hz oscillations; pair orientation was in stereotaxic sagittal and coronal (mainly, and diagonal. As shown previously, LFP oscillations at each site were modulated during the lever-press task. Synchronization across LFP pairs showed an evident basic anisotropy at rest: sagittal pairs of LFPs were better synchronized (more than double the cross-correlation coefficients than coronal pairs, and more than diagonal pairs. On the other hand, this basic anisotropy was modifiable: during the active expectancy condition, where sagittal and coronal orientations were tested, synchronization of LFP pairs would increase just preceding movement, most notably for the coronal pairs. This lateral extension of synchronization was not observed in passive expectancy. The basic pattern of synchronization at rest, favoring sagittal synchrony, thus seemed to adapt in a dynamic fashion, potentially extending laterally to include more cerebellar cortex elements. This dynamic anisotropy in LFP synchronization could underlie GCL network organization in the context of sensorimotor tasks.

Age-related contrast enhancement study of normal bone marrow in lumbar spinal MR imaging

International Nuclear Information System (INIS)

Kim, Young A; Ha, Doo Hoe

1999-01-01

The purpose of this study was to evaluate the degree of contrast enhancement of normal bone marrow in L-spine relating to aging and to determine the range of contrast enhancement in normal bone marrow. We analyzed a total of 120 patients (20 per decade) who had undergone lumbar spinal MRI and who ranged in age from the 2nd decade to more than the 7th. Bone marrow revealed no abnormal pathology. Sagittal T1-weighted spin echo sequences were obtained before and after gadolinium administration. For each sequence, a region of interest was drawn within the L1 vertebral body from the midsagittal slice. Signal intensity (SI) values of each sequence were ascertained and the percentage increase in SI was calculated. After contrast enhancement, lumbar MRI revealed no statistically significant in the percentage increase in SI of normal bone marrow in relation to aging. Most patients (99%) however showed an SI increase of between 10% and 49%. In only four, none of whom were aged over 40, was this increase above 50%. Lumbar MRI, revealed no statistically significant difference in percentage increase in SI in normal bone marrow relating to aging, but when the increase is above 50% in a patient aged over 40, bone marrow pathology should be further investigated

PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

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Krüger, Marie T.; Sircar, Ronen; Kogias, Evangelos; Scholz, Christoph; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

2014-01-01

Purpose. To compare radiographic and clinical outcomes after anterior cervical discectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up. Methods. Anterior cervical discectomy was performed in 107 patients in one or two levels using empty PEEK cages (51 levels), Sulcem PMMA spacers (49 levels) or Palacos PMMA spacers (41 levels) between January, 2005 and February, 2009. Bony fusion, subsidence, and sagittal alignment were retrospectively assessed in CT scans and radiographs at follow-up. Clinical outcome was measured using the VAS, NDI, and SF-36. Results. Bony fusion was assessed in 65% (PEEK cage), 57% (Sulcem), and 46% (Palacos) after a mean follow-up of 2.5 years. Mean subsidence was 2.3–2.6 mm without significant differences between the groups. The most pronounced loss of lordosis was found in PEEK cages (−4.1°). VAS was 3.1 (PEEK cage), 3.6 (Sulcem), and 2.7 (Palacos) without significant differences. Functional outcome in the PEEK cage and Palacos group was superior to the Sulcem group. Conclusions. The substitute groups showed differing fusion rates. Clinical outcome, however, appears to be generally not correlated with fusion status or subsidence. We could not specify a superior disc substitute for anterior cervical discectomy. This trial is registered with DRKS00003591. PMID:25110734

Anatomic Assessment of K-Wire Trajectory for Transverse Percutaneous Fixation of Small Finger Metacarpal Fractures: A Cadaveric Study.

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Grandizio, Louis C; Speeckaert, Amy; Kozick, Zach; Klena, Joel C

2018-01-01

The purpose of this cadaveric study is to evaluate the trajectory of percutaneous transverse Kirschner wire (K-wire) placement for fifth metacarpal fractures relative to the sagittal profile of the fifth metacarpal in order to develop a targeting strategy for the treatment of fifth metacarpal fractures. Using 12 unmatched fresh human upper limbs, we evaluated the trajectory of percutaneous transverse K-wire placement relative to the sagittal profile of the fifth metacarpal in order to develop a targeting strategy for treatment of fifth metacarpal fractures. The midpoint of the small and ring finger metacarpals in the sagittal plane was identified at 3 points. At each point, a K-wire was inserted from the small finger metacarpal into the midpoint of the ring finger metacarpal ("center-center" position). The angle of the transverse K-wire relative to the table needed to achieve a center-center position averaged 20.8°, 18.9°, and 16.7° for the proximal diaphysis, middiaphysis, and the collateral recess, respectively. Approximately 80% of transversely placed K-wires obtained purchase in the long finger metacarpal. These results can serve as a guide to help surgeons in the accurate placement of percutaneous K-wires for small finger metacarpal fractures and may aid in surgeon training.

Effect of stretching program in an industrial workplace on hamstring flexibility and sagittal spinal posture of adult women workers: a randomized controlled trial.

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Muyor, José M; López-Miñarro, Pedro A; Casimiro, Antonio J

2012-01-01

To determine the effect of a stretching program performed in the workplace on the hamstring muscle extensibility and sagittal spinal posture of adult women. Fifty-eight adult women volunteers (mean age of 44.23 ± 8.87 years) from a private fruit and vegetable company were randomly assigned to experimental (n=27) or control (n=31) groups. The experimental group performed three exercises of hamstrings stretching of 20 seconds per exercise, three sessions a week for a period of 12 weeks. The control group did not participate in any hamstring stretching program. Hamstring flexibility was evaluated through the passive straight leg raise test and toe-touch test, performed both before and after the stretching program. Thoracic and lumbar curvatures and pelvic inclination were measured in relaxed standing and toe-touch test with a Spinal Mouse. Significant increases (p < 0.01) in toe-touch score and straight leg raise angle (in both legs) were found in the experimental group during post-test, while the control group showed a non-significant decrease for both toe-touch score and straight leg raise test. A significant decrease in thoracic curve and significant increase in pelvic inclination were found in the toe-touch test for the experimental group (p <0.05). However, no significant changes were found in standing posture for any group. Hamstring stretching exercises performed in the working place are effective for increasing hamstring muscle extensibility. This increase generates a more aligned thoracic curve and more anterior pelvic inclination when maximal trunk flexion is performed.

Restoration of lumbopelvic sagittal alignment and its maintenance following transforaminal lumbar interbody fusion (TLIF): comparison between straight type versus curvilinear type cage.

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Kim, Jong-Tae; Shin, Myung-Hoon; Lee, Ho-Jin; Choi, Du-Yong

2015-11-01

To evaluate a radiological and clinical difference between the curvilinear type cages compared to the straight type cages for the restoration of lumbopelvic sagittal alignment and its maintenance after transforaminal lumbar interbody fusion (TLIF) procedure. 68 patients who underwent single-level TLIF using either the straight type or curvilinear type cage were retrospectively reviewed. Assessment of the lumbopelvic parameters and the height of disc space was performed before surgery as well as 2 days, 6 and 12 months after surgery. Clinical outcome was assessed using VAS and ODI. The curvilinear type cages were positioned more anteriorly than the straight type. Restoration of the segmental lordosis (SL) in the curvilinear group was significantly greater than the straight group and at 12 months of follow-up, the straight group showed greater decrease in the disc height than the curvilinear group. The straight group failed to show improvement of lumbar lordosis (LL), while the curvilinear group showed significant restoration of LL and could maintain it to the 6 months of follow-up. In both groups, pelvic tilt was significantly decreased and it lasted to 6 months in the straight group; whereas in the curvilinear group, it was maintained to the last follow-up of 12 months. There were no significant differences between the two groups in mean VAS and ODI score over the follow-up period. This study demonstrates that the curvilinear type cage is superior to the straight type cage in improving the SL and maintaining both the restored lumbopelvic parameters and elevated disc height. These results could be attributable to the anterior position of the curvilinear cage which permits easy restoration of segmental lordosis and less sinking of cages.

Control of body's center of mass motion relative to center of pressure during uphill walking in the elderly.

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Hong, Shih-Wun; Leu, Tsai-Hsueh; Wang, Ting-Ming; Li, Jia-Da; Ho, Wei-Pin; Lu, Tung-Wu

2015-10-01

Uphill walking places more challenges on the locomotor system than level walking does when the two limbs work together to ensure the stability and continuous progression of the body over the base of support. With age-related degeneration older people may have more difficulty in maintaining balance during uphill walking, and may thus experience an increased risk of falling. The current study aimed to investigate using gait analysis techniques to determine the effects of age and slope angles on the control of the COM relative to the COP in terms of their inclination angles (IA) and the rate of change of IA (RCIA) during uphill walking. The elderly were found to show IAs similar to those of the young, but with reduced self-selected walking speed and RCIAs (PIA in the sagittal plane (PIA and RCIA during walking provide a sensitive measure to differentiate individuals with different balance control abilities. The current results and findings may serve as baseline data for future clinical and ergonomic applications. Copyright © 2015 Elsevier B.V. All rights reserved.

Position des lignes temporales sur le cranium de «Mrs » Ples (A.africanus) : une attribution sexuelle est-elle possible ?Possible position of the temporal lines on the cranium of 'Mrs' Ples (A. africanus): is sexual determination possible?

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Prat, Sandrine; Thackeray, John Francis

2001-03-01

The cranium and associated matrix of Sts 5, a cranium of Australopithecus africanus is re-examined in the context of an unfused sagittal suture and the position of the temporal lines. These lines are not developed as a sagittal crest although they are close to the mid-sagittal line. A comparative study of the presence of sagittal crests in male, female, juvenile and adult specimens of extant great apes ( Gorilla, Pan, Pongo) suggests that the existence of a sagittal crest is influenced to a greater extent by anatomical age rather than by the sex of the individuals.

Accuracy of two face-bow/semi-adjustable articulator systems in transferring the maxillary occlusal cant.

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Nazir, Nazia; Sujesh, M; Kumar, Ravi; Sreenivas, P

2012-01-01

The precision of an arbitrary face-bow in accurately transferring the orientation of the maxillary cast to the articulator has been questioned because the maxillary cast is mounted in relation to arbitrary measurements and anatomic landmarks that vary among individuals. This study was intended to evaluate the sagittal inclination of mounted maxillary casts on two semi-adjustable articulator/face-bow systems in comparison to the occlusal cant on lateral cephalograms. Maxillary casts were mounted on the Hanau and Girrbach semi-adjustable articulators following face-bow transfer with their respective face-bows. The sagittal inclination of these casts was measured in relation to the fixed horizontal reference plane using physical measurements. Occlusal cant was measured on lateral cephalograms. SPSS software (version 11.0, Chicago, IL, USA) was used for statistical analysis. Repeated measures analysis of variance and Tukey's tests were used to evaluate the results (P occlusal cant on the articulators and cephalogram revealed statistically significant differences. Occlusal plane was steeper on Girrbach Artex articulator in comparison to the Hanau articulator. Within the limitations of this study, it was found that the sagittal inclination of the mounted maxillary cast achieved with Hanau articulator was closer to the cephalometric occlusal cant as compared to that of the Girrbach articulator. Among the two articulators and face-bow systems, the steepness of sagittal inclination was greater on Girrbach semi-adjustable articulator. Different face-bow/articulator systems could result in different orientation of the maxillary cast, resulting in variation in stability, cuspal inclines and cuspal heights.

Open-bite treatment utilizing clear removable appliances with intermaxillary and intramaxillary elastics.

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Park, Jae Hyun; Kim, Tae Weon

2009-01-01

Clear removable appliances with elastics can be effective and efficient in extruding maxillary teeth during aligner treatment or following a relapse of an open bite. Some patients with open bites refuse to wear conventional fixed appliances. In these individuals, clear aligners with elastics could be a valuable alternative. © 2009 Quintessence Publishing Co, Inc. All Rights Reserved

Walking on uneven terrain with a powered ankle prosthesis: A preliminary assessment.

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Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

2015-01-01

A successful walking gait with a powered prosthesis depends heavily on proper timing of power delivery, or push-off. This paper describes a control approach which provides improved walking on uneven terrain relative to previous work intended for use on even (level) terrain. This approach is motivated by an initial healthy subject study which demonstrated less variation in sagittal plane shank angle than sagittal plane ankle angle when walking on uneven terrain relative to even terrain. The latter therefore replaces the former as the control signal used to initiate push-off in the powered prosthesis described herein. The authors demonstrate improvement in consistency for several gait characteristics, relative to healthy, as well as controller characteristics with the new control approach, including a 50% improvement in the consistency of the percentage of stride at which push-off is initiated.

THE “PENDULUM LAW” - HOW TO EXPLAIN THE SPINAL SHAPE? PART I

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GILLES NOROTTE

Full Text Available ABSTRACT The author uses the classical parameters that allow studying the sagittal form of the spine, following a vertebral semantics (lordosis, kyphosis, spinopelvic parameters, and sagittal balance. Then he proposes a very different perspective that analyzes the shape of the column, not in the sagittal-coronal plane but in the vertical plane, that is, integrating gravity as a three-dimensional construction axis. Beginning with an analysis of the global body scheme of which the column is part, the muscular synergies are introduced using reference points, defining tension lines, anatomical and functional arches, highlighting the importance of the respiratory function that stabilizes the shape of the thoracolumbar spine. This shows that, whatever the pelvic or frequent anomalies, the biomechanical scheme depends on a single unique law related to gravity: the “pendulum law”. This allows us to define an ideal shaped spine, in comparison to different models, evoking the semantic practical and therapeutic interest of such a perspective.

Combined effects of alcohol and caffeine on the late components of the event-related potential and on reaction time.

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Martin, Frances Heritage; Garfield, Joshua

2006-01-01

The effects of .7 ml/kg alcohol and 200 mg caffeine on the P200, N200, P300 and N500 difference wave components of the event-related potential and on reaction time (RT) were examined in 16 females who performed both simple and choice RT tasks. Alcohol slowed the decision time (DT) component of reaction time, lengthened the latency of the P200 and P300 components, reduced N200 amplitude, increased P300 amplitude at parietal sites, and modified the effect of sagittal site on N500 difference wave peak amplitude. Caffeine shortened DT in the choice RT task, shortened N200 latency at right hemisphere sites, and shortened N200 latency in the choice RT task in combination with alcohol compared to when alcohol was administered alone. Caffeine also increased P300 amplitude in the choice RT task and reduced the integral of the N500 difference wave at most sites when combined with alcohol. It was concluded that whereas alcohol slows attention allocation and impairs working memory, caffeine accelerated response-related decisions and enhanced cortical arousal.

Relationship Between T1 Slope and Cervical Alignment Following Multilevel Posterior Cervical Fusion Surgery: Impact of T1 Slope Minus Cervical Lordosis.

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Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

2016-04-01

Retrospective study. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r = 0.495). C2-C7 lordosis (P = 0.001) and T1S-CL (P = 0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50 mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r = 0.871 and r = 0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50 mm corresponded to a T1S-CL value of 26.1°. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50 mm. 3.

Biomechanical in vitro evaluation of three stable internal fixation techniques used in sagittal osteotomy of the mandibular ramus: a study in sheep mandibles

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Leandro Benetti de Olivera

2012-08-01

Full Text Available Among the osteotomies performed in orthognathic surgery, the sagittal osteotomy of the mandibular ramus (SOMR is the most common, allowing a great range of movements and stable internal fixation (SIF, therefore eliminating the need of maxillomandibular block in the postoperative period. OBJECTIVES: The purpose of this study was to evaluate the biomechanical resistance of three national systems used for SIF in SOMR in sheep mandibles. MATERIAL AND METHODS: The study was performed in 30 sheep hemi-mandibles randomly divided into 3 experimental groups, each containing 10 hemi-mandibles. The samples were measured to avoid discrepancies and then subjected to SOMR with 5-mm advancement. In group I, 2.0x12 mm screws were used for fixation, inserted in an inverted "L" pattern (inverted "L" group. In group II, fixation was performed with two 2.0x12 mm screws, positioned in a linear pattern and a 4-hole straight miniplate and four 2.0x6.0 mm monocortical screws (hybrid group. In group III, fixation was performed with two 4-hole straight miniplates and eight 2.0x6.0 mm monocortical screws (mini plate group. All materials used for SIF were supplied by Osteosin - SIN. The hemimandibles were subjected to vertical linear load test by Kratos K2000MP mechanical testing unit for loading registration and displacement. RESULTS: All groups showed similar resistance during mechanical test for loading and displacement, with no statistically significant differences between groups according to analysis of variance. CONCLUSION: These results indicate that the three techniques of fixation are equally effective for clinical fixation of SOMR.

Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine.

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Breen, Alexander; Breen, Alan

2016-07-01

Quantitative fluoroscopy (QF) was developed to measure intervertebral mechanics in vivo and has been found to have high repeatability and accuracy for the measurement of intervertebral rotations. However, sagittal plane translation and finite centre of rotation (FCR) are potential measures of stability but have not yet been fully validated for current QF. This study investigated the repeatability and accuracy of QF for measuring these variables. Repeatability was assessed from L2-S1 in 20 human volunteers. Accuracy was investigated using 10 consecutive measurements from each of two pairs of linked and instrumented dry human vertebrae as reference; one which tilted without translation and one which translated without tilt. The results found intra- and inter-observer repeatability for translation to be 1.1mm or less (SEM) with fair to substantial reliability (ICC 0.533-0.998). Intra-observer repeatability of FCR location for inter-vertebral rotations of 5° and above ranged from 1.5mm to 1.8mm (SEM) with moderate to substantial reliability (ICC 0.626-0.988). Inter-observer repeatability for FCR ranged from 1.2mm to 5.7mm, also with moderate to substantial reliability (ICC 0.621-0.878). Reliability was substantial (ICC>0.81) for 10/16 measures for translation and 5/8 for FCR location. Accuracy for translation was 0.1mm (fixed centre) and 2.2mm (moveable centre), with an FCR error of 0.3mm(x) and 0.4mm(y) (fixed centre). This technology was found to have a high level of accuracy and with a few exceptions, moderate to substantial repeatability for the measurement of translation and FCR from fluoroscopic motion sequences. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Evaluation of the accuracy of linear measurements on multi-slice and cone beam computed tomography scans to detect the mandibular canal during bilateral sagittal split osteotomy of the mandible.

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Freire-Maia, B; Machado, V deC; Valerio, C S; Custódio, A L N; Manzi, F R; Junqueira, J L C

2017-03-01

The aim of this study was to compare the accuracy of linear measurements of the distance between the mandibular cortical bone and the mandibular canal using 64-detector multi-slice computed tomography (MSCT) and cone beam computed tomography (CBCT). It was sought to evaluate the reliability of these examinations in detecting the mandibular canal for use in bilateral sagittal split osteotomy (BSSO) planning. Eight dry human mandibles were studied. Three sites, corresponding to the lingula, the angle, and the body of the mandible, were selected. After the CT scans had been obtained, the mandibles were sectioned and the bone segments measured to obtain the actual measurements. On analysis, no statistically significant difference was found between the measurements obtained through MSCT and CBCT, or when comparing the measurements from these scans with the actual measurements. It is concluded that the images obtained by CT scan, both 64-detector multi-slice and cone beam, can be used to obtain accurate linear measurements to locate the mandibular canal for preoperative planning of BSSO. The ability to correctly locate the mandibular canal during BSSO will reduce the occurrence of neurosensory disturbances in the postoperative period. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Relationship between screw sagittal angle and stress on endplate of adjacent segments after anterior cervical corpectomy and fusion with internal fixation: a Chinese finite element study.

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Zhang, Yu; Tang, Yibo; Shen, Hongxing

2017-12-01

In order to reduce the incidence of adjacent segment disease (ASD), the current study was designed to establish Chinese finite element models of normal 3rd~7th cervical vertebrae (C3-C7) and anterior cervical corpectomy and fusion (ACCF) with internal fixation , and analyze the influence of screw sagittal angle (SSA) on stress on endplate of adjacent cervical segments. Mimics 8.1 and Abaqus/CAE 6.10 softwares were adopted to establish finite element models. For C4 superior endplate and C6 inferior endplate, their anterior areas had the maximum stress in anteflexion position, and their posterior areas had the maximum stress in posterior extension position. As SSA increased, the stress reduced. With an increase of 10° in SSA, the stress on anterior areas of C4 superior endplate and C6 inferior endplate reduced by 12.67% and 7.99% in anteflexion position, respectively. With an increase of 10° in SSA, the stress on posterior areas of C4 superior endplate and C6 inferior endplate reduced by 9.68% and 10.22% in posterior extension position, respectively. The current study established Chinese finite element models of normal C3-C7 and ACCF with internal fixation , and demonstrated that as SSA increased, the stress on endplate of adjacent cervical segments decreased. In clinical surgery, increased SSA is able to play important role in protecting the adjacent cervical segments and reducing the incidence of ASD.

Accuracy of two face-bow/semi-adjustable articulator systems in transferring the maxillary occlusal cant

Directory of Open Access Journals (Sweden)

Nazia Nazir

2012-01-01

Full Text Available Context: The precision of an arbitrary face-bow in accurately transferring the orientation of the maxillary cast to the articulator has been questioned because the maxillary cast is mounted in relation to arbitrary measurements and anatomic landmarks that vary among individuals. Aim: This study was intended to evaluate the sagittal inclination of mounted maxillary casts on two semi-adjustable articulator/face-bow systems in comparison to the occlusal cant on lateral cephalograms. Materials and Methods: Maxillary casts were mounted on the Hanau and Girrbach semi-adjustable articulators following face-bow transfer with their respective face-bows. The sagittal inclination of these casts was measured in relation to the fixed horizontal reference plane using physical measurements. Occlusal cant was measured on lateral cephalograms. SPSS software (version 11.0, Chicago, IL, USA was used for statistical analysis. Repeated measures analysis of variance and Tukey′s tests were used to evaluate the results (P < 0.05. Results: Comparison of the occlusal cant on the articulators and cephalogram revealed statistically significant differences. Occlusal plane was steeper on Girrbach Artex articulator in comparison to the Hanau articulator. Conclusion: Within the limitations of this study, it was found that the sagittal inclination of the mounted maxillary cast achieved with Hanau articulator was closer to the cephalometric occlusal cant as compared to that of the Girrbach articulator. Among the two articulators and face-bow systems, the steepness of sagittal inclination was greater on Girrbach semi-adjustable articulator. Different face-bow/articulator systems could result in different orientation of the maxillary cast, resulting in variation in stability, cuspal inclines and cuspal heights.

Clinical significance of three-dimensional measurement of tumour thickness on magnetic resonance imaging in patients with oral tongue squamous cell carcinoma

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Kwon, Minsu [Gyeongsang National University Hospital, School of Medicine, Department of Otorhinolaryngology, Jinju (Korea, Republic of); Moon, Hyun; Nam, Soon Yuhl; Kim, Ji Won; Lee, Yoon-Se; Roh, Jong-Lyel; Choi, Seung-Ho [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Lee, Jeong Hyun [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Centre, Seoul (Korea, Republic of); Kim, Sang-Yoon [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Korea Institute of Science and Technology, Biomedical Research Institute, Seoul (Korea, Republic of)

2016-03-15

To identify the clinical significance of primary tumour thickness (TT) and its direction in patients with oral tongue squamous cell carcinoma (OTSCC), we measured TT in all axial/coronal/sagittal views on magnetic resonance imaging (MRI) and evaluated their meaning. A total of 53 OTSCC patients were analysed who had undergone preoperative three-dimensional MRI and had been surgically treated. TT measured on axial (mediolateral direction), coronal (superoinferior direction), and sagittal (anteroposterior direction) views was compared to that in pathologic specimens. The association between TT on MRI and other pathologic parameters was also evaluated. TT on MRI in each plane showed relatively high concordance rates with the histological measurements. TT in all three planes was significantly correlated with lymph node (LN) metastasis. Occult LN metastasis was found in 15 of 39 (38.5 %) patients, and the cutoff value of TT in axial/coronal/sagittal MRI predicting occult LN metastasis was 6.7 mm, 7.2 mm, and 12.3 mm, respectively. TT on MRI did not show any significant association with recurrence and survival. TT on MRI in all three planes showed relatively high coincidence with TT on histopathology and presented a potential cut-off value as a predictive indicator for occult LN metastasis. (orig.)

Clinical significance of three-dimensional measurement of tumour thickness on magnetic resonance imaging in patients with oral tongue squamous cell carcinoma

International Nuclear Information System (INIS)

Kwon, Minsu; Moon, Hyun; Nam, Soon Yuhl; Kim, Ji Won; Lee, Yoon-Se; Roh, Jong-Lyel; Choi, Seung-Ho; Lee, Jeong Hyun; Kim, Sang-Yoon

2016-01-01

To identify the clinical significance of primary tumour thickness (TT) and its direction in patients with oral tongue squamous cell carcinoma (OTSCC), we measured TT in all axial/coronal/sagittal views on magnetic resonance imaging (MRI) and evaluated their meaning. A total of 53 OTSCC patients were analysed who had undergone preoperative three-dimensional MRI and had been surgically treated. TT measured on axial (mediolateral direction), coronal (superoinferior direction), and sagittal (anteroposterior direction) views was compared to that in pathologic specimens. The association between TT on MRI and other pathologic parameters was also evaluated. TT on MRI in each plane showed relatively high concordance rates with the histological measurements. TT in all three planes was significantly correlated with lymph node (LN) metastasis. Occult LN metastasis was found in 15 of 39 (38.5 %) patients, and the cutoff value of TT in axial/coronal/sagittal MRI predicting occult LN metastasis was 6.7 mm, 7.2 mm, and 12.3 mm, respectively. TT on MRI did not show any significant association with recurrence and survival. TT on MRI in all three planes showed relatively high coincidence with TT on histopathology and presented a potential cut-off value as a predictive indicator for occult LN metastasis. (orig.)

Detection of bridging veins draining into superior sagittal sinus by using susceptibility weighted imaging and three dimensional contrast enhancement MR venography

International Nuclear Information System (INIS)

Xia Chunhua; Chen Dan; Chen Bing; Wang Yajun; Xia Shiyong; Liu Wenli; Zhang Zhenhua; Wang Hui; Wu Lingqiao

2011-01-01

Objective: To use the superior sagittal sinus (SSS) as an example to identify anatomical features of the bridging veins (BVs) draining into the SSS in both susceptibility weighted imaging (SWI) and three dimensional contrast enhancement MR venography (3D-CEMRV) images. Methods: A total of 20 healthy volunteers (40 sides) were examined in this study. The venograms of each patient was obtained from SWI (40 sides out of 20 volunteers) and 3D-CE MRV (40 sides out of 20 volunteers). The data were analyzed by t test. Results: According to their draining location with respect to the SSS, bridging veins were divided into two groups. Between the anterior group and the posterior group were two segments of the SSS into which few bridging veins drained. Observed by 3D-CE MRV and SWI, the average numbers of the anterior group were 1.9±0.6 and 3.2±0.8, respectively, and the average diameters of the anterior group were (3.4±1.1) and (2.1±0.5) mm, respectively. These differences between 3D-CE MRV and SWI images were significant (t=11.23, 9.76, P<0.01). Observed by 3D-CE MRV and SWI, the average numbers of the posterior group were 3.5±1.2 and 5.9±1.1, respectively, and the average diameters of the posterior group were (3.7±0.9) and (2.9±0.7) mm, respectively. The differences between the two technique were significant as well (t=11.51, 8.47, P<0.01). Conclusion: The dural entrance of BVs into the SSS can be identified in both SWI and 3D-CE MRV images. The preoperative venogram by using 3D-CE MRV and SWI is useful to design a individual-tailored surgical approach for the preservation of BVs draining into SSS. SWI outweighs 3D-CE MRV in identifying anatomical features of the dural entrance of BVs into the SSS. (authors)

A pilot study and novel angiographic classification for superior sagittal sinus stenting in patients with non-thrombotic intracranial venous occlusive disease.

Science.gov (United States)

Raper, Daniel M S; Buell, Thomas J; Ding, Dale; Pomeraniec, I Jonathan; Crowley, R Webster; Liu, Kenneth C

2018-01-01

Safety and efficacy of superior sagittal sinus (SSS) stenting for non-thrombotic intracranial venous occlusive disease (VOD) is unknown. The aim of this retrospective cohort study is to evaluate outcomes after SSS stenting. We evaluated an institutional database to identify patients who underwent SSS stenting. Radiographic and clinical outcomes were analyzed and a novel angiographic classification of the SSS was proposed. We identified 19 patients; 42% developed SSS stenosis after transverse sinus stenting. Pre-stent maximum mean venous pressure (MVP) in the SSS of 16.2 mm Hg decreased to 13.1 mm Hg after stenting (p=0.037). Preoperative trans-stenosis pressure gradient of 4.2 mm Hg decreased to 1.5 mm Hg after stenting (pSSS stenosis distal to the stent construct was noted. Improvement in headache, tinnitus, and visual obscurations was reported by 66.7%, 63.6%, and 50% of affected patients, respectively, at mean follow-up of 5.2 months. We divided the SSS into four anatomically equal segments, numbered S1-S4, from the torcula to frontal pole. SSS stenosis typically occurs in the S1 segment, and the anterior extent of SSS stents was deployed at the S1-S2 junction in all but one case. SSS stenting is reasonably safe, may improve clinical symptoms, and significantly reduces maximum MVP and trans-stenosis pressure gradients in patients with VOD with SSS stenosis. The S1 segment is most commonly stenotic, and minimum pressure gradients for symptomatic SSS stenosis may be lower than for transverse or sigmoid stenosis. Additional studies and follow-up are necessary to better elucidate appropriate clinical indications and long-term efficacy of SSS stenting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sex differences in lower extremity kinematics and patellofemoral kinetics during running.

Science.gov (United States)

Almonroeder, Thomas G; Benson, Lauren C

2017-08-01

The incidence of patellofemoral pain (PFP) is 2 times greater in females compared with males of similar activity levels; however, the exact reason for this discrepancy remains unclear. Abnormal mechanics of the hip and knee in the sagittal, frontal, and transverse planes have been associated with an increased risk of PFP. The purpose of this study was to compare the mechanics of the lower extremity in males and females during running in order to better understand the reason(s) behind the sex discrepancy in PFP. Three-dimensional kinematic and kinetic data were collected as male and female participants completed overground running trials at a speed of 4.0 m · s -1 (±5%). Patellofemoral joint stress (PFJS) was estimated using a sagittal plane knee model. The kinematics of the hip and knee in the frontal and transverse planes were also analysed. Male participants demonstrated significantly greater sagittal plane peak PFJS in comparison with the female participants (P < .001, ES = 1.9). However, the female participants demonstrated 3.5° greater peak hip adduction and 3.4° greater peak hip internal rotation (IR). As a result, it appears that the sex discrepancy in PFP is more likely to be related to differences in the kinematics of the hip in the frontal and transverse planes than differences in sagittal plane PFJS.

Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty

Directory of Open Access Journals (Sweden)

William D. Bugbee

2013-01-01

Full Text Available Customized patient instrumentation (CPI combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA. We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.

Sagittal Plane Correction Using the Lateral Transpsoas Approach: A Biomechanical Study on the Effect of Cage Angle and Surgical Technique on Segmental Lordosis.

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Melikian, Rojeh; Yoon, Sangwook Tim; Kim, Jin Young; Park, Kun Young; Yoon, Caroline; Hutton, William

2016-09-01

Cadaveric biomechanical study. To determine the degree of segmental correction that can be achieved through lateral transpsoas approach by varying cage angle and adding anterior longitudinal ligament (ALL) release and posterior element resection. Lordotic cage insertion through the lateral transpsoas approach is being used increasingly for restoration of sagittal alignment. However, the degree of correction achieved by varying cage angle and ALL release and posterior element resection is not well defined. Thirteen lumbar motion segments between L1 and L5 were dissected into single motion segments. Segmental angles and disk heights were measured under both 50 N and 500 N compressive loads under the following conditions: intact specimen, discectomy (collapsed disk simulation), insertion of parallel cage, 10° cage, 30° cage with ALL release, 30° cage with ALL release and spinous process (SP) resection, 30° cage with ALL release, SP resection, facetectomy, and compression with pedicle screws. Segmental lordosis was not increased by either parallel or 10° cages as compared with intact disks, and contributed small amounts of lordosis when compared with the collapsed disk condition. Placement of 30° cages with ALL release increased segmental lordosis by 10.5°. Adding SP resection increased lordosis to 12.4°. Facetectomy and compression with pedicle screws further increased lordosis to approximately 26°. No interventions resulted in a decrease in either anterior or posterior disk height. Insertion of a parallel or 10° cage has little effect on lordosis. A 30° cage insertion with ALL release resulted in a modest increase in lordosis (10.5°). The addition of SP resection and facetectomy was needed to obtain a larger amount of correction (26°). None of the cages, including the 30° lordotic cage, caused a decrease in posterior disk height suggesting hyperlordotic cages do not cause foraminal stenosis. N/A.

Change in running kinematics after cycling are related to alterations in running economy in triathletes.

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Bonacci, Jason; Green, Daniel; Saunders, Philo U; Blanch, Peter; Franettovich, Melinda; Chapman, Andrew R; Vicenzino, Bill

2010-07-01

Emerging evidence suggests that cycling may influence neuromuscular control during subsequent running but the relationship between altered neuromuscular control and run performance in triathletes is not well understood. The aim of this study was to determine if a 45 min high-intensity cycle influences lower limb movement and muscle recruitment during running and whether changes in limb movement or muscle recruitment are associated with changes in running economy (RE) after cycling. RE, muscle activity (surface electromyography) and limb movement (sagittal plane kinematics) were compared between a control run (no preceding cycle) and a run performed after a 45 min high-intensity cycle in 15 moderately trained triathletes. Muscle recruitment and kinematics during running after cycling were altered in 7 of 15 (46%) triathletes. Changes in kinematics at the knee and ankle were significantly associated with the change in VO(2) after cycling (precruitment in some triathletes and that changes in kinematics, especially at the ankle, are closely related to alterations in running economy after cycling. Copyright 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis.

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Molfenter, Sonja M; Amin, M R; Branski, R C; Brumm, J D; Hagiwara, M; Roof, S A; Lazarus, C L

2015-06-01

Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism underlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lumen area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70+). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lumen area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post-hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed significant differences between 20s versus 70+ for all variables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyngeal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases.

Does correction of preoperative coronal imbalance make a difference in outcomes of adult patients with deformity?

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Daubs, Michael D; Lenke, Lawrence G; Bridwell, Keith H; Kim, Yongjung J; Hung, Man; Cheh, Gene; Koester, Linda A

2013-03-15

Retrospective study with prospectively collected outcomes data. Determine the significance of coronal balance on spinal deformity surgery outcomes. Sagittal balance has been confirmed as an important radiographic parameter correlating with adult deformity treatment outcomes. The significance of coronal balance on functional outcomes is less clear. Eighty-five patients with more than 4 cm of coronal imbalance who underwent reconstructive spinal surgery were evaluated to determine the significance of coronal balance on functional outcomes as measured with the Oswestry Disability Index (ODI) and Scoliosis Research Society outcomes questionnaires. Sixty-two patients had combined coronal (>4 cm) and sagittal imbalance (>5 cm), while 23 patients had coronal imbalance alone. Postoperatively, 85% of patients demonstrated improved coronal balance. The mean improvement in the coronal C7 plumb line was 26 mm for a mean correction of 42%. The mean preoperative sagittal C7 plumb line in patients with combined coronal and sagittal imbalance was 118 mm (range, 50-310 mm) and improved to a mean 49 mm. The mean preoperative and postoperative ODI scores were 42 (range, 0-90) and 27 (range, 0-78), for a mean improvement of 15 (36%) (P = 0.00001; 95% CI, 12-20). The mean Scoliosis Research Society scores improved by 17 points (29%) (P = 0.00). Younger age (P = 0.008) and improvement in sagittal balance (P = 0.014) were positive predictors for improved ODI scores. Improvement in sagittal balance (P = 0.010) was a positive predictor for improved Scoliosis Research Society scores. In patients with combined coronal and sagittal imbalance, improvement in sagittal balance was the most significant predictor for improved ODI scores (P = 0.009). In patients with preoperative coronal imbalance alone, improvement in coronal balance trended toward, but was not a significant predictor for improved ODI (P = 0.092). Sagittal balance improvement is the strongest predictor of improved outcomes in

Facial growth and development in unilateral cleft lip and palate from the time of palatoplasty to the onset of puberty: a longitudinal study.

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Smahel, Z; Müllerová, Z

1995-01-01

X-ray cephalometry was used for the assessment of facial growth and development from the time of palate surgery to the onset of puberty (from 5 to 11 years) in 24 boys with unilateral cleft lip and palate treated with primary periosteoplasty (at 8 months) and palatal pushback supplemented by pharyngeal flap surgery (at 5 years). The lowest growth showed the depth of the maxilla and the height of the upper lip. An increasing protrusion of the mandible and in particular the increasing retrusion of the maxilla resulted in a flattening of the face and in an impairment of sagittal jaw relations. However, it was possible to attain an improvement of overjet produced by a substantial increase of the proclination of upper incisors and of the alveolar process. There was a deterioration of the prominence of the upper lip. Anterior growth rotation was absent during the development of the face, though a rotation in both directions was quite common in individual cases. The steepness of the mandibular body, vertical jaw relations, and facial vertical proportions remained unchanged. As compared to the pubertal period, the growth and development differed only by a more marked proclination of the dentoalveolar component of the maxilla and by an improvement of overjet. Facial convexity and sagittal jaw relations deteriorated in more than 90% of the patients, the overjet only in 20%, yet the prominence of the lip in 70%. Facial convexity and sagittal jaw relations were not correlated with mandibular rotation but they affected the overjet and the prominence of the upper lip.(ABSTRACT TRUNCATED AT 250 WORDS)

Herniated disk disease

International Nuclear Information System (INIS)

Ross, J.S.; Masaryk, T.J.; Modic, M.T.; Bohlman, H.; Wilber, G.; Carter, J.

1988-01-01

Thirty patients with symptoms of disk herniation and no previous surgery were examined with Gd-DTPA-enhanced MR imaging. Studies obtained before and after administration of Gd-DTPA included the following sequences: sagittal and axial spin echo (SE) 500/17 (repetition time, msec/echo time, msec), sagittal SE 2,000/60, sagittal FLASH 200/13/60. Studies were interpreted separately for presence of extradural disease (EDD) characterized by morphology, mass effect, and enhancement. Post Gd-DTPA diagnoses were: normal, n = 1; herniation, n = 28; neoplasm, n = 1. Tissue diagnosis was obtained in 13. The Gd-DTPA examination correctly changed the diagnosis in one case, provided increased confidence in the diagnosis in four, and was equivalent to the precontrast study in eight. Increased conspicuity of EDD with Gd-DTPA was related to the enhancement of epidural space analogous to IV CT and enhancement of scar surrounding disk herniation. Histologically, this scar was identical to that seen in postoperative spines, Gd-DTPA appears to be a useful adjunct in cervical and thoracic degenerative disk disease

Relationship between functional assessments and exercise-related changes during static balance.

Science.gov (United States)

Clifton, Daniel R; Harrison, Blain C; Hertel, Jay; Hart, Joseph M

2013-04-01

The Functional Movement Screen (FMS) is currently used for injury risk prediction, although researchers have not studied its relationships to injury risk factors. The purpose of this study was to compare FMS scores at rest to changes in static balance after exercise. Second, we examined FMS scores pre and post exercise. Twenty-five participants performed center of pressure (COP) measures and FMS testing. An acclimatization session for the FMS occurred on day 1, whereas day 2 involved COP measures for static balance and FMS testing before and after a 36-minute exercise protocol. Center of pressure standard deviations in the frontal (COPML-SD) and sagittal (COPAP-SD) planes, center of pressure velocity (COP-Velocity), center of pressure area (COP-Area), and FMS scores were recorded. No significant correlations occurred between preexercise FMS scores and change in COP measures. Preexercise hurdle step scores related to preexercise COPML-SD (p = -0.46), COPAP-SD (p = -0.43), and COP-Area (p = -0.50). Preexercise in-line lunge scores related to postexercise COPAP-SD (p = -0.44) and COP-Velocity (p = -0.39), whereas preexercise active straight leg raise (ASLR) scores related to postexercise COPML-SD (p = -0.46). Functional Movement Screen scores were not related to changes in static balance after exercise and may therefore not be useful to predict who will experience greater static balance deficits after exercise. Additionally, FMS scores did not differ before and after exercise. Clinicians aiming to identify injury risk from a general static balance standpoint may find the hurdle step, in-line lunge, and ASLR useful. Clinicians aiming to identify injury risk from a change in static balance standpoint may need to explore other screening tools.

The spectrum of Apert syndrome: phenotype, particularities in orthodontic treatment, and characteristics of orthognathic surgery

Directory of Open Access Journals (Sweden)

Ehmer Ulrike

2007-02-01

move, or moved insufficiently (especially with respect to rotations and torque irrespective of surgical procedures or orthodontic mechanics and materials applied, and without prognostic factors indicating these problems. Establishing occlusal contact of all teeth was difficult. Tooth movement was generally retarded, increasing the duration of orthodontic treatment. Planning of extractions was different from that of patients without this syndrome. In one patient, the sole surgical procedure after orthodontic treatment with fixed appliances in the maxilla and mandible was a genioplasty. Most patients needed two- jaw surgery (bilateral sagittal split osteotomy [BSSO] with mandibular setback and distraction in the maxilla. During the period of distraction, the orthodontist guided the maxilla into final position by means of bite planes and intermaxillary elastics. To our knowledge, this is the first article in the PubMed accessible literature describing the problems with respect to interdisciplinary orthodontic and surgical procedures. Although the treatment results are not perfect, patients undergoing these procedures benefit esthetically to a high degree. Patients need to be informed with respect to the different kinds of extractions that need to be performed, the increased treatment time, and the results, which may be reached using realistic expectations.

Treatment of the superior sagittal sinus and transverse sinus thrombosis associated with intracranial hemorrhage with the mechanical thrombectomy and thrombolytics: Case report.

Science.gov (United States)

Liu, Yuchun; Li, Keqin; Huang, Yi; Sun, Jie; Gao, Xiang

2017-12-01

The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal. Computed tomography (CT) demonstrated both subarachnoid and intraparenchymal hemorrhage and brain edema at the right temporal lobe accompanied by high density shadow in the right transverse sinus. Digital subtraction angiography (DSA) revealed extensive thrombosis of the SSS and bilateral transverse sinus. The SSS and transverse sinus thrombosis, accompanied by right temporal lobe hemorrhage, subarachnoid hemorrhage (SAH). An emergent mechanical thrombectomy by placed Solitair AB stent in the SSS, respectively, passed left and right sigmoid sinus-transverse sinus route. We removed the most clots, DSA revealed recanalization of the SSS and left transverse sinus was seen with normalization of the venous outflow, the occlusion of right transverse sinus was still present. There were 4 hours after patient back to neurosurgical intensive care unit (NICU), patient appeared anisocoria (R/L:4.0/2.5 mm), bilateral light reflexes disappeared, then we took a CT reexamination revealed intraparenchymal hemorrhage increased, brain edema was aggravated at the left temporal lobe, and mild midline shift. Subsequently, we performed decompressive hemicraniectomy and puncture the hematoma supplemented by B ultrasonic. Anticoagulation treatment was initiated 24 hours after surgery, and follow-up DSA showed gradually improved patency in the SSS and bilateral transverse sinus. Despite occlusion of the SSS and bilateral transverse sinus, patient's symptoms resolved after the operations and he

Reliability of tunnel angle in ACL reconstruction: two-dimensional versus three-dimensional guide technique.

Science.gov (United States)

Leiter, Jeff R S; de Korompay, Nevin; Macdonald, Lindsey; McRae, Sheila; Froese, Warren; Macdonald, Peter B

2011-08-01

To compare the reliability of tibial tunnel position and angle produced with a standard ACL guide (two-dimensional guide) or Howell 65° Guide (three-dimensional guide) in the coronal and sagittal planes. In the sagittal plane, the dependent variables were the angle of the tibial tunnel relative to the tibial plateau and the position of the tibial tunnel with respect to the most posterior aspect of the tibia. In the coronal plane, the dependent variables were the angle of the tunnel with respect to the medial joint line of the tibia and the medial and lateral placement of the tibial tunnel relative to the most medial aspect of the tibia. The position and angle of the tibial tunnel in the coronal and sagittal planes were determined from anteroposterior and lateral radiographs, respectively, taken 2-6 months postoperatively. The two-dimensional and three-dimensional guide groups included 28 and 24 sets of radiographs, respectively. Tibial tunnel position was identified, and tunnel angle measurements were completed. Multiple investigators measured the position and angle of the tunnel 3 times, at least 7 days apart. The angle of the tibial tunnel in the coronal plane using a two-dimensional guide (61.3 ± 4.8°) was more horizontal (P guide (64.7 ± 6.2°). The position of the tibial tunnel in the sagittal plane was more anterior (P guide group compared to the three-dimensional guide group (43.3 ± 2.9%). The Howell Tibial Guide allows for reliable placement of the tibial tunnel in the coronal plane at an angle of 65°. Tibial tunnels were within the anatomical footprint of the ACL with either technique. Future studies should investigate the effects of tibial tunnel angle on knee function and patient quality of life. Case-control retrospective comparative study, Level III.

Brain oxygen saturation assessment in neonates using T2-prepared blood imaging of oxygen saturation and near-infrared spectroscopy

DEFF Research Database (Denmark)

Alderliesten, Thomas; De Vis, Jill B; Lemmers, Petra Ma

2017-01-01

saturation in the sagittal sinus (R(2 )= 0.49, p = 0.023), but no significant correlations could be demonstrated with frontal and whole brain cerebral blood flow. These results suggest that measuring oxygen saturation by T2-prepared blood imaging of oxygen saturation is feasible, even in neonates. Strong...... sinus. A strong linear relation was found between the oxygen saturation measured by magnetic resonance imaging and the oxygen saturation measured by near-infrared spectroscopy (R(2 )= 0.64, p ..., and magnetic resonance imaging measures of frontal cerebral blood flow, whole brain cerebral blood flow and venous oxygen saturation in the sagittal sinus (R(2 )= 0.71, 0.50, 0.65; p 

Misinterpreting growth and treatment outcome from serial cephalographs.

Science.gov (United States)

Ghafari, J; Baumrind, S; Efstratiadis, S S

1998-11-01

This communication addresses the issue of interpretation of serial cephalometric records. Angular measurements provide information that combines the vertical and sagittal components of a landmark's displacement. For example, a decrease in the SNA angle following orthodontic treatment with a headgear demonstrates maxillary retraction relative to nasion, an important assessment to depict a change closely related to the facial profile. Upon superimposition on the anterior cranial base, however, the vertical movement of point A may be the prevalent displacement, which would still account for the decrease in the SNA angle. The superposition allows the evaluation of the displacement in its vertical and sagittal components separately, relative to a structure that is relatively more stable than nasion. The superimposition enhanced the precision of the information regarding the actual displacement of the jaw. A patient's cephalometric records are presented, further demonstrating that the interpretation of changes during growth and treatment should be based not only on angular measurements, but also on regional superpositions. The frames of reference of both procedures are needed to fully understand the facial changes.

The influence of sagittal profile alteration and final lordosis on the clinical outcome of cervical spondylotic myelopathy. A Delta-Omega-analysis.

Directory of Open Access Journals (Sweden)

Daniel Koeppen

Full Text Available Decompression and maintaining or restoring a cervical lordosis are major goals in the surgical treatment of cervical spondylotic myelopathy (CSM. Numerous studies support the assumption that cervical lordosis is a key factor for neurological recovery and pain reduction. However, even kyphotic patients can be asymptomatic. The balance of the spine is subject of an increasing number of publications. The main purpose of the study was to evaluate the validity of lordotic alignment on the course of CSM and to set this parameter in context with well-validated tools, namely the modified Japanese Orthopaedic Association scoring system (mJOAS and the visual analogue scale (VAS, to predict and measure the clinical outcome after surgery.This is a retrospective study with prospectively collected data of a heterogeneous cohort. The authors analyzed the records of 102 patients suffering from CSM that underwent decompressive surgery and instrumentation. Clinical outcome was assessed by using the mJOAS, VAS and Odom's criteria. The radiological analysis involved comparison of pre- and postoperative radiographs. The patients were divided into subgroups to be able to compare the influence of various amounts of correction (3 Delta-groups: 14°. The comparison of Odom's criteria showed that preoperatively kyphotic patients benefitted more from surgery than lordotic patients (p = 0.029, but no differences could be seen comparing neck pain and neurological improvement. The improvement of pain and neurological impairment measured by VAS and mJOAS supports the statistical impact and validity of the data despite comparatively small numbers of patients. The lack of postoperative kyphosis is a major limitation of the study to encompass the impact of sagittal alignment on clinical outcome.Decompression and stabilization appear to be key elements of surgical treatment of CSM. While the achievement of cervical lordosis remains a major goal of surgery, clinical improvement is

Targeted traction of impacted teeth with C-tube miniplates.

Science.gov (United States)

Chung, Kyu-Rhim; Kim, Yong; Ahn, Hyo-Won; Lee, Dongjoo; Yang, Dong-Min; Kim, Seong-Hun; Nelson, Gerald

2014-09-01

Orthodontic traction of impacted teeth has typically been performed using full fixed appliance as anchorage against the traction force. This conventional approach can be difficult to apply in the mixed dentition if the partial fixed appliance offers an insufficient anchor unit. In addition, full fixed appliance can induce unwanted movement of adjacent teeth. This clinical report presents 3 cases where impacted teeth were recovered in the mixed or transitional dentition with skeletal anchorage on the opposite arch without full fixed appliance. Instead, intermaxillary traction was used to bring the impacted teeth into position. With this approach, side effects on teeth and periodontal tissues adjacent to the impaction were minimized.

Malunited fracture of the body and condyle of the mandible : A Case Report.

Science.gov (United States)

Yeluri, Ramakrishna; Baliga, Sudhindra; Munshi, Autar Krishen

2010-07-01

Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, developing tooth buds and growth issues. One major factor is the inherent instability of the occlusion in the mixed deciduous-permanent tooth phase. This case report documents a child in mixed dentition period with a complication arising due to direct fixation of the fractured mandible.

Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

International Nuclear Information System (INIS)

Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan; Koese, Faruk

2005-01-01

The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults: comparison of SAD, waist circumference and body mass index for identifying dysglycemia.

Science.gov (United States)

Kahn, Henry S; Gu, Qiuping; Bullard, Kai McKeever; Freedman, David S; Ahluwalia, Namanjeet; Ogden, Cynthia L

2014-01-01

The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD's distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia. In the 2011-2012 National Health and Nutrition Examination Survey, supine SAD was measured ("abdominal height") between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥ 20; response rate 88%) we used sample weights to estimate SAD's population distribution by sex and age groups. SAD's population mean was 22.5 cm [95% confidence interval 22.2-22.8]; median was 21.9 cm [21.6-22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m(2)) to identify prevalent dysglycemia (HbA1c ≥ 5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (pSAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, pSAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.

Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers.

Science.gov (United States)

Masaki, Mitsuhiro; Aoyama, Tomoki; Murakami, Takashi; Yanase, Ko; Ji, Xiang; Tateuchi, Hiroshige; Ichihashi, Noriaki

2017-11-01

Muscle stiffness of the lumbar back muscles in low back pain (LBP) patients has not been clearly elucidated because quantitative assessment of the stiffness of individual muscles was conventionally difficult. This study aimed to examine the association of LBP with muscle stiffness assessed using ultrasonic shear wave elastography (SWE) and muscle mass of the lumbar back muscle, and spinal alignment in young and middle-aged medical workers. The study comprised 23 asymptomatic medical workers [control (CTR) group] and 9 medical workers with LBP (LBP group). Muscle stiffness and mass of the lumbar back muscles (lumbar erector spinae, multifidus, and quadratus lumborum) in the prone position were measured using ultrasonic SWE. Sagittal spinal alignment in the standing and prone positions was measured using a Spinal Mouse. The association with LBP was investigated by multiple logistic regression analysis with a forward selection method. The analysis was conducted using the shear elastic modulus and muscle thickness of the lumbar back muscles, and spinal alignment, age, body height, body weight, and sex as independent variables. Multiple logistic regression analysis showed that muscle stiffness of the lumbar multifidus muscle and body height were significant and independent determinants of LBP, but that muscle mass and spinal alignment were not. Muscle stiffness of the lumbar multifidus muscle in the LBP group was significantly higher than that in the CTR group. The results of this study suggest that LBP is associated with muscle stiffness of the lumbar multifidus muscle in young and middle-aged medical workers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Variation in the location of the shoe sole flexion point influences plantar loading patterns during gait

NARCIS (Netherlands)

van der Zwaard, B.C.; Vanwanseele, B.; Holtkamp, F.; van der Horst, H.E.; Elders, P.J.M.; Menz, H.B.

2014-01-01

Background: Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally

Variation in the location of the shoe sole flexion point influences plantar loading patterns during gait

NARCIS (Netherlands)

H. van der Horst; H.B. Menz; ing., M.Sc F.C. Holtkamp; P. Elders; B. Vanwanseele; B. van der Zwaard

2014-01-01

Background Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally

Diferentes aferições do diâmetro abdominal sagital e do perímetro da cintura na predição do HOMA-IR Mediciones distintas del diámetro abdominal sagital y del perímetro de la cintura en la predicción del HOMA-IR Different measurements of the sagittal abdominal diameter and waist perimeter in the prediction of HOMA-IR

Directory of Open Access Journals (Sweden)

Ana Carolina Junqueira Vasques

2009-11-01

umbilical, menor cintura, inmediatamente superior a la cresta ilíaca y punto promedio entre la cresta ilíaca y la última costilla se calcularon en cuatro locales diferentes. La resistencia a la insulina se evaluó por el índice HOMA-IR. RESULTADOS: Todas las mediciones presentaron correlación intraclase de 0,986-0,999. Tanto el diámetro abdominal sagital calculado en la menor cintura (r=0,482 y AUC=0,739±0,049 como el perímetro de la cintura calculado en el punto promedio entre la última costilla y la cresta ilíaca (r=0,464 e AUC=0,746±0,05 presentaron mayores correlaciones con el HOMA-IR, así como un mejor poder discriminante para el HOMA-IR según el análisis ROC (pBACKGROUND: The correlation between the increase in visceral fat and insulin resistance makes the sagittal abdominal diameter and the waist perimeter as potential tools for the prediction of insulin resistance. OBJECTIVE: To assess the reproducibility of different measurements of the sagittal abdominal diameter and the waist perimeter and analyze the discriminating power of the measurements when predicting insulin resistance. METHODS: A total of 190 adult males were studied. The sagittal abdominal diameter (smallest girth, larger abdominal diameter, umbilical level and midpoint between the iliac crests and the waist perimeter (umbilical level, smallest girth, immediately above the iliac crest and midpoint between the iliac crest and the last rib were measured at four different sites. Insulin resistance was assessed by the homeostasis model of assessment-insulin resistance (HOMA-IR index. RESULTS: All measurements presented an intraclass correlation of 0.986-0.999. The sagittal abdominal diameter measured at the smallest girth (r=0.482 and AUC=0.739±0.049 and the waist perimeter measured at the midpoint between the last rib and the iliac crest (r=0.464 and AUC=0.746±0.05 presented the highest correlations with the HOMA-IR and the best discriminating power for HOMA-IR according to the ROC analysis

The wrinkled patellar tendon: An indication of abnormality in the extensor mechanism of the knee

International Nuclear Information System (INIS)

Berlin, R.C.; Levinsohn, E.M.; Chrisman, H.

1991-01-01

Rupture of the quadriceps tendon is an uncommon condition which requires early diagnosis and treatment to avert prolonged disability. In four patients who had surgically confirmed quadriceps tendon rupture, lateral radiographs of the knee and/or sagittal magnetic resonance (MR) images demonstrated a corrugated appearance to the patellar tendon. Sagittal MR images of the knee following patellectomy in one patient and radiographs of a transverse fracture of the patella in another also demonstrated this appearance. MRI has superb contrast resolution which provides optimal visualization of the contour of the patellar tendon on sagittal images. A retrospective review of 50 consecutive knee MRI examinations was carried out to evaluate the appearance of the normal patellar tendon. In 49 of 50 patients, the sagittal images demonstrated a straight or nearly straight patellar tendon. A corrugated appearance of the patellar tendon on sagittal images indicates a reduction in the normal tensile force applied to it and indicates the need for careful evaluation of the patella and quadriceps tendon mechanism. (orig.)

Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients

NARCIS (Netherlands)

Jafarnezhadgero, Amir Ali; Oliveira, Anderson S.; Mousavi, Seyed Hamed; Madadi-Shad, Morteza

Osteoarthritis progression can be related to the external knee adduction and flexion moments during walking. Lateral foot wedges and knee braces have been used as treatment for osteoarthritis, but little is known about their influence on knee joint moments generated in the sagittal and frontal

Surface slope metrology of highly curved x-ray optics with an interferometric microscope

Science.gov (United States)

Gevorkyan, Gevork S.; Centers, Gary; Polonska, Kateryna S.; Nikitin, Sergey M.; Lacey, Ian; Yashchuk, Valeriy V.

2017-09-01

The development of deterministic polishing techniques has given rise to vendors that manufacture high quality threedimensional x-ray optics. The surface metrology on these optics remains a difficult task. For the fabrication, vendors usually use unique surface metrology tools, generally developed on site, that are not available in the optical metrology labs at x-ray facilities. At the Advanced Light Source X-Ray Optics Laboratory, we have developed a rather straightforward interferometric-microscopy-based procedure capable of sub microradian characterization of sagittal slope variation of x-ray optics for two-dimensionally focusing and collimating (such as ellipsoids, paraboloids, etc.). In the paper, we provide the mathematical foundation of the procedure and describe the related instrument calibration. We also present analytical expression describing the ideal surface shape in the sagittal direction of a spheroid specified by the conjugate parameters of the optic's beamline application. The expression is useful when analyzing data obtained with such optics. The high efficiency of the developed measurement and data analysis procedures is demonstrated in results of measurements with a number of x-ray optics with sagittal radius of curvature between 56 mm and 480 mm. We also discuss potential areas of further improvement.