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Sample records for lumbar apical vertebral

  1. Relationship between New Osteoporotic Vertebral Fracture and Instrumented Lumbar Arthrodesis

    OpenAIRE

    Kim, Bung-Hak; Choi, Dong-Hyuk; Jeon, Seong-Hun; Choi, Yong-Soo

    2010-01-01

    Study Design Retrospective study. Purpose To evaluate the relationship between a new osteoporotic vertebral fracture and instrumented lumbar arthrodesis. Overview of Literature In contrast to the growing recognition of the importance of adjacent segment disease after lumbar arthrodesis, relatively little attention has been paid to the relationship between osteoporotic vertebral fractures and instrumented lumbar arthrodesis. Methods Twenty five patients with a thoracolumbar vertebral fracture ...

  2. Limbus lumbar and sacral vertebral fractures.

    Science.gov (United States)

    Mendez, Jorge S; Huete, Isidro L; Tagle, Patricio M

    2002-03-01

    We evaluated the fractures of the lumbar and sacral vertebral limbus by disc impingement at the peripheral ring apophysis in 23 adults associated with trauma in 16 of them. Lumbalgia, radicular pain and narrow canal symptoms are the presenting forms of this underdiagnosed pathology. CT is the best method of examination, while plain roentgenograms and MR are usually negative. Accurate diagnosis and surgical technique with larger exposure are needed to resect the fractured fragments and protruded disc material for decompressing the roots and the dural sac. Our results were very good on the majority of cases.

  3. Functional aspects of strepsirrhine lumbar vertebral bodies and spinous processes.

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    Shapiro, Liza J; Simons, Cornelia V M

    2002-06-01

    The relationship between form and function in the lumbar vertebral column has been well documented among platyrrhines and especially catarrhines, while functional studies of postcranial morphology among strepsirrhines have concentrated predominantly on the limbs. This morphometric study investigates biomechanically relevant attributes of the lumbar vertebral morphology of 20 species of extant strepsirrhines. With this extensive sample, our goal is to address the influence of positional behavior on lumbar vertebral form while also assessing the effects of body size and phylogenetic history. The results reveal distinctions in lumbar vertebral morphology among strepsirrhines in functional association with their habitual postures and primary locomotor behaviors. In general, strepsirrhines that emphasize pronograde posture and quadrupedal locomotion combined with leaping (from a pronograde position) have the relatively longest lumbar regions and lumbar vertebral bodies, features promoting sagittal spinal flexibility. Indrids and galagonids that rely primarily on vertical clinging and leaping with orthograde posture share a relatively short (i.e., stable and resistant to bending) lumbar region, although the length of individual lumbar vertebral bodies varies phylogenetically and possibly allometrically. The other two vertical clingers and leapers, Hapalemur and Lepilemur, more closely resemble the pronograde, quadrupedal taxa. The specialized, suspensory lorids have relatively short lumbar regions as well, but the lengths of their lumbar regions are influenced by body size, and Arctocebus has dramatically longer vertebral bodies than do the other lorids. Lumbar morphology among galagonids appears to reflect a strong phylogenetic signal superimposed on a functional one. In general, relative length of the spinous processes follows a positively allometric trend, although lorids (especially the larger-bodied forms) have relatively short spinous processes for their body size

  4. The Neandertal vertebral column 2: The lumbar spine.

    Science.gov (United States)

    Gómez-Olivencia, Asier; Arlegi, Mikel; Barash, Alon; Stock, Jay T; Been, Ella

    2017-05-01

    Here we provide the most extensive metric and morphological analysis performed to date on the Neandertal lumbar spine. Neandertal lumbar vertebrae show differences from modern humans in both the vertebral body and in the neural arch, although not all Neandertal lumbar vertebrae differ from modern humans in the same way. Differences in the vertebral foramen are restricted to the lowermost lumbar vertebrae (L4 and L5), differences in the orientation of the upper articular facets appear in the uppermost lumbar vertebrae (probably in L1 and L2-L3), and differences in the horizontal angle of the transverse process appear in L2-L4. Neandertals, when compared to modern humans, show a smaller degree of lumbar lordosis. Based on a still limited fossil sample, early hominins (australopiths and Homo erectus) had a lumbar lordosis that was similar to but below the mean of modern humans. Here, we hypothesize that from this ancestral degree of lumbar lordosis, the Neandertal lineage decreased their lumbar lordosis and Homo sapiens slightly increased theirs. From a postural point of view, the lower degree of lordosis is related to a more vertical position of the sacrum, which is also positioned more ventrally with respect to the dorsal end of the pelvis. This results in a spino-pelvic alignment that, though different from modern humans, maintained an economic postural equilibrium. Some features, such as a lower degree of lumbar lordosis, were already present in the middle Pleistocene populations ancestral to Neandertals. However, these middle Pleistocene populations do not show the full suite of Neandertal lumbar morphologies, which probably means that the characteristic features of the Neandertal lumbar spine did not arise all at once. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Direction of the formation of anterior lumbar vertebral osteophytes

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    Akeda Koji

    2009-01-01

    Full Text Available Abstract Background X-ray images of lumbar degenerative diseases often show not only claw osteophytes, but also pairs of osteophytes that form in a direction away from the adjacent disc. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration. Methods The direction of the formation of 14,250 pairs of anterior lumbar vertebral osteophytes across the adjacent intervertebral discs in 2,850 patients who were all over 60 years old was investigated. Anterior lumbar vertebral osteophytes were distributed into six groups based on the direction of extension of each pair of osteophytes across the intervertebral disc space. Results In L1–L2 and L2–L3, the number of patients classified into groups B (the pair of osteophytes extended in the direction of the adjacent disc and C (almost complete bone bridge formation by a pair of osteophytes across the intervertebral disc space was larger than that classified into group D (the pair of osteophytes extended in a direction away from the adjacent disc. In L3–L4, L4–L5 and L5-S1, the number of patients in group D was greater than that of patients belonging to groups B and C. Conclusion Our study showed that pairs of osteophytes frequently formed in the direction of the adjacent disc in the upper lumbar vertebrae (L1–L2 and L2–L3 and in the direction away from the adjacent disc in middle or lower lumbar vertebrae (L3–L4, L4–L5, and L5-S1.

  6. Lumbo-Costo-Vertebral Syndrome with Congenital Lumbar Hernia

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    Lucky Gupta

    2014-02-01

    Full Text Available Lumbo-costo-vertebral syndrome (LCVS is a set of rare abnormalities involving vertebral bodies, ribs, and abdominal wall. We present a case of LCVS in a 2-year-old girl who had a progressive swelling over left lumbar area noted for the last 12 months. Clinical examination revealed a reducible swelling with positive cough impulse. Ultrasonography showed a defect containing bowel loops in the left lumbar region. Chest x-ray showed scoliosis and hemivertebrae with absent lower ribs on left side. Meshplasty was done.

  7. Lumbo-costo-vertebral syndrome with congenital lumbar hernia.

    Science.gov (United States)

    Gupta, Lucky; Mala, Tariq Ahmed; Gupta, Rahul; Malla, Shahid Amin

    2014-01-01

    Lumbo-costo-vertebral syndrome (LCVS) is a set of rare abnormalities involving vertebral bodies, ribs, and abdominal wall. We present a case of LCVS in a 2-year-old girl who had a progressive swelling over left lumbar area noted for the last 12 months. Clinical examination revealed a reducible swelling with positive cough impulse. Ultrasonography showed a defect containing bowel loops in the left lumbar region. Chest x-ray showed scoliosis and hemivertebrae with absent lower ribs on left side. Meshplasty was done.

  8. The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

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    Edmundo Zarzur

    1996-09-01

    Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

  9. Lumbar vertebral pedicles: radiologic anatomy and pathology

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    Patel, N.P.; Kumar, R.; Kinkhabwala, M.; Wengrover, S.I.

    1988-01-01

    With the advancement of high-resolution computed tomography (CT) scanning the spine has added new knowledge to the various conditions affecting the pedicles. We wish to review the entire spectrum of pedicular lesions: the embryology, normal anatomy, normal variants, pitfalls, congenital anomalies, and pathological conditions are discussed. Different imaging modalities involving CT, isotope bone scanning, and Magnetic Resonance Imaging (MRI) are used to complement plain films of the lumbar spine. This subject review is an excellent source for future reference to lumbar pedicular lesions. 27 references.

  10. Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability

    OpenAIRE

    Guo, Shuguang; Sun, Junying; TANG, GENLIN

    2013-01-01

    The aim of this study was to observe the clinical effects of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability. The 48 patients comprised 27 males and 21 females, aged 47–72 years. Three cases had first and second degree lumbar spondylolisthesis and all received bilateral vertebral lamina fenestration for posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC), which maintains the three-column...

  11. RADIOLOGICAL STUDY OF HUMAN LUMBAR VERTEBRAL CANAL IN VIDHARBHA REGION

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    Shruti

    2015-06-01

    Full Text Available Increase in number of patients suffering from backache all over world needs changing health polices and cost benefit analysis, it is important to look at diseases causing low back pain and for this study of radiological structure of lumbar vertebral canal is undertaken. AIMS : To reveal the radiological feature of Human lumbar vert ebral canal. METHOD AND MATERIAL : 50 - xray of lumbar canal was collected from orthopedic department of government medical college, Nagpur. STATISTICAL ANALYSIS : Data is presented in mean ± standard deviation and categorical variable are presented in percen tage. Comparison with previous study is done. RESULT : M aximum measurement as greater in male than female of same age group. CONCLUSION : T he present study and previous studies are compared and the non - significant result is found.

  12. Fracture of posterior margin of lumbar vertebral body

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    Krishnan Ajay

    2005-01-01

    Full Text Available Background: Avulsion or fracture of posterior ring apophysis of lumbar vertebra is not a common clinical entity and is missed often. These fractures are mostly traumatic lesions typically seen in adolescents and young adults, because fusion in this area is not complete until the age of 18 to 25 years. These fractures are occult on plain radiographs and are frequently missed due to unfamiliarity with the entity. But, CT scanning and MR imaging shows characteristic picture. Methods: We had 21 cases of fracture of posterior margin of a lumbar vertebral body from 1991 to 2002. Fracture in all patients were classified according to CT imaging, into the three types described by Takata et al. Out of these, 8 patients were of type I, 4 patients of type II and 9 patients of type III respectively. Focal deficit / muscle weakness was present in only three patients. No fractures of type IV (Epstein et al was found. Twelve patients were treated conservatively and 9 patients were treated by posterior decompression with total laminectomy and removal of retropulsed fragment and discectomy. Results: The mean follow-up period was of 42 months. Conventional radiography could locate the fracture in only 6 cases and CT scan was required in all cases for stamping the diagnosis and classification. Though it is uncommon, high index of suspicion is required to diagnose it, in especially adolescent patients. All the 21 patients had good outcome following the management. Conclusion: Avulsion or fracture of posterior margin of lumbar vertebral body is not so rare entity. In children and young adults diagnosed as having lumbar disc herniation, this lesion may be the proper diagnosis. These fractures need to be accurately diagnosed because as compared to simple disc herniations these fractures require more extensive exposure and resection to relieve the nerve impingent.

  13. Caudal lumbar vertebral fractures in California Quarter Horse and Thoroughbred racehorses.

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    Collar, E M; Zavodovskaya, R; Spriet, M; Hitchens, P L; Wisner, T; Uzal, F A; Stover, S M

    2015-09-01

    To gain insight into the pathophysiology of equine lumbar vertebral fractures in racehorses. To characterise equine lumbar vertebral fractures in California racehorses. Retrospective case series and prospective case-control study. Racehorse post mortem reports and jockey injury reports were retrospectively reviewed. Vertebral specimens from 6 racehorses affected with lumbar vertebral fractures and 4 control racehorses subjected to euthanasia for nonspinal fracture were assessed using visual, radiographic, computed tomography and histological examinations. Lumbar vertebral fractures occurred in 38 Quarter Horse and 29 Thoroughbred racehorses over a 22 year period, primarily involving the 5th and/or 6th lumbar vertebrae (L5-L6; 87% of Quarter Horses and 48% of Thoroughbreds). Lumbar vertebral fractures were the third most common musculoskeletal cause of death in Quarter Horses and frequently involved a jockey injury. Lumbar vertebral specimens contained anatomical variations in the number of vertebrae, dorsal spinous processes and intertransverse articulations. Lumbar vertebral fractures examined in 6 racehorse specimens (5 Quarter Horses and one Thoroughbred) coursed obliquely in a cranioventral to caudodorsal direction across the adjacent L5-L6 vertebral endplates and intervertebral disc, although one case involved only one endplate. All cases had evidence of abnormalities on the ventral aspect of the vertebral bodies consistent with pre-existing, maladaptive pathology. Lumbar vertebral fractures occur in racehorses with pre-existing pathology at the L5-L6 vertebral junction that is likely predisposes horses to catastrophic fracture. Knowledge of these findings should encourage assessment of the lumbar vertebrae, therefore increasing detection of mild vertebral injuries and preventing catastrophic racehorse and associated jockey injuries. © 2014 EVJ Ltd.

  14. Measurements of vertebral shape by radiographic morphometry: sex differences and relationships with vertebral level and lumbar lordosis

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    Cheng, X.G.; Sun, Y.; Boonen, S.; Nicholson, P.H.F.; Dequeker, J. [Arthritis and Metabolic Bone Disease Research Unit, U.Z. Pellenberg, Division of Rheumatology, Pellenberg (Belgium); Brys, P. [Radiology Department, University Hospitals, Katholieke Universiteit Leuven, Leuven (Belgium); Felsenberg, D. [Radiology Department, Freie Univ. Berlin (Germany)

    1998-07-01

    Objective. To examine sex-related and vertebral-level-specific differences in vertebral shape and to investigate the relationships between the lumbar lordosis angle and vertebral morphology. Design and patients. Lateral thoracic and lumbar spine radiographs were obtained with a standardized protocol in 142 healthy men and 198 healthy women over 50 years old. Anterior (Ha), central (Hc) and posterior (Hp) heights of each vertebra from T4 to L4 were measured using a digitizing technique, and the Ha/Hp and Hc/Hp ratios were calculated. The lumbar lordosis angle was measured on the lateral lumbar spine radiographs. Results. Ha/Hp and Hc/Hp ratios were smaller in men than women by 1.8% and 0.7%, respectively, and these ratios varied with vertebral level. Significant correlations were found between vertebral shape and the lumbar lordosis angle. Conclusions. These results demonstrate that vertebral shape varies significantly with sex, vertebral level and lumbar lordosis angle. Awareness of these relationships may help prevent misdiagnosis in clinical vertebral morphometry. (orig.) With 4 figs., 2 tabs., 17 refs.

  15. RADIOGRAPHIC MEASUREMENTS OF THE HEIGHTS OF VERTEBRAL BODIES IN THORACIC AND LUMBAR SPINE

    Institute of Scientific and Technical Information of China (English)

    戴力扬

    1996-01-01

    Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporodc vertebral fractures were discussed.

  16. Automated quantification of lumbar vertebral kinematics from dynamic fluoroscopic sequences

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    Camp, Jon; Zhao, Kristin; Morel, Etienne; White, Dan; Magnuson, Dixon; Gay, Ralph; An, Kai-Nan; Robb, Richard

    2009-02-01

    We hypothesize that the vertebra-to-vertebra patterns of spinal flexion and extension motion of persons with lower back pain will differ from those of persons who are pain-free. Thus, it is our goal to measure the motion of individual lumbar vertebrae noninvasively from dynamic fluoroscopic sequences. Two-dimensional normalized mutual information-based image registration was used to track frame-to-frame motion. Software was developed that required the operator to identify each vertebra on the first frame of the sequence using a four-point "caliper" placed at the posterior and anterior edges of the inferior and superior end plates of the target vertebrae. The program then resolved the individual motions of each vertebra independently throughout the entire sequence. To validate the technique, 6 cadaveric lumbar spine specimens were potted in polymethylmethacrylate and instrumented with optoelectric sensors. The specimens were then placed in a custom dynamic spine simulator and moved through flexion-extension cycles while kinematic data and fluoroscopic sequences were simultaneously acquired. We found strong correlation between the absolute flexionextension range of motion of each vertebra as recorded by the optoelectric system and as determined from the fluoroscopic sequence via registration. We conclude that this method is a viable way of noninvasively assessing twodimensional vertebral motion.

  17. Musculoskeletal simulations to investigate the influence of vertebral geometrical parameters on lumbar spine loading

    DEFF Research Database (Denmark)

    Putzer, Michael; Rasmussen, John; Penzkofer, Rainer;

    the model according to measurements of the vertebral body height, disc height and the curvature of the spine from X-rays. Han, K.-S., Rohlmann, A., Zander, T., Taylor, W. R., 2012. Lumbar spinal loads vary with body height and weight. Medical Engineering & Physics 35, 969–977. Niemeyer, F., Wilke, H...... of the facet joints and the curvature of the lumbar spine have been varied. Figure 1 depicts the used musculoskeletal model in the flexed posture and a lumbar vertebra labeled with all relevant linear dimensions except the disc height. Additionally, all combinations of the three parameters vertebral body...... height (between 6% and 13%), vertebral body depth (up to 8%) and the curvature of the lumbar spine (up to 7%). Combinations of parameters added the results of the particular single parameter simulations with only a slight amplification. The findings for vertebral body height and disc height...

  18. Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability.

    Science.gov (United States)

    Guo, Shuguang; Sun, Junying; Tang, Genlin

    2013-03-01

    The aim of this study was to observe the clinical effects of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability. The 48 patients comprised 27 males and 21 females, aged 47-72 years. Three cases had first and second degree lumbar spondylolisthesis and all received bilateral vertebral lamina fenestration for posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC), which maintains the three-column spinal stability. Attention was given to ensure the correct pre-operative fenestration, complete decompression and the prevention of adhesions. After an average follow-up of 26.4 months, the one year post-operative X-ray radiographs suggested that the successful fusion rate was 88.1%, and this was 100% in the two-year post-operative radiographs. Moreover, the functional recovery rate was 97.9%. Bilateral vertebral lamina fenestration for lumbar interbody fusion is an ideal surgical method for the treatment of lower lumbar instability. The surgical method retains the spinal posterior column and middle column and results in full decompression and reliable fusion by a limited yet effective surgical approach.

  19. Musculoskeletal simulations to investigate the influence of vertebral geometrical parameters on lumbar spine loading

    DEFF Research Database (Denmark)

    Putzer, Michael; Rasmussen, John; Penzkofer, Rainer

    Body Modeling System and a parameterized musculoskeletal lumbar spine model for four different postures: upright standing, flexion (50°), torsion (10°) and lateral bending (15°). The linear dimensions of the vertebral body, the posterior parts of the vertebrae as well as the disc height, the orientation...... of the facet joints and the curvature of the lumbar spine have been varied. Figure 1 depicts the used musculoskeletal model in the flexed posture and a lumbar vertebra labeled with all relevant linear dimensions except the disc height. Additionally, all combinations of the three parameters vertebral body......Musculoskeletal simulations of subject-specific loads in the lumbar spine are computed by using subject-specific geometrical data. However this data has an inherent inaccuracy. This study evaluates the influence of defined geometrical parameters on lumbar spine loading utilizing the Any...

  20. Lumbar disc herniation in a patient with congenital vertebral body anomaly: a case report.

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    Atabey, Cem; Eroğlu, Ahmet; Topuz, Ali Kivanc; Velioğlu, Murat; Demircan, Mehmet Nusret

    2014-12-01

    Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

  1. Does the correlation between Schmorl's nodes and vertebral morphology extend into the lumbar spine?

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    Plomp, Kimberly; Roberts, Charlotte; Strand Vidarsdottir, Una

    2015-07-01

    Schmorl's nodes are depressions on vertebrae due to herniation of the nucleus pulposus of the intervertebral disc into the vertebral body. This study provides an extension of our previous study which analyzed the shape of the lower thoracic spine and found that vertebral morphology was associated with the presence of Schmorl's nodes. Ninety adult individuals from the late Medieval site of Fishergate House, York, and the Post-Medieval site of Coach Lane, North Shields, Tyne and Wear, England, were analysed using 2D geometric morphometrics to identify possible relationships between vertebral morphology and Schmorl's nodes at the thoraco-lumbar junction and in the lumbar spine. A significant correlation was found between vertebral shape and the presence of Schmorl's nodes in the twelfth thoracic vertebrae and the first to third lumbar vertebrae. The findings corroborate previous studies and suggest that vertebral shape may be an important factor in spinal health. It is hypothesized that the pedicle shape of affected vertebrae may not provide adequate structural support for the vertebral bodies, resulting in vertical disc herniation.

  2. Association between vertebral cross-sectional area and lumbar lordosis angle in adolescents.

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    Wren, Tishya A L; Aggabao, Patricia C; Poorghasamians, Ervin; Chavez, Thomas A; Ponrartana, Skorn; Gilsanz, Vicente

    2017-01-01

    Lumbar lordosis (LL) is more prominent in women than in men, but the mechanisms responsible for this discrepancy are poorly defined. A recent study indicates that newborn girls have smaller vertebral cross-sectional area (CSA) when compared to boys-a difference that persists throughout life and is independent of body size. We determined the relations between vertebral cross-sectional area (CSA) and LL angle and whether sex differences in lumbar lordosis are related to sex differences in vertebral CSA. Using multi-planar magnetic resonance imaging (MRI), we measured vertebral cross-sectional area (CSA) and vertebral height of the spine of 40 healthy boys and 40 girls, ages 9-13 years. Measures of the CSA of the lumbar vertebrae significantly differed between sexes (9.38 ± 1.46 vs. 7.93 ± 0.69 in boys and girls, respectively; P < 0.0001), while the degree of LL was significantly greater in girls than in boys (23.7 ± 6.1 vs. 27.6 ± 8.0 in boys and girls, respectively; P = 0.02). When all subjects were analyzed together, values for LL angle were negatively correlated to vertebral CSA (r = -0.47; P < 0.0001); this was also true when boys and girls were analyzed separately. Multivariate regression analysis indicated that vertebral CSA was independently associated with LL, even after accounting for sex, age, height or vertebral height, and weight. Similar negative relations were present when thoracic vertebrae were analyzed (Model P < 0.0001, R2 = 0.37, thoracic vertebral CSA slope P < 0.0001), suggesting that deficient vertebral cross-sectional dimensions are not merely the consequence of the anterior lumbar curvature. We conclude that vertebral CSA is negatively associated with LL, and that the greater degree of LL in females could, at least in part, be due to smaller vertebral cross-sectional dimensions. Studies are needed to examine the potential relations between vertebral CSA and spinal conditions known to be associated with increased LL, such as spondylolysis

  3. Fractal analysis of lumbar vertebral cancellous bone architecture.

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    Feltrin, G P; Macchi, V; Saccavini, C; Tosi, E; Dus, C; Fassina, A; Parenti, A; De Caro, R

    2001-11-01

    Osteoporosis is characterized by bone mineral density (BMD) decreasing and spongy bone rearrangement with consequent loss of elasticity and increased bone fragility. Quantitative computed tomography (QCT) quantifies bone mineral content but does not describe spongy architecture. Analysis of trabecular pattern may provide additional information to evaluate osteoporosis. The aim of this study was to determine whether the fractal analysis of the microradiography of lumbar vertebrae provides a reliable assessment of bone texture, which correlates with the BMD. The lumbar segment of the spine was removed from 22 cadavers with no history of back pain and examined with standard x-ray, traditional tomography, and quantitative computed tomography to measure BMD. The fractal dimension, which quantifies the image fractal complexity, was calculated on microradiographs of axial sections of the fourth lumbar vertebra to determine its characteristic spongy network. The relationship between the values of the BMD and those of the fractal dimension was evaluated by linear regression and a statistically significant correlation (R = 0.96) was found. These findings suggest that the application of fractal analysis to radiological analyses can provide valuable information on the trabecular pattern of vertebrae. Thus, fractal dimensions of trabecular bone structure should be considered as a supplement to BMD evaluation in the assessment of osteoporosis.

  4. Investigation of biomechanical behavior of lumbar vertebral segments with dynamic stabilization device using finite element approach

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    Deoghare, Ashish B.; Kashyap, Siddharth; Padole, Pramod M.

    2013-03-01

    Degenerative disc disease is a major source of lower back pain and significantly alters the biomechanics of the lumbar spine. Dynamic stabilization device is a remedial technique which uses flexible materials to stabilize the affected lumbar region while preserving the natural anatomy of the spine. The main objective of this research work is to investigate the stiffness variation of dynamic stabilization device under various loading conditions under compression, axial rotation and flexion. Three dimensional model of the two segment lumbar spine is developed using computed tomography (CT) scan images. The lumbar structure developed is analyzed in ANSYS workbench. Two types of dynamic stabilization are considered: one with stabilizing device as pedicle instrumentation and second with stabilization device inserted around the inter-vertebral disc. Analysis suggests that proper positioning of the dynamic stabilization device is of paramount significance prior to the surgery. Inserting the device in the posterior region indicates the adverse effects as it shows increase in the deformation of the inter-vertebral disc. Analysis executed by positioning stabilizing device around the inter-vertebral disc yields better result for various stiffness values under compression and other loadings. [Figure not available: see fulltext.

  5. Antenatal factors in the development of the lumbar vertebral canal: a magnetic resonance imaging study.

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    Jeffrey, Janet E; Campbell, Doris M; Golden, Michael H N; Smith, Francis W; Porter, Richard W

    2003-07-01

    The lumbar vertebral canal was measured in two cohorts of 10-year-old children (n = 161) using magnetic resonance imaging (MRI) and compared with obstetric records. To investigate whether there are identifiable obstetric factors that determine the size of the lumbar vertebral canal. The most rapid period growth for the lumbar vertebral canal is between 12 and 32 weeks in utero, with the midsagittal diameter of L1-L4 already 70% of adult dimension at birth. Therefore, adverse antenatal factors during this critical growth period may be expected to affect the size of the canal. The canal size was measured from axial MRI sections taken through each lumbar vertebra (L1-L5) at the pedicular level of 84 children. Relations with obstetric data, prospectively collected in a neonatal database, were sought. The relation of low birthweight and canal size was further investigated in a second cohort of children (n = 77). The canal size, particularly the midsagittal diameter and the cross-sectional area, was found to be significantly reduced by low birthweight (with growth retardation in utero being a more important factor than length of gestation), low placenta weight, and lower socioeconomic class. Smoking during pregnancy significantly reduced the perimeter at L3 (P = 0.032) and L5 (P = 0.031), and also the cross-sectional area at L3 (P = 0.030) and L5 (P = 0.016). This study showed that, for this group of children, the size of the lumbar vertebral canal was reduced by low birthweight, with maternal smoking as an added adverse factor. Therefore, good antenatal care and maternal education may help to reduce the risk of spinal stenosis in adult life.

  6. Sudden progression of lumbar disk protrusion during vertebral axial decompression traction therapy.

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    Deen, H Gordon; Rizzo, Thomas D; Fenton, Douglas S

    2003-12-01

    Vertebral axial decompression (VAX-D) is a form of spinal traction that is widely promoted as an effective and safe treatment of degenerated and herniated lumbar intervertebral disks. Information targeted at the general public emphasizes that the treatment is completely risk-free. We describe a patient with a large lumbar disk protrusion who experienced sudden, severe exacerbation of radicular pain during a VAX-D therapy session. Follow-up magnetic resonance imaging of the lumbar region showed marked enlargement of the disk protrusion, and urgent microdiskectomy was required. To our knowledge, this is the first reported complication of VAX-D therapy. This case shows that VAX-D therapy has the potential to cause sudden deterioration requiring urgent surgical intervention.

  7. Treatment of osteoid osteoma in the vertebral body of the lumbar spine by radiofrequency ablation

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    Cristante, Alexandre Fogaca; Barros Filho, Tarcisio; Oliveira, Reginaldo Perilo de; Babrabrini, Almir F.; Teixeira, William G.J. [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Inst. de Ortopedia e Traumatologia]. E-mail: aacristante@uol.com.br

    2007-07-01

    A case of Osteoid osteoma, a rare bone tumor, is studied in a 44-year-old female patient. Scintigraphy using Tc{sup 99m} demonstrated increased uptake on the left side of the vertebral body of the fourth vertebra. Computed tomography of the lumbar spine revealed an area of hypoattenuation surrounded by an area of hyperattenuation (bone sclerosis), suggestive of an osteogenic tumor . Complementary examination using MRI demonstrated a signal alteration of 1 cm diameter in the vertebral body of the fourth lumbar vertebra, surrounded by an area of signal compatible with bone edema. The anamnesis data, physical evaluation, and complementary examinations suggested the presence of osteoid osteoma in the vertical body of the fourth lumbar vertebra. A tomography-guided biopsy was performed, and material was collected for cultures, pathological studies in paraffin, and fast freezing (in print). Pathological study of frozen sections ruled out the presence of neoplastic cells. At the same time, minimally invasive destruction of the tumor was performed through a pedicullar approach, via a radiofrequency probe. One year after the procedure, computed tomography did not demonstrate any tumor, and the patient did not report any lumbar pain. (MAC)

  8. Hernia of intervertebral disk in the lumbar vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, H.K.; Uhlenbrock, D.; Steiner, G.

    1986-02-01

    Degenerations of the spinal disc especially in the lumbar region are the most frequent degenerative diseases in orthopedics. As diagnostic proceedings to discover disc herniation myelography and computerized tomography have been proven to be very useful. Each of those methods show a high sensitivity and accuracy. Computerized tomography seems to be the first procedure because of the lac of any risk. Myelography has been reserved for the second approach, if there is any doubt in diagnosis. This paper will especially discuss advantages and disadvantages of MRI-tomography for the diagnosis of disc herniation. In MRI-tomography we have no radiation, there is no risk for the patient and we have the possibility of slices in different orientations with the sagittal orientation having priority in diagnosis of disc herniation. A more pronounced contrast in MRI relatively to the computerized tomography with nearly the same spatial resolution is an other important fact in favour for MRI. The value of MRI diagnosis of the spine depends however mainly on the use of special surface coils and on the use of high magnetic fields which provides a good signal to noise relation and which would permit us to use a thin-slice technique. The main disadvantage by now are the relative high costs.

  9. MR imaging of degenerative lumbar disc disease emphasizing on signal intensity changes in vertebral body

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    Toyoda, Keiko; Ida, Masahiro; Murakami, Yoshitaka; Harada, Junta; Tada, Shimpei (Jikei Univ., Tokyo (Japan). School of Medicine)

    1992-12-01

    Magnetic resonance imaging was performed in 400 patients with degenerative disc disease. Signal changes and their sites in the vertebral body were classified and referred to narrowing of the intervertebral disc space. MR findings were compared with those of plain roentgenograms of the lumbar spine. Signal changes in the vertebral body were noted in 83 cases (102 vertebral bodies). Low-intensity abnormality on both T1- and T2-weighted images (WI) was the most common finding, and was most frequently seen at the end plate and/or the angle. These changes were correlated with narrowing of the disc space and osteosclerosis on the plain roentgenogram of the lumbar spine. Signal changes occasionally occurred in the inner region of the vertebral body, and these lesions tended to show a high-intensity abnormality on T1-WI. We conclude that signal changes in degenerative disc disease are not specific, but are sometimes difficult to distinguish from the signal changes in other conditions such as spinal tumor or bone marrow disorder. (author).

  10. [A synovial cyst accompanied by asymptomatic lumbar vertebral fracture requiring differentiation from spinal metastasis].

    Science.gov (United States)

    Miura, Isamu; Ujiie, Hiroshi; Nakagawa, Masanori; Saito, Taiichi; Shiono, Saori; Okada, Yoshikazu

    2015-06-01

    We experienced a case with a synovial cyst accompanied by asymptomatic lumbar vertebral fracture that required differentiation from spinal metastasis. An 82-year-old man suffered from right leg and anal pain. Computed tomography (CT) showed L5 spondylolysis. Magnetic resonance images (MRI) revealed an intra spinal cyst and acute lumbar vertebral fracture of L5 vertebral body. The surrounding area of the cyst presented contrast enhancement, and the extradural mass compressed the dural sac. Bone scintigraphy with 99m technetium-MDP demonstrated intense uptake on the right first, fourth, fifth, and seventh ribs and L2, L3, and L5 vertebra. The F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) image demonstrated an increased radiotracer uptake in the L5 vertebra(standardized uptake value(SUV) max=3.5). Spinal metastasis was suspected. Because of the cauda equina compression syndrome, it was surgically removed. Intraoperatively, a well-demarcated extradural cyst was found and compressed the dural sac markedly. The cyst capsule was thin and contained clear, thin fluid with no signs of bleeding. The histological diagnosis was a synovial cyst. His neurological symptoms improved after the surgery. The synovial cyst may enlarge after asymptomatic vertebral fractures.

  11. Surgical treatment of low lumbar osteoporotic vertebral collapse: a single-institution experience.

    Science.gov (United States)

    Nakajima, Hideaki; Uchida, Kenzo; Honjoh, Kazuya; Sakamoto, Takumi; Kitade, Makoto; Baba, Hisatoshi

    2016-01-01

    Low lumbar osteoporotic vertebral collapse (OVC) has not been well documented compared with OVC of the thoracolumbar spine. The differences between low lumbar and thoracolumbar lesions should be studied to provide better treatment. The aim of this study was to clarify the clinical and imaging features as well as outcomes of low lumbar OVC and to discuss the appropriate surgical treatment. Thirty patients (10 men; 20 women; mean age 79.3 ± 4.7 years [range 70-88 years]) with low lumbar OVC affecting levels below L-3 underwent surgical treatment. The clinical symptoms, morphological features of affected vertebra, sagittal spinopelvic alignment, neurological status before and after surgery, and surgical procedures were reviewed at a mean follow-up period of 2.4 years. The main clinical symptom was radicular leg pain. Most patients had old compression fractures at the thoracolumbar level. The affected vertebra was flat-type and concave or H-shaped type, not wedge type as often found in thoracolumbar OVC. There were mismatches between pelvic incidence and lumbar lordosis on plain radiographs. On CT and MR images, foraminal stenosis was seen in 18 patients (60%) and canal stenosis in 24 patients (80%). Decompression with short fusion using a posterior approach was performed. Augmentations of vertebroplasty, posterolateral fusion, and posterior lumbar interbody fusion were performed based on the presence/absence of local kyphosis of lumbar spine, cleft formation, and/or intervertebral instability. Although the neurological and visual analog scale scores improved postoperatively, 8 patients (26.7%) developed postoperative complications mainly related to instrumentation failure. In patients with postoperative complications, lumbar spine bone mineral density was significantly low, but the spinopelvic alignment showed no correlation when compared with those without complications. The main types of low lumbar OVC were flat-type and concave type, which resulted in neurological

  12. Posterior-Only Circumferential Decompression and Reconstruction in the Surgical Management of Lumbar Vertebral Osteomyelitis

    Science.gov (United States)

    Skovrlj, Branko; Guzman, Javier Z.; Caridi, John; Cho, Samuel K.

    2015-01-01

    Study Design Case report. Objective The purpose of this report is to discuss the surgical management of lumbar vertebral osteomyelitis with a spinal epidural abscess (SEA) and present a single-stage, posterior-only circumferential decompression and reconstruction with instrumentation using an expandable titanium cage and without segmental nerve root sacrifice as an option in the treatment of this disease process. Methods We report a 42-year-old man who presented with 3 days of low back pain and chills who rapidly decompensated with severe sepsis following admission. Magnetic resonance imaging of his lumbosacral spine revealed intramuscular abscesses of the left paraspinal musculature and iliopsoas with SEA and L4 vertebral body involvement. The patient failed maximal medical treatment, which necessitated surgical treatment as a last resort for infectious source control. He underwent a previously undescribed procedure in the setting of SEA: a single-stage, posterior-only approach for circumferential decompression and reconstruction of the L4 vertebral body with posterior segmental instrumented fixation. Results After the surgery, the patient's condition gradually improved; however, he suffered a wound dehiscence necessitating a surgical exploration and deep wound debridement. Six months after the surgery, the patient underwent a revision surgery for adjacent-level pseudarthrosis. At 1-year follow-up, the patient was pain-free and off narcotic pain medication and had returned to full activity. Conclusion This patient is the first reported case of lumbar osteomyelitis with SEA treated surgically with a single-stage, posterior-only circumferential decompression and reconstruction with posterior instrumentation. Although this approach is more technically challenging, it presents another viable option for the treatment of lumbar vertebral osteomyelitis that may reduce the morbidity associated with an anterior approach. PMID:26835214

  13. Percutaneous vertebroplasty of the entire thoracic and lumbar vertebrate for vertebral compression fractures related to chronic glucocorticosteriod use: Case report and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Qing Hwa; Wu, Chun Gen; Xiao, Quan; Ping; He, Cheng Jian; Gu, Yi Feng; Wang, Tao; Li, Ming Hua [Dept. of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

    2014-12-15

    Glucocorticosteroid-induced osteoporosis is the most frequent of all secondary types of osteoporosis, and can increase the risk of vertebral compression fractures (VCFs). There are promising additions to current medical treatment for appropriately selected osteoporotic patients. Few studies have reported on the efficiency of percutaneous vertebroplasty (PVP) or kyphoplasty for whole thoracic and lumbar glucocorticosteroid-induced osteoporotic vertebral compression fractures. We report a case of a 67-year-old man with intractable pain caused by successional VCFs treated by PVP.

  14. Serial MRI findings of osteoporotic vertebral fractures in the thoracic and lumbar spine

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    Hamada, Yoshitaka; Henmi, Tatsuhiko; Sakamoto, Rintaro; Hiasa, Masahiko [Health Insurance Naruto Hospital, Tokushima (Japan)

    1998-12-01

    The prognosis of osteoporotic vertebral fractures in the thoracic and lumbar spine was studied by serial MRI findings. This study covered 80 vertebrae in 69 patients treated conservatively and followed-up for more than six months (23 males and 46 females, average age 70 yrs). Group A, characterized by poor diagnostic imaging, consisted of patients who had both severely collapsed vertebra which was progressive in the lateral roentgenogram and delayed improvement in MRI signal intensities. Group B, consisting of poor clinical prognosis, comprised patients with persistent back pain. The predictive factors for Group A were found to be T{sub 1}-low finding over the entire vertebra within one month after injury and fractures of Th{sub 12} or L{sub 1} vertebra. Areas of T{sub 1}-low and T{sub 2}-low intensity adjacent to the vertebral disc presented no improvement in signal intensity and often caused persistent back pain. (author)

  15. CLINICAL OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE PLUS MANUAL REPOSITION FOR TREATMENT OF ACUTE LUMBAR VERTEBRAL ARTICULAR DYSKINESIA

    Institute of Scientific and Technical Information of China (English)

    骆钧梵

    2003-01-01

    Objective: To observe the therapeutic effect of acupuncture plus manual reposition for treatment of acute lumbar vertebral articular dyskinesia for choosing a better remedy. Methods: 66 cases of acute lumbar vertebral articular dyskinesia were randomly divided into acupuncture plus manual reposition group (treatment group, n= 33) and routine manual reposition group (control group, n = 33). Yaotong-point was punctured, when, the patient was asked to move his or her waist simultaneously. Results: After one session of treatment, of the two 33 cases in treatment and control groups, 28 (84.85%) and20 (60.61%) were cured, 4 (12.12%) and 9 (27.27%) were improved, and 1 (3.03%) and 4 (12.12%) failed in the treatment. The therapeutic effect of treatment group was significantly superior to that of control group ( P< 0.05). Conclusion: Acupuncture combined with manual reposition is apparently superior to simple routine manual reposition in relieving acute lumbar vertebral articular dyskinesia.

  16. Late vertebral body fracture after lumbar transpedicular fixation. Report of three cases.

    Science.gov (United States)

    Missori, Paolo; Ramieri, Alessandro; Costanzo, Giuseppe; Peschillo, Simone; Paolini, Sergio; Miscusi, Massimo; D'Andrea, Giancarlo; Delfini, Roberto

    2005-07-01

    Late-onset vertebral body (VB) fracture after lumbar transpedicular fixation has not been previously described in the literature. The authors present three cases in which VB fracture occurred several months after posterolateral fixation in patients with degenerative disease or traumatic injury. The authors suggest that postoperative osteopenia, modified load-sharing function, and intravertebral clefts were responsible for the fractures. Two women and one man were evaluated at a mean follow-up interval of 3 months. Two patients suffered recurrent lumbar pain. Radiography and magnetic resonance imaging revealed fracture of some of the instrumentation-treated VBs. These two patients underwent surgical superior or inferior extension of instrumentation. The third, an asymptomatic patient, received conservative management. The two patients who underwent reoperation made complete recoveries, and there was no evidence of further bone collapse in any case. The authors speculate that alterations in the VBs may occur following application of spinal instrumentation. In rare cases, the device can fracture and consequently lead to recurrent lumbar back pain. Recovery can be achieved by extending the instrumentation in the appropriate direction.

  17. The vertebral signal change on MRI and histological examination of the operated cases for lumbar disc herniations

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    Kasama, Fumio; Kusakabe, Takashi; Sato, Katsumi; Komatsu, Tetsuro; Watanuki, Munenori; Hara, Seigo [Tohoku Rosai Hospital, Sendai (Japan)

    2002-03-01

    We examined the pre-operative MRI of 97 cases of lumbar disc herniation retrospectively. Ninety-two cases (95%) had vertebral signal changes, end plate erosions and/or vertebral posterior corner changes. Thirty-seven (47%) cases of 78 histological examinations had a cartilaginous end plate. Patients whose MRI showed high signal intensity on both T1 and T2 weighted images near the end plates, had a high incidence of having the end plates in the prolapsed disc herniations. We must recognize the lumbar disc herniation as the injured state of the disc and endplates. (author)

  18. Regional variations in the compressive properties of lumbar vertebral trabeculae. Effects of disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Keller, T.S.; Hansson, T.H.; Abram, A.C.; Spengler, D.M.; Panjabi, M.M. (Orthopaedic Biomechanics Lab, Nashville, TN (USA))

    1989-09-01

    The compressive mechanical properties of human lumbar vertebral trabeculae were examined on the basis of anatomic origin, bone density, and intervertebral disc properties. Trabecular bone compressive strength and stiffness increased with increasing bone density, the latter proportional to strength and stiffness to the one-half power. Regional variations within each segment were found, the most prevalent differences occurring in regions of bone overlying the disc nucleus in comparison with bone overlying the disc anulus. For normal discs, the ratio of strength of bone overlying the disc nucleus to bone overlying the disc anulus was 1.25, decreasing to 1.0 for moderately degenerated discs. These results suggest that an interdependency of trabecular bone properties and intervertebral disc properties may exist.

  19. PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine

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    Böker, Dieter-Karsten

    2003-11-01

    Full Text Available Object: Patients with osteolytic metastases frequently suffer from serious local and radicular pain. Pathophysiologically, local pain arises from skeletal instability, whereas radicular pain originates from compression of nerve roots by local tumor growth. Causal treatment of osteolytic metastases in disseminated malignant disease is very difficult. Resection of vertebrae, in combination with ventro-dorsal stabilization, is a complex treatment for patients with a limited life expectancy. Percutaneous polymethylmethacrylate (PMMA vertebroplasty is a new and easy method of relieving patients' pain. In addition, it is both cost effective and safe. Pain is reduced immediately after treatment. Due to the regained vertebral stability, early mobilization of the patients is possible. Methods: A total of 22 patients with osteolytic malignancies of the thoracic and lumbar spine were treated with PMMA vertebroplasty. Prior to and after surgery, then six weeks and six months after discharge from hospital, patients answered the Oswestry Low Back Pain Disability (OLBPD Questionnaire for assessment of treatment-related change in disability. Percutaneous vertebroplasty was performed in a total of 19 patients. In three patients with tumor related compression of nerve roots an open neurolysis was performed followed by vertebroplasty. Results: A total of 86% of patients reported a significant pain reduction. Vertebroplasty was highly beneficial for patients with pain related to local instability of the spine, but less so in patients with additional nerve root compression. Extravasation of PMMA beyond the vertebral margins was observed in 23% of the cases. No treatment-related clinical or neurological complications were seen. Conclusions: PMMA vertebroplasty is a useful and safe method of pain relief for patients with malignant osteolytic diseases of the thoracic and lumbar spine.

  20. EVALUATION OF THE DIAMETER OF THE LUMBAR VERTEBRAL CANAL USING COMPUTED TOMOGRAPHY IN MEXICAN POPULATION

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    Roxana Torres Castellanos

    Full Text Available ABSTRACT Objective: To conduct a descriptive study to find measures of central tendency in the vertebral bodies L3, L4, and L5 in the Mexican population. Methods: Fifty patients were considered, 33 male and 17 female, aged between 30 and 55 years. Measurements were performed at the levels L3, L4 and L5 taking the interpedicular distance (A, mid-sagittal diameter (B, anteroposterior distance (AP and the depth of lateral recess (R in axial 2-mm sections of CT scans (Somaton Emotion, SIEMENS, 2 sections in a Mexican population with healthy vertebral bodies, with no history of lumbar pathology. Results: Overall, the measures obtained were mean interpedicular distance of 22.80 in L3, range of 16.34/28.72. In L4, mean of 23.83, range of 17.62/27.92. In L5, mean of 25.28, range of 21.88/31.29. Conclusions: This study managed to make a database that did not exist in Mexico, using measures of central tendency. Therefore, it opens the way for it to be possible, in future studies, to identify predictive factors or even developing implants.

  1. Sacral Insufficiency Fractures: Recognition and Treatment in Patients with Concurrent Lumbar Vertebral Compression Fractures

    Science.gov (United States)

    Granville, Michelle; Jacobson, Robert E; Berti, Aldo

    2017-01-01

    Introduction In reviewing a larger group of osteoporotic vertebral compression fractures (VCFs), we found that the overall incidence of sacral insufficiency fractures (SIFs) is higher than commonly reported values. This is especially seen in patients with previous or concurrent lumbar VCFs and also in a subgroup that had lumbar stenosis or hip arthroplasty. The altered biomechanics due to associated lumbar stenosis or hip arthroplasty lead to increased mechanical stress on already weakened and deficient sacral alae, which are more vulnerable to osteoporotic weakening than other parts of the sacrum. Materials & methods We studied an overall population of patients with VCF seen clinically and separated the patients into the following groups: patients not previously treated, patients treated with vertebroplasty or kyphoplasty at one or more levels, and patients diagnosed with sacral fractures and treated with vertebroplasty or kyphoplasty. We wanted to see if a pattern existed among the patients who had sacral symptoms, were diagnosed with sacral insufficiency fractures, and subsequently underwent sacroplasty. Results In a review of 79 consecutive patients, over a 24-month period, with VCF who underwent surgical treatment, there were 10 patients who also had sacral insufficiency fractures. Four of the patients had sacral insufficiency fractures without VCF. None of the patients with sacral insufficiency fractures were on treatment for osteoporosis at the time of diagnosis. The following symptoms indicated SIF: lower sacral pain (n = 10), buttock pain (n = 7), lateral hip pain (n = 5), and groin pain radiating to the thigh (n = 4). The average time to diagnose SIF was two months after the onset of pain. Conclusions Sacral insufficiency fractures are a frequent cause of both acute and chronic pain; however, they are often missed by the majority of physicians. The frequency of undetected sacral fractures is high. This is due to a number of potential pitfalls

  2. The validity of vertebral translation and rotation in differentiating patients with lumbar segmental instability.

    Science.gov (United States)

    Taghipour-Darzi, Mohammad; Takamjani, Esmail Ebrahimi; Salavati, Mahyar; Mobini, Bahram; Zekavat, Hajar

    2012-12-01

    Lumbar segmental instability (LSI) is a sub-group of non-specific low back pain (NSLBP), without any accepted diagnostic tool as a golden standard. Some authors emphasize on clinical findings, and others focus on vertebral translation and rotation, but construct validity of these measures had not been approved. Therefore, the purpose of the study was to evaluate convergent and known group validity of vertebral translation and rotation in differentiating LSI from NSLBP and control subjects. Study variables included full-range and mid-range vertebral translation and rotation in sagittal plane. Five x-rays were taken in neutral, full flexion and extension and mid-flexion and mid-extension positions of lumbar spine. The variables were calculated using Computer Aided Radiographic Analysis of Spine (CARA) software after scanning. Sixty-six volunteered males participated in three groups. Twenty-two subjects were in the control group, and 44 NSLBP were divided into LSI and not LSI groups according to the criteria adopted by Hicks et al. The ANOVA and Tukey test were used in statistic analysis. ANOVA results demonstrated differences in three groups; for full-range translation and rotation, were not significant. However, the results of ANOVA demonstrated significant difference in L4-5 mid-range translation and rotation (p < 0/05). Tukey test showed significant difference for L4-5 mid-range translation between control (2.14 mm) and LSI (1.33 mm) groups (p < 0/05). Tukey test demonstrated difference between the control (14.18°) and LSI (11.65°) groups (p < 0/05); the control and not LSI (10.80) groups (p < 0/05) were significant for L4-5 mid-range rotation. On the basis of the study results, the full-range translation and rotation cannot differentiate LSI from not LSI and control groups. Moreover, the mid-range translation only differentiates control from LSI, whereas mid-range rotation differentiates control from both LSI and not LSI. Copyright © 2012

  3. CT volumetry of lumbar vertebral bodies in patients with hypoplasia L5 and bilateral spondylolysis and in normal controls

    Energy Technology Data Exchange (ETDEWEB)

    Wilms, Guido E.; Demaerel, Philippe; Keyzer, Frederik de [UZ Leuven, Campus Gasthuisberg, Department of Radiology, Leuven (Belgium); Willems, Endry [ZOL, Department of Radiology, Genk (Belgium)

    2012-08-15

    To examine the feasibility and results of calculating the volume of lumbar vertebral bodies in normal patients and patients with suspected hypoplasia of L5. Lumbar multi-detector CT was performed in 38 patients with bilateral spondylolysis and hypoplasia of L5 and in 38 normal patients. Lumbar vertebral body volume of L3, L4 and L5 was measured by CT volumetry with a semi-automated program, created with MeVisLab. In the control group, the average vertebral body volume (in cubic centimeters) of L3 was 35.93 ({+-}7.33), 36.34 ({+-}7.13) for L4 and 34.63 ({+-}6.88) for L5. In patients with suspected hypoplasia L5 the average body volume (in cubic centimeters) of L3 was 36.85 ({+-}7.37), 36.90 ({+-}6.99) for L4 and 33.14 ({+-}6.57) for L5. The difference in mean vertebral body volume for L3, L4 and L5 between both groups was statistically not significant. However, there was a statistically significant difference of the ratio L5/L4 (P < 0.001) between both groups: the mean ratio L5/L4 in the control group was 95.3 {+-} 3.9%, the ratio for the hypoplastic L5 group was 89.9 {+-} 6.3%. There was no significant difference in the vertebral body volume for L3, L4 and L5 between both groups due to inter-patient variability. However, the relation between the body volume of L5 and L4 is significantly different between both groups. The volume of the vertebral body of L5 proved to be on average 10.2% smaller than the volume of L4 in the group with hypoplasia L5 versus 4.7% in the control group. (orig.)

  4. Intra- and interobserver reproducibility of vertebral endplate signal (modic) changes in the lumbar spine: the Nordic Modic Consensus Group classification

    DEFF Research Database (Denmark)

    Jensen, Tue Secher; Sorensen, Joan Solgaard; Kjær, Per

    2007-01-01

    BACKGROUND: The lumbar vertebral endplate is considered a potential cause of specific low back pain. However, in relation to future research, there is need for a reliable and detailed magnetic resonance imaging (MRI) protocol to be used in the evaluation of vertebral endplate signal changes...... by the Nordic Modic Consensus Group. After consensus was established, all 50 MRI examinations were evaluated independently by each observer. Intraobserver reliability was assessed by re-evaluation of the 50 examinations by one of the observers. Kappa statistics were used to calculate agreement. RESULTS: Intra...

  5. Differences in perfusion parameters between upper and lower lumbar vertebral segments with dynamic contrast-enhanced MRI (DCE MRI)

    Energy Technology Data Exchange (ETDEWEB)

    Savvopoulou, Vasiliki; Vlahos, Lampros; Moulopoulos, Lia Angela [University of Athens, Areteion Hospital, Department of Radiology, Medical School, Athens (Greece); Maris, Thomas G. [University of Crete, Deparment of Medical Physics, Faculty of Medicine, Heraklion (Greece)

    2008-09-15

    To investigate the influence of age, sex and spinal level on perfusion parameters of normal lumbar bone marrow with dynamic contrast-enhanced MRI (DCE MRI). Sixty-seven subjects referred for evaluation of low back pain or sciatica underwent DCE MRI of the lumbar spine. After subtraction of dynamic images, a region of interest (ROI) was placed on each lumbar vertebral body of all subjects, and time intensity curves were generated. Consequently, perfusion parameters were calculated. Statistical analysis was performed to search for perfusion differences among lumbar vertebrae and in relation to age and sex. Upper (L1, L2) and lower (L3, L4, L5) vertebrae showed significant differences in perfusion parameters (p<0.05). Vertebrae of subjects younger than 50 years showed significantly higher perfusion compared to vertebrae of older ones (p<0.05). Vertebrae of females demonstrated significantly increased perfusion compared to those of males of corresponding age (p<0.05). All perfusion parameters, except for washout (WOUT), showed a mild linear correlation with age. Time to maximum slope (TMSP) and time to peak (TTPK) showed the same correlation with sex (0.22lumbar spine, of younger compared to older subjects and of females compared to males. (orig.)

  6. Comparative evaluation of single-level closing-wedge vertebral osteotomies for the correction of fixed kyphotic deformity of the lumbar spine: a cadaveric study.

    Science.gov (United States)

    Li, F; Sagi, H C; Liu, B; Yuan, H A

    2001-11-01

    Anatomic study. To compare spinal osteotomies with respect to obtainable correction and change in anterior height and distance of the spinal column and to describe a modification of the decancellation closing-wedge osteotomy to obtain further correction. Fixed kyphotic deformity of the lumbar spine can cause difficulty with sitting, lying flat, and pain and can pose a risk to adjacent spinal cord and nerves as well as impair respiratory and abdominal function. Various corrective osteotomies have been described. Osteotomies involving decancellation and a closing wedge of the apical vertebra theoretically decrease the risk to anterior vascular structures. Single-level vertebral osteotomies were performed on three groups of fresh-frozen human cadaveric lumbar spines. Group 1 underwent a conventional anterior opening-wedge/posterior closing-wedge osteotomy, Group 2 underwent a conventional decancellation posterior closing-wedge osteotomy, and Group 3 underwent our modified decancellation posterior closing-wedge osteotomy. Sagittal plane angulation as well as anterior height and distance of the spinal column were measured before and after osteotomy. The mean correction was 38 degrees for Group 1, 36 degrees for Group 2, and 49 degrees for Group 3. The mean change in anterior height and distance was 20 and 30 mm, respectively, for Group 1. For Groups 2 and 3 it was only 2-4 mm. The authors recommend single-level posterior decancellation procedures for correction of fixed kyphotic deformities of the thoracolumbar spine to decrease the risk to anterior neurovascular structures. An additional 10-13 degrees of correction can be obtained with the authors' modification.

  7. Delayed Neurologic Deficit due to Foraminal Stenosis following Osteoporotic Late Collapse of a Lumbar Spine Vertebral Body

    Directory of Open Access Journals (Sweden)

    Yu Sasaki

    2013-01-01

    Full Text Available We report an 85-year-old woman with an L3 vertebral body fracture who presented with back pain, bilateral leg pain, and weakness after four months of conservative treatment. Because of unstable pseudoarthrosis, the L3 vertebral body collapsed in the standing position and the L3 nerve root was compressed. The indicated surgery decompressed the L3-L4 foramen and fused the unstable segment. The back pain and neurologic symptoms improved significantly following surgery. We propose that delayed neurologic deficit following an osteoporotic fracture of the lumbar body may be caused not only by retropulsion of vertebral body fragments with significant canal compromise, but also by foraminal stenosis with the late collapse of the vertebral fracture. This new pathomechanism for delayed neurologic deficit has not been previously described. If a collapse takes place in the caudal part of the vertebral body below the base of the pedicle, spine surgeons should be aware of the possibility of foraminal stenosis.

  8. Comparison of polymethylmethacrylate versus expandable cage in anterior vertebral column reconstruction after posterior extracavitary corpectomy in lumbar and thoraco-lumbar metastatic spine tumors.

    Science.gov (United States)

    Eleraky, Mohammed; Papanastassiou, Ioannis; Tran, Nam D; Dakwar, Elias; Vrionis, Frank D

    2011-08-01

    Single-stage posterior corpectomy for the management of spinal tumors has been well described. Anterior column reconstruction has been accomplished using polymethylmethacrylate (PMMA) or expandable cages (EC). The aim of this retrospective study was to compare PMMA versus ECs in anterior vertebral column reconstruction after posterior corpectomy for tumors in the lumbar and thoracolumbar spine. Between 2006 and 2009 we identified 32 patients that underwent a single-stage posterior extracavitary tumor resection and anterior reconstruction, 16 with PMMA and 16 with EC. There were no baseline differences in regards to age (mean: 58.2 years) or performance status. Differences between groups in terms of survival, estimated blood loss (EBL), kyphosis reduction (decrease in Cobb's angle), pain, functional outcomes, and performance status were evaluated. Mean overall survival and EBL were 17 months and 1165 ml, respectively. No differences were noted between the study groups in regards to survival (p = 0.5) or EBL (p = 0.8). There was a trend for better Kyphosis reduction in favor of the EC group (10.04 vs. 5.45, p = 0.16). No difference in performance status or VAS improvements was observed (p > 0.05). Seven patients had complications that led to reoperation (5 infections). PMMA or ECs are viable options for reconstruction of the anterior vertebral column following tumor resection and corpectomy. Both approaches allow for correction of the kyphotic deformity, and stabilization of the anterior vertebral column with similar functional and performance status outcomes in the lumbar and thoracolumbar area.

  9. Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison

    Directory of Open Access Journals (Sweden)

    Savni R Satoskar

    2014-01-01

    Full Text Available Objective : The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ′Goel facet spacer′ in the treatment of degenerative spinal canal stenosis. Materials and Methods : Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results : The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions : Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis.

  10. A predictive mechanical model for evaluating vertebral fracture probability in lumbar spine under different osteoporotic drug therapies.

    Science.gov (United States)

    López, E; Ibarz, E; Herrera, A; Puértolas, S; Gabarre, S; Más, Y; Mateo, J; Gil-Albarova, J; Gracia, L

    2016-07-01

    Osteoporotic vertebral fractures represent a major cause of disability, loss of quality of life and even mortality among the elderly population. Decisions on drug therapy are based on the assessment of risk factors for fracture from bone mineral density (BMD) measurements. A previously developed model, based on the Damage and Fracture Mechanics, was applied for the evaluation of the mechanical magnitudes involved in the fracture process from clinical BMD measurements. BMD evolution in untreated patients and in patients with seven different treatments was analyzed from clinical studies in order to compare the variation in the risk of fracture. The predictive model was applied in a finite element simulation of the whole lumbar spine, obtaining detailed maps of damage and fracture probability, identifying high-risk local zones at vertebral body. For every vertebra, strontium ranelate exhibits the highest decrease, whereas minimum decrease is achieved with oral ibandronate. All the treatments manifest similar trends for every vertebra. Conversely, for the natural BMD evolution, as bone stiffness decreases, the mechanical damage and fracture probability show a significant increase (as it occurs in the natural history of BMD). Vertebral walls and external areas of vertebral end plates are the zones at greatest risk, in coincidence with the typical locations of osteoporotic fractures, characterized by a vertebral crushing due to the collapse of vertebral walls. This methodology could be applied for an individual patient, in order to obtain the trends corresponding to different treatments, in identifying at-risk individuals in early stages of osteoporosis and might be helpful for treatment decisions.

  11. Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis – A cross sectional study in 150 patients

    Directory of Open Access Journals (Sweden)

    Kim Hak-Jun

    2008-08-01

    Full Text Available Abstract Background Hueter-Volkmann's law regarding growth modulation suggests that increased pressure on the end plate of bone retards the growth (Hueter and conversely, reduced pressure accelerates the growth (Volkmann. Literature described the same principle in Rat-tail model. Human spine and its deformity i.e. scoliosis has also same kind of pattern during the growth period which causes wedging in disc or vertebral body. Methods This cross sectional study in 150 patients of adolescent idiopathic scoliosis was done to evaluate vertebral body and disc wedging in scoliosis and to compare the extent of differential wedging of body and disc, in thoracic and lumbar area. We measured wedging of vertebral bodies and discs, along with two adjacent vertebrae and disc, above and below the apex and evaluated them according to severity of curve (curve 30° to find the relationship of vertebral body or disc wedging with scoliosis in thoracic and lumbar spine. We also compared the wedging and rotations of vertebrae. Results In both thoracic and lumbar curves, we found that greater the degree of scoliosis, greater the wedging in both disc and body and the degree of wedging was more at apex supporting the theory of growth retardation in stress concentration area. However, the degree of wedging in vertebral body is more than the disc in thoracic spine while the wedging was more in disc than body in lumbar spine. On comparing the wedging with the rotation, we did not find any significant relationship suggesting that it has no relation with rotation. Conclusion From our study, we can conclude that wedging in disc and body are increasing with progression on scoliosis and maximum at apex; however there is differential wedging of body and disc, in thoracic and lumbar area, that is vertebral body wedging is more profound in thoracic area while disc wedging is more profound in lumbar area which possibly form 'vicious cycle' by asymmetric loading to spine for the

  12. Three-dimensional lumbar spine vertebral motion during running using indwelling bone pins.

    Science.gov (United States)

    MacWilliams, Bruce A; Rozumalski, Adam; Swanson, Andrew N; Wervey, Roy; Dykes, Daryll C; Novacheck, Tom F; Schwartz, Michael H

    2014-12-15

    Eight healthy volunteers participated in this observational study. Quantify 3-dimensional motions of the lumbar vertebrae during running via direct in vivo measurement and compare these motions to walking data from the same technique and running data from a skin-mounted technique. Lumbar spine motions in running are only reported in 1 series of articles using a skin-mounted technique subject to overestimation and only instrumented a single vertebra. Reflective marker triads were attached to Kirschner wires inserted into the spinous processes of L1-S1. Anatomic registration between each vertebra and attached triad was achieved using spinal computed tomographic scans. Skin-mounted trunk markers were used to assess thoracic motions. Subjects ran several times in a calibrated volume at self-selected speed while 3-dimensional motion data were collected. Lumbar spine flexion and pelvic rotation patterns in running were reversed compared with walking. Increased lumbar spine motions during running occurred at the most inferior segments. Thoracic spine, lumbar spine and pelvis exhibited significantly greater range of sagittal plane motion with running. The pelvis had significantly greater range of frontal plane motion, and the thoracic spine had significantly greater range of transverse plane motion with running. Skin-mounted studies reported as much as 4 times the motion range determined by the indwelling bone pin techniques, indicating that the skin motion relative to the underlying bone during running was greater than the motion of the underlying vertebrae. The lumbar spine acts as a distinct functional segment in the spine during running, chiefly contributing lateral flexion to balance the relative motions between the trunk and pelvis. The lumbar spine is also shown to oppose thoracic spine sagittal flexion. While the lumbar spine chiefly contributes to frontal plane motion, the thoracic spine contributes the majority of the transverse plane motion. N/A.

  13. [Case of painful muscle spasm induced by thoracic vertebral fracture: successful treatment with lumbar sympathetic ganglia block].

    Science.gov (United States)

    Shimizu, Fumitaka; Kawai, Motoharu; Koga, Michiaki; Ogasawara, Jun-ichi; Negoro, Kiyoshi; Kanda, Takashi

    2008-10-01

    We report a 70-year-old man, who developed painful involuntary muscle contraction of the left leg after the lumbar discectomy, which exacerbated after a vertebral fracture of Th12. This involuntary movement was accompanied with the abnormal position of left leg simulating triple flexion response, and was induced by active or passive movement of his left knee and foot joints. Several drugs including benzodiazepines and dantrolene were ineffective, although treatment with baclofen or carbamazepine was effective. These findings suggest that hyperexcitability of the anterior horn cells following the disturbance of spinal inhibitory interneurons was involved. Electophysiological studies suggested the disturbance of left lumber nerve roots. The spinal root blocks from L3 to S1 were performed, after which the painful involuntary muscle spasm was resolved. The lumbar sympathetic ganglia block was also effective; suggesting that abnormal afferent neuronal input to spinal cord was caused by the nerve root trauma which triggered the formation of secondary abnormal network in the spine. Lumbar sympathetic ganglia block should be recommended to a therapeutic option for the refractory painful muscle spasm of the leg.

  14. Medida da área do canal vertebral lombar em diferentes faixas etárias Medida de la superficie del canal vertebral lumbar en los diferentes grupos de edad Lumbar spinal canal area in different age groups

    Directory of Open Access Journals (Sweden)

    Jair Ortiz

    2009-03-01

    Full Text Available OBJETIVO: medir as dimensões do canal vertebral lombar por meio de tomografia computadorizada, de modo a comparar os valores das diferentes faixas etárias e determinação da possível diferença entre elas. MÉTODOS: a área do canal vertebral lombar foi medida em 78 indivíduos, divididos em oito grupos etários, com dados obtidos de exames de tomografia computadorizada do abdômen. As medidas foram realizadas nos cortes axiais nas vértebras L1, L3 e L5 ao nível da região trans-pedicular. Utilizado o método estatístico de ANOVA (análise de variância com análise de diferentes "p-value" para cada grupo estudado. RESULTADOS: as medidas para L1 produziram um "p-value" de 0,586 para a faixa etária e um "p-value" de 0,003 para o sexo. Portanto, não há diferença entre as faixas etárias e há diferença entre os sexos, sendo maior no sexo masculino. Para L3, o "p-value" da faixa etária foi de 0,258 e para o sexo de 0,062; no caso de L5, o "p-value" para a faixa etária foi de 0,279 e para o sexo de 0,003. CONCLUSÃO: não foi observada diferença estatística da área do canal vertebral lombar nos níveis L1, L3 e L5 nas diferentes faixas etárias. No entanto o diâmetro no sexo masculino foi maior com diferença estatística.OBJETIVO: medir el área del canal vertebral lumbar, utilizando la tomografía computarizada, comparándolo entre los distintos grupos de edad y determinar si existen diferencias entre ellos. MÉTODOS: el área del canal vertebral lumbar se midió en 78 temas, divididos en 8 grupos, con los datos obtenidos a partir de exploraciones de tomografía computarizada del a domen. Las mediciones se hicieron en las vértebras L1, L3 y L5 en la región transpedicular. RESULTADOS: medidas para L1 producido un p-valor de 0,586 para el grupo de edad y un p-valor de 0,003 para el sexo, por tanto, no hay diferencia entre los grupos de edad y hay diferencias entre los sexos, siendo mayor en los hombres; para L3, el "pvalue" del

  15. CLINICAL ANALYSIS ON TREATMENT OF LUMBAR VERTEBRAL RETROGRADE AFFECTION WITH ACUPUNCTURE, TDP-IRRADIATION AND CUPPING

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi

    2002-01-01

    In the present paper, 70 cases of retrograde affection of the lumbar vertebrae are randomly and evenly divided into treatment group and control group. Shenshu (BL 23), Qihaishu (BL 24), Dachangshu (BL 25),Weizhong (BL 40), Jiaji (EX-B 2), etc. are used. In treatment group, acupuncture, TDP irradiation and cupping are performed, and in control group, only acupuncture is given. After 30 sessions (3 therapeutic courses) of treatment, in treatment and control groups, the total effective rates are 91.43 % and 71.43 % respectively. The therapeutic effect of comprehensive treatment is significantly superior to that of simple acupuncture therapy (P < 0.05).

  16. Influence of overall nursing intervention and lumbar and abdominal mus-cle strength training on lumbar vertebral function of patients with lumbar intervertebral disc protrusion%整体护理干预腰腹肌肌力训练对腰椎间盘突出症患者腰椎功能的影响

    Institute of Scientific and Technical Information of China (English)

    丛培彦; 张灵芝; 于丽

    2015-01-01

    Objective To assess the influence of overall nursing intervention and lumbar and abdominal muscle strength training on the lumbar vertebral function of patients with lumbar intervertebral disc protrusion. Methods Seventy-six patients with lumbar intervertebral disc protrusion treated in our hospital from May 2013 to December 2014 were ran-domly divided into the control group and the observation group. The control group was given simple lumbar and ab-dominal muscle strength training, and the observation group was given additional overall nursing intervention on the ba-sis of lumbar and abdominal muscle strength training. The changes of lumbar vertebral function scores and the patient satisfaction rates of the two groups were compared. Results Before nursing training, the two groups were not signifi-cantly different in the lumbar vertebral function score (P>0.05); after nursing training, the observation group was sig-nificantly higher than the control group in the lumbar vertebral function score, with statistically significant difference(P0.05);护理训练后观察组腰椎功能评分明显高于对照组,差异具有统计学意义(孕<0.05)。观察组患者的满意度明显高于对照组,差异具有统计学意义(孕<0.05)。结论整体护理干预腰腹肌肌力训练能有效提高患者对疾病的认知程度,使患者积极配合治疗,效果显著,患者满意度高,值得临床推广应用。

  17. Delayed Recognition of Thoracic and Lumbar Vertebral Compression Fractures in Minor Accident Cases

    OpenAIRE

    Hatgis, Jesse; Granville, Michelle; Jacobson, Robert E

    2017-01-01

    Osteoporotic vertebral compression fractures (VCFs) in the elderly are commonly diagnosed after a minor fall or trauma; however, the majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall.?Although accidents are a known cause of VCFs, these fractures are too often undiagnosed. In reviewing a group of patients seen after minor falls or automobile accidents?who were?complainin...

  18. Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Mitra, D. [Department of Neuroradiology, Newcastle General Hospital, Westgate Road, NE4 6BE, Newcastle upon Tyne (United Kingdom); Cassar-Pullicino, V.N.; Mccall, I.W. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (United Kingdom)

    2004-09-01

    The purpose of this study was to investigate the temporal evolution of type-1 end-plate changes on MRI in patients with degenerative disease of the lumbar spine and to evaluate whether any correlation exists between such evolution and the change in patients' symptoms. Forty-four patients with 48 Modic type-1 end-plate changes (low TI signal and high T2 signal) were studied. All patients had an initial and a follow-up non-contrast lumbar MRI with variable intervals between the studies (12-72 months). Severity of the end-plate changes was assessed by eyeball estimation. Correlation with patients' symptoms was studied with the help of the Visual Analogue Score (VAS), Oswestry Questionnaire Score (OQS) and patients' subjective assessment. Of the 48 disc levels with type-1 changes, 18 (37.5%) converted fully to type 2 (high T1 signal and intermediate to high T2 signal), 7 (14.6%) partially converted to type 2, 19 (39.6%) became worse (i.e. type 1 changes became more extensive) and 4 (8.3%) showed no change. Higher average VAS (5.7) and OQS (42.3) scores were noted in patients where there was worsening type-1 change and lower scores (3.8 and 27, respectively) were seen in those where there was conversion to type-2 change. These trends, however, did not reach statistical significance (P values 0.16 and 0.09 for VAS and OQS, respectively). The statistical relationship was stronger after exclusion of patients with confounding factors (i.e. changes in lumbar MRI other than end-plate changes that could independently explain the evolution of patients' symptoms) with P-values of 0.08 and 0.07 for VAS and OQS, respectively. Type-1 end-plate change represents a dynamic process and in a large majority of cases either converts to type-2 change or becomes more extensive. The evolution of type-1 change relates to change in patient's symptoms, but not to a statistically significant level. (orig.)

  19. Relationships between lumbar inter-vertebral motion and lordosis in healthy adult males: a cross sectional cohort study.

    Science.gov (United States)

    du Rose, Alister; Breen, Alan

    2016-03-10

    Intervertebral motion impairment is widely thought to be related to chronic back disability, however, the movements of inter-vertebral pairs are not independent of each other and motion may also be related to morphology. Furthermore, maximum intervertebral range of motion (IV-RoMmax) is difficult to measure accurately in living subjects. The purpose of this study was to explore possible relationships between (IV-RoMmax) and lordosis, initial attainment rate and IV-RoMmax at other levels during weight-bearing flexion using quantitative fluoroscopy (QF). Continuous QF motion sequences were recorded during controlled active sagittal flexion of 60° in 18 males (mean age 27.6 SD 4.4) with no history of low back pain in the previous year. IV-RoMmax, lordotic angle, and initial attainment rate at all inter-vertebral levels from L2-S1 were extracted. Relationships between IV-RoMmax and the other variables were explored using correlation coefficients, and simple linear regression was used to determine the effects of any significant relationships. Within and between observer repeatability of IV-RoMmax and initial attainment rate measurements were assessed in a sub-set of ten participants, using the intra-class correlation coefficient (ICC) and standard error of measurement (SEM). QF measurements were highly repeatable, the lowest ICC for IV-RoMmax, being 0.94 (0.80-0.99) and highest SEM (0.76°). For initial attainment rate the lowest ICC was 0.84 (0.49-0.96) and the highest SEM (0.036). The results also demonstrated significant positive and negative correlations between IV-RoMmax and IV-RoMmax at other lumbar levels (r = -0.64-0.65), lordosis (r = -0.52-0.54), and initial attainment rate (r = -0.64-0.73). Simple linear regression analysis of all significant relationships showed that these predict between 28 and 42 % of the variance in IV-RoMmax. This study found weak to moderate effects of individual kinematic variables and lumbar lordosis on IV-RoMmax at

  20. Anàlisi biomecànic amb un model d'elements finits de la corporectomia vertebral lumbar utilitzant al·loempelts estructurals

    OpenAIRE

    Saló i Bru, Guillem

    2006-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Objectiu: Investigar el comportament biomecànic de diversos al•loempelts (fèmur, tíbia i peroné) col•locats anteriorment en substitució del cos vertebral. Investigar la influència de la preparació del platet vertebral en un model de corporectomia per avaluar la millor configuració biomecànica. Material i mètode: S'utilitza un model no linear d'elements finits en tres dimensions del raquis lumbar (Noailly 2003) al qual s'...

  1. A case of aseptic vertebral necrosis in the context of metastatic lumbar disease

    Energy Technology Data Exchange (ETDEWEB)

    Panow, C. [Radiologie Florissant, Geneva (Switzerland); Valavanis, A. [Institut fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland)

    2002-03-01

    Aseptic bone necrosis has many well recognized etiologies: caisson disease, corticosteroids, alcohol, Gaucher's disease and sickle cell anemia being a few of a long list. Little attention has been paid to metastatic disease as a possible cause and we were unable to find reference in the literature to this association. We present imaging features of metastatic Ewing's sarcoma involving the vertebral spine, which, in certain aspects, mimics other well-known entities of this region, such as Kuemmell's and Scheuermann's diseases. (orig.)

  2. [Analysis of pain management in a pre- and post-surgical periods performed for traumatic injury of the lower-thoracic and lumbar portions of the vertebral column].

    Science.gov (United States)

    Bodnarchuk, Iu A; Tanasiĭchuk, O F; Tolstikhin, O V; Holovan', M V

    2013-11-01

    The results of managing of 129 injured persons, treated for injuries of the lower-thoracic and lumbar portions of vertebral column, are adduced. The puncture transcutaneous vertebroplasty was done in 58 patients, stabilizing systems "Sekstant" were installed in 15, the "Mantis" systems--in 13, rigid systems by the open method--in 43. The pain syndrome dynamics was estimated in of the patients in accordance to the visual analogue scale. Positive dynamics in a frame of the pain syndrome regression was noted postoperatively. Differentiated application of various methods of treatment in the patients, suffering nonstable compressional fracture of the lower-thoracic and lumbar portions of vertebral column, permits to reduce anesthesiological risk significantly, to improve the results of treatment, to reduce the patients rehabilitation duration.

  3. Proximal Vertebral Body Fracture after 4-Level Fusion Using L1 as the Upper Instrumented Vertebra for Lumbar Degenerative Disease: Report of 2 Cases with Literature Review

    Directory of Open Access Journals (Sweden)

    Yasuhara,Takao

    2013-06-01

    Full Text Available Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture.

  4. EARLY AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF THE THORACIC AND LUMBAR VERTEBRAL AND SPINAL TRAUMA

    Directory of Open Access Journals (Sweden)

    V. D. Usikov

    2014-01-01

    Full Text Available The article demonstrates the outcomes of operative treatment of 190 patients with spinal cord injuryof thoracic and lumbar spine for 10 years. Associated injuries were revealed in 96 patients, the mean ISS score being27.5. All patients underwent decompressive and stabilizing interventions using a transpedicular system of “Synthes” production (Saint Petersburg. Ventral interventions were performed in 27 (14.2% patients. In all cases, decompression of the spinal canalcontents at the level of damage was achieved. In those patients who were operated within two weeks after trauma, transpedicular system allowed for recovery of a form and size of the spinal canal and the damaged vertebral body. The fractures of transpedicular system were observed in patients operated both with only rear and with combined access. The errors and complications, which happened during surgery, did not influence the outcomes of treatment. The outcomes of treatment were assessed according to the neurological statusdynamics (ASIA score, recovery of support ability of the spine, the presence of pain, and patients’ recovery (Е Denis score. Favorable outcomes were achieved in 114 (61.3% patients, satisfactoryin 53 (28.5%,and poor in 19 (10.2 %.

  5. Analysis of body composition of the abdomen at the level of the 4th lumbar vertebral body by CT

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Tetsujiro

    1988-10-01

    Body composition of the area at the level of the 4th lumbar vertebral section was studied on X-ray CT images in 62 normal volunteers (32 men and 30 women ), whose ages ranged from 20 and 79 years. The total cross-sectional area was smallest in persons in their twenties, irrespecstive of sex, and began to increase after the age of 30. The abdominal cavity and muscles had the highest cross-sectional ratio (34%) to the total body, followed by subcutaneous fat in men. In women, the subcutaneous fat and abdominal cavity had a ratio of 34% to the total body. According to age groups, men in their twenties and thirties had the highest ratio of the muscle to the total body, followed by that of abdominal cavity and subcutaneous fat. In the group older than 40, the ratio of organs to the total body was as follows: the abdominal cavity>muscle>subcutaneous fat. Since the age of 70, each ratio of the muscle or subcutaneous fat to the total body was the same. Women between their twenties and fifties had the highest ratio of subcutaneous fat to the total body. Since the age of 60, the ratio of the abdominal cavity became highest. The subcutaneous fat and abdominal cavity tended to increase with aging; and the muscles tended to decrease. The real area of the vertebra increased slightly, but the vertebral foramen tended to decrease with aging. In men, mean areas of the muscles were as follows: abdominis lateralis>erector spinae>psoas major>quadratus lumborum and transversospinalis>rectus abdominis muscle. The same tendency was observed for women, except for the quadratus lumborum and rectus abdominis muscle. According to Rohrer index, the real areas of all components except the vertebral foramen tended to increase in the order of types A, C, and D in men. In women, the real area of the subcutaneous fat increased as well in the order of types A, C, and D. (Namekawa, K).

  6. Therapeutic Observation on Treatment of 68 Cases of Prolapse of Lumbar Intervertebral Disc with Lumber Vertebral Traction plus Ding's Rolling Technique

    Institute of Scientific and Technical Information of China (English)

    叶建兴; 朱函亭

    2007-01-01

    Objective: To observe the clinical therapeutic efficacy of treatment of prolapse of lumbar intervertebral disc with lumber vertebral traction plus Ding's Rolling Technique.Methods: 133 cases of prolapse of lumbar intervertebral disc were randomly divided into two groups. There were 68 cases in the treatment group, which were treated with lumber vertebral traction plus Tuina. There were 65 cases in the control group, which were treated with simple lumber vertebral traction. Results: There were statistic differences in the two groups (x2=6.86,P<0.01). The therapeutic efficacy in the treatment group was better than the control group.Conclusion: The clinical therapeutic efficacy treated with lumber vertebral traction plus Ding's Rolling Technique was better than simple lumber vertebral traction in treating prolapse of lumbar intervertebral disc.%目的:观察腰椎牵引后结合丁氏滚法推拿治疗腰椎间盘突出症的临床疗效.方法:将133例腰椎间盘突出症患者随机分为两组,治疗组68例,采用腰椎牵引后结合推拿治疗;对照组65例,采用单纯腰椎牵引治疗.结果:两组差异有统计学意义(x2=6.86,P<0.01),治疗组效果显著优于对照组.结论:腰椎牵引后结合丁氏滚法推拿治疗腰椎间盘突出症的临床疗效优于单纯采用腰椎牵引治疗.

  7. 应用脊椎操纵器顶椎双侧去旋转技术治疗特发性脊柱侧凸的早期疗效%Preliminary outcome of three-dimensional correction on idiopathic scoliosis by bilateral apical vertebral derotation by vertebral column manipulation

    Institute of Scientific and Technical Information of China (English)

    孙麟; 宋跃明; 刘立岷; 周春光; 安永刚; 龚全; 孔清泉

    2012-01-01

    main curve was 57.5°. The other 18 IS patients ( 6 men and 12 women ) were included in the rod derotation group from July 2010 to February 2011 with an average age of 14. 5 years old. IS presented with Lenke type 1 ( n = 10 ), 2 ( n = 8 ). The average Cobb s angle of main curve was 58.1°. After surgery,the Cobb s angle of the main curve were evaluated, and the rotation angle sagittal( RAsag ) were measured to assess the correction of rotation deformity. The correction was calculated as ( preoperative value - postoperative value )/preoperative value x 100%. The sagittal corrected effect was assessed with thoracic kyphosis, and lumbar lor-dosis. Results All patients underwent this surgical protocol successfully without major complications. In the VCM group, the correction of the main curve Cobb' s angle was ( 85. 3 ± 7. 2 )% , and in the rod derotation group, the correction of the main curve Cobb' s angle was ( 79.4 ± 11.4 )%. No difference in correction of the main curve Cobb' s angle between the 2 groups was noted ( P >0.05 ). Corrections of RAsag were ( 61. 4 ± 12. 9 )% in the VCM group and ( 26. 1 ± 20. 6 )% in the rod derotation group respectively, and had statistical significance between the 2 groups ( P0.05 ). Patients were followed up for an average of 8.7 months in the VCM group, and an average of 13.4 months in the rod derotation group showing no signifi cant loss of correction. Conclusion Bilateral apical vertebral derotation by VCM can manage coronal misalignment, recover spine sagittal alignment and rotational deformity of IS effectively. Moreover bilateral apical vertebral derotation by VCM can signally correct the rotational deformity.

  8. Traumatic extradural lumbar haematoma due to a pathological metastatic vertebral body fracture L3. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Balasa Daniel

    2016-06-01

    Full Text Available Spinal epidural haematoma (SEH is a rare entity. We present the case of a 45 years old patient with lumbar epidural hematoma produced by a L3 vertebral tumoral (metastatic fracture. Neurological status: cauda equina syndrome with sphincterian deficits, incomplete paraplegia (Frankel C, with neurological level L1. Emergency surgery was performed (L3-L2-bilateral laminectomy, L1 left laminectomy, posterior stabilization L2-L4 by titan screws offering the possibility to progressive motor, sensitive and sphincterian deficites recovery.

  9. Vertebral osteolysis originating from subchondral cyst end plate defects in transforaminal lumbar interbody fusion using rhBMP-2. Report of two cases.

    Science.gov (United States)

    Balseiro, Sarah; Nottmeier, Eric W

    2010-07-01

    Vertebral osteolysis has been reported as a complication of off-label recombinant human bone morphogenetic protein-2 (rhBMP-2) use in transforaminal lumbar interbody fusion (TLIF). It has been postulated that end plate violation during disc space preparation, rhBMP-2 overdosing, or a combination thereof can contribute to the development of vertebral osteolysis when rhBMP-2 is used in the lumbar interspace. To present two cases of vertebral osteolysis that occurred after TLIF in which rhBMP-2 was used. In each case, the osteolysis originated from subchondral cysts that were present on preoperative computed tomographic (CT) scans. Case report. Two patients underwent instrumented TLIF using INFUSE (Medtronic, Inc., Littleton, MA, USA) on an absorbable collagen sponge carrier. In each patient, approximately 4 mg of rhBMP-2 was placed anteriorly in the disc space with 0.1 mg of rhBMP-2 being placed inside a polyetheretherketone interbody cage. Morcellized allograft bone mixed with demineralized bone matrix was also placed in the disc space and cage. The remaining rhBMP-2 was placed posterolaterally on the contralateral side. Each patient presented with worsening back pain approximately 3 to 4 months postoperatively and CT scans revealed osteolysis affecting the L4 and L5 vertebral bodies. The osteolysis appeared to originate from preoperative vertebral defects caused by subchondral cysts. One patient underwent removal of the interbody cage at the L4-L5 level and revision of the fusion with iliac crest autograft. At 15-month follow-up, he had no complaints of back pain, and CT scanning revealed solid fusion across the L4-L5 disc space. The other patient was offered revision of his fusion but declined any further surgery. At 2-year follow-up, that patient had persistent back pain but still declined any further surgery. A CT scan revealed unchanged osteolysis at the L4 and L5 levels. It has been proposed that rhBMP-2-induced vertebral osteolysis occurring in TLIF

  10. Age- and direction-related adaptations of lumbar vertebral trabecular bone with respect to apparent stiffness and tissue level stress distribution

    Science.gov (United States)

    Gong, He; Fan, Yubo; Zhang, Ming; Qin, Ling

    2009-02-01

    The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthogonal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography (micro-CT) system, then converted to micro-finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level von Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions (transverse directions) were derived and compared between two age groups. The results showed that at the apparent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction-related adaptation of Chinese male lumbar vertebral trabecular bone from two different levels: stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.

  11. Age- and direction-related adaptations of lumbar vertebral trabecular bone with respect to apparent stiffness and tissue level stress distribution

    Institute of Scientific and Technical Information of China (English)

    He Gong; Yubo Fan; Ming Zhang; Ling Qin

    2009-01-01

    The objective of this study was to study the age-related adaptation of lumbar vertebral trabecular bone at the apparent level, as well as the tissue level in three orthog-onal directions. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and were scanned using a high-resolution micro-computed tomography (micro-CT) system, then converted to micro-finite element models to do micro-finite element analyses. The relationship between apparent stiffness and bone volume fraction, and the tissue level von Mises stress distribution for each trabecular specimen when compressed separately in the longitudinal direction, medial-lateral and anterior-posterior directions (transverse directions) were derived and compared between two age groups. The results showed that at the appar-ent level, trabecular bones from 69-year group had stiffer bone structure relative to their volume fractions in all three directions, and in both age groups, changes in bone volume fraction could explain more variations in apparent stiffness in the longitudinal direction than the transverse directions; at the tissue level, aging had little effect on the tissue von Mises stress distributions for the compressions in all the three directions. The novelty of the present study was that it provided quantitative assessments on the age and direction-related adaptation of Chinese male lumbar vertebral trabec-ular bone from two different levels: stiffness at the apparent level and stress distribution at the tissue level. It may help to understand the failure mechanisms and fracture risks of vertebral body associated with aging and direction for the prevention of fracture risks in elder individuals.

  12. 骨质疏松症患者腰椎椎体骨密度变化特点临床研究%Lumbar vertebral bone mineral density change characteristics about Osteoporosis patients on clinical research

    Institute of Scientific and Technical Information of China (English)

    覃勇; 樊继波; 李莎; 鄂建设; 丁小刚

    2011-01-01

    目的:研究老年腰椎退变性疾病患者椎体膏密度(BMD)变化特点.方法:40例老年骨质琉松症并发腰椎退变性疾病患者(年龄>50岁)进行腰椎双能X线骨密度测定,测定椎体包括L2-IA椎体,以BMD值为标准,研究腰椎退变性疾病患者病变椎体BMD与非病变椎体的差异,结果:40例患者中病变节段椎体BMD值高于紧邻的非病变节段(P<0.05)结论:腰椎退变性疾病患者腰椎病变节段比其紧邻的节段BMD增高.%Objective:To study vertebral bone mineral density (BvD) change characteristics about old patients who get lumbar degenerative disease Methods: 40 cases senile osteoporosis degenerative disease complicated lumbar patients (age>50) for dual energy X-ray absorptiometry lumbar vertebral bone mineral density determination, including I.2-L4, to study the difference between degenerative disease lumbar BMD and non-disease lumbar BMD,as vertebral bodies BMD value for the standard, Results: degenerative disease lumbar BMD is higher than non-disease lumbar BMD in 40 patients (P<0.05). Conclusion: Degenerative disease lumbar BMD is increased than non-disease lumbar.

  13. An investigation of thoracic and lumbar cancellous vertebral architecture using power-spectral analysis of plain radiographs.

    Science.gov (United States)

    Buck, A M; Price, R I; Sweetman, I M; Oxnard, C E

    2002-05-01

    The internal architecture of the vertebral bodies spanning the levels T1 to L5 in seven male columns was studied using mammographic-resolution radiographs of 2.5-mm-thick planar parasagittal slices. The overlapping radiographic shadows of vertebral trabeculae combined in the image to form a series of 'elements', broadly representative of the cancellous structure. The orientations and sizes of these elements were analysed by applying the Fast Fourier transform (FFT) to the digitized radiographic images. Elements aligned in the 'vertical' orientation, along the long axis of the column, were the most prominent for all vertebral levels. The relative prominence of horizontal to vertical elements was generally constant along the column below T5. In contrast, the relative prominence of oblique to vertical elements declined in the cranio-caudal direction, particularly in individuals aged > or = 60 years. The ratio of 'large' (x > 0.3 mm) to 'small' (0.15 mm or = 60 years, large elements increased in relative prominence in the caudal direction. These results suggest that a basic orthogonal pattern of trabeculae is found along the male human spine, regardless of differences in vertebral body size. Power-spectral analysis is shown to yield information summarizing the predominant orientations and sizes of radiographically rendered architectural elements of vertebral cancellous bone, to define the effects of ageing on architecture, and to identify broad structural differences between vertebral levels in the adult male spine.

  14. Conservative treatment of children with vertebral compression fractures of the thoracic and lumbar spine in the Russian Federation: a literature review

    Directory of Open Access Journals (Sweden)

    Алексей Георгиевич Баиндурашвили

    2016-03-01

    Full Text Available Various options for medical treatment of children with compression fractures of the thoracic and lumbar spine include unloading of damaged segments by simultaneous or gradual reclination (e.g., functional traction and reclination of the spine; measures aimed at building and strengthening the muscular “corset” of the back; and the use of orthotic devices of various designs (e.g., fixating-discharging, fixating-correcting corsets, orthoses on a modular basis. Questions regarding the early and late use of orthotics in patients with compression fractures of the vertebral bodies are discussed. Literature analysis, considering different methods used in the treatment of these patients in terms of their effectiveness to restore the height and shape of the damaged spinal segment revealed the absence of a differentiated approach for choosing treatment and selection criteria for orthopedic management.

  15. Treatment with tibolone partially protects 3-D microarchitecture of lumbar Vertebral Bone Tissues and Prevents Ovariectomy-induced Reduction in Mechanical Properties

    DEFF Research Database (Denmark)

    Ding, Ming

    Treatment with Tibolone partially Protects 3-D Microarchitecture of Lumbar Vertebral Bone Tissues and Prevents Ovariectomy-induced Reduction in Mechanical Properties Tibolone (Org OD14) is a tissue selective steroid with estrogenic effects on the brain, bone and vagina, without stimulating...... hypothesized that tibolone might have significant effects on 3-D microarchitecture of vertebra, thus to preserve OVX-induced reduction in mechanical properties. One hundred and sixty-six female 10-month-old rats were randomly allocated into one of the 13 groups. These groups included a baseline control group...... of tibolone treatment. This partially improved microarchitecture resulted in full recovery of mechanical properties to normal level, suggesting increased bone quality after long-term tibolone treatment. We concluded that long-term tibolone treatment completely preserved bone’s mechanical properties...

  16. Medida da área do canal vertebral lombar em diferentes faixas etárias Medida de la superficie del canal vertebral lumbar en los diferentes grupos de edad Lumbar spinal canal area in different age groups

    National Research Council Canada - National Science Library

    Jair Ortiz; Alex Veneziano Oliveira Junior; José Luis Amim Zabeu

    2009-01-01

    OBJETIVO: medir as dimensões do canal vertebral lombar por meio de tomografia computadorizada, de modo a comparar os valores das diferentes faixas etárias e determinação da possível diferença entre elas. MÉTODOS...

  17. Intervertebral disc degeneration and bone density in degenerative lumbar scoliosis: a comparative study between patients with degenerative lumbar scoliosis and patients with lumbar stenosis

    Institute of Scientific and Technical Information of China (English)

    DING Wen-yuan; YANG Da-long; CAO Lai-zhen; SUN Ya-peng; ZHANG Wei; XU Jia-xin; ZHANG Ying-ze; SHEN Yong

    2011-01-01

    Background Degenerative lumbar scoliosis is common in older patients.Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis.A means of quantifying the relative signal intensity for degenerative disc disease has not been previously discussed.The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study.Methods From January 2001 to August 2010,96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls.Cobb angle,height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides,the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group.The height of L2/L3,L3/L4,L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group.The grade of intervertebral disc degeneration was evaluated using T2WI sagittal images in both groups.The bone density of lumbar vertebrae was measured with dual-energy X-ray.Results In scoliosis group,the intervertebral disc height on the convex side was greater than the height on the concave side (P <0.001 ).The vertebral body height on the convex side was greater than the height on the concave side (P=0.016).There was a significant difference between the scoliosis group and the control group (P=0.003),and between T-value and the rate of osteoporosis between the two groups (both P <0.001).Results were verified using multiple linear regression analysis.Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces.There is a positive correlation between the angle of scoliosis and

  18. Para-muscular and trans-muscular approaches to the lumbar inter-vertebral foramen: an anatomical comparison

    OpenAIRE

    2005-01-01

    Foraminal and extra-foraminal disc herniations comprise up to 11.7% of all lumbar disc herniations. Facetectomy, which had been the classic approach, is now recognized as cause of pain and instability after surgery. Otherwise, posterior lateral approaches through a trans-muscular or a para-muscular technique offer no significant damage to key structures for spinal stability. The surgical anatomy of these approaches has already been described, but they were not compared. In order to quantify t...

  19. A hierarchical 3D segmentation method and the definition of vertebral body coordinate systems for QCT of the lumbar spine.

    Science.gov (United States)

    Mastmeyer, André; Engelke, Klaus; Fuchs, Christina; Kalender, Willi A

    2006-08-01

    We have developed a new hierarchical 3D technique to segment the vertebral bodies in order to measure bone mineral density (BMD) with high trueness and precision in volumetric CT datasets. The hierarchical approach starts with a coarse separation of the individual vertebrae, applies a variety of techniques to segment the vertebral bodies with increasing detail and ends with the definition of an anatomic coordinate system for each vertebral body, relative to which up to 41 trabecular and cortical volumes of interest are positioned. In a pre-segmentation step constraints consisting of Boolean combinations of simple geometric shapes are determined that enclose each individual vertebral body. Bound by these constraints viscous deformable models are used to segment the main shape of the vertebral bodies. Volume growing and morphological operations then capture the fine details of the bone-soft tissue interface. In the volumes of interest bone mineral density and content are determined. In addition, in the segmented vertebral bodies geometric parameters such as volume or the length of the main axes of inertia can be measured. Intra- and inter-operator precision errors of the segmentation procedure were analyzed using existing clinical patient datasets. Results for segmented volume, BMD, and coordinate system position were below 2.0%, 0.6%, and 0.7%, respectively. Trueness was analyzed using phantom scans. The bias of the segmented volume was below 4%; for BMD it was below 1.5%. The long-term goal of this work is improved fracture prediction and patient monitoring in the field of osteoporosis. A true 3D segmentation also enables an accurate measurement of geometrical parameters that may augment the clinical value of a pure BMD analysis.

  20. Influence of lumbar curvature and rotation on forward flexibility in idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Feng-Chun Kao

    2014-04-01

    Full Text Available Background: Lumbar spine facet joints are arranged sagittally and mainly provide forward flexibility. Rotation of the lumbar vertebral body and coronal plane deformity may influence the function of lumbar forward flexibility. We hypothesize that the more advanced axial and coronal plane deformity could cause more limitation on forward flexibility in patients with idiopathic scoliosis. Methods: Between January 2011 and August 2011, 85 patients with adolescent idiopathic scoliosis were enrolled in this study. The proximal thoracic, major thoracic, thoracolumbar/lumbar (TL/L, and lumbar (L1/L5 curves were measured by Cobb's method. Lumbar apical rotation was graded using the Nash-Moe score. Lumbar forward flexibility was measured using the sit and reach (S and R test. Statistical analysis was performed using one-way analysis of variance (ANOVA, Spearman's and Pearson's correlation coefficients. Results: The mean age was 16.1 ± 2.84 years. The mean proximal thoracic, major thoracic, TL/L, and L1/L5 curves were 17.61° ± 8.92, 25.56° ± 11.61, 26.09° ± 8.6, and 15.10° ± 7.85, respectively. The mean S and R measurement was 25.56 ± 12.33 cm. The magnitude of the TL/L and L1/L5 curves was statistically positively related to vertebral rotation (rs = 0.580 and 0.649, respectively. The correlation between the S and R test and both the TL/L and L1/L5 curves was negative (rp = –0.371 and –0.595, respectively. Besides, the S and R test also demonstrated a significant negative relationship with vertebral rotation (rs = –0.768. Conclusion: In patients with idiopathic scoliosis, spinal deformity can diminish lumbar forward flexibility. Higher lumbar curvature and rotation lead to greater restriction of lumbar flexion.

  1. Optical, spectroscopic, and Doppler evaluation of "normal" and "abnormal" reflexology areas in lumbar vertebral pathology: a case study.

    Science.gov (United States)

    Dalal, Krishna; Elanchezhiyan, D; Maran, V B; Das, Raunak Kumar; Kumar, Piyush; Singh, S P; Murali Krishna, C; Chatterjee, Jyotirmoy

    2012-01-01

    Scientific validation of reflexology requires an in-depth and noninvasive evaluation of "reflexology/reflex areas" in health and disease. The present paper reports the differential properties of "normal" and "abnormal" reflexology areas related to the lumbar vertebrae in a subject suffering from low back pain. The pathology is supported by radiological evidence. The reflexology target regions were clinically assessed with respect to colour and tenderness in response to finger pressure. Grey scale luminosity and pain intensity, as assessed by visual analogue scale scores, differentiated "normal" from "abnormal" skin. Skin swept source-optical coherence tomography recorded their structural differences. Infrared thermography revealed temperature variations. A laser Doppler study using a combined microcirculation and transcutaneous oxygen monitoring system indicated alterations in blood flow and oxygen perfusion. Raman spectroscopy showed differences in chemical signatures between these areas. The present findings may indicate a potential correlation between the reflexology areas and subsurface pathological changes, showing an association with the healthy or unhealthy status of the lumbar vertebrae.

  2. Effects of thrust amplitude and duration of high velocity low amplitude spinal manipulation on lumbar muscle spindle responses to vertebral position and movement

    Science.gov (United States)

    Cao, Dong-Yuan; Reed, William R.; Long, Cynthia R.; Kawchuk, Gregory N.; Pickar, Joel G.

    2013-01-01

    OBJECTIVE Mechanical characteristics of high velocity low amplitude spinal manipulations (HVLA-SM) can be variable. Sustained changes in peripheral neuronal signaling due to altered load transmission to a sensory receptor’s local mechanical environment are often considered a mechanism contributing to the therapeutic effects of spinal manipulation. The purpose of this study was to determine whether an HVLA-SM’s thrust amplitude or duration altered neural responsiveness of lumbar muscle spindles to either vertebral movement or position. METHODS Anesthetized cats (n=112) received L6 HVLA-SMs delivered to the spinous process. Cats were divided into 6 cohorts depending upon the peak thrust force (25%, 55%, 85% body weight) or thrust displacement (1, 2, 3mm) they received. Cats in each cohort received 8 thrust durations (0–250ms). Afferent discharge from 112 spindles was recorded in response to ramp and hold vertebral movement before and after the manipulation. Changes in mean instantaneous frequency (MIF) during the baseline period preceding the ramps (ΔMIFresting), during ramp movements (ΔMIFmovement), and with the vertebra held in the new position (ΔMIFposition) were compared. RESULTS Thrust duration had a small but statistically significant effect on ΔMIFresting at all six thrust amplitudes compared to control (0ms thrust duration). The lowest amplitude thrust displacement (1mm) increased ΔMIFresting at all thrust durations. For all the other thrust displacements and forces, the direction of change in ΔMIFresting was not consistent and the pattern of change was not systematically related to thrust duration. Regardless of thrust force, displacement, or duration, ΔMIFmovement and ΔMIFposition were not significantly different from control. Conclusion Relatively low amplitude thrust displacements applied during an HVLA-SM produced sustained increases in the resting discharge of paraspinal muscle spindles regardless of the duration over which the thrust was

  3. Effects of thrust amplitude and duration of high-velocity, low-amplitude spinal manipulation on lumbar muscle spindle responses to vertebral position and movement.

    Science.gov (United States)

    Cao, Dong-Yuan; Reed, William R; Long, Cynthia R; Kawchuk, Gregory N; Pickar, Joel G

    2013-02-01

    Mechanical characteristics of high-velocity, low-amplitude spinal manipulations (HVLA-SMs) can vary. Sustained changes in peripheral neuronal signaling due to altered load transmission to a sensory receptor's local mechanical environment are often considered a mechanism contributing to the therapeutic effects of spinal manipulation. The purpose of this study was to determine whether variation in an HVLA-SM's thrust amplitude and duration alters the neural responsiveness of lumbar muscle spindles to either vertebral movement or position. Anesthetized cats (n = 112) received L6 HVLA-SMs delivered to the spinous process. Cats were divided into 6 cohorts depending upon the peak thrust force (25%, 55%, 85% body weight) or thrust displacement (1, 2, 3 mm) they received. Cats in each cohort received 8 thrust durations (0-250 milliseconds). Afferent discharge from 112 spindles was recorded in response to ramp and hold vertebral movement before and after the manipulation. Changes in mean instantaneous frequency (∆MIF) during the baseline period preceding the ramps (∆MIFresting), during ramp movement (∆MIFmovement), and with the vertebra held in the new position (∆MIFposition) were compared. Thrust duration had a small but statistically significant effect on ∆MIFresting at all 6 thrust amplitudes compared with control (0-millisecond thrust duration). The lowest amplitude thrust displacement (1 mm) increased ∆MIFresting at all thrust durations. For all the other thrust displacements and forces, the direction of change in ∆MIFresting was not consistent, and the pattern of change was not systematically related to thrust duration. Regardless of thrust force, displacement, or duration, ∆MIFmovement and ∆MIFposition were not significantly different from control. Relatively low-amplitude thrust displacements applied during an HVLA-SM produced sustained increases in the resting discharge of paraspinal muscle spindles regardless of the duration over which the thrust

  4. Internal morphology of human facet joints: comparing cervical and lumbar spine with regard to age, gender and the vertebral core.

    Science.gov (United States)

    Wilke, Hans-Joachim; Zanker, Daniel; Wolfram, Uwe

    2012-03-01

    Back pain constitutes a major problem in modern societies. Facet joints are increasingly recognised as a source of such pain. Knowledge about the internal morphology and its changes with age may make it possible to include the facets more in therapeutic strategies, for instance joint replacements or immobilisation. In total, 168 facets from C6/7 and L4/5 segments were scanned in a micro-computed tomography. Image analysis was used to investigate the internal morphology with regard to donor age and gender. Additional data from trabecular bone of the vertebral core allowed a semi-quantitative comparison of the morphology of the vertebral core and the facets. Porosity and pore spacing of the cortical sub-chondral bone does not appear to change with age for either males or females. In contrast, bone volume fraction decreases in females from approximately 0.4 to 0.2 , whereas it is constant in males. Trabecular thickness decreases during the ageing process in females and stays constant in males , whereas trabecular separation increases during the ageing process in both genders. The results of this study may help to improve the understanding of pathophysiological changes in the facet joints. Such results could be of value for understanding back pain and its treatment.

  5. 骨盆参数及骨盆空间位置关系与腰椎稳定性的相关性%Correlation between pelvic indices, pelvic spatial orientation and lumbar vertebrate instability

    Institute of Scientific and Technical Information of China (English)

    蔡思逸; 花苏榕; 袁青; 沈建雄; 仉建国; 赵宏; 赵丽娟; 李书纲

    2014-01-01

    目的 通过比较腰椎不稳和腰椎稳定两组患者的骨盆投射角(PI)、腰椎前凸角(LL)、骨盆倾斜角(PT)和骶骨倾斜角(SS),分析骨盆参数及骨盆空间位置与腰椎稳定性的关系.方法 回顾性分析2012年2月至2013年1月北京协和医院78例因腰椎间盘突出症接受手术患者的术前影像学资料,测量并比较腰椎不稳和腰椎稳定两组患者的PI、PT、SS及LL值.结果 腰椎不稳与腰椎稳定两组间PI、LL、PT及SS等方面无统计学差异;无论在总体上还是在各层内,腰椎不稳组的平均PI值均大于腰椎稳定组,但差异无统计学意义.在L4/5节段病变患者中,腰椎不稳组的SS值显著大于腰椎稳定组[(38.7±4.7)°比(34.0±6.6)°,P=0.023].在腰椎不稳组内,L5/S1节段病变亚组的PT值显著大于L4/5节段病变亚组(17.5±7.0)比(14.9±5.3),P=0.027.结论 腰椎不稳患者的骨盆参数及骨盆空间位置与腰椎稳定患者相比均明显差异,但增大的SS可能提示发生L4/5节段不稳定的风险升高.%Objective To explore the correlation between the stability of lumbar vertebrate and pelvic indices of pelvic incidence (PI),lumber lordosis (LL),pelvic tilt (PT) and sacrum slope (SS).Methods The preoperative imaging data were analyzed retrospectively for 78 patients with lumbar disc protrusion.The values of PI,PT,SS and LL were measured and compared between lumbar vertebrate stability and lumbar vertebrate instability groups.Results No inter-group statistical difference existed in PI,LL,PT or SS.The average PI of lumbar vertebrate instability group was higher than that of lumbar vertebrate stability group.In patients with L4/5 segmental lesion,SS of lumbar vertebrate instability group was higher than that of lumbar vertebrate stability group (38.7 ± 4.7) ° vs (34.0 ± 6.6) °,p =0.023.And PT in patients with LS/S1 segmental lesion was higher than those with LA/5 segmental lesion (17.5 ± 7.0 vs 14.9 ± 5.3,P =0.027).Conclusion No

  6. Apical cap

    Energy Technology Data Exchange (ETDEWEB)

    McLoud, T.C.; Isler, R.J.; Novelline, R.A.; Putman, C.E.; Simeone, J.; Stark, P.

    1981-08-01

    Apical caps, either unilateral or bilateral, are a common feature of advancing age and are usually the result of subpleural scarring unassociated with other diseases. Pancoast (superior sulcus) tumors are a well recognized cause of unilateral asymmetric apical density. Other lesions arising in the lung, pleura, or extrapleural space may produce unilateral or bilateral apical caps. These include: (1) inflammatory: tuberculosis and extrapleural abscesses extending from the neck; (2) post radiation fibrosis after mantle therapy for Hodgkin disease or supraclavicular radiation in the treatment of breast carcinoma; (3) neoplasm: lymphoma extending from the neck or mediastinum, superior sulcus bronchogenic carcinoma, and metastases; (4) traumatic: extrapleural dissection of blood from a ruptured aorta, fractures of the ribs or spine, or hemorrhage due to subclavian line placement; (5) vascular: coarctation of the aorta with dilated collaterals over the apex, fistula between the subclavian artery and vein; and (6) miscellaneous: mediastinal lipomatosis with subcostal fat extending over the apices.

  7. A study on the mineral density of the lumbar vertebral bone in children of metabolic disorders and control using single energy quantitative CT

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Kazutoshi (Tokyo Women' s Medical Coll. (Japan))

    1991-06-01

    A cross sectional study on the mineral density of the 3rd lumbar vertebral trabecular bone was carried out in 123 children less than 15 years old, comprising 44 controls, and 79 patients affected with conditions which are at risk for developing metabolic derangement of skeletal bone (34 patients taking antiepileptic drugs (AED), 29 undergoing glucocorticoid (GC) therapy and 16 bedridden patients), by using quantitative computed tomography (QCT) with a CaCO{sub 3} phantom. Serum Ca and alkaline-phosphatase (Alp) levels were measured at the time of QCT examinations in all. The results obtained were as follows: The QCT values in the control children showed neither age dependency nor a sexual difference before puberty. The QCT values in each group showed significant difference with one another; the control group>the AED group>the GC group>the bedridden group (p<0.05{approx}0.005). The serum Ca levels in each pathology group were significantly lower than those in the control group (p<0.05{approx}0.005). The serum Alp levels in the AED group were significantly higher (p<0.005) and those in the GC and bedridden groups significantly lower (p<0.01 and p<0.005 respectively) than those in the control group. The only GC group was significant (p<0.01) in the study of the relationships between the QCT value and the serum Alp level of each group. These results suggest that mechanisms underlying the decreased bone mineral density with AED and GC therapy and immobility are different from one another. Especially in the GC group abnormality of the Alp activity may be closely related to the decrease of trabecular bone mineral density. (author).

  8. Combination of external Chinese herb and traction for senile lumbar vertebral compression fracture%牵引结合中药外敷治疗老年腰椎压缩性骨折临床研究

    Institute of Scientific and Technical Information of China (English)

    冯树生; 孙波; 张凌; 米仕弟

    2011-01-01

    Objective:To explore the clinical therapeutic effect of combination of external Chinese herb and traction for senile lumbar vertebral compression fracture. Methods: 197 aged patients with lumbar vertebral fracture were randomly divided into two groups: treatment group ( treated with traction combination of external Chinese herb and take calcium tablet) 103 cases included and control group ( treated with traction and take calcium tablet)94 cases included. Results:Release lumbago, promote movement function resume, reduce time in hospital of treatment group was significantly better than that of control group( P <0.05 ). Conclusion :The therapeutic effect of combination of external Chinese herb and traction for senile lumbar vertebral compression fracture is a kind of effective method.%目的:观察牵引结合中药外敷治疗老年腰椎压缩性骨折的有效性.方法:将197例老年腰椎压缩性骨折患者随机分为对照组观察组,对照组94例采用仰卧硬板床、牵引、骨折部位垫厚枕、口服补钙剂;观察组103例在对照组基础上结合中药外敷.结果:观察组在缓解局部疼痛、促进活动恢复及缩短平均住院天数等方面都显著优于对照组(P<0.05).结论:牵引结合中药外敷是治疗老年腰椎压缩性骨折的有效方法.

  9. Research Progress on Resorption After Protrusion of Lumbar Vertebral Disc%腰椎间盘突出后的重吸收研究进展

    Institute of Scientific and Technical Information of China (English)

    俞振翰; 姜宏; 周红海

    2012-01-01

    This paper introduces the chronological characteristic of the resorption after protrusion of lumbar vertebral disc (PLVD) and its relation to different PLVD types. It also discusses the mechanism of the resorption after PLVD, which includes inflammatory cytophagocytosis, autoimmune reaction, vascularization, reduced matrix metalloproteinase synthesis, dehydration and hematoma absorption, influence of growth factors and cytokines, and traditional Chinese medicine (TCM) understanding of this resorption. The author indicates that the resorption after PLVD has provided a powerful prove for the rea-sonability and effectiveness of TCM conservative therapy in protrusion of the intervertebral disc, and suggests that inflammatory reaction helps the resorption but causes nerve stimulation leading to pain, so how to control and make use of inflammation is a important research direction in the future.%介绍了腰椎间盘突出后重吸收的时间特点及其与分型的关系,并论述了腰椎间盘突出后重吸收的发生机制,包括炎性细胞吞噬作用、自身免疫反应、血管化、基质金属蛋白酶合成减少、脱水及血肿的吸收、生长因子与细胞因子的影响等,另外论述了中医药对此现象的认识.认为腰椎间盘突出后重吸收现象为中医保守治疗椎间盘突出症的合理性、有效性提供了有力的依据.并提出炎性反应有利于重吸收但同时会造成神经刺激引发疼痛,如何控制、利用炎症是今后研究的一个重要方向.

  10. Lordose lombar: estudo dos valores angulares e da participação dos corpos vertebrais e discos intervertebrais Lumbar lordosis: a study of angle values and of vertebral bodies and intervertebral discs role

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Fonseca Damasceno

    2006-01-01

    Full Text Available Foi estudado, em indivíduos normais, o valor angular da lordose lombar e a participação dos corpos vertebrais e discos intervertebrais na sua composição. Foram avaliadas as radiografias da coluna lombar de 350 indivíduos normais e assintomáticos com a idade variando de 18 a 50 anos (média 29,0 anos ± 8,24, sendo 143 homens e 207 mulheres. Foram medidas a curvatura lombossacra (L1S1 e a curvatura lombolombar (L1L5. As medidas das curvaturas lombares e dos seus componentes apresentaram grande variabilidade. Foram observados valores médios de -61° para a curvatura lombossacra e de -45° para a curvatura lombolombar. As medidas dos corpos vertebrais apresentaram valores cifóticos para L1, neutros para L2, e progressivamente lordóticos de L3 a L5. Os discos intervertebrais apresentaram angulação lordótica progressiva desde L1-L2. Os elementos caudais da curvatura, discos intervertebrais L4-L5 e L5-S1 e o corpo vertebral L5 corresponderam a quase 60% medida angular da curvatura lombossacra. Foi observada diferença significante entre os sexos masculino e feminino para as medidas das curvaturas lombares, e dos corpos vertebrais L2 e L4, tendo sido observados valores maiores no sexo feminino. Foram observadas diferenças relacionadas à idade na medida das curvaturas lombares e dos corpos vertebrais.The angular value of lumbar lordosis and the role of vertebral bodies and intervertebral discs in its constitution were studied in normal individuals. X-Ray images of lumbar spine were studied in 350 normal and asymptomatic individuals, ages ranging from 18 to 50 years old (average 29.0 years old ± 8.24, being 143 males and 207 females. The lumbosacral (L1S1 and the lumbolumbar (L1L5 curves were measured. Measurements for lumbar curves and their components presented a large variation. Average values of -61º were seen for lumbosacral curve and of -45º for lumbolumbar curve. Vertebral bodies measurements presented kyphotic values for L1

  11. Investigation on spondylolysis of lumbar vertebral arch in 100 recruits before and after reinforced training%新战士100名强化训练前后腰椎椎弓峡部断裂情况调查

    Institute of Scientific and Technical Information of China (English)

    宋一平; 张发惠

    2006-01-01

    背景:新战士在新兵训练期间出现腰椎椎弓峡部断裂发病率较高并影响了正常训练.目的:分析部队新兵中腰椎椎弓峡部断裂的发病率与训练及其腰部原有病变的关系.设计:随机抽样调查.单位:解放军第九十七医院骨科.对象:某部2003年入伍的新兵100名,男性,平均年龄18.7岁.方法:对100名新兵全程追踪随访,于训练前及100 d强化训练后分别摄腰部X射线正、侧位和双斜位片进行对照观察.主要观察指标:椎弓峡部断裂病例发病率,原有断裂者有无滑脱等加重现象.结果:调查对象100名均进入结果分析.①新兵训练前、后椎弓峡部断裂发病率:训练开始前的入伍新兵,L5椎弓峡部断裂5例,发病率为5%.100 d训练结束时,腰椎椎弓峡部断裂8例,发病率增加至8%.②新兵训练前、后X射线检查结果:100名新战士X射线片训练开始前,左侧L5椎弓峡部变细2例,右侧L5椎弓峡部变细1例;双侧L5椎弓峡部断裂5例,其中1例呈Ⅰ度滑脱.100 d训练结束时,原双侧L5椎弓峡部断裂5例中Ⅰ度以内滑脱3例,另3例原腰椎椎弓变细者均发生断裂. 结论:腰椎椎弓峡部断裂发病率与训练强度有关.建议加强入伍新兵脊柱体检,常规加拍腰椎正、侧位和双斜位X射线片检查项目.%BACKGROUND: The incidence rate of spondylolysis of lumbar vertebral arch in recruits is higher during the training, and it affects the normal training. OBJECTIVE: To analyze the correlation of the incidence rate of spondy lolysis of lumbar vertebral arch with training and the original lesions at waist in recruits. DESIGN: A randomized sampling survey. SETTING: Department of Orthopaedics, the 97 Hospital of Chinese PLA. PARTICIPANTS: Totally 100 male recruits aged 18.7 years averagely en rolled in 2003 were involved in the survey. METHODS: The 100 recruits were followed up for the whole course, the X-ray examination at lumbar vertebrae of right, lateral and two

  12. Association of femoral bone mineral density with lumbar vertebral fractures in patients with ankylosing spondylitis%强直性脊柱炎患者股骨密度与腰椎椎体骨折的相关性

    Institute of Scientific and Technical Information of China (English)

    魏萌; 谢庆云; 杨晓平; 徐沪济

    2009-01-01

    目的:之前的观点认为强直性脊柱炎患者易发生椎体骨折是由于其继发性弥漫性的骨质疏松,而近年对强直性脊柱炎患者的骨矿物密度和椎体骨折的研究发现,两者之间并无相关性.文章旨在调查强直性脊柱炎患者腰椎椎体骨折与临床、实验室及影像学指标的相关性.方法:对65例强直性脊柱炎患者及62例健康体检者进行对比观察,每例受试者均拍摄腰椎平片判断有无椎体骨折,评估疾病活动性包括C-反应蛋白、血沉水平、指地距、Schober指数、Bath指数以及韧带骨赘评分,应用双能X射线吸收法测定腰椎及股骨骨密度.结果:65例强直性脊柱炎中有10例出现腰椎椎体骨折,占15.4%,其中楔形变4例,双凹畸形6例.强直性脊柱炎患者的腰椎和股骨骨密度均明显低于对照组(P<0.01).有椎体骨折和无椎体骨折的强直性脊柱炎患者相比,其Schober指数、指地距、Bath指数、韧带骨赘评分以及转子间骨密度差异均有显著性意义(P<0.01).多元Logistic回归分析发现,强直性脊柱炎患者转子间骨密度与腰椎椎体骨折的发生有独立相关性(P=0.041).结论:强直性脊柱炎的股骨尤其是转子问低骨密度值与腰椎椎体骨折发生的危险性具有相关性.%OBJECTIVE: Previous opinions consider the secondary diffuse osteoporosis as the very cause of vertebral fractures in patients with ankylosing spondylitis (AS). However, recent studies on bone mineral density (BMD) and vertebral fractures in AS patients reveal that there is no relation between the two. This article aims at investigating the association of lumbar vertebral fractures with clinical, laboratory, and imaging indexes in AS patients.METHODS: A contrast observation was performed between 65 AS patients and 62 healthy physical examinees, whose lumbar vertebral plain radiographs were taken for checking vertebral fractures. Disease activity evaluation indexes included C

  13. Intraobserver and interobserver reliability of the Landim's Classification System for lumbar spinal stenosis Evaluación intraobservador e ínterobservador del Sistema de Clasificación de Landim para estenosis vertebral lumbar Avaliação intra-observador e inter-observadores do Sistema de Classificação de Landim para estenose vertebral lombar

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    Rodrigo Castro de Medeiros

    2009-03-01

    Full Text Available OBJECTIVE: the Classification proposed by Landim for lumbar spine stenosis could be a method of diagnostic standardization once, on the literature, there are no studies that standardize the use of a classification which allows the comparison of results. It is necessary the evaluation of intra and interobservers' reproducibility for such system as to validate it for this matter. METHODS: pre-operative image exam of lumbosacral column of 11 patients diagnosed with symptomatic lumbar stenosis were selected. The criteria for selection were image exams with good quality and diverse etiologies. The age group ranged from 15 to 87 years and included both sexes. The studied samples were followed at the Ambulatory of Spine Column of the Department of Orthopaedics and Traumatology of the Hospital das Clínicas, Universidade de Campinas (Unicamp, city of Campinas, state of São Paulo, Brazil. Twelve spine surgeons classified the 11 sample exams according to Landim's Classification in two different moments with a time interval of 3 weeks. The intra and interobservers' statistical analysis used were the Wilcoxon and the Alpha of Cronbach Tests, respectively. Significant results were considered as POBJETIVO: la clasificación propuesta por Landim para estenosis vertebral lumbar es un método de uniformidad diagnóstica, una vez que en la literatura los estudios no estandarizan la utilización de una clasificación que permita la comparación de resultados. Para validar esta clasificación hicimos una evaluación de reproducibilidad de la misma intra e interobservadores. MÉTODOS: los exámenes de imagen preoperatorios de las columnas lumbosacras de 11 pacientes, con diagnóstico de estenosis lumbar sintomática fueron seleccionados. Los criterios de selección fueron exámenes de imagen con buena calidad y etiologías diversificadas. La edad varió entre 15 y 87 años e incluyó ambos sexos. Todos los casos involucrados en el estudio fueron acompañados en el

  14. Vertebral chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States); Unni, Krishnan K. [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States)

    2003-02-01

    To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral

  15. 腰椎间盘退变中椎体终板骨软骨炎的低场MRI表现%Low field MRI findings of vertebral end-plate osteochondritis in lumbar disc degeneration

    Institute of Scientific and Technical Information of China (English)

    许思祥

    2011-01-01

    目的 探讨腰椎间盘退变中椎体终板骨软骨炎的磁共振成像(MRI)表现及其临床意义.方法 搜集2008年3月~2009年3月间经临床及影像学诊断的腰椎椎体终板骨软骨炎115例,累及235处腰椎终板,全部病例均有不同程度的临床症状.回顾性分析终板及邻近椎体骨质信号改变.结果 115例椎体终板骨软骨炎患者中,有235处终板信号异常,按Modic分型,其中Ⅰ型改变有91处(占38.7%);Ⅱ型改变有120处(占51.1%),Ⅲ型改变有24处(占10.2%).伴随改变:合并椎间盘膨出23处,突出97处,脱出6处,Schmorls结节68处,椎体滑脱7处,压缩性骨折4处.结论 终板骨软骨炎是造成临床局部疼痛的原因之一,低场MRI能清楚显示腰椎间盘退变中椎体终板炎各期的信号特点,对病灶的显示满意,是检查本病的最佳方法.%Aim To explore the magnetic resonance imaging ( MRI ) performance and clinical significance of vertebral end-plate osteochondritis in lumbar disc degeneration. Methods 115 cases of vertebral end-plate osteochondritis were collected by the clinical and imaging diagnosis from Mar. 2008 to Mar. 2009 ,involving 235 lumbar end-plates. All patients had various degrees of clinical symptoms. The signal change of vertebral end-plate and adjacent bones was analyzed. Results In 115 cases of vertebral end-plate osteochondritis , there were 235 end-plates signal abnormalities. According to Modic categorization, there were 91 cases( 38. 7% ) of Modic type Ⅰ .120 cases (51. 1% ) Modic type Ⅱ and 24 cases( 10. 2% ) Modic type Ⅲ. Accompanied changes were merge disc bulges 23 cases, disc herniations 97 cases , disc extrusions 6 cases , Schmorls nodules 68 cases , vertebral spondylolisthesis 7 cases , and compression fractures 4 cases. Conclusion The end-plate osteochondritis is one of the reasons to cause the clinical local pain. Low field MRI can clearly showed the signal characteristics of end-plate osteochondritis phases in

  16. Dynamic fe Model of Sitting Man Adjustable to Body Height, Body Mass and Posture Used for Calculating Internal Forces in the Lumbar Vertebral Disks

    Science.gov (United States)

    Pankoke, S.; Buck, B.; Woelfel, H. P.

    1998-08-01

    Long-term whole-body vibrations can cause degeneration of the lumbar spine. Therefore existing degeneration has to be assessed as well as industrial working places to prevent further damage. Hence, the mechanical stress in the lumbar spine—especially in the three lower vertebrae—has to be known. This stress can be expressed as internal forces. These internal forces cannot be evaluated experimentally, because force transducers cannot be implementated in the force lines because of ethical reasons. Thus it is necessary to calculate the internal forces with a dynamic mathematical model of sitting man.A two dimensional dynamic Finite Element model of sitting man is presented which allows calculation of these unknown internal forces. The model is based on an anatomic representation of the lower lumbar spine (L3-L5). This lumber spine model is incorporated into a dynamic model of the upper torso with neck, head and arms as well as a model of the body caudal to the lumbar spine with pelvis and legs. Additionally a simple dynamic representation of the viscera is used. All these parts are modelled as rigid bodies connected by linear stiffnesses. Energy dissipation is modelled by assigning modal damping ratio to the calculated undamped eigenvalues. Geometry and inertial properties of the model are determined according to human anatomy. Stiffnesses of the spine model are derived from static in-vitro experiments in references [1] and [2]. Remaining stiffness parameters and parameters for energy dissipation are determined by using parameter identification to fit measurements in reference [3]. The model, which is available in 3 different postures, allows one to adjust its parameters for body height and body mass to the values of the person for which internal forces have to be calculated.

  17. Assessment of spontaneous correction of lumbar curve after fusion of the main thoracic in Lenke 1 adolescent idiopathic scoliosis☆

    Science.gov (United States)

    Mizusaki, Danilo; Gotfryd, Alberto Ofenhejm

    2016-01-01

    Objective To evaluate the clinical and radiographic response of the lumbar curve after fusion of the main thoracic, in patients with adolescent idiopathic scoliosis of Lenke type 1. Methods Forty-two patients with Lenke 1 adolescent idiopathic scoliosis who underwent operations via the posterior route with pedicle screws were prospectively evaluated. Clinical measurements (size of the hump and translation of the trunk in the coronal plane, by means of a plumb line) and radiographic measurements (Cobb angle, distal level of arthrodesis, translation of the lumbar apical vertebral and Risser) were made. The evaluations were performed preoperatively, immediately postoperatively and two years after surgery. Results The mean Cobb angle of the main thoracic curve was found to have been corrected by 68.9% and the lumbar curve by 57.1%. Eighty percent of the patients presented improved coronal trunk balance two years after surgery. In four patients, worsening of the plumb line measurements was observed, but there was no need for surgical intervention. Less satisfactory results were observed in patients with lumbar modifier B. Conclusions In Lenke 1 patients, fusion of the thoracic curve alone provided spontaneous correction of the lumbar curve and led to trunk balance. Less satisfactory results were observed in curves with lumbar modifier B, and this may be related to overcorrection of the main thoracic curve. PMID:26962505

  18. Assessment of spontaneous correction of lumbar curve after fusion of the main thoracic vertebrae in Lenke 1 adolescent idiopathic scoliosis

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    Danilo Mizusaki

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical and radiographic response of the lumbar curve after fusion of the main thoracic vertebrae, in patients with adolescent idiopathic scoliosis of Lenke type 1. METHODS: Forty-two patients with Lenke 1 adolescent idiopathic scoliosis who underwent operations via the posterior route with pedicle screws were prospectively evaluated. Clinical measurements (size of the hump and translation of the trunk in the coronal plane, by means of a plumb line and radiographic measurements (Cobb angle, distal level of arthrodesis, translation of the lumbar apical vertebral and Risser were made. The evaluations were performed preoperatively, immediately postoperatively and two years after surgery. RESULTS: The mean Cobb angle of the main thoracic curve was found to have been corrected by 68.9% and the lumbar curve by 57.1%. Eighty percent of the patients presented improved coronal trunk balance two years after surgery. In four patients, worsening of the plumb line measurements was observed, but there was no need for surgical intervention. Less satisfactory results were observed in patients with lumbar modifier B. CONCLUSIONS: In Lenke 1 patients, fusion of the thoracic curve alone provided spontaneous correction of the lumbar curve and compensation of the trunk. Less satisfactory results were observed in curves with lumbar modifier B, and this may be related to overcorrection of the main thoracic curve.

  19. Correlation Between Vertebral Osteoporosis and Trabecular Bone Change in Patients with Lumbar Scoliosis%腰椎侧凸患者椎体骨小梁结构稀少与骨质疏松的相关性

    Institute of Scientific and Technical Information of China (English)

    张友; 赵尧; 朱晓勃; 陈岩

    2013-01-01

    Purpose To study the correlation between vertebral osteoporosis and trabecular bone change in adult patients with lumbar scoliosis. Materials and Methods One hundred patients with lumbar scoliosis diagnosed by using CT (patient group) and one hundred patients with a history of backleg pain but not diagnosed as lumbar scoliosis (control group) were enrolled. The CT readings of vertebra and vertebral trabecular bone volume to tissue volume (BV/TV) of patients in both groups were measured. Three-dimensional reconstruction of trabecular bone was performed to visualize its structure change. Results The measured CT and BV/TV values in patient group were significantly higher than those in control group (P<0.05). Three-dimensional volume rendering showed patient group had detectable trabecular discontinuities, reduced trabecular bone number, and less dense trabecular. There was a significant negative correlation between BV/TV and age (r=―0.513, P<0.01) for all the participants. Conclusion As a consequence of aging, the BV/TV value is reduced, the structure of spongy bone is changed and consequently, the incidence rate of vertebral osteoporosis is increased. The sparse trabecular structure, reduced trabecular number, and the structure change in spongy bone are the main reasons for adult lumbar scoliosis.%  目的观察成人腰椎侧凸患者椎体骨小梁的改变及其与骨质疏松的相关性.资料与方法收集经腰椎 CT 检查确诊的腰椎侧凸患者(病例组)及无腰椎侧凸的腰腿痛患者(对照组)各100例,分别测量两组受试者椎体 CT 值及椎体骨小梁容积百分比(BV/TV);同时重建骨小梁的三维图像,观察骨小梁的结构改变.结果病例组椎体 CT 值及 BV/TV 值均较对照组明显降低(P<0.05).容积再现三维图像显示,病例组患者骨小梁连续性中断,数目减少;对照组患者骨小梁相对致密.所有受试者 BV/TV 值与年龄呈负相关(r=―0.513, P<0.01).

  20. Cambios en la lordosis lumbar luego de una artrodesis vertebral posterior de la columna torácica y su relación con la incidencia pelviana. [Changes in lumbar lordosis after further spinal fusion of thoracic spine and its relationship to pelvic incidence].

    Directory of Open Access Journals (Sweden)

    Miguel Puigdevall

    2016-05-01

    Full Text Available Objetivo: El objetivo de este trabajo fue evaluar las variables del plano sagital en pacientes con escoliosis idiopática del adolescente que fueron operados mediante una artrodesis vertebral posterior instrumentada con tornillos pediculares y establecer la existencia de relaciones entre las mismas. Material y Método: Fueron evaluados retrospectivamente 20 pacientes. Se compararon entre el espinograma preoperatorio, postoperatorio inmediato y el realizado a los 2 años de la cirugía, los cambios ocurridos en la lordosis cervical, la cifosis torácica, la lordosis lumbar, la incidencia pélvica, el balance sagital global y la cifosis de la unión proximal. Además, los cambios postoperatorios ocurridos en la lordosis lumbar fueron correlacionados con  los cambios postoperatorios ocurridos en la cifosis torácica y en la incidencia pélvica. Resultados: Se observó una disminución significativa en la cifosis torácica (de 24,2° a 14,8° (p<0,0001 y en la lordosis lumbar (de -60,3° a -39,8° (p<0,00001 en el espinograma postoperatorio inmediato. Ambos parámetros mostraron un aumento en el espinograma realizado a los 2 años postoperatorios (de 14,8° a 18,7° la cifosis torácica (p=0,021 y de -39,8° a -52,4° la lordosis lumbar (p=0,0036. También se encontró un aumento significativo entre el preoperatorio y el postoperatorio a 2 años en la cifosis de la unión proximal (de 5,1° a 12,4° (p<0,0001 y en la lordosis cervical (de -4,2° a -14,8° (p=0,025. La única correlación postoperatoria significativa encontrado fue entre la lordosis lumbar y la incidencia pélvica (r=0,61 en el espinograma realizado a los 2 años de la cirugía. Conclusión: La AVP instrumentada con tornillos pediculares en pacientes con curvas Lenke 1 provoca una reducción postoperatoria de la cifosis torácica y de la lordosis lumbar, y un aumento postoperatorio de la lordosis cervical y de la cifosis de la unión proximal. En las radiografías realizadas a los 2

  1. Optical, Spectroscopic, and Doppler Evaluation of “Normal” and “Abnormal” Reflexology Areas in Lumbar Vertebral Pathology: A Case Study

    Directory of Open Access Journals (Sweden)

    Krishna Dalal

    2012-01-01

    Full Text Available Scientific validation of reflexology requires an in-depth and noninvasive evaluation of “reflexology/reflex areas” in health and disease. The present paper reports the differential properties of “normal” and “abnormal” reflexology areas related to the lumbar vertebrae in a subject suffering from low back pain. The pathology is supported by radiological evidence. The reflexology target regions were clinically assessed with respect to colour and tenderness in response to finger pressure. Grey scale luminosity and pain intensity, as assessed by visual analogue scale scores, differentiated “normal” from “abnormal” skin. Skin swept source-optical coherence tomography recorded their structural differences. Infrared thermography revealed temperature variations. A laser Doppler study using a combined microcirculation and transcutaneous oxygen monitoring system indicated alterations in blood flow and oxygen perfusion. Raman spectroscopy showed differences in chemical signatures between these areas. The present findings may indicate a potential correlation between the reflexology areas and subsurface pathological changes, showing an association with the healthy or unhealthy status of the lumbar vertebrae.

  2. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Ebbesen, Ebbe Nils; Mosekilde, Lis

    2002-01-01

    The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...... of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly...... of improving the prediction of bone strength of the vertebral body. The correlations between BV/TV of L-2 and bone strength of L-3 were comparable with the correlation obtained by quantitative computed tomography (QCT), peripheral QCT (pQCT), and dual-energy X-ray absorptrometry (DEXA) of L-3 and bone strength...

  3. "Effectiveness of continuous vertebral resonant oscillation using the POLD method in the treatment of lumbar disc hernia". A randomized controlled pilot study.

    Science.gov (United States)

    López-Díaz, Juan Vicente; Arias-Buría, José Luis; Lopez-Gordo, Estrella; Lopez Gordo, Sandra; Oyarzún, Alejandra P Aros

    2015-06-01

    This study analyses the efficacy of manual oscillatory therapy, following the POLD technique, for acute Lumbar Disc Hernia (LDH) and compares it to usual treatment. A randomised, controlled, triple-blind pilot clinical trial. The sample of 30 patients was divided into two homogeneous groups to receive usual treatment (A) or treatment with the POLD technique (B). We analysed range of motion and subjective variables such as the severity (visual analogue pain scale (VAS)) and extension of the pain. With the application of POLD therapy, patients presented significant changes on range of motion (forward flexion with p POLD Method was shown to be an effective manual therapy approach for reducing the severity and irradiation of the pain in LDH patients with sciatica, and more efficient than usual treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome.

    Science.gov (United States)

    Jones, Sarah L; Thomas, Iona; Hamill, James

    2010-02-01

    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  5. Lateral Lumbar Interbody Fusion

    Science.gov (United States)

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-01-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  6. Matriz óssea homóloga desmineralizada associada à medula óssea autógena fresca na artrodese vertebral dorsolateral lombar em coelhos Homologous demineralized bone matrix associated to autologous bone marrow in a rabbit dorsolateral lumbar vertebral fusion

    Directory of Open Access Journals (Sweden)

    D. Rizzo

    2005-04-01

    Full Text Available Foi avaliada a matriz óssea homóloga desmineralizada (MOD, associada à medula óssea autógena fresca (MO, na artrodese vertebral dorsolateral lombar em 24 coelhos (grupo 1, depositada sobre os processos transversos de L5-L6 previamente descorticados. Em outros nove coelhos (grupo-controle, foi realizada apenas a descorticação dos processos transversos e nas diferentes avaliações, foi observada insignificante reação periosteal local, sem união óssea. No grupo 1, às cinco semanas de pós-operatório, 87,5% dos animais apresentaram união (artrodese à palpação, seguido por 75 e 100% às sete e nove semanas, respectivamente. Os índices de artrodese aos RX foram de 50%, 62% e 75%, no mesmo período de avaliação. Histologicamente, às cinco semanas havia características de osteointegração da MOD com os processos transversos descorticados, de onde partiram os vasos sangüíneos que penetraram a matriz, e presença de ilhas de cartilagem no centro do enxerto. Nas semanas seguintes, a ossificação endocondral evoluiu e a MOD foi quase totalmente substituída por tecido ósseo trabecular, formando uma ponte de osso maduro entre e sobre os processos transversos adjacentes, propiciando ao segmento operado maior resistência mecânica em comparação aos segmentos adjacentes. A associação da MOD com a MO mostrou-se uma opção exeqüível e de baixo custo na artrodese vertebral dorsolateral lombar em coelhos.It was evaluated the homologous demineralized bone matrix (HDBM, associated with the fresh autogenous bone marrow (FABM, in the vertebral dorsolateral lumbar union in 24 rabbits (group 1, that was placed on the transverse processes of previously decorticated L5-L6 vertebrae. In other nine rabbits (control group, it was just accomplished the decortications of the transverse processes, which showed insignificant local periostial reaction, without bone union after different evaluations. In the group 1, after five weeks of

  7. Are the determinants of vertebral endplate changes and severe disc degeneration in the lumbar spine the same? A magnetic resonance imaging study in middle-aged male workers

    Directory of Open Access Journals (Sweden)

    Korpelainen Raija

    2008-04-01

    Full Text Available Abstract Background Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI, and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1. Only limited information exists about the determinants of Modic changes. The objective of this study was to evaluate the determinants of vertebral endplate (Modic changes, and whether they are similar for Modic changes and severe disc degeneration focusing on L5-S1 level. Methods 228 middle-aged male workers (159 train engineers and 69 sedentary factory workers from northern Finland underwent sagittal T1- and T2-weighted MRI. Modic changes and disc degeneration were analyzed from the scans. The participants responded to a questionnaire including items of occupational history and lifestyle factors. Logistic regression analysis was used to evaluate the associations between selected determinants (age, lifetime exercise, weight-related factors, fat percentage, smoking, alcohol use, lifetime whole-body vibration and Modic type I and II changes, and severe disc degeneration (= grade V on Pfirrmann's classification. Results The prevalences of the Modic changes and severe disc degeneration were similar in the occupational groups. Age was significantly associated with all degenerative changes. In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference were associated with type II changes. Exposure to whole-body vibration, besides age, was the only significant determinant for severe disc degeneration. In the multivariate model, BMI was associated with type II changes at L5-S1 (OR 2.75 per one SD = 3 unit increment in BMI, and vibration exposure with severe disc degeneration at L5-S1 (OR 1.08 per one SD = 11-year increment in vibration exposure. Conclusion Besides age, weight-related factors seem important in the pathogenesis of Modic changes, whereas whole-body vibration was the only significant determinant

  8. Learning about Vertebrate Limb Development

    Science.gov (United States)

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  9. Learning about Vertebrate Limb Development

    Science.gov (United States)

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  10. 姚新苗教授治疗腰椎间盘突出下肢麻木经验浅谈%Mr. Yao Xinmiao's Experience in Treating Numb Lower Limbs of Lumbar Vertebral Disc Protrusion

    Institute of Scientific and Technical Information of China (English)

    应建伟; 朱胤晟; 裘伟国; 姚新苗

    2013-01-01

      [目的]总结姚新苗教授治疗腰椎间盘突出症引起的下肢麻木的临床经验。[方法]从病因病机、治法治则等方面阐述姚新苗教授治疗腰椎间盘突出症引起的下肢麻木的临床经验,并附案例2则以验证。[结果]腰突症引起的下肢麻木主要病机是寒湿内侵、痰瘀血滞、气血亏虚,治疗上分别予散寒燥湿、化痰祛瘀、补气养血。[结论]姚新苗教授通过中医辨证论治,治疗腰椎间盘突出症引起的下肢麻木屡获佳效,易为患者所接受。%Objective] To sum up pro. Yao Xinmiao's experience in treating numb lower limbs induced by lumbar vertebral disc protrusion. [Method] It reiterates his experiences from causa morbi, mechanism, therapy and treating rules. [Result] Such numb lower limbs are owing to cold dump invasion, blocked sputum, stasis and blood and deficient Qi and blood, respectively treated with removing coldness to dry dump, removing sputum and stasis, nour-ishing Qi and blood. [Conclusion] Pro. Yao Xinmiao's experience in treating the disease above by differentiation of signs, has good effect, easily accepted by patients.

  11. Extensive spinal epidural abscess treated with "apical laminectomies" and irrigation of the epidural space: report of 2 cases.

    Science.gov (United States)

    Abd-El-Barr, Muhammad M; Bi, Wenya Linda; Bahluyen, Biji; Rodriguez, Samuel T; Groff, Michael W; Chi, John H

    2015-03-01

    Spinal epidural abscess (SEA) is a rare but often devastating infection of the epidural space around the spinal cord. When an SEA is widespread, extensive decompression with laminectomy is often impossible, as it may subject the patient to very long operative times, extensive blood loss, and mechanical instability. A technique called "skip laminectomy" has been described in the literature, in which laminectomies are performed at the rostral and caudal ends of an abscess that spans 3-5 levels and a Fogarty catheter is used to mechanically drain the abscess, much like in an embolectomy. In this report of 2 patients, the authors present a modification of this technique, which they call "apical laminectomies" to allow for irrigation and drainage of an extensive SEA spanning the entire length of the vertebral column (C1-2 to L5-S1). Two patients presented with cervico-thoraco-lumbar SEA. Laminectomies were performed at the natural apices of the spine, namely, at the midcervical, midthoracic, and midlumbar spine levels. Next, a pediatric feeding tube was inserted in the epidural space from the thoracic laminectomies up toward the cervical laminectomy site and down toward the lumbar laminectomy site, and saline antibiotics were used to irrigate the SEA. Both patients underwent this procedure with no adverse effects. Their SEAs resolved both clinically and radiologically. Neither patient suffered from mechanical instability at 1 year after treatment. For patients who present with extensive SEAs, apical laminectomies seem to allow for surgical cure of the infectious burden and do not subject the patient to extended operating room time, an increased risk of blood loss, and the risk of mechanical instability.

  12. [Lumbar hernia].

    Science.gov (United States)

    Teiblum, Sandra Sofie; Hjørne, Flemming Pii; Bisgaard, Thue

    2010-03-22

    Lumbar hernia is a rare condition. Lumbar hernia should be considered a rare differential diagnosis to unexplained back pain. Symptoms are scarce and diffuse and can vary with the size and content of the hernia. As there is a 25% risk of incarceration, operation is indicated even in asymptomatic hernias. We report a case of lumbar hernia in a woman with a slow growing mass in the lumbar region. She presented with pain and a computed tomography confirmed the diagnosis. She underwent open surgery and fully recovered with recurrence within the first half year.

  13. Vertebral contour in spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. S.; Rho, J. C.; Park, J. H.; Choi, H. Y.; Kim, B. K. [Wallace memorial Baptist Hospital, Busan (Korea, Republic of)

    1981-09-15

    The defect in the pars interarticularis of spondylolisthesis may be dependent on contributing factors related to trauma and stress to which the neural arch is subjected, superimposed on a hereditary diasthesis. Posterior wedging of 5th lumber vertebral body in lumbosacral spondylolisthesis together with the degree of slip have been measured. The average wedging in spondylolisthesis is significantly greater than patient without this condition, and forms a characteristic radiological sign. The degree of wedging and slip show a statistically valid correlation. The diagnosis of spondylolisthesis is becoming more prevalent as the complexity of our society result in the increasing use of roentgenography of the lumbar spine. Isolated lateral deviation and rotation of spinous process seen in anteroposterior radiographs of the lumbar spine seems to be associated with pathology in the pars interarticularis.

  14. Fem Modelling of Lumbar Vertebra System

    Directory of Open Access Journals (Sweden)

    Rimantas Kačianauskas

    2014-02-01

    Full Text Available The article presents modeling of human lumbar vertebra and it‘sdeformation analysis using finite elements method. The problemof tissue degradation is raised. Using the computer aided modelingwith SolidWorks software the models of lumbar vertebra(L1 and vertebra system L1-L4 were created. The article containssocial and medical problem analysis, description of modelingmethods and the results of deformation test for one vertebramodel and for model of 4 vertebras (L1-L4.

  15. The vertebral column of Australopithecus sediba.

    Science.gov (United States)

    Williams, Scott A; Ostrofsky, Kelly R; Frater, Nakita; Churchill, Steven E; Schmid, Peter; Berger, Lee R

    2013-04-12

    Two partial vertebral columns of Australopithecus sediba grant insight into aspects of early hominin spinal mobility, lumbar curvature, vertebral formula, and transitional vertebra position. Au. sediba likely possessed five non-rib-bearing lumbar vertebrae and five sacral elements, the same configuration that occurs modally in modern humans. This finding contrasts with other interpretations of early hominin regional vertebral numbers. Importantly, the transitional vertebra is distinct from and above the last rib-bearing vertebra in Au. sediba, resulting in a functionally longer lower back. This configuration, along with a strongly wedged last lumbar vertebra and other indicators of lordotic posture, would have contributed to a highly flexible spine that is derived compared with earlier members of the genus Australopithecus and similar to that of the Nariokotome Homo erectus skeleton.

  16. Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery

    Directory of Open Access Journals (Sweden)

    Ding Zi-hai

    2011-04-01

    Full Text Available Abstract Background Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. Methods To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH data set were prepared and used in the study. Three-dimensional (3D computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. Results The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP. All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. Conclusion The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical

  17. Left ventricular apical diseases.

    Science.gov (United States)

    Cisneros, Silvia; Duarte, Ricardo; Fernandez-Perez, Gabriel C; Castellon, Daniel; Calatayud, Julia; Lecumberri, Iñigo; Larrazabal, Eneritz; Ruiz, Berta Irene

    2011-08-01

    There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

  18. Lumbar facet stress fracture in a ballet dancer.

    Science.gov (United States)

    Fehlandt, A F; Micheli, L J

    1993-12-01

    A frequent cause of back pain in athletes and dancers is stress injury to the posterior vertebral elements. Stress fractures affect the pars interarticularis and, rarely, other vertebral regions. The authors present their experience with the diagnosis and treatment of a fourth lumbar inferior articular facet stress fracture in a ballerina in this brief report and discuss the literature concerning posterior element stress fractures.

  19. Lumbar lordosis.

    Science.gov (United States)

    Been, Ella; Kalichman, Leonid

    2014-01-01

    Lumbar lordosis is a key postural component that has interested both clinicians and researchers for many years. Despite its wide use in assessing postural abnormalities, there remain many unanswered questions regarding lumbar lordosis measurements. Therefore, in this article we reviewed different factors associated with the lordosis angle based on existing literature and determined normal values of lordosis. We reviewed more than 120 articles that measure and describe the different factors associated with the lumbar lordosis angle. Because of a variety of factors influencing the evaluation of lumbar lordosis such as how to position the patient and the number of vertebrae included in the calculation, we recommend establishing a uniform method of evaluating the lordosis angle. Based on our review, it seems that the optimal position for radiologic measurement of lordosis is standing with arms supported while shoulders are flexed at a 30° angle. There is evidence that many factors, such as age, gender, body mass index, ethnicity, and sport, may affect the lordosis angle, making it difficult to determine uniform normal values. Normal lordosis should be determined based on the specific characteristics of each individual; we therefore presented normal lordosis values for different groups/populations. There is also evidence that the lumbar lordosis angle is positively and significantly associated with spondylolysis and isthmic spondylolisthesis. However, no association has been found with other spinal degenerative features. Inconclusive evidence exists for association between lordosis and low back pain. Additional studies are needed to evaluate these associations. The optimal lordotic range remains unknown and may be related to a variety of individual factors such as weight, activity, muscular strength, and flexibility of the spine and lower extremities. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Situación actual de la cirugía de la columna vertebral degenerativa aplicada al manejo del dolor lumbar crónico: Estenosis de canal. Discopatia degenerativa, resultados basados en la evidencia científica Present state of degenerative back surgery and its implications in the management of chronic lumbar pain, canal stenosis and degenerative disk disease: Evidence based outcomes

    Directory of Open Access Journals (Sweden)

    F. J. Robaina

    2006-04-01

    Full Text Available La búsqueda de soluciones terapéuticas para pacientes con síndromes de dolor postlaminectomía o dolor lumbar crónico constituye uno de los aspectos fundamentales de la carga de trabajo de las Unidades de Dolor Crónico. A la luz de los resultados de las publicaciones científicas y revisiones que han seguido los principios de la "medicina basada en la evidencia", cuando se analizan los resultados de la cirugía de la hernia dis-cal, se observa, cómo no existe todavía en la literatura mundial ningún trabajo científico correctamente realizado que compare la cirugía y el tratamiento conservador sin ningún tipo de sesgo científico en la recogida de datos. Por esa razón, se siguen buscando soluciones no quirúrgicas a este problema. Un aspecto fundamental a tener en cuenta a la hora de analizar los resultados de la cirugía de la columna, es lo que se denomina en los medios económicos de la bolsa Americana la "burbuja de la cirugía de columna". La literatura científica no muestra evidencias claras en los estudios coste-beneficio de muchas técnicas de cirugía instrumentada de la columna sobre el tratamiento conservador. No ha sido demostrado que la cirugía de fusión vertebral y el reemplazo del disco intervertebral sea mejor que el tratamiento conservador. Destacar, que actualmente, "existen relaciones entre la industria y el dolor lumbar" y que también "existe una industria del dolor lumbar". No obstante, "el mercado de la cirugía de la columna", sigue aumentando, ya que los pacientes siguen demandando soluciones para resolver su dolor de espalda. La marea de la evidencia científica parece que va en contra de la fusión espinal en la enfermedad discal degenerativa, el dolor discogénico y el dolor lumbar inespecífico. Después de dos décadas de avances tecnológicos en este campo, el resultado de las fusiones espinales es mediocre. Estudios epidemiológicos recientes muestran que la "fusión espinal" debe aceptarse como "un m

  1. Sensitivity of lumbar spine loading to anatomical parameters

    DEFF Research Database (Denmark)

    Putzer, Michael; Ehrlich, Ingo; Rasmussen, John

    2016-01-01

    models for four different postures. The in uence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine were studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force......Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the in uence of dened geometrical parameters on lumbar spine loading utilizing ve parametrized musculoskeletal lumbar spine...... were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most in uential. The results indicated that measuring these parameters from X-rays would be most important to morph an existing musculoskeletal...

  2. 应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折%The Application of Improved AF Spinal Internal Fixation System With Percutaneous Minimally Invasive Internal Fixation for the Treatment of Thoracic and Lumbar Vertebral Compression Fracture

    Institute of Scientific and Technical Information of China (English)

    李晓龙; 王志军

    2015-01-01

    Objective To explore the efficacy of the AF spinal internal fixation system with percutaneous minimally invasive internal fixation for the treatment of thoracic and lumbar vertebral compression fracture. Methods Collected in our hospital 48 cases of thoracolumbar compression fractures, application of improved percutaneous minimally invasive internal fixation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures, postoperative review X-ray for curative effect analysis. Results 48 cases of compression injury vertebral height of vertebral body than preoperative obviously restoration, 90%of the average recovery to normal height of vertebral body Conclusion Application of improved percutaneous minimally invasive internal ifxation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures curative effect is distinct.%目的:探讨应用AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折的疗效。方法收集本院48例胸腰椎压缩骨折,应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折,术后复查X片进行疗效分析。结果48例压缩的伤椎椎体高度比术前明显得到恢复,平均恢复至正常椎体高度的90%。结论应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折疗效显著。

  3. Pulmonary Embolism with Vertebral Augmentation Procedures

    Directory of Open Access Journals (Sweden)

    Swetha Bopparaju

    2013-01-01

    Full Text Available With the prevalence of an aging American population on the rise, osteoporotic vertebral fractures are becoming a common occurrence, resulting in an increase in vertebral augmentation procedures and associated complications such as cement leakage, vertebral compressions, and pulmonary embolism. We describe a patient who presented with respiratory distress three years following kyphoplasty of the lumbar vertebra. Computed tomography (CT angiogram of the chest confirmed the presence of polymethylmethacrylate (PMMA cement in the lung fields and pulmonary vessels. We conducted a systematic review of the published literature identifying effective management strategies for the treatment of vertebroplasty-associated pulmonary embolism.

  4. 椎弓根螺钉置入内固定与单纯椎管减压治疗退行性腰椎滑脱的比较%Comparison of pedicle screw fixation and simple vertebral canal decompression in the treatment of lumbar degenerative spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    刘保华; 王沛; 夏群; 冯世庆; 郑永发; 李冰

    2011-01-01

    of pedicle screw fixation and fusion in treatment of degenerative spondylolisthesis, and to compare with simple vertebral canal compression.METHODS: A total of 38 patients with lumbar degenerative spondylolisthesis received treatment at the Department of Orthopaedics, General Hospital of Tianjin Medical University were selected, and 3 patients were lost in follow-up. Of the remaining 35 cases, 21 cases underwent pedicle screw fixation posterolateral fusion and 14 cases underwent simple vertebral canal decompression. Simple vertebral canal compression group treated with the rongeur bite yellow ligament and lamina to relieve nerve root compression, forward vertebral slippage of adjacent vertebral body with posterior inferior formation relative prominence was chiseled with osteotome. According to Wein-stein method pedicle screw into the needle localization, then screw into the pedicle screw and undergo vertebral plate decompression on the basis of compression condition in pedicle screw fixation and fusion group. The clinical effect underwent comprehensive evaluation of oswestry dysfunction index; horizontal displacement and angular displacement were observed at hyperextension and flexion time. Degenerative condition of adjacent segment was evaluated by UCLA system.RESULTS AN D CONCLUSION : A total of 35 patients were followed up for 1 year. The excellent rate in pedicle screw fixation and fusion group was significantly higher than that in simple vertebral canal compression group (P < 0.05). Pedicle screw fixation and fusion has little effect on the stability of lumbar. There was no significant change in adjacent segment before degenerative insertion and 1 year after insertion. Simple vertebral canal compression had a significant effect on the stability of lumbar, and there was no significant change in adjacent segment degeneration before treatment and 1 year after treatment. It is indicated that pedicle screw fixation and fusion has satisfying effects in treatment of

  5. [Apical endodontic surgery].

    Science.gov (United States)

    Lindeboom, J A

    2004-04-01

    If (a revision of) a conventional endodontic treatment is not possible or not successful, apical endodontic surgery can be indicated. The contemporary indications, the better retrograde preparation techniques with ultrasonic retro-tips, and the better visualisation of the operation area with an operation microscope can lead to higher success percentages. Moreover, the current developments in the field of compatible filling materials are promising. Also the application of lasers is promising, but has still to prove its clinical usefulness.

  6. Lumbo-costo-vertebral syndrome with posterior spinal dysraphism.

    Science.gov (United States)

    Kumar, G Samson Sujit; Kulkarni, Vaijayantee; Haran, R P

    2005-09-01

    Lumbo-costo-vertebral syndrome, which includes abnormalities of the vertebral bodies, ribs and trunk musculature, is very rare and only few cases have been reported. We report a case of 18-month-old female child with absent ribs, hemivertebrae, superior lumbar hernia (features of lumbo-costo-vertebral syndrome) and posterior spinal dysraphism, which to our knowledge is the first case in the English literature with such a combination of defects. Embryology and management of the case is discussed.

  7. Lumbar spine CT scan

    Science.gov (United States)

    CAT scan - lumbar spine; Computed axial tomography scan - lumbar spine; Computed tomography scan - lumbar spine; CT - lower back ... your breath for short periods of time. The scan should take only 10 to 15 minutes.

  8. 腰椎问盘置换术后对邻近节段腰椎终板的应力影响与影响因素分析%Stress effects and influencing factors of lumbar disc replacement surgery for adjacent segment vertebral endplate

    Institute of Scientific and Technical Information of China (English)

    孙云明; 戚广秀; 王立民

    2012-01-01

    Objective To investigate the stress effects and influencing factors of lumbar disc replacement surgery for adjacent segment vertebral endplate. Methods Four fresh adult lumbar spine (Li-Si) segments of specimens were selected, SMH-1 artificial disc experimental prosthesis for artificial disc replacement operation was used. All adjacent segment end-surgery, and then proceed to axial compression movement test. Results Adjacent segment endplate average maximum stress showed increased in axial compression, compared with normal lumbar interverlebral disc status group, it had significant difference (P < 0.05), but significantly less than lumbar diseeciomy (P < 0.05). Adjacent segment stress test fixed---point, end plate type and operation on the lumbar spine endplate of the adjacent segments had significant biological effects. Conclusion The stress load of lumbar interverlebral disc replacement on the adjacent segment endplate is significantly less than the lumbar discectomy, it can be effective in preventing the top of the adjacent segments and accelerate degeneration, should be widely applied.%目的 探讨腰椎问盘置换术后对邻近节段腰椎终板的生物影响.方法 选用4具新鲜成人腰椎(L2~S1)节段标本,采用SMH-1型人工腰椎间盘实验假体进行人工腰椎间盘置换操作.所有邻近节段终板模型标本选择正常腰椎间盘、髓核摘除术和人工腰椎间盘置换术,然后进行轴向压缩运动测验.结果 轴向压缩下邻近节段终板平均最大应力均显示有所增大,与腰椎间盘正常状态组别比较差异有统计学意义(P<0.05),但是明显少于腰椎间盘摘除术(P<0.05).邻近节段应力测试定点,终板类型以及手术方法对邻近节段腰椎终板都有明显的生物影响.结论 腰椎问盘置换术对上邻近节段终板应力负荷明显小于腰椎间盘摘除术,可有效地预防上方邻近节段加速退变,值得推广应用.

  9. Abceso apical agudo

    OpenAIRE

    Jara Ortiz, M.; López, M.; Gómez Viglino, L.; Maydana, N.; Hervit, M.; Bertola, N.

    2015-01-01

    En casos de urgencia, muchas veces debemos poner a prueba distintos elementos de diagnóstico para encontrar la mejor respuesta posible. En este caso se reporta un absceso apical agudo en la zona palatina del sector 1, que, de acuerdo al test de vitalidad pulpar y correcta interpretación radiográfica se localiza la pieza causal N° 1.8.Asistió a la consulta un paciente masculino 30 años de edad, dolor a la masticación, edema y tumefacción, en zona palatina comprendida en piezas 1.5; 1.6; 1.7 y ...

  10. Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy.

    Science.gov (United States)

    Roy, Ranjini Raina; Hakim, Fayaz A; Hurst, R Todd; Simper, David; Appleton, Christopher P

    2014-04-01

    Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apical-variant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.

  11. Cambios en la lordosis lumbar luego de una artrodesis vertebral posterior de la columna torácica y su relación con la incidencia pelviana. [Changes in lumbar lordosis after further spinal fusion of thoracic spine and its relationship to pelvic incidence

    National Research Council Canada - National Science Library

    Miguel Puigdevall; Santiago Bosio; Carolina Halliburton; Jorge Hokama; Ruben Maenza

    2016-01-01

    ... idiopática del adolescente que fueron operados mediante una artrodesis vertebral posterior instrumentada con tornillos pediculares y establecer la existencia de relaciones entre las mismas. Material y Método...

  12. Hernia discal lumbar: Tratamiento conservador

    OpenAIRE

    López-Sastre Núñez, Antonio; Candau Pérez, Ernesto

    1999-01-01

    Existe una gran demanda de patología lumbar crónica y aguda que debe de tratarse conjuntamente entre el especialista en Rehabilitación y el Cirujano de columna vertebral. En este trabajo se detallan las posibilidades del tratamiento conservador antes de optar por la cirugía. Se realiza una revisión bibliográfica de los resultados conservadores del tratamiento de la lumbociática de origen discal comparando aquellos estudios publicados con validez estadística. Se detallan las modernas pautas de...

  13. 两种术式治疗腰椎间盘突出伴腰椎不稳症的疗效比较%Comparison of curative effectiveness between two operation patterns for patients with lumbar inter-vertebral disc protrution and lumbar instability

    Institute of Scientific and Technical Information of China (English)

    杨刚; 潘兵; 许文根; 张志武; 李玢

    2014-01-01

    目的:对比研究后正中入路后路腰椎椎间融合术(PLIF)与经椎旁肌间隙入路改良后路经椎间孔椎间融合术(TLIF)治疗腰椎间盘突出伴腰椎不稳症的临床疗效。方法:2009年4月-2011年5月我院收治的腰椎间盘突出伴腰椎不稳症患者78例,其中37例行后正中入路PLIF术,41例行经椎旁肌间隙入路改良TLIF术,比较2组患者手术时间、术中出血量及手术后JOA评分改善率、优良率、植骨融合率。结果:改良TLIF组术中出血量降低、手术时间缩短,与PLIF组比较,差异有统计学意义(P<0.05);JOA评分改善率、优良率、植骨融合率均提高,但与PLIF组比较差异无统计学意义。结论:与后正中入路后路腰椎椎间融合术比较,经椎旁肌间隙入路改良后路经椎间孔椎间融合术更安全有效。%Objective:To compare therapeutic effects of posterior lumbar interbody fusion(PLIF)from post-midline approach and modified transforaminal lumbar interbody fusion (TLIF)from paraspinal approach on treating lumbar intervertebral disc protrution and lumbar instability. Methods:A total of 78 patients with lumbar intervertebral disc protrution and lumbar in-stability were treated between April 2009 and May 2011,including 37 patients managed by PLIF and 41 patients managed by TLIF. The operation time,amount of intra-operative blood loss of patients were recorded and improvement rate of JOA score,excellent rate,bony union rate of patients were calculated. Results:Compared with PLIF group,operation time was shortened and amount of intra-operative blood loss was decreased in TLIF group (P<0.05);improvement rate of JOA score, excellent rate and bony union rate of TLIF group were increased,but there was no statistically difference. Conclusions:Mmodified transforaminal lumbar interbody fusion(TLIF)from paraspinal approach is securer and more effective on treating lumbar intervertebral disc protrution and lumbar

  14. Vertebral Pnomocyst

    Directory of Open Access Journals (Sweden)

    Elif Karadeli

    2015-11-01

    Full Text Available The pneumatocyst in the spine is a rare condition and is usually discovered incidentally in patients being examined for unrelated problems. Intraosseous gas collection is occured in different pathologic conditions, containing osteomyelitis with gas-forming organisms, vertebral collapse due to osteonecrosis, and postoperative and posttraumatic conditions.  

  15. 臭氧治疗术在复杂性腰椎间盘突出症治疗中的临床效果%Clinical Effect of Ozone Therapy in Treatment of Complex Lumbar Inter-vertebral Disc Heraiation

    Institute of Scientific and Technical Information of China (English)

    黄振华

    2016-01-01

    Objective To discuss the effect of ozone therapy in treatment of complex lumbar intervertebral disc heraiation. Methods 65 cases of patients with complex lumbar intervertebral disc heraiation treated in the hospital cooperating with our unit from October 2014 to November 2015 were selected and were treated with ozone, and the treatment effect was ob-served. Results The total effective rate was 89.2%, and there was no adverse reactions, the Oswestry disability index after treatment was (25.21±13.20)%, which was lower than that before treatment, and there was an difference between groups, P<0.05. Conclusion The ozone therapy in treatment of complex lumbar intervertebral disc heraiation has a good effect.%目的:探讨臭氧治疗复杂性腰椎间盘突出症的效果。方法整群选取2014年10月—2015年11月该单位合作医院复杂性腰椎间盘突出症患者共65例,给予臭氧治疗,观察治疗效果。结果总有效率为89.2%,均未出现不良反应;治疗后Oswestry功能障碍指数为(25.21±13.20)%,低于治疗前,组间比较差异有统计学意义(P<0.05)。结论臭氧治疗复杂腰椎间盘突出症具有良好的效果。

  16. Problems of posterior lumbar interbody fusion (PLIF) for the rheumatoid spondylitis of the lumbar spine.

    Science.gov (United States)

    Inaoka, Masahiro; Tada, Koichi; Yonenobu, Kazuo

    2002-03-01

    We performed posterior lumbar interbody fusion (PLIF) on 7 patients with rheumatoid spondylitis (RA) of the lumbar spine with severe low-back pain and/or cauda equina symptoms, and evaluated the effectiveness of PLIF for the lumbar spinal instability in RA secondary to destruction of the anterior elements, including vertebral endplates and the apophyseal joint. The subjects were 7 patients with classic RA, 2 men and 5 women, mean age 65 years old, and the mean duration of RA was 21 years. All had severe low-back pain and difficulty with walking. According to the ARA classification, the patients were at stage 3 or worse and in class 3. Diagnostic imaging including magnetic resonance imaging (MRI), tomography, myelography, and computed tomographic myelography (CTM) of the lumbar spine clearly delineated pathology, destruction of the vertebral endplate, subluxation, and cauda compression which can be well treated with PLIF. We performed L4/5PLIF (5 cases), L3/4 and L4/5 PLIF (2 cases), and posterior fixation with instruments for anterior column repair and stabilization and posterior decompression. Autografts (all cases) and Brantigan IF cage (2 cases) were used. Stable fixation of the lumbar spine was achieved after surgery, and improvement in gait and activities of daily living were achieved through the relief of low-back pain and radicular pain; the mean duration of follow-up was 22 months. Postoperative, plain radiography, CT, and MRI revealed the enlargement of the lumbar canal and fusion and incorporation of grafted bone, but in some cases, collapse of graft, migration of pedicle screw, instability of adjacent level, and collapse of adjacent vertebra were noted. PLIF with spinal instruments is a preferred treatment for rheumatoid spondylitis of the lumbar spine, but in the mutilating type of RA with severe osteoporosis, PLIF in combination with a long fixation system and/or augmentation of the vertebral bodies might be needed.

  17. Vertebral osteomyelitis: clinical features and diagnosis.

    Science.gov (United States)

    Eren Gök, S; Kaptanoğlu, E; Celikbaş, A; Ergönül, O; Baykam, N; Eroğlu, M; Dokuzoğuz, B

    2014-10-01

    We aimed to describe clinical and diagnostic features of vertebral osteomyelitis for differential diagnosis and treatment. This is a prospective observational study performed between 2002 and 2012 in Ankara Numune Education and Research Hospital in Ankara, Turkey. All the patients with vertebral osteomyelitis were followed for from 6 months to 3 years. In total, 214 patients were included in the study, 113 out of 214 (53%) were female. Out of 214 patients, 96 (45%) had brucellar vertebral osteomyelitis (BVO), 63 (29%) had tuberculous vertebral osteomyelitis (TVO), and 55 (26%) had pyogenic vertebral osteomyelitis (PVO). Mean number of days between onset of symptoms and establishment of diagnosis was greater with the patients with TVO (266 days) than BVO (115 days) or PVO (151 days, p 15 mm, sensitivity was 0.66, specificity was 0.97, positive predictive value was 0.89, negative predictive value was 0.88, and receiver operating characteristics area was 0.8. Tuberculous and brucellar vertebral osteomyelitis remained the leading causes of vertebral osteomyelitis with delayed diagnosis. In differential diagnosis of vertebral osteomyelitis, consumption of unpasteurized cheese, dealing with husbandry, sweating, arthralgia, hepatomegaly, elevated alanine transaminase, and lumbar involvement in magnetic resonance imaging were found to be predictors of BVO, thoracic involvement in magnetic resonance imaging and tuberculin skin test > 15 mm were found to be predictors of TVO, and history of spinal surgery and leucocytosis were found to be predictors of PVO.

  18. Osteoporotic vertebral fracture simulating a spinal tumor: a case report

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2015-06-01

    Full Text Available Vertebral fractures are a frequent entity, mainly in the thoracolumbar and lumbar spine. In some circumstances the differential diagnosis of vertebral injuries can confuse the physician, since the difference between an osteoporotic vertebral fracture and a fracture secondary to a tumor is not clear. We report the case of a patient with osteoporotic vertebral fracture simulating a spinal tumor, handled by our department of neurosurgery as illustrative experience to guide the approach in those cases, in which the definitive diagnosis is crucial for therapeutic decision making

  19. Planar cell polarity signaling in vertebrates.

    Science.gov (United States)

    Jones, Chonnettia; Chen, Ping

    2007-02-01

    Planar cell polarity (PCP) refers to the polarization of a field of cells within the plane of a cell sheet. This form of polarization is required for diverse cellular processes in vertebrates, including convergent extension (CE), the establishment of PCP in epithelial tissues and ciliogenesis. Perhaps the most distinct example of vertebrate PCP is the uniform orientation of stereociliary bundles at the apices of sensory hair cells in the mammalian auditory sensory organ. The establishment of PCP in the mammalian cochlea occurs concurrently with CE in this ciliated epithelium, therefore linking three cellular processes regulated by the vertebrate PCP pathway in the same tissue and emerging as a model system for dissecting PCP signaling. This review summarizes the morphogenesis of this model system to assist the interpretation of the emerging data and proposes molecular mechanisms underlying PCP signaling in vertebrates.

  20. Incidence of and risk factors for non-vertebral and vertebral fracture in female Chinese patients with systemic lupus erythematosus: a five-year cohort study.

    Science.gov (United States)

    Zhu, T Y; Griffith, J F; Au, S-K; Tang, X-L; Kwok, A W; Leung, P-C; Li, E K; Tam, L-S

    2014-08-01

    The objective of this paper is to investigate the incidence of both non-vertebral and vertebral fracture in female patients with systemic lupus erythematosus (SLE) and to identify risk factors for incident fracture. In a five-year prospective study of 127 female Chinese SLE patients with an average age of 46.9 years (SD: 10.1 years), information on potential risk factors, including demographics, clinical data and bone mineral density (BMD) at lumbar spine and hip by dual-energy X-ray absorptiometry was collected at baseline. At follow-up, participants reported incident non-vertebral fracture during the study period. Semi-quantitative analysis was used to determine incident vertebral fracture on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20%-25% reduction or more in any vertebral height) at follow-up. Nine incident non-vertebral fractures occurred in eight patients during the study period. Six patients had one or more incident vertebral fractures. The incidence of non-vertebral and vertebral fracture was 1.26 and 0.94 per 100 patient-years, respectively. In multivariate logistic analyses, independent variables associated with incident non-vertebral fracture were duration of glucocorticoid use and prevalent lumbar spine osteoporosis, while risk factors associated with incident vertebral fracture were higher organ damage and prevalent lumbar spine osteoporosis. The incidence of fracture in SLE patients is lower than the prevalence reported in cross-sectional studies. Lumbar spine BMD appears to have a stronger relationship with incident fracture than hip BMD. This warrants further investigation regarding the optimal site of BMD measurement when predicting fracture risk in SLE patients. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Destructive discovertebral degenerative disease of the lumbar spine.

    Science.gov (United States)

    Charran, A K; Tony, G; Lalam, R; Tyrrell, P N M; Tins, B; Singh, J; Eisenstein, S M; Balain, B; Trivedi, J M; Cassar-Pullicino, V N

    2012-09-01

    The uncommon variant of degenerative hip joint disease, termed rapidly progressive osteoarthritis, and highlighted by severe joint space loss and osteochondral disintegration, is well established. We present a similar unusual subset in the lumbar spine termed destructive discovertebral degenerative disease (DDDD) with radiological features of vertebral malalignment, severe disc resorption, and "bone sand" formation secondary to vertebral fragmentation. Co-existing metabolic bone disease is likely to promote the development of DDDD of the lumbar spine, which presents with back pain and sciatica due to nerve root compression by the "bone sand" in the epidural space. MRI and CT play a complimentary role in making the diagnosis.

  2. Slipped vertebral epiphysis (report of 2 cases

    Directory of Open Access Journals (Sweden)

    Majid Reza Farrokhi

    2009-02-01

    Full Text Available

    • Avulsion or fracture of posterior ring apophysis of lumbar vertebra is an uncommon cause of radicular low back pain in pediatric age group, adolescents and athletes. This lesion is one of differential diagnosis of disc herniation. We reported two teenage boys with sever low back pain and sciatica during soccer play that ultimately treated with diagnosis of lipped vertebral apophysis.
    • KEY WORDS: Ring Apophysis, vertebral fracture, sciatica, low back pain, disc herniation.

  3. Vertebral Geometry Parameters Can Predict Fractures

    Directory of Open Access Journals (Sweden)

    P Tofighi

    2007-08-01

    Full Text Available Background: The aim of this study was to investigate vertebral geometry changes and determine cutoff value of vertebral height to predict fractures. Methods: In a cross-sectional study, 280 postmenopausal women recruited .In all subjects bone mineral density and radiog¬raphy of the lumbar spine performed. Lateral radiographs were evaluated for identification of vertebral fractures, using a validated semiquantitative method. T-score of vertebral height was calculated based on data extracted from Iranian Multi¬center Osteoporosis Study. ROC curve used to determine cut off value of vertebral height T-score to predict fractures. Results: The mean of age and BMI were 55.34±8.7 years and 27.73±5 kg/m2, respectively. Among osteoporotic women, 59.8% had one or more vertebral fractures and 23.8% had at least 2 fractures. In fracture group the T-score of spine and femur BMD was lower than the others. The mean of vertebral height in women without fractures was 12.94±0.6 cm, and in the patient with 4 or more fractures was12.3, thus every fracture accompany with 1.2% decreases in the height of vertebrae. The prevalence of vertebral fracture in osteoporotic patients was 71.4% and in healthy cases 39.5%. Better estimation of vertebral height T score in ROC curve was less than -0.7.The sensitivity and specificity of the cut off value were 81.3% and 52.9%, respectively. Conclusion: Vertebral fractures are common fractures in postmenopausal women. There was a correlation between verte¬bral height and fractures. Vertebral geometric parameters especially height T score can be used for fracture screening.

  4. Grynfelt lumbar hernias. Presentation of a congenital case.

    Directory of Open Access Journals (Sweden)

    Cleopatra Cabrera Cuellar

    2006-04-01

    Full Text Available Lumbar hernias are uncommon and are reported rarely, they are informed only few more than 300 in literature and of them only 10 cases are congenital. The hernias that are produced through the superior lumbar space or Grynfelt-Lesshalf´s hernia, are due to the fact that they are more constant and larger they are usually more frequent than the Petit triangle. We are reporting a Newborn infant with the diagnosis of bilateral lumbar hernias and malformation of the vertebral column.

  5. 腰椎术后患者佩戴支具的依从性研究%The Compliance Research of Orthosis Wearing Among Patients after Lumbar Vertebral Operation

    Institute of Scientific and Technical Information of China (English)

    贾宇; 贾燕瑞

    2015-01-01

    Objectives To acquire the compliance status of orthosis wearing and the views of patients through telephone interview after vertebral column operation, and provide evidence for improving the compliance of orthosis wearing after operation as well as reducing complications risks. Methods To adopt questionnaires research on 100 patients who need to wear orthosis after vertebral column operation, then conduct statistical analysis on the questionnaires after clearing up with the application of SPSS19.0.Results The percent of high compliance of 100 patients with orthosis wearing after vertebral column operation only accounted for 41% and middle compliance accounted for 47%. There were significant differences in aspects such as lack of necessity awareness of wearing orthosis(p=0.001), afraid of taking activities after operation(p=0.012) and felt uncomfortableness while wearing orthosis(p=0.001).Conclusions The compliance of orthosis wearing among patients after vertebral column operation was not high, which were due to the shortage of diseases related knowledge or the necessity of wearing orthosis, had no ideas on rehabilitation exercise on the early phase after operation as well as the uncomfortable feeling. Therefore, the clinical nursing staff should carry out pointed nursing work according to different situations, so as to increase the compliance of orthosis wearing among patients after vertebral column operation.%*摘要目的通过对脊柱术后患者进行电话采访,了解患者佩戴支具的依从性现状及其对支具佩戴的看法,为提高患者术后佩戴支具的依从性、减少发生术后并发症的风险提供依据。方法采取问卷调查的方式对100名脊柱疾病术后需要佩戴支具的患者进行问卷调查,将收取后的问卷整理后输入SPSS19.0统计学软件进行统计学分析。结果100名脊柱疾病术后患者中支具佩戴依从性高者仅占41.0%,依从性中等者占47.0%;不同依从性的患者,

  6. Efficacy of traditional treatment regimen on Kati Shoola with special reference to lumbar spondylolisthesis

    OpenAIRE

    Ediriweera, E. R. H. S. S.; Gunathilka, H. D. P.; Weerasinghe, K. D. C. M.; Kalawana, O. T. M. R. K. S. B.

    2013-01-01

    According to Ayurveda, Kati Shoola is a disease with pain in lumbar region. Lumbar spondylolisthesis, anterior displacement of a vertebra or the vertebral column in relation to the vertebrae below, is one of the common causes. Current case study was carried out at Ayurveda Teaching hospital, Borella, to evaluate the efficacy of a treatment regimen used by Sri Lankan traditional physician family “Weerasinghe.” A 59-year-old female with a 9-month history of lumbar spondylolisthesis was treated ...

  7. [Lateral lumbar disk hernia].

    Science.gov (United States)

    Monod, A; Desmoineaux, P; Deburge, A

    1990-01-01

    Lateral lumbar disc herniations (L.D.H.) develop in the foramen, and compress the nerve root against the overlying vertebral pedicle. In our study of L.D.H. from the clinical, radiographical, and therapeutical aspects, we reviewed 23 cases selected from the 590 patients treated for discal herniation from 1984 to 1987. The frequency of L.D.H. in this series was 3.8 per cent. The clinical pattern brings out some suggestive signs of L.D.H. (frequency of cruralgia, a seldom very positive Lasegue's test, the paucity of spinal signs, non impulsive pain). Saccoradiculography and discography rarely evidenced the L.D.H.. The T.D.M. was the investigation of choice on condition that it was correctly used. When the image was doubtful, disco-CT confirmation should be proceeded too. This latter method of investigation enabled the possibility of sequestration to be explored. 14 patients were treated by chemonucleolysis, with 9 successful outcomes. The 5 failures were cases where chemonucleolysis should not have been indicated, mainly due to associated osseous stenosis. 9 patients underwent immediate surgery with good results in each case.

  8. Para-muscular and trans-muscular approaches to the lumbar inter-vertebral foramen: an anatomical comparison Acessos paramuscular e transmuscular ao forame intervertebral lombar: comparação anatômica

    Directory of Open Access Journals (Sweden)

    Arthur Werner Poetscher

    2005-03-01

    Full Text Available Foraminal and extra-foraminal disc herniations comprise up to 11.7% of all lumbar disc herniations. Facetectomy, which had been the classic approach, is now recognized as cause of pain and instability after surgery. Otherwise, posterior lateral approaches through a trans-muscular or a para-muscular technique offer no significant damage to key structures for spinal stability. The surgical anatomy of these approaches has already been described, but they were not compared. In order to quantify the angle of vision towards the intervertebral foramen offered by each technique, 12 fresh cadavers were dissected and studied regarding these approaches. The angle presented by trans-muscular approach was wider in all studied lumbar levels. Surgery through the trans-muscular approach is performed with a better working angle, requiring a smaller resection of surrounding tissues. Therefore, minor surgical trauma can be expected. Our measurements support previously published data that point the trans-muscular approach as the best surgical option.As hérnias de disco lombares apresentam-se como foraminais ou extra-foraminais em até 11,7% dos casos. Seu tratamento cirúrgico através de facetectomias pode causar dor e instabilidade, o que não ocorre com a utilização de acessos cirúrgicos posteriores laterais ao canal central, quer seja por via transmuscular ou paramuscular. Nosso objetivo foi comparar o ângulo de trabalho relativo ao forame intervertebral permitido por cada via e avaliar possíveis implicações cirúrgicas. Dissecções e medidas realizadas em doze cadáveres frescos demonstraram que este ângulo é maior na via transmuscular em todos os níveis lombares estudados. Dado que um ângulo mais favorável permite uma ressecção menor das estruturas envolvidas para que se estabeleça o campo de trabalho, a cirurgia por meio da via transmuscular permitirá, então, um trauma cirúrgico menor. Nossos resultados corroboram publicações pr

  9. Colgajo de reposición apical Apically positioned flap

    Directory of Open Access Journals (Sweden)

    L. Pérez-Salcedo

    2011-08-01

    Full Text Available Se describe la técnica del colgajo de reposición apical desde el primer autor, Nabers en 1954, así como las modificaciones realizadas por Ariaudo y Tyrrel en 1957 y Friedman en 1962. También se presenta un caso clínico donde se describen los diferentes pasos de la cirugía de reposición apical. Por último, se hace una revisión evaluando la eficacia del colgajo de reposición apical en el tratamiento de la periodontitis.This paper describes the technique apically positioned flap since the first author Nabers in 1954 and also the modifications performed by Ariaudo and Tyrrell in 1957 and Friedman in 1962. Also a clinical case is presented where it can be observed the different steps of the apically positioned flap in clinical pictures. Afterwards some papers in which the efficacy of the apically positioned flap in the treatment of periodontitis are evaluated and described.

  10. Bone mineral content in the spongiosa of the lumbar spine of healthy perimenopausal women measured by QCT. Normal values and their relationship to mechanical stress of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Montag, M.; Meyer-Galander, H.M.; Peters, P.E.; Doeren, M.; Montag, T.

    1988-04-01

    Healthy perimenopausal women (152) were examined by QCT to quantify the mineral content of the axial skeleton. The density was measured in the spongiosa of the L 2-4, using single energy technique and the Cann-Genant calibration phantom. The women, aged 37 to 64, had no history of pathological fractures, ovariectomy, metabolic disease, or hormone therapy. The age-related mean values were 25 mg K2HP04cm/sup 3/ lower than the normal values reported by Genant et al. for 203 healthy American women. The 95% confidence interval was distinctly narrower (+-40 mgcm/sup 3/) than the American confidence interval (+-60 mgcm/sup 3/). To evaluate the relationship of the BMC to mechanical stress, the BMC was compared with body weight, body mass index (weightheight/sup 2/), and the lumbar muscle mass was estimated from cross sections of the paravertebral muscles in the CT images. The assumption that higher mechanical stress results in higher bone mineralization could not be confirmed.

  11. 脊柱滑脱对腰椎峡部裂的诊断价值及两种测量方法比较%Diagnostic value of spondylolisthesis in lumbar vertebral laminar spondylolysis and comparison of measuring accuracy between two methods

    Institute of Scientific and Technical Information of China (English)

    屈国林; 朱岳龙; 王春艳; 杨军; 张志虎; 李长彬; 金青松; 宋云龙

    2011-01-01

    目的 探讨脊柱滑脱对腰椎峡部裂的诊断价值,比较Meyerding与Taillard方法测量的准确性.方法 以招收飞行学员的52例L5双侧峡部裂者作为研究对象,取立位腰椎侧位X线片,分别按Meyerding和Taillard方法测量L5椎体滑脱的程度,计算阳性率,分析滑脱对峡部裂诊断的意义.结果 侧位片按Meyerding和Taillard方法测量,L5滑脱率分别为40.38%(21/52)和86.54%(45/52),Taillard较Meyerding测量方法更精细准确(P<0.05).结论 L5脊柱滑脱是L5峡部裂诊断的重要间接X线征象,它不仅说明峡部裂的存在,也说明了双侧性;采用Taillard法测量L5滑脱较Meyerding法更准确.在招收飞行员体检和青年人腰椎疾病诊断中,侧位片脊柱滑脱高度提示相应椎体峡部裂的诊断.%Objective To investigate the diagnostic value of spondylolisthesis in lumbar vertebral laminar spondylolysis and compare the measuring accuracy between Meyerding and Taillard methods. Methods 52 cases of bilateral spondylolyis of I5 confirmed in health examination for pilot recruitment were included in this study. According to lateral X - ray films taken in the erect position, the degree of spondylolisthesis of L5 was measured using Meyerding and Taillard methods, respectively, and their positive rates were calculated. Then the significance of spondylolisthesis in the diagnosis of spondylolysis was analyzed. Results On lateral view, spondylolisthesis of L5 accounted for 40. 38% ( 21/52 )with Meyerding method and 86. 54% ( 45/52 )with Taillard method. The difference was statistically significant ( P < 0. 05 ). Taillard method was more accurate than Meyerding method. Conclusion Spondylolisthesis of L5 is an important indirect sign in the diagnosis of vertebral laminar spondylolyis of I5 , which not only indicates its presence,but also did bilateral lesions. Using Taillard method to measure spondylolisthesis of I5 is more accurate than using Meyerding method. In health examination

  12. L5椎体后缘连线与棘突上缘连线交角对腰椎峡部裂诊断的价值%Diagnostic value of intersecting angle formed by line aligning L5 vertebral posterior margin and that aligning L5 superior margin of spinous process in lumbar spondylolysis

    Institute of Scientific and Technical Information of China (English)

    屈国林; 徐晓明; 刘庆东; 金青松; 张志虎; 腾树春; 朱岳龙; 宋云龙

    2011-01-01

    Objective To investigate the diagnostic value of intersecting angle formed by the line aligning posterior vertebral margin and that aligning the superior margin of spinous process( ∠θ )in lumbar spondylolysis. Methods 33 young male candidates diagnosed as bilateral L5 spondylolysis in health examination for pilot recruitment were selected as observation group, and other 47 ones without this lesion were selected as control group. Anteroposterior, lateral and double oblique views of lumbar spine X - ray were taken in the erect position using CR or DR;8 subjects additionally underwent CT with 2D/3D reconstruction. ∠θ of L5 on lateral view as a major parameter was measured and compared with that of L4. Results In observation group, ∠θ of L5 less than that of L4( L5 < L4 ) accounted for 54.55%( 18/33 )and ∠θ of L5 greater than that of L4( L5 > L4 )occurred in 15 cases. In control group, L5 < L4 only occurred in 1 cases and accounted for 2.13% ( 1/47 ),and other 46 cases were L5 > L4. There was a significant difference in the incidence of L5 < L4 between the two groups( P < 0.01 ). Conclusion The intersecting angle formed by the line aligning the posterior vertebral margin and that aligning superior margin of spinous process is a useful X ray sign. When the angle of L5 is less than that of L4 , it provides a indirect clue for the diagnosis of lumbar spondylolysis especially in the absence of direct sign on lateral view.%目的 探讨在招收飞行员腰椎峡部裂的X线诊断中,椎体后缘连线与棘突上缘连线夹角的诊断价值.方法 选择33例诊断L5双侧峡部裂患者,采用CR或DR立位拍摄腰椎正、侧及双斜位X线片,8例加做腰椎CT扫描并二、三维重建,重点对侧位片L5椎体后缘连线与棘突上缘连线的夹角进行测量,其角度与L4同法测量的角度进行比较.结果 观察组18例L5<L4型,占54.55%(18/33);15例呈L5>L4型.正常对照组1例L5<L4型,占2.13%(1/47);46例呈L5

  13. 后路经伤椎植骨内固定治疗胸腰椎骨折的疗效分析%Effect of Posterior Vertebral Bone Graft Internal Fixation for the Treatment of Thoracic and Lumbar Fracture Analysis

    Institute of Scientific and Technical Information of China (English)

    曾德清; 熊福生; 万仲贤; 喻刚; 廖华; 吴威甫

    2015-01-01

    Objective To observe the ef icacy,indication and clinical outcome of fixation via injured vertebra for the treatment of thoracolumbar fracture.Methods From March 2012 to March 2014,30 patients with thinacolumbar fracture underwent surgical procedure of reduction and pediele screw at the fracture level,X-rays and CT scans were performed after operation,Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagit al diameter stenosis rate of the injured spinal canal were observed for radiographic evaluation.Neurological function was evaluated by the Frankel scale.Results Al patients were fol1owed-up from 12 to 36 months.There was no pseudoarticulation,solid bone fusion was achieved in al cases.Cobb angle of the injured vertebral segment was cor ected from preoperative (25.6±9.7)degree to postoperative (9.1±4.1)degree and (10.2±4.7)degree at last fol ow-up.The percentage of vertebral compression was cor ected from preoperative (48.3±10.1)%to postoperative(6.5±3.2)%and(7.5±3.7)%at last fol ow-up.Spinal canal sagit al diameter stenosis rate was cor ected from preoperative(36.9±11.2)%to postoperative(6.3±4.7)%and(6.4±4.5)%one year after operation.The spinal cord function was improved 1 to 2 degree in al patients except 1 patients of grade A.Conclusion Indirect reduction and fixation with pedicle screw to treat thoracolumbar vertebral fracture have several advantages:less trauma,less stif ness,less complications with more stable vertebral column,which can rectify or prevent kyphosis ef ectively.%目的探讨经伤椎椎弓根螺钉内固定治疗胸腰椎骨折的可行性、适应症及临床疗效。方法自2012年3月~2014年3月采用后路经伤椎植骨内固定治疗胸腰椎骨折30例,分别于术后3~5d、12个月、末次随访时复查X线片及CT,对伤椎Cobb角、椎体压缩百分比、椎管占位、内固定物状况进行随访;通过Frankel标准对脊髓神经功能进行评定。

  14. Acquired lumbar spinal stenosis.

    Science.gov (United States)

    Deasy, JoAnn

    2015-04-01

    Lumbar spinal stenosis is the most frequent reason for spinal surgery in patients over age 65 years. In this condition, narrowing of the lumbar spinal canal and nerve root canals leads to painful, debilitating compression of spinal nerves and blood vessels. As the population ages, an increasing number of patients will be diagnosed and treated for lumbar spinal stenosis by primary care providers. This article reviews the pathophysiology, diagnosis, and management of lumbar spinal stenosis in adults over age 50 years.

  15. Congenital Lumbar Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Sharma

    2008-01-01

    Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  16. (Modic) signal alterations of vertebral endplates and their correlation to a minimally invasive treatment of lumbar disc herniation using epidural injections; (Modic-)Signalveraenderungen vertebraler Endplatten und ihr Bezug zu einer minimalinvasiven Injektionstherapie lumbaler Bandscheibenvorfaelle

    Energy Technology Data Exchange (ETDEWEB)

    Liphofer, J.P.; Becker, G.T.; Koester, O. [Inst. fuer Diagnostische und Interventionelle Radiologie und Nuklearmedizin, St. Josef-Hospital Bochum (Germany); Theodoridis, T. [Klinik fuer Orthopaedie und Unfallchirurgie, St. Josef-Hospital Bochum (Germany); Schmid, G. [Klinik fuer Diagnostische und Interventionelle Radiologie, Johanna-Etienne-Krankenhaus Neuss (Germany)

    2006-11-15

    Purpose: To study the influence of (Modic) signal alterations (SA) of the cartilage endplate (CEP) of vertebrae L3-S1 on the outcome of an in-patient minimally invasive treatment (MIT), using epidural injections on patients with lumbar disc herniation (LDH). Materials and Methods: The MR images of 59 consecutive patients with LDH within segments L3/L4-L5/S1 undergoing in-patient minimally invasive treatment with epidural injections were evaluated in a clinical study. The (Modic) signal alterations of the CEP were recorded using T1- and T2-weighted sagittal images. On the basis of the T2-weighted sagittal images, the extension and distribution of the SA were measured by dividing each CEP into 9 areas. The outcome of the MIT was recorded using the Oswestry Disability Index (ODI) before and after therapy and in a 3-month follow-up. Within a subgroup of patients (n=35), the distribution and extension of the signal alterations were correlated with the development of the ODI. Results: Segments with LDH showed significantly more (p<0.001) SA of the CEP than segments without LDH. Although the extension of the SA was not dependent on sex, it did increase significantly with age (p=0.017). The outcome after MIT did not depend on the sex and age of the patients or on the type od LDH. The SA extension tended to have a negative correlation with the outcome after MIT after 3 months (p=0.071). A significant negative correlation could be established between the SA extension in the central section of the upper endplate and the outcome after 3 months (p=0.019). (orig.)

  17. Classification of the lumbar disc degeneration using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hirotoshi; Shinomiya, Kenichi; Okamoto, Akihiko; Muto, Naoko; Furuya, Kotaro (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1992-11-01

    Magnetic resonance (MR) imaging has been performed in consecutive 114 patients with a chief complaint of lumbar pain. A retrospective review of MR images of a total of 570 lumbar vertebrae from these patients were done to examine lumbar disc degeneration. According to the MR intensity of nucleus pulposus on T2-wighted sagittal images, lumbar disc degeneration was graded on a scale of 0-4: 0=uniform hyperintensity; 1=slight hypointensity; 2=centrally band-like hypointensity with marginal hyperintensity; 3=irregular hypointensity in both the central and marginal sites; 4=uniform hypointensity. Lumbar disc degeneration was observed in 76%; and it was rapidly increased in frequency in the 30 or older age groups. Of 570 vertebrae, 51 (8.9%) had narrowing of intervertebral cavity. For these vertebrae, a mean score of lumbar disc degeneration was 3.1. Lumbar disc herniation was seen in 93 vertebrae, with a mean score of lumbar disc degeneration being 3.07. Changes in vertebral body marrow were seen in 14 vertebrae (2.5%), in which a mean score of intervertebral disc degeneration was 3.71. (N.K.).

  18. The transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor%单纯后路经椎弓根椎体次全切除内固定联合人工椎体置换治疗胸腰椎转移瘤

    Institute of Scientific and Technical Information of China (English)

    燕太强; 郭卫; 杨荣利; 董森; 李晓

    2011-01-01

    Objective To evaluate the clinical outcome of the transpedicular corpectomy through simple posterior approach combined with intemal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor.Methods From January 2007 to March 2010, 21 patients with thoracic and lumbar spine metastatic tumors (9 males, 12 females; 16 in thoracic spine, 5 in lumbar spine) underwent the transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement.The mean age was 58 years (range, 39-77 years).The average pre-operative VAS score was 7.4 (range, 5-10).According to the pre-operative Frankel grades for spinal cord, 3 cases obtained grade C, 6 grade D and 12 grade E.Pre-operative ECOG grades showed 1 case with grade 2, 18 with grade 3 and 2 with grade 4.Results The mean operative time was 3.5 hours (range, 2-5 hours), with no intra-operative death.The mean intra-operative blood loss was 2150 ml (range, 800-5000ml).1 patient died of multiple organ failure two weeks postoperatively.A11 patients with pain reported lower VAS scores postoperatively (with average being 3.1; range, 1-4.5).Of the Frankel grades, 1 patient with grade C reported no change after surgery, while 1 patient with grade C was improved to grade D and 6 patients with grade D to grade E.3 cases (14.3%)were re-operated half year to 1 year after surgery due to recurrence.In the last follow-up, 20 patients had already been followed up for an average of 13 months (range, 3-24months).Among them, 13 cases died of the primary disease with an average survival of 10 months.The remaining surviving patients reported ECOG grades from grade 1 to grade 3.Conclusions The transpedicular corpectomy through simple posterior approach combined with internal fixation and prosthetic vertebral replacement for thoracic and lumbar spine metastatic tumor can provide plentiful decompression and achieve favorable surgical results.It can effectively

  19. Dynamic stabilization for degenerative spondylolisthesis and lumbar spinal instability.

    Science.gov (United States)

    Ohtonari, Tatsuya; Nishihara, Nobuharu; Suwa, Katsuyasu; Ota, Taisei; Koyama, Tsunemaro

    2014-01-01

    Lumbar interbody fusion is a widely accepted surgical procedure for patients with lumbar degenerative spondylolisthesis and lumbar spinal instability in the active age group. However, in elderly patients, it is often questionable whether it is truly necessary to construct rigid fixation for a short period of time. In recent years, we have been occasionally performing posterior dynamic stabilization in elderly patients with such lumbar disorders. Posterior dynamic stabilization was performed in 12 patients (6 women, 70.9 ± 5.6 years old at the time of operation) with lumbar degenerative spondylolisthesis in whom % slip was less than 20% or instability associated with lumbar disc herniation between March 2011 and March 2013. Movement occurs through the connector linked to the pedicle screw. In practice, 9 pairs of D connector system where the rod moves in the perpendicular direction alone and 8 pairs of Dynamic connector system where the connector linked to the pedicle screw rotates in the sagittal direction were installed. The observation period was 77-479 days, and the mean recovery rate of lumbar Japanese Orthopedic Association (JOA) score was 65.6 ± 20.8%. There was progression of slippage due to slight loosening in a case with lumbar degenerative spondylolisthesis, but this did not lead to exacerbation of the symptoms. Although follow-up was short, there were no symptomatic adjacent vertebral and disc disorders during this period. Posterior dynamic stabilization may diminish the development of adjacent vertebral or disc disorders due to lumbar interbody fusion, especially in elderly patients, and it may be a useful procedure that facilitates decompression and ensures a certain degree of spinal stabilization.

  20. Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration.

    Science.gov (United States)

    Sparrey, Carolyn J; Bailey, Jeannie F; Safaee, Michael; Clark, Aaron J; Lafage, Virginie; Schwab, Frank; Smith, Justin S; Ames, Christopher P

    2014-05-01

    The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.

  1. Metástases do segmento torácico e lombar da coluna vertebral: estudo prospectivo comparativo entre o tratamento cirúrgico e radioterápico com a imobilização externa e radioterapia Metastatic tumor of thoracic and lumbar spine: prospective study comparing the surgery and radiotherapy vs external immobilization with radiotherapy

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2007-09-01

    Full Text Available As metástases ósseas que acometem o segmento torácico e lombar da coluna vertrebal têm como principais complicações o fenômeno doloroso e a compressão medular ou radicular. O tratamento adotado dependerá das condições clínicas e neurológicas do paciente e do grau de invasão tumoral. Foram analisados, prospectivamente, 32 pacientes acometidos por metástases do segmento torácico e lombar da coluna vertebral, sendo tratados com cirurgia de descompressão e estabilização interna seguida por radioterapia ou irradiação com mobilização externa. A seleção dos grupos foi estabelecida de acordo com a sensibilidade do tumor a radioterapia, condições clínicas, grau de estabilidade da coluna, grau de compressão medular/radicular e opção do paciente. A escala de Frankel e o teste visual de dor foram aplicados no momento do diagnóstico e após 1 e 6 meses. O grupo cirúrgico apresentou melhores resultados, mantendo a deambulação por mais tempo, pois manteve a força muscular nos pacientes Frankel E, propiciou a reversão do déficit neurológico pré-operatório em 61,5% dos casos e propiciou melhora significativa da dor.Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had

  2. Sensitivity of lumbar spine loading to anatomical parameters.

    Science.gov (United States)

    Putzer, Michael; Ehrlich, Ingo; Rasmussen, John; Gebbeken, Norbert; Dendorfer, Sebastian

    2016-04-11

    Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the influence of defined geometrical parameters on lumbar spine loading utilising five parametrised musculoskeletal lumbar spine models for four different postures. The influence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine was studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most influential. These parameters can be easily acquired from X-rays and should be used to morph a musculoskeletal lumbar spine model for subject-specific approaches with respect to bone geometry. Furthermore, the model was very sensitive to uncommon configurations and therefore, it is advised that stiffness properties of discs and ligaments should be individualised.

  3. Multisegmental pneumatocysts of the lumbar spine mimic osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Steingruber, I.E.; Buchberger, W. [Dept. of Radiology, University of Innsbruck (Austria); Bach, C.M.; Wimmer, C.; Nogler, M. [Dept. of Orthopedic Surgery, University of Innsbruck (Austria)

    2001-05-01

    Circumscribed radiolucencies within the vertebral bones can be due to a variety of changes including benign and malignant tumours or tumour-like lesions. Radiolucencies due to degenerative intraosseous pneumatocyst are very uncommon but have to be taken into the differential diagnosis in well-circumscribed lytic lesions of the vertebral bodies. We describe the first case of multisegmental pneumatocysts in the lumbar spine mimicking osteolytic lesions. On computed tomography, the air-equivalent attenuation values of the lesions and the close vicinity to the degenerated vertebral endplates with vacuum phenomenon led to the correct diagnosis. (orig.)

  4. Lumbo-costo-vertebral syndrome with posterior spinal dysraphism

    Directory of Open Access Journals (Sweden)

    Sujit Kumar G

    2005-01-01

    Full Text Available Lumbo-costo-vertebral syndrome, which includes abnormalities of the vertebral bodies, ribs and trunk musculature, is very rare and only few cases have been reported. We report a case of 18-month-old female child with absent ribs, hemivertebrae, superior lumbar hernia (features of lumbo-costo-vertebral syndrome and posterior spinal dysraphism, which to our knowledge is the first case in the English literature with such a combination of defects. Embryology and management of the case is discussed.

  5. Reliability analysis for radiographic measures of lumbar lordosis in adult scoliosis: a case–control study comparing 6 methods

    National Research Council Canada - National Science Library

    Hong, Jae Young; Suh, Seung Woo; Modi, Hitesh N; Hur, Chang Yong; Song, Hae Ryong; Park, Jong Hoon

    2010-01-01

    Several methods are used to measure lumbar lordosis. In adult scoliosis patients, the measurement is difficult due to degenerative changes in the vertebral endplate as well as the coronal and sagittal deformity...

  6. X-Ray parameters of lumbar spine

    Directory of Open Access Journals (Sweden)

    Otabek Ablyazov

    2012-05-01

    Full Text Available Knowledge of anatomic spinal structures, especially its relation-ship to the functions performed, is necessary to form a correct diagnosis. The anatomical structure of the vertebrae varies de-pending on the level of the spinal segment. Normal anatomical parameters, derived from bone structures of the spine, are roughly determined by X-ray method.This paper presents the results of the survey radiography of the lumbar spine in a straight line and lateral projections in 30 individ-uals without pathology spine, aged 21-60 years with frequently observed lumbar spinal stenosis stenosis. Applying X-ray method there were studied shape, height, and the contours of the vertebral bodies and intervertebral disc in the front (interpedicular and sagittal planes; there were measured dimensions of the lumbar canal and foramen holes in the same planes. Using X-ray method can fully identify the bone parameters of vertebral column. How-ever, the informativity of the method depends on knowledge of radiologist about topographic anatomical features of spine.

  7. Apical constriction: themes and variations on a cellular mechanism driving morphogenesis.

    Science.gov (United States)

    Martin, Adam C; Goldstein, Bob

    2014-05-01

    Apical constriction is a cell shape change that promotes tissue remodeling in a variety of homeostatic and developmental contexts, including gastrulation in many organisms and neural tube formation in vertebrates. In recent years, progress has been made towards understanding how the distinct cell biological processes that together drive apical constriction are coordinated. These processes include the contraction of actin-myosin networks, which generates force, and the attachment of actin networks to cell-cell junctions, which allows forces to be transmitted between cells. Different cell types regulate contractility and adhesion in unique ways, resulting in apical constriction with varying dynamics and subcellular organizations, as well as a variety of resulting tissue shape changes. Understanding both the common themes and the variations in apical constriction mechanisms promises to provide insight into the mechanics that underlie tissue morphogenesis.

  8. Supreme 喉罩与 i-gel 喉罩用于俯卧位腰椎手术患者气道管理效果的比较%Comparison of the efficacy of laryngeal mask of Supreme and laryngeal mask of i-gel for the airway man-agement in patients undergoing elective lumbar vertebral surgery in prone position

    Institute of Scientific and Technical Information of China (English)

    黄祥; 康芳; 李娟; 张华明

    2016-01-01

    目的:比较 Supreme 喉罩和 i-gel 喉罩用于俯卧位腰椎手术患者气道管理的效果。方法择期行俯卧位腰椎手术患者264例,采用随机数字表法将患者分为两组,每组132例。麻醉诱导后 S 组和 I 组分别置入 Supreme 喉罩和 i-gel 喉罩。记录喉罩置入次数、置入时间;记录仰卧位和俯卧位时的通气质量、气道峰压、气道密封压,并采用纤支镜观察喉罩位置,行喉罩对位分级;记录喉罩血染的发生情况;记录喉罩相关并发症的发生情况。结果 I 组有1例患者于仰卧位时3次置入喉罩均失败,被排除。两组患者置入喉罩型号、置入时间、仰卧位和俯卧位气道峰压和纤支镜评级差异无统计学意义。与 S 组比较,I 组喉罩尝试置入次数明显增多,俯卧位通气质量明显升高,俯卧位和仰卧位气道密封压明显升高(P <0.01或 P <0.05)。两组患者喉罩相关并发症发生情况差异无统计学意义。结论俯卧位腰椎手术患者气道管理中,相比 Supreme 喉罩,i-gel 喉罩置入难度较大,但具有更高的气道密封压。%Objective To compare the efficacy of laryngeal mask of Supreme and i-gel for the airway management in patients undergoing elective lumbar vertebral surgery in prone position. Methods A total of 264 patients,ASA physical status Ⅰ or Ⅱ,scheduled for elective lumbar verte-bral surgery in prone position under general anesthesia were divided into two groups (n =132)using a random number table:laryngeal mask of Supreme group (group S)and laryngeal mask of i-gel group (group I).The laryngeal mask of Supreme or i-gel were respectively placed in group S and group I im-mediately after anesthesia induction according to manufacturers’specification.Volume-controlled ven-tilation was used to observe the ventilation quality.The number of laryngeal mask insertion,laryngeal mask insertion time and the ventilation quality in supine and prone position were recorded

  9. Immunolocalization of FGF8/10 in the Apical Epidermal Peg and Blastema of the regenerating tail in lizard marks this apical growing area.

    Science.gov (United States)

    Alibardi, Lorenzo

    2016-07-01

    Previous studies have shown that Fibroblast Growth Factors are present in the regenerating tail tissues of lizards where they may stimulate the process of regeneration. The present study is focused on the immunolocalization of FGF8 and FGF10 in the regenerating lizard tail, two signaling proteins of the apical epidermal cup/ridge and mesenchymal blastema sustaining tail and limb regeneration in amphibians and the development of the tail and limbs in vertebrate embryos. Main immunoreactive protein bands at 15-18kDa for FGF8/10 are detected in the regenerating epidermis and only a band at 30 or 35kDa in the underlying connective tissues. FGF8 appears particularly localized in cells and nuclei of the apical epidermal peg and of the ependymal ampulla present at the tip of the regenerating tail. FGF10 is also immuno-localized in the apical epidermis but is particularly intensely localized in the mesenchyme of the apical blastema. In accordance with previous studies, the present observations supports the hypothesis that the apical epidermal peg and the ependymal tube with the few regenerated neurons present within it, release FGF8/10 that may contribute to maintenance of cell proliferation in the apical front of the mesenchyme for the growth of the regenerating tail.

  10. Diagnosis by images of vertebral tuberculosis. A case report

    Directory of Open Access Journals (Sweden)

    Aimara de la Caridad Vergara Santos

    2015-04-01

    Full Text Available Vertebral tuberculosis, also known like espondilitis tuberculous, disease of Pott or Pott's disease, is a presentation of extra-pulmonary tuberculosis. A case of a 35 year old female Venezuelan patient was presented with a history of sacrum lumbar pain. A study of magnetic resonance in a high-technology center was accomplished and Pott's disease was diagnosed. The tuberculosis constitutes a heath problem in Venezuela as well as in many other countries. Pott's disease is not common in adults, but it should be taken into account on persistent or chronic lumbar pain. It is important to diagnose the disease timely to administrate the specific treatment during the first manifestations and avoid vertebral instability, neurological compromise or xiphotic vertebral deformity.

  11. Measurement of angular and linear segmental lumbar spine flexion-extension motion by means of image registration

    NARCIS (Netherlands)

    Penning, L; Irwan, R; Oudkerk, M

    2005-01-01

    Background The presently available method of measuring segmental lumbar spine mobility by means of superimposition of lumbar spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction

  12. Imaging Characterization Lumbar Disk Hernia in Operated patients.

    Directory of Open Access Journals (Sweden)

    Enrique Hernández Padrón

    2009-07-01

    Full Text Available Background: The details of lumbar disk hernia are specifically described in imaging studies, which leads to very specific diagnosis contributing to its appropriate treatment. Objective: To characterize through imaging studies the lumbar disk hernia in operated patients. Methods: Descriptive observational, correlational, retrospective study of a series of cases, carried out in the University Hospital “Dr. Gustavo Aldereguía Lima” of Cienfuegos, from 2000 to 2005, including all the patients who required imaging studies for a suspect of lumbar disk hernia, who received surgical treatment in that institution. The available imaging means were used: spine simple radiography in lumbar area, myelography and computerized axial tomography. Results: Males were more affected by lumbar disk hernia. The most common sings observed through spine simple radiography in lumbar area were: decrease of the intervertebral space and arthrosic changes in the vertebral bodies. Myelography was performed in six patients and three of them were positive. The most common kind of hernia according with their localization was the lateral, and according with the amount of herniated material, the protruded hernia. The most affected spaces were: L5- S1 and L4-L5. The patients of the third and fourth decade of life were the most affected, with a prevalence of the protruded hernia in the L5-S1 y L4 -L5 spaces. Conclusions: The imaging studies contributed to a correct characterization of lumbar disk hernia.

  13. Vertebral Fractures and Spondylosis in Men - Original Investigation

    Directory of Open Access Journals (Sweden)

    Selmin Gülbahar

    2008-04-01

    Full Text Available Aim: The aim of this study was to investigate the relationship between vertebral fractures and spondylosis and bone mineral density in men older than 60 years. Material and Method: Thirty-two men with back and low back pain aged over 60 years were included into the study. Thoracic and lumbar spine radiographs were taken and, anterior, central and posterior heights of each vertebral body from T4 to L5 was measured and than the number of vertebral fractures was assessed. Osteophyte and disc scores were used for evaluation of spondylosis. Bone mineral density was measured by dual-energy-X-ray absorptiometry. Measurements were obtained from lumbar vertebrae and proximal femoral region. Results: Significant positive correlations were found between vertebral fracture and osteophyte score and bone mineral density of total femoral region. When osteophyte score and total femoral bone mineral density were taken into consideration, there were no significant correlations between other parameters and vertebral fracture. Significant positive correlations were observed between osteophyte score and bone mineral density and t scores of L1-4. Also there were significant positive correlations between disc score and both bone mineral density and t scores of L1-4. Significant positive correlation was also found between femoral bone density and body weight. Conclusion: Finally, lumbar bone mineral density increases with spinal degenerative changes, but the increase in bone mineral density can not prevent sub clinic vertebral fractures. Especially, in the men who have intensive spinal degenerative changes, the measurement of lumbar bone mineral density is not enough for determining the fracture risk. Measurement of femoral bone mineral density and evaluation of clinic risk factors are more important for determining the fracture risk. (From the World of Osteoporosis 2008;14:1-6

  14. Validation, repeatability and reproducibility of a noninvasive instrument for measuring thoracic and lumbar curvature of the spine in the sagittal plane Validade, repetibilidade e reprodutibilidade de um instrumento não-invasivo para medição das curvaturas torácica e lombar da coluna vertebral no plano sagital

    Directory of Open Access Journals (Sweden)

    Fabiana O. Chaise

    2011-12-01

    Full Text Available BACKGROUND: The need for early identification of postural abnormalities without exposing patients to constant radiation has stimulated the development of instruments aiming to measure the spinal curvatures. OBJECTIVE: To verify the validity, repeatability and reproducibility of angular measures of sagittal curvatures of the spine obtained using an adapted arcometer, by comparing them with Cobb angles of the respective curvatures obtained by using X-rays. METHODS: 52 participants were submitted to two procedures designed to evaluate the thoracic and lumbar curvatures: (1 X-ray examination from which the Cobb angles (CA of both curvatures were obtained, and (2 measuring the angles with the arcometer (AA. Two evaluators collected the data using the arcometer, with the rods placed at T1, T12, L1 and L5 spinous processes levels in a way as to permit linear measurements which, with aid of trigonometry, supplied the AA. RESULTS: There was a very strong and significant correlation between AA and CA (r=0.94; pCONTEXTUALIZAÇÃO: A necessidade de identificação precoce de alterações posturais, sem expor as pessoas à radiação constante, tem estimulado a construção de instrumentos para medir as curvaturas da coluna vertebral. OBJETIVO: Verificar a validade, repetibilidade e reprodutibilidade dos ângulos das curvaturas sagitais da coluna vertebral, obtidos por meio de um arcômetro adaptado, comparando-os com os ângulos de Cobb (AC das respectivas curvaturas, obtidos por meio de exames radiográficos. MÉTODOS: Cinquenta e dois indivíduos foram submetidos a dois procedimentos destinados a avaliar as curvaturas torácica e lombar: (1 exame de raios-X, a partir do qual os AC de ambas as curvaturas foram obtidos e (2 medição dos ângulos das curvaturas com o arcômetro (AA. Dois avaliadores coletaram os dados usando o arcômetro com as hastes sobre os processos espinhosos T1, T12, L1 e L5, de modo a permitir medidas que, com auxílio de

  15. 肌间隙入路、椎弓根椎体内植骨结合骨折椎螺钉治疗胸腰椎骨折%The treatment of chest lumbar vertebra bone fracture by muscle gap approach with vertebral transpedicular grafting the bone union bone vertebral fractures screws

    Institute of Scientific and Technical Information of China (English)

    王桥贵

    2016-01-01

    目的:探讨胸腰段脊柱肌间隙后入路(muscle gap approach,MGA)经椎弓根植骨(transpedicular grafting,TPG)和结合骨折椎螺钉(vertebral fractures screws,VFS )治疗胸腰段脊柱骨折的方法和疗效。方法对30例胸腰椎骨折患者经MGA, TPG,VFS,后路短节段椎弓根内固定手术,记录手术时间、失血量、住院时间。在术前,术后及末次随访时测量伤椎前缘高度与正常高度的比值、后凸Cobb角,末次随访的过伸过屈位X线片上测量手术节段运动范围,了解神经功能改变及腰背疼痛变化,功能评定采用Greenough腰痛评分。结果随访15-38个月(平均22.3个月),平均手术时间:130min,平均失血量362ml,平均住院时间15d。术前平均Cobb角360,椎体平均相对高度降低48.8%,术后平均Cobb角2.30,术后椎体相对高度降低≤6.2%。末次随访平均Cobb角矫正丢失2.50,椎体相对高度矫正丢失2.3%。无断钉及内固定物松动,无供骨区并发症。结论肌间隙入路椎弓根椎体内植骨结合骨折椎螺钉治疗胸腰椎骨折,疗效满意。具有失血量少,保留手术节段运动范围,无供骨区并发症。最大可能保留后柱完整性,增强胸腰椎骨折后路短节段内固定的牢固性,利于矫正后凸畸形和维持矫正效果。%Objective This discussion aims at the methods and treatment of the chest waist section spinal column bone fracture through chest waist section spinal column muscle gap approach with the bone transpedicular grafting(TPG)and the union bone vertebral fractures screws(VFS).Methods 30 cases were conducted an operation on the chest waist section spinal column bone fracture by MGA, TPG,VFS and the fixed surgery in the rear guard short stage vertebral arch root. The surgery time,the amount of blood loss,the time of treatment in hospital were recorded. It should be learned that the ratio of the injury front height and

  16. Laparoscopic lumbar hernia repair.

    Science.gov (United States)

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S

    2006-04-01

    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  17. Rapid prototyping drill guide template for lumbar pedicle screw placement

    Institute of Scientific and Technical Information of China (English)

    LU Sheng; XU Yong-qing; ZHANG Yuan-zhi; LI Yan-bing; SHI Ji-hong; CHEN Guo-ping; CHEN Yu-bing

    2009-01-01

    To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping techniques, and to validate its accuracy by experimental and clinical studies. Methods: A 3D reconstruction model for the desired lumbar vertebra was generated by using the Mimics 10.11 software, and the optimal screw size and orientation were determined using the reverse engineering software. Afterwards, a drill template was created by reverse engi-neering principle, whose surface was the antitemplate of the vertebral surface. The drill template and its correspond-ing vertebra were manufactured using the rapid prototyping technique. Results: The accuracy of the drill template was con-firmed by drilling screw trajectory into the vertebral biomodel preoperatively. This method also showed its ability to cus-tomize the placement and size of each screw based on the unique morphology of the lumbar vertebra.The drill tem-plate fits the postural surface of the vertebra very well in the cadaver experiment. Postoperative CT scans for controlling the pedicle bore showed that the personalized template had a high precision in cadaver experiment and clinical application. No misplacement occurred by using the per-sonalized template. During surgery, no additional computer assistance was needed.Conclusions: The authors have developed a novel drill template for lumbar pedicle screw placement with good applicability and high accuracy. The potential use of drill templates to place lumbar pedicle screws is promising. Our methodology appears to provide an accurate technique and trajectory for pedicle screw placement in the lumbar spine.

  18. Function of root apical meristem

    OpenAIRE

    Benešová, Šárka

    2013-01-01

    A root apical meristem is the only source of cells for all tissues in the root. The root growth relies on its function. Regulation of a cell division frequency and cell differentiation affects organization and function of the differentiated tissues and the proper meristem function. If the cell differentiation overbalances the cell proliferation, the meristem exhaustion occurs and the root growth irreversibly terminates. This thesis describes existing knowledge about regulation of the primary ...

  19. Are spinal or paraspinal anatomic makers helpful for vertebral numbering and diagnosing lumbosacral transitional vertebrae?

    Energy Technology Data Exchange (ETDEWEB)

    Tokgoz, Nil; Ucar, Murat; Erdogan, Aylin Billur; Killic, Koray; Ozcan, Cahide [Dept. of Radiology, Gazi University School of Medicine, Ankara (Turkmenistan)

    2014-04-15

    To evaluate the value of spinal and paraspinal anatomic markers in both the diagnosis of lumbosacral transitional vertebrae (LSTVs) and identification of vertebral levels on lumbar MRI. Lumbar MRI from 1049 adult patients were studied. By comparing with the whole-spine localizer, the diagnostic errors in numbering vertebral segments on lumbar MRI were evaluated. The morphology of S1-2 disc, L5 and S1 body, and lumbar spinous processes (SPs) were evaluated by using sagittal MRI. The positions of right renal artery (RRA), superior mesenteric artery, aortic bifurcation (AB) and conus medullaris (CM) were described. The diagnostic error for evaluation of vertebral segmentation on lumbar MRI alone was 14.1%. In lumbarization, all patients revealed a well-formed S1-2 disc with squared S1 body. A rhombus-shaped L5 body in sacralization and a rectangular-shaped S1 body in lumbarization were found. The L3 had the longest SP. The most common sites of spinal and paraspinal structures were: RRA at L1 body (53.6%) and L1-2 disc (34.1%), superior mesenteric artery at L1 body (55.1%) and T12-L1 disc (31.6%), and AB at L4 body (71.1%). CM had variable locations, changing from the T12-L1 disc to L2 body. They were located at higher sacralization and lower lumbarization. The spinal morphologic features and locations of the spinal and paraspinal structures on lumbar MRI are not completely reliable for the diagnosis of LSTVs and identification on the vertebral levels.

  20. Planar cell polarity and vertebrate organogenesis.

    Science.gov (United States)

    Karner, Courtney; Wharton, Keith A; Carroll, Thomas J

    2006-04-01

    In addition to being polarized along their apical/basal axis, cells composing most (if not all) organs are also polarized in a plane vertical to the A/B axis. Recent studies indicate that this so-called planar cell polarity (PCP) plays an essential role in the formation of multiple organ systems regulating directed cell migrations, polarized cell division and proper differentiation. In this review we will discuss the molecular mechanisms regulating PCP, including the hypothesized roles for Wnt ligands in this process, and its roles in vertebrate organogenesis.

  1. Osteomielitis vertebral piógena Pyogenic vertebral osteomyelitis

    Directory of Open Access Journals (Sweden)

    Pedro P. Perrotti

    2009-10-01

    Full Text Available La osteomielitis vertebral piógena (OVP es una localización poco frecuente (2-7% Se confirma con el aislamiento de un microorganismo de una vértebra, disco intervertebral, absceso epidural o paravertebral. Se describe una serie de casos por la infrecuente presentación de esta enfermedad, que puede ser consulta inicial en los servicios de clínica médica y por su sintomatología inespecífica que supone una dificultad diagnóstica. Tanto la columna lumbar como la dorsal fueron los sitios más afectados. El dolor dorsolumbar y la paraparesia fueron los síntomas más frecuentes de presentación. En ocho pacientes se aislaron Staphylococcus aureus, en uno Escherichia coli y en el restante Haemophylus sp. Se observó leucocitosis sólo en tres pacientes, y en dos velocidad de sedimentación globular mayor de 100 mm/h. Los diez pacientes presentaron imágenes características de osteomielitis vertebral piógena en la resonancia nuclear magnética. Dentro de las complicaciones, los abscesos paravertebrales y epidurales fueron los más frecuentes (en cinco enfermos. Además, un paciente presentó empiema pleural. De los diez pacientes de esta serie, siete recibieron inicialmente tratamiento médico empírico y luego específico para el germen aislado. En los restantes el tratamiento fue guiado de acuerdo al antibiograma. A dos enfermos fue necesario realizarles laminectomía descompresiva por compromiso de partes blandas y a otros dos estabilización quirúrgica por inestabilidad espinal, observándose buena evolución en todos los casos. Esta serie demuestra que, ante un paciente con dolor dorsolumbar y síntomas neurológicos se deberá tener en cuenta esta entidad para evitar un retraso en el tratamiento.Pyogenic osteomyelitis seldom affects the spine (2-7%. It is diagnosed by the isolation of a bacterial agent in the vertebral body, the intervertebral disks or from paravertebral or epidural abscesses. We report a retrospective study of ten

  2. V. Terrestrial vertebrates

    Science.gov (United States)

    Dean Pearson; Deborah Finch

    2011-01-01

    Within the Interior West, terrestrial vertebrates do not represent a large number of invasive species relative to invasive weeds, aquatic vertebrates, and invertebrates. However, several invasive terrestrial vertebrate species do cause substantial economic and ecological damage in the U.S. and in this region (Pimental 2000, 2007; Bergman and others 2002; Finch and...

  3. OUTCOME OF POSTEROLATERAL FUSION VERSUS CIRCUMFERENTIAL FUSION WITH CAGE FOR LUMBAR STENOSIS AND LOW DEGREE LUMBAR SPONDYLOLISTHESIS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumbar spondylolisthesis. Methods From April 1998 to April 2003, 45 patients suffering from lumbar stenosis with low degree lumbar spondylolisthesis treated in our hospital were retrospectively reviewed and assigned to two groups. Among them, 24 patients (group A) were treated with instrumented posterolateral fusion and 21 patients (group B) with instrumented circumferential fusion. The two groups were compared for clinical and radiological outcomes. Results All patients were followed up for 12 to 72 months. In group A, results showed preoperative clinical symptoms disappeared completely in 12 of 24 patients, and pain relief was seen in 91.7% (22/24). Two cases suffered from residual symptoms. Twenty-two cases obtained complete reduction of olisthy vertebral bodies, and anatomical reduction rate was 91.7%. No infection or neurological complication occurred in this group. In group B, results showed preoperative clinical symptoms disappeared completely in 13 of 21 patients, and pain relief was seen in 90. 5% ( 19/21 ). One case suffered from residual symptoms. Twenty cases obtained complete reduction of the olisthy vertebral bodies, and anatomical reduction rate was 95.2%. Four cases of infection or neurological complication occurred in this group. Both groups indicated no significant difference in clinical outcomes and anatomical reduction rate during followup. But group A had better intraoperative circumstances and postoperative outcome than group B, while group B had better postoperative parameters in X-ray of Angle of Slipping and Disc Index than group A.Conclusions The first choice of surgical method for lumbar stenosis with low degree lumbar spondylolisthesis is instrumented posterolateral fusion. Only when patients suffer from severe preoperative disc

  4. 己烯雌酚与淫羊藿总黄酮联合用药对去卵巢大鼠腰椎和股骨的影响%Influence of diethylstilbestrol combined with epimedium pubescens flavonoids on lumbar vertebral body and femur in ovariectomized rats

    Institute of Scientific and Technical Information of China (English)

    许碧连; 吴铁; 崔燎; 刘钰瑜; 邹丽宜

    2005-01-01

    BACKGROUND: Previous experiments indicate that epimedium pubesceus flavonoids (EPF) could enhance protective effect of estrogen on proximal tibial metaphysis (PTM) and reduce its adverse effect on uterine tissue in ovariectomized rats. Do they have synergetic effects on lumbar vertebral body and femur in ovariectomized rats when used in combination?OBJECTIVE: To observe the influence of diethylstilbestrol combined with EPF on metabolic biochemical indexes and bone histomorphometry of lumbar and femur in ovariectomized rats.DESIGN: Randomized controlled study on experimental animals.SETTING: Department of Pharmacology, Guangdong Medical College.MATERIALS: Female unmated SD rats of 4 months old, with the body mass of (225±15)g, were provided by Shanghai Experimental Animal Centre of the Chinese Academy of Sciences. They were of clean grade (Certification No. CSAM003). All rats were randomized into 5 groups: namely,sham- operation group, ovariectomy group, diethylstilbestrol group, EPF group, and combination group with 10 rats in each group.METHODS: Rats in all the groups except sham operation group were subjected to bilateral ovariectomy. Those in sham operation group and ovariectomy group were given solvent as control, while rats in the other groups were given gastric perfusion of: diethylstilbestrol at the dosage of 22.5 μg/metric analysis was used to assess the static parameters [percent trabecular area(%Tb. Ar), trabecular number(Tb.N), trabecular thickness (Tb.Th), trabecular seperation(Tb. Sp), osteoclast number per mm2 (Oc.N)] and dynamic parameters[percent labeled perimeter(%L.Pm), mineral apposition rate (MAR), bone formation rate(BFR)per unit of bone volume (BFR/BV)] of the fifth lumbar vertebral body(LV5). Meanwhile the contents of femur calcium,phosphorus and hydroxyproline were also measured.static parameters of LV5 of ovariectomized rats due to the combined adethylstilbestrol and EPF on femur biochemical indexes in ovariectomized rats.RFSULTS: Five

  5. The influence of muscle forces on the stress distribution in the lumbar spine

    DEFF Research Database (Denmark)

    Wong, C; Rasmussen, J; Simonsen, Erik B.;

    2011-01-01

    Introduction: Previous studies of bone stresses in the human lumbar spine have relied on simplified models when modeling the spinal musculature, even though muscle forces are likely major contributors to the stresses in the vertebral bones. Detailed musculoskeletal spine models have recently become...... available and show good correlation with experimental findings. A combined inverse dynamics and finite element analysis study was conducted in the lumbar spine to investigate the effects of muscle forces on a detailed musculoskeletal finite element model of the 4th lumbar vertebral body. Materials...... and Methodology: The muscle forces were computed with a detailed and validated inverse dynamics musculoskeletal spine model in a lifting situation, and were then applied to an orthotropic finite element model of the 4th lumbar vertebra. The results were compared with those from a simplified load case without...

  6. Lumbar stenosis: clinical case

    Directory of Open Access Journals (Sweden)

    Pedro Sá

    2014-08-01

    Full Text Available Lumbar stenosis is an increasingly common pathological condition that is becoming more frequent with increasing mean life expectancy, with high costs for society. It has many causes, among which degenerative, neoplastic and traumatic causes stand out. Most of the patients respond well to conservative therapy. Surgical treatment is reserved for patients who present symptoms after implementation of conservative measures. Here, a case of severe stenosis of the lumbar spine at several levels, in a female patient with pathological and surgical antecedents in the lumbar spine, is presented. The patient underwent two different decompression techniques within the same operation.

  7. Optimal patient positioning for ligamentotaxis during balloon kyphoplasty of the thoracolumbar and lumbar spine.

    LENUS (Irish Health Repository)

    Cawley, D T

    2011-06-01

    Percutaneous balloon kyphoplasty aims to restore vertebral height, correct angular deformity and stabilize the spine in the setting of vertebral compression fractures. The patient is positioned prone with supports under the iliac crests and upper thorax to allow gravity to extend the spine. In the treatment of lumbar fractures, we evaluated patient positioning with the contribution of hip extension to increase anterior ligamentotaxis, thus facilitating restoration of vertebral height. Our positioning technique created a mean anterior height increase from 72% to 78% of the average height of the cranial and caudal vertebrae (p=0.037). Balloon inflation did not significantly further increase anterior or posterior vertebral height, or Cobb angle.

  8. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-07-01

    The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

  9. Current concepts on spinal arthrodesis in degenerative disorders of the lumbar spine

    OpenAIRE

    Lykissas, Marios G; Aichmair, Alexander

    2013-01-01

    Back pain is a common chronic disorder that represents a large burden for the health care system. There is a broad spectrum of available treatment options for patients suffering from chronic lower back pain in the setting of degenerative disorders of the lumbar spine, including both conservative and operative approaches. Lumbar arthrodesis techniques can be divided into sub-categories based on the part of the vertebral column that is addressed (anterior vs posterior). Furthermore, one has to ...

  10. Congenital abnormalities of the vertebral column in ferrets.

    Science.gov (United States)

    Proks, Pavel; Stehlik, Ladislav; Paninarova, Michaela; Irova, Katarina; Hauptman, Karel; Jekl, Vladimir

    2015-01-01

    Vertebral column pathologies requiring surgical intervention have been described in pet ferrets, however little information is available on the normal vertebral formula and congenital variants in this species. The purpose of this retrospective study was to describe vertebral formulas and prevalence of congenital vertebral anomalies in a sample of pet ferrets. Radiographs of 172 pet ferrets (96 males and 76 females) were included in this retrospective study. In 143 ferrets (83.14%), five different formulas of the vertebral column were recorded with normal morphology of vertebrae (rib attachment included) but with a variable number of thoracic (Th), lumbar (L), and sacral (S) vertebrae. The number of cervical (C) vertebrae was constant in all examined animals. Observed vertebral formulas were C7/Th14/L6/S3 (51.74%), C7/Th14/L6/S4 (22.10%), C7/Th14/L7/S3 (6.98%), C7/Th15/L6/S3 (1.74%), and C7/Th15/L6/S4 (0.58%). Formula C7/Th14/L6/S4 was significantly more common in males than in females (P vertebral anomalies included block (two ferrets) and wedge vertebra (one ferret). Spina bifida was not detected. Findings from the current study indicated that vertebral formulas may vary in ferrets and congenital abnormalities are common. This should be taken into consideration for surgical planning.

  11. Imaging of vertebral fractures

    Directory of Open Access Journals (Sweden)

    Ananya Panda

    2014-01-01

    Full Text Available Vertebral fracture is a common clinical problem. Osteoporosis is the leading cause of non-traumatic vertebral fracture. Often, vertebral fractures are not clinically suspected due to nonspecific presentation and are overlooked during routine interpretation of radiologic investigations. Moreover, once detected, many a times the radiologist fails to convey to the clinician in a meaningful way. Hence, vertebral fractures are a constant cause of morbidity and mortality. Presence of vertebral fracture increases the chance of fracture in another vertebra and also increases the risk of subsequent hip fracture. Early detection can lead to immediate therapeutic intervention improving further the quality of life. So, in this review, we wish to present a comprehensive overview of vertebral fracture imaging along with an algorithm of evaluation of vertebral fractures.

  12. Radiographic evaluation of the use of transverse traction device in vertebral arthrodesis for degenerative diseases

    OpenAIRE

    Edgar Takao Utino; João Paulo Machado Bergamaschi; Luciano Antonio Nassar Pellegrino; Ricardo Shigueaki Galhego Umeta; Maria Fernanda Silber Caffaro; Robert Meves; Osmar Avanzi

    2014-01-01

    OBJECTIVE: Perform radiographic analysis of the use of Transverse Traction Device (DTT) with respect to fusion rate in patients submitted to vertebral arthrodesis for degenerative lumbar diseases. METHODS: We selected x-ray images on anteroposterior, lateral and oblique views and with maximum flexion and extension dynamics of 23 patients submitted to posterolateral arthrodesis of the lumbar spine with a minimum follow-up period of six months. The images were evaluated and classified by the ...

  13. Design of three-dimensional visualization based on the posterior lumbar pedicle screw fixation

    Directory of Open Access Journals (Sweden)

    Kai XU

    2011-09-01

    Full Text Available Objective To establish a three-dimensional visualization model of posterior lumbar pedicle screw fixation.Methods A patient with lumbar intervertebral disc hernia and another patient with compression fracture of lumbar vertebra were involved in the present study.Both patients underwent multi-slice spiral CT scan before and after lumbar pedicle screw fixation.The degree of preoperative vertebral compression,vertebral morphology before and after surgery,postoperative pedicle screw position,and decompression effects were observed.The original data of the multi-slice spiral CT were inputted into the computer.The three-dimensional reconstructed images of the lumbar and implanted screws were obtained using the software Amira 4.1 to show the three-dimensional shape of the lumbar vertebrae before and after surgery and the location of the implanted screws.Results The morphology and structure of the lumbar vertebrae before and after surgery and of the implanted screws were reconstructed using the digital navigation platform.The reconstructed 3D images could be displayed in multicolor,transparent,or arbitrary combinations.In the 3D surface reconstruction images,the location and structure of the implanted screws could be clearly observed,and the decompression of the spinal cord or nerve roots and the severity of the fracture and the compression of lumbar vertebrae could be fully evaluated.The reconstructed images before operation revealed the position of the vertebral pedicles and provided reference for intraoperative localization.Conclusions The three-dimensional computerized reconstructions of lumbar pedicle screw fixation may be valuable in basic research,clinical experiment,and surgical planning.The software Amira is one of the bases of three-dimensional reconstruction.

  14. Multiexpandable cage for minimally invasive posterior lumbar interbody fusion

    Science.gov (United States)

    Coe, Jeffrey D; Zucherman, James F; Kucharzyk, Donald W; Poelstra, Kornelis A; Miller, Larry E; Kunwar, Sandeep

    2016-01-01

    The increasing adoption of minimally invasive techniques for spine surgery in recent years has led to significant advancements in instrumentation for lumbar interbody fusion. Percutaneous pedicle screw fixation is now a mature technology, but the role of expandable cages is still evolving. The capability to deliver a multiexpandable interbody cage with a large footprint through a narrow surgical cannula represents a significant advancement in spinal surgery technology. The purpose of this report is to describe a multiexpandable lumbar interbody fusion cage, including implant characteristics, intended use, surgical technique, preclinical testing, and early clinical experience. Results to date suggest that the multiexpandable cage allows a less invasive approach to posterior/transforaminal lumbar interbody fusion surgery by minimizing iatrogenic risks associated with static or vertically expanding interbody prostheses while providing immediate vertebral height restoration, restoration of anatomic alignment, and excellent early-term clinical results. PMID:27729817

  15. Sex determination by discriminant function analysis of lumbar vertebrae.

    Science.gov (United States)

    Ostrofsky, Kelly R; Churchill, Steven E

    2015-01-01

    Sex determination is critical for developing the biological profile of unidentified skeletal remains. When more commonly used elements (os coxa, cranium) for sexing are not available, methods utilizing other skeletal elements are needed. This study aims to assess the degree of sexual dimorphism of the lumbar vertebrae and develop discriminant functions for sex determination from them, using a sample of South African blacks from the Raymond A. Dart Collection (47 males, 51 females). Eleven variables at each lumbar level were subjected to univariate and multivariate discriminant function analyses. Univariate equations produced classification rates ranging from 57.7% to 83.5%, with the highest accuracies associated with dimensions of the vertebral body. Multivariate stepwise analysis generated classification rates ranging from 75.9% to 88.7%. These results are comparable to other methods for sexing the skeleton and indicate that measures of the lumbar vertebrae can be used as an effective tool for sex determination.

  16. Morphology and function of the lumbar spine of the Kebara 2 Neandertal.

    Science.gov (United States)

    Been, Ella; Peleg, Smadar; Marom, Assaf; Barash, Alon

    2010-08-01

    The morphology of the lumbar spine is crucial for upright posture and bipedal walking in hominids. The excellent preservation of the lumbar spine of Kebara 2 provides us a rare opportunity to observe a complete spine and explore its functionally relevant morphology. The lumbar spine of Kebara 2 is analyzed and compared with the lumbar spines of modern humans and late Pleistocene hominids. Although no size differences between the vertebral bodies and pedicles of Kebara 2 and modern humans are found, significant differences in the size and orientation of the transverse processes (L(1)-L(4)), and the laminae (L(5), S(1)) are demonstrated. The similarity in the size of the vertebral bodies and pedicles of Kebara 2 and modern humans suggests similarity in axial load transmission along the lumbar spine. The laterally projected (L(2)-L(4)) and the cranially oriented (L(1), L(3)) transverse processes of Kebara 2 show an advantage for lateral flexion of the lumbar spine compared with modern humans. The characteristic morphology of the lumbar spine of Kebara 2 might be related to the wide span of its pelvic bones.

  17. 腰椎间盘突出症术后康复治疗%Postoperative rehabilitation treatment of patients with prolapse of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background:Now,transcutaneous lumbar removal of vertebral disc,a kind of effective treatments for prolapse of lumbar intervertebral disc is widely used in clinic .Postoperative rehabilitation training has been recepted in clinic. Objective:In order to strengthen stability of spine,oppression and stimulation for nerve root were removed. Unit:General Hospital of Shenyang Military Region.

  18. Lumbar corsets can decrease lumbar motion in golf swing

    National Research Council Canada - National Science Library

    Hashimoto, Koji; Miyamoto, Kei; Yanagawa, Takashi; Hattori, Ryo; Aoki, Takaaki; Matsuoka, Toshio; Ohno, Takatoshi; Shimizu, Katsuji

    2013-01-01

    Swinging a golf club includes the rotation and extension of the lumbar spine. Golf-related low back pain has been associated with degeneration of the lumbar facet and intervertebral discs, and with spondylolysis...

  19. Incidência Pélvica: um parâmetro fundamental para definição do equilíbrio sagital da coluna vertebral Incidência pélvica: un parámetro fundamental para definir el equilibrio sagital de la columna Pelvic incidence: a fundamental parameter for defining the sagittal balance of the spine

    Directory of Open Access Journals (Sweden)

    Sérgio Afonso Henneman

    2012-09-01

    Full Text Available Este trabalho propõe um parâmetro anatômico, a incidência pélvica, como fator chave para a compreensão do alinhamento da coluna vertebral. Existe estreita relação, tanto para indivíduos normais como para indivíduos com deformidades da coluna, entre o parâmetro anatômico de incidência pélvica e a inclinação sacral, determinantes da lordose lombar. O ângulo de Cobb e a rotação vertebral apical servem de instrumento para o entendimento do aspecto tridimensional da coluna vertebral e das relações entre a pelve e a coluna. Uma equação preditiva para lordose é apresentada. A incidência pélvica parece ser o fator determinante do equilíbrio sagital da coluna. Ela determina as curvas da coluna vertebral, variando conforme outros parâmetros.En este trabajo se propone un parámetro anatómico, la incidencia de la pelvis, como el factor clave para entender la alineación de la columna vertebral. Hay estrecha relación, tanto para el normal y para las personas con deformidades de la columna entre el parámetro anatómico de la incidencia de la pelvis y la inclinación del sacro, determinantes de la lordosis lumbar. El ángulo de Cobb y la rotación vertebral apical sirven como una herramienta para entender el aspecto tridimensional de la columna vertebral y de su relación con la pelvis. Se presenta una ecuación de predicción para la lordosis. La incidencia pélvica parece ser el factor determinante del equilibrio sagital de la columna. Dicha ecuación determina las curvas de la columna y varía según otros parámetros.This paper proposes an anatomical parameter, the pelvic incidence, as the key factor for managing the spinal balance. There is a close relationship for both normal individuals and those with spinal deformities between the anatomical parameter of pelvic incidence and the sacral slope, which determine lumbar lordosis. The Cobb angle and the apical vertebral rotation serve as a tool for understanding the three

  20. Grynfelt lumbar hernias. Presentation of a congenital case. Hernias lumbares de Grynfelt. Presentación de un caso de origen congénito

    Directory of Open Access Journals (Sweden)

    Sergio Elías Molina Lamothe

    2006-04-01

    Full Text Available Lumbar hernias are uncommon and are reported rarely, they are informed only few more than 300 in literature and of them only 10 cases are congenital. The hernias that are produced through the superior lumbar space or Grynfelt-Lesshalf´s hernia, are due to the fact that they are more constant and larger they are usually more frequent than the Petit triangle. We are reporting a Newborn infant with the diagnosis of bilateral lumbar hernias and malformation of the vertebral column.
    Las hernias lumbares son sumamente raras, y se reportan en muy pocas ocasiones. Solo se informan poco más de 300 casos en la literatura, y de ellas solo existen 10 casos que se han presentado de forma congénita, según reportes. Las hernias que se producen a través del espacio lumbar superior o de Grynfelt-Lesshaft por ser de más constantes y de mayor tamaño suelen aparecer con más frecuencia que las que se producen a través del triángulo de Petit. Se reporta un recién nacido con diagnóstico de hernias lumbares bilaterales y malformación de la columna vertebral.

  1. SACRALISATION OF LUMBAR VERTEBRAE

    Directory of Open Access Journals (Sweden)

    Sangeeta Wazir

    2014-06-01

    Full Text Available Background: Lumbar backache is a very common problem nowadays. Sacralisation of lumbar vertebrae is one of the cause for that. During routine osteology teaching a sacrum with incomplete attached lumbar 5 vertebrae is seen. Observation: Incompletely fused L 5 vertebrae with sacrum is seen. The bodies of the vertebrae are fused but the transverse process of left side is completely fused with the ala of sacrum.But on the right side is incompletely fused. Conclusion: The person is usually asymptomatic or may present with symptoms which include spinal or radicular pain, disc degeneration, L4/L5 disc prolapse, lumbar scoliosis and lumbar extradural defects. In transitional lumbosacral segmentation, it was observed that the lumbosacral intervertebral disc is significantly narrowed. The incidence of disc herniation is found to be higher and can occur even at young ages. There was also relationship established between transitional vertebrae and the degree of slippage in spondylolytic spondylolisthesis. In addition, this anomaly has known implications in the field of disc surgery.

  2. CT of adult lumbar disc herniations mimicking posterior apophyseal ring fractures

    Energy Technology Data Exchange (ETDEWEB)

    Gomori, J.M. (Hadassah Univ. Hospital, Jerusalem (Israel). Dept. of Radiology); Floman, Y.; Liebergall, M. (Hadassah Univ. Hospital, Jerusalem (Israel). Dept. of Orthopedics)

    1991-10-01

    This report concerns 35 adult patients with lumbar or sciatic pain and axial CT findings reportedly associated with posterior apophyseal ring fractures. Review of the CT images suggested two pathophysiologic categories. (1) Posterior Schmorl - A posterior intravertebral disc herniation with posterior displacement of a fractured or remodelled vertebral margin. (2) Calcified subligamentous - Reactive annular and or posterior longitudinal ligament calcification at the periphery of a herniated disc with or without remodelling and anterior displacement of the posterior vertebral margin. (orig.).

  3. Effects of sagittal endplate shape on lumbar segmental mobility as evaluated by kinetic magnetic resonance imaging.

    Science.gov (United States)

    Li, Yawei; Lord, Elizabeth; Cohen, Yermie; Ruangchainikom, Monchai; Wang, Bing; Lv, Guohua; Wang, Jeffrey C

    2014-08-01

    Retrospective analysis using kinetic magnetic resonance imaging. To investigate relationships between vertebral endplate remodeling, Modic changes, disc degeneration, and lumbar segmental mobility. Previous studies have shown that disc degeneration and vertebral endplate Modic changes are associated with differences in spinal motion, however, the effects of vertebral endplate morphology on lumbar segmental motion have not been fully investigated. A total of 420 patients underwent kinetic magnetic resonance imaging of 2100 lumbar motion segments. Sagittal endplate shapes (concave, flat, irregular), Modic changes (types, 0-3), and disc degeneration (grade, I-V) were assessed along with translational and angular motion of vertebral segments in flexion, extension, and neutral positions. The most common findings were concave endplate shape (63.24%), type 2 Modic change (71.79%), and grade II disc degeneration (40.33%). Flat, irregular endplates were more common at L1-L2, L4-L5, and L5-S1 than L2-L3 and L3-L4. Types 1, 2, and 3 Modic changes increased in frequency according to endplate shape: concave less than flat less than irregular. Type 0 was observed to decrease with the change of endplate shape from flat to concave to irregular. Vertebral levels with irregular endplates had more disc generation than those with flat; levels with flat endplates had significantly more disc degeneration than those with concave. Translational motion of the lumbar segment was greatest at levels with irregular endplates and decreased at those with flat and then concaves endplates. Angular motion was least at levels with irregular endplates and increased at levels with flat, then concave endplates. The degree of pathogenic lumbar segmental motion is associated with remodeling of the sagittal endplate. Endplate remodeling may occur as an adaptation to restrain abnormal movement of the lumbar segment. N/A.

  4. Incarcerated inferior lumbar (Petit's) hernia.

    Science.gov (United States)

    Astarcioğlu, H; Sökmen, S; Atila, K; Karademir, S

    2003-09-01

    Petit's hernia is an uncommon abdominal wall defect in the inferior lumbar triangle. Colonic incarceration through the inferior lumbar triangle, which causes mechanical obstructive symptoms, necessitates particular diagnostic and management strategy. We present a rare case of inferior lumbar hernia, leading to mechanical bowel obstruction, successfully treated with prosthetic mesh reinforcement repair.

  5. Sympathetic radiofrequency neurolysis for unilateral lumbar hyperhidrosis: a case report.

    Science.gov (United States)

    Aşik, Züleyha Soytürk; Orbey, Başak Ceyda; Aşik, Ibrahim

    2008-07-01

    Patients with hyperhidrosis suffer from physical, social and mental discomfort which often cannot be treated sufficiently using conservative measures. A new percutaneous approach to sympathectomy using radiofrequency denervation has seemed to offer longer duration of action and less incidence of post sympathetic neuralgia. This article reports the authors' experience with sympathetic RF neurolysis in a 35 year old male with right unilateral lumbar hyperhidrosis. Under scopy guided localization of the lumbar spine sympathetic blockade with local anesthetics to L2-5 vertebral levels were performed as a diagnostic block. Lesion effectiveness is monitored by bilateral feet skin temperature measurement. Clinical effects produced by the first sympathetic ganglion block were sustained for 1 week and then RF neurolysis of lumbar sympathetic ganglion was performed to the same levels for a longer effect. The procedure was accomplished within 30 minutes and the patient was discharged within 2 hours after the procedure. Hyperhidrosis was relieved after the procedure and there were no postsympathectomy neuralgia and sexual dysfunction. The patient obtained improvement of lumbar hyperhidrosis at his first month of follow- up and was satisfied with the outcome. In conclusion, RF neurolysis of lumbar sympathetic ganglions is a safe and effective palliative procedure with minimal invasiveness for relieving excessive sweat secretion in patients with localized hyperhidrosis.

  6. Characterization of radiographic features of consecutive lumbar spondylolisthesis

    Science.gov (United States)

    Sun, Yapeng; Wang, Hui; Yang, Dalong; Zhang, Nan; Yang, Sidong; Zhang, Wei; Ding, Wenyuan

    2016-01-01

    Abstract Radiographic features of consecutive lumbar spondylolisthesis were retrospectively analyzed in a total of 17 patients treated for this condition at the Third Hospital of Hebei Medical University from June 2005 to March 2012. To investigate the radiographic features, pelvic compensatory mechanisms, and possible underlying etiologies of consecutive lumbar spondylolisthesis. To the best of our knowledge, there is no previous report concerning the characteristics of consecutive lumbar spondylolisthesis. The Taillard index and the lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), and pelvic tilt (PT) were determined on lateral X-ray images, and the angular displacement was analyzed on flexion–extension X-ray images. Correlation between LL and various pelvic parameters and correlation between Taillard index and angular displacement were assessed by Pearson correlation analysis. A total of 20 cases of isthmic spondylolisthesis and 14 of degenerative spondylolisthesis were retrospectively studied in 17 patients. The Taillard index and the angular displacement in the lower vertebrae were both larger than those in the upper vertebrae. Statistical analysis revealed that LL was correlated with PI and PT, whereas PI was correlated with PT and SS. However, no correlation was identified between Taillard index and angular displacement. In consecutive lumbar spondylolisthesis, the degree of vertebral slip and the angular displacement of the lower vertebrae were both greater than those of the upper vertebrae, indicating that the compensatory mechanism of the pelvis plays an important role in maintaining sagittal balance. PMID:27861359

  7. LUMBAR SPINAL STENOSIS. A REVIEW OF BIOMECHANICAL STUDIES

    Institute of Scientific and Technical Information of China (English)

    戴力扬; 徐印坎

    1998-01-01

    ObjectS. To investigate the biomechanical aspects of etiology, pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods. A series of biomechanical methods, such as three-dimensional finite element models, threedimensional kinematic measurement, cadeveric evaluation, and imaging assessment was applied to correlate lumbar biomechanics and lumber spinal stenosls. Surgery of lumber spinal stenosis has been improved. Results.The stresses significantly concentrate on the posterolateral part of the annulus fibrcsms of disc, the posterior surface of vertebral body, the pedlcle, the interarticularis and the beet joints. This trend is intensified by disc degeneration and lumber backward extension. Posterior elcxnent resection has a definite effect upon the biomechanical behavior of lumbar vertebrae. The improved operations proved satisfactory. Conclusion. Stress concentration in the lumber vertebrae is of importance to the etiology of degenerative lumbar spinal stenosls, and disc degeneratkm is the initial key of this process. Than these will be aggravatnd by backward extension. Functloval radiography and myelography are of assistance to the diagnosis of the lumhar spinal stenosls. For the surgcal treatment of the lumber spinal stenosis, destruction of the posterior element should be avoid as far as possible based upon the thorough decmnpression. Maintaining the lumbar spine in flexion by fusion after decorapression has been proved a useftd method. When developmental spinal stenoals is combined with disc herniation, discectoray through laminotomy is recommend for decompression.

  8. Quantitative CT observation of lumbar vertebrate bone mineral density and the related factors in patients with type 2 diabetes mellitus%CT定量分析2型糖尿病患者腰椎骨密度及其相关因素

    Institute of Scientific and Technical Information of China (English)

    路志凯; 李健丁; 王冠民; 张士峰; 刘国玉; 肖军

    2011-01-01

    目的 探讨2型糖尿病(T2DM)患者腰椎骨密度(BMD)及其相关因素.方法对127例50~82岁T2DM患者及89名50~83岁的健康体检者(对照组)的L1~3椎体行BMD定量CT(QCT)测定.按年龄和病程分组对两组腰椎BMD及骨质疏松(OP)患病率进行比较,并将腰椎BMD与年龄、病程、体质量指数(BMI)、女性绝经年龄和绝经年限行相关性分析.结果①T2DM患者腰椎BMD及OP患病率与对照组间差异均无统计学意义(P>0.05)②男性T2DM不同病程腰椎BMD差异无统计学意义(P>0.05),女性病程10年以上者L2椎体BMD显著低于5年以下者,差异有统计学意义(P<0.05).③T2DM患者腰椎BMD与年龄呈显著负相关,与BMI呈显著正相关;将年龄作为控制因子,T2DM患者腰椎BMD与病程无相关.④将年龄作为控制因子,女性T2DM患者腰椎BMD与绝经年限呈显著性偏相关(r=-0.216,P<0.05),与绝经年龄无相关.结论①T2DM患者腰椎BMD和OP患病率均与正常人基本相似.②随着年龄增长、BMI的减低,T2DM患者腰椎BMD呈下降趋势.③随着绝经年限的延长,女性T2DM患者腰椎BMD呈下降趋势.%Objective To investigate the changes of lumar vertebrate bone mineral density (BMD) and related factors in patients with type 2 diabetes mellitus (T2DM).Methods Quantitative CT (QCT) was used to measure BMD of lumbar spine in 127 patients with T2DM aged 50-82 years (T2DM group) and 89 healthy subjects aged 50-83 years (control group).BMD of lumbar spine and prevalence rate of osteporosis (OP) with T2DM was compared with normal subjects.The correlation of BMD in T2DM with age, diabetic duration, BMI, menopausal age, and duration after menopausal were analyzed.Results ① BMD of L1-3 and the prevalence rate of OP in the T2DM group were similar to those in the control group (P>0.05).② BMD of lumar spine in the male T2DM were similar in every diabetic duration group (P>0.05).BMD of L2 in the female T2DM diabetic duration more than 10

  9. Testing Skills in Vertebrates

    Science.gov (United States)

    Funk, Mildred Sears; Tosto, Pat

    2007-01-01

    In this article, the authors present a project that gives students examples of basic skills that many vertebrate species develop as they grow and function in their ecosystem. These activities involve information gathering about surroundings, learning how to use objects, and tracking and searching skills. Different vertebrate species may acquire…

  10. Testing Skills in Vertebrates

    Science.gov (United States)

    Funk, Mildred Sears; Tosto, Pat

    2007-01-01

    In this article, the authors present a project that gives students examples of basic skills that many vertebrate species develop as they grow and function in their ecosystem. These activities involve information gathering about surroundings, learning how to use objects, and tracking and searching skills. Different vertebrate species may acquire…

  11. Software-assisted morphometry and volumetry of the lumbar spine.

    Science.gov (United States)

    Narloch, Jerzy; Glinkowski, Wojciech

    2016-01-01

    The aim of the study was to measure volumes of the lumbar vertebral bodies with use dedicated Computed Tomography (CT) workstation software to predict expected volume of PMMA for vertebroplasty and supplement calculations using computed tomography scanogram. Quantitative CT scans of 87 women's (mean age 69.4 years; SD 10.9) and 15 men's (mean age 64.3 years; SD 11.8) lumbar spines were analyzed; this made a total of 379 vertebrae. The population of patients was divided into three groups depending on measured BMD value, in accordance with American College of Radiology Practice Parameter for the Performance of Quantitative Computed Tomography (QCT) Bone Densitometry. With the use of the general linear model and least squares means groups were compared regarding vertebral volume, anterior, middle, and posterior vertebral heights. Morphometric parameters tended to be greater in males than in females, in a population of diversified bone mineral density. BMD result should be considered as the modifying factor for preoperative planning of the bone cement volume to be deposited inside the vertebra. Vertebral body volumetry might prove to be a useful tool in pre-operative planning as well as an alternative for treatment monitoring after minimally invasive spinal procedures.

  12. Is it possible to preserve lumbar lordosis after hybrid stabilization? Preliminary results of a novel rigid-dynamic stabilization system in degenerative lumbar pathologies.

    Science.gov (United States)

    Formica, Matteo; Cavagnaro, Luca; Basso, Marco; Zanirato, Andrea; Felli, Lamberto; Formica, Carlo

    2015-11-01

    To evaluate the results of a novel rigid-dynamic stabilization technique in lumbar degenerative segment diseases (DSD), expressly pointing out the preservation of postoperative lumbar lordosis (LL). Forty-one patients with one level lumbar DSD and initial disc degeneration at the adjacent level were treated. Circumferential lumbar arthrodesis and posterior hybrid instrumentation were performed to preserve an initial disc degeneration above the segment that has to be fused. Clinical and spino-pelvic parameters were evaluated pre- and postoperatively. At 2-year follow-up, a significant improvement of clinical outcomes was reported. No statistically significant difference was noted between postoperative and 2-year follow-up in LL and in disc/vertebral body height ratio at the upper adjacent fusion level. When properly selected, this technique leads to good results. A proper LL should be achieved after any hybrid stabilization to preserve the segment above the fusion.

  13. Modular evolution of the Cetacean vertebral column.

    Science.gov (United States)

    Buchholtz, Emily A

    2007-01-01

    Modular theory predicts that hierarchical developmental processes generate hierarchical phenotypic units that are capable of independent modification. The vertebral column is an overtly modular structure, and its rapid phenotypic transformation in cetacean evolution provides a case study for modularity. Terrestrial mammals have five morphologically discrete vertebral series that are now known to be coincident with Hox gene expression patterns. Here, I present the hypothesis that in living Carnivora and Artiodactyla, and by inference in the terrestrial ancestors of whales, the series are themselves components of larger precaudal and caudal modular units. Column morphology in a series of fossil and living whales is used to predict the type and sequence of developmental changes responsible for modification of that ancestral pattern. Developmental innovations inferred include independent meristic additions to the precaudal column in basal archaeocetes and basilosaurids, stepwise homeotic reduction of the sacral series in protocetids, and dissociation of the caudal series into anterior tail and fluke subunits in basilosaurids. The most dramatic change was the novel association of lumbar and anterior caudal vertebrae in a module that crosses the precaudal/caudal boundary. This large unit is defined by shared patterns of vertebral morphology, count, and size in all living whales (Neoceti).

  14. Manejo del síndrome doloroso lumbar Management of lumbar syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Rivas Hernández

    2010-03-01

    Full Text Available Se realizó una revisión bibliográfica del síndrome doloroso lumbar y se seleccionaron los artículos relacionados con este síndrome publicados desde 1991 hasta 2009. Se hizo hincapié en la búsqueda de guías para el manejo del dolor lumbar en la práctica clínica, y sus criterios fueron revisados por el equipo de especialistas en Ortopedia y Traumatología del Servicio de columna vertebral del Hospital Ortopédico Docente "Fructuoso Rodríguez" y adaptados a las condiciones del Sistema Nacional de Salud cubano.A bibliographic review on painful syndrome was made selecting the articles published from 1991 to 2009 related to this syndrome. Authors emphasize in the search of guides for management of lumbar pain in the clinical practice, whose criteria were analyzed by the team Orthopedics and Traumatology team of the spinal column service from the "Fructuoso Rodríguez" Hospital and adjusted to conditions of the Cuban Health System.

  15. Lumbar hernia: a diagnostic dilemma.

    Science.gov (United States)

    Ahmed, Syed Tausif; Ranjan, Rajeeva; Saha, Subhendu Bikas; Singh, Balbodh

    2014-04-15

    Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Hence the diagnosis can be easily missed. This leads to delay in the treatment causing increased morbidity. We report a case of lumbar hernia in a middle-aged woman. It was misdiagnosed as lipoma by another surgeon. It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Clinical and MRI findings were correlated to reach the diagnosis. We also highlight the types, the process of diagnosis and the surgical repair of lumbar hernias. We wish to alert our fellow surgeons to keep the differential diagnosis of the lumbar hernia in mind before diagnosing any lumbar swelling as lipoma.

  16. Epidurography in lumbar spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, J.G.; Hauge, O.

    1982-04-01

    Seventeen patients with lytic lumbar spondylolisthesis (Meyerding grade I-II) and radicular symptoms were examined by epidurography in addition to radiculomyelography before surgical treatment. Epidurography is considered more suitble than radiculomyelogrphy for assessing this condition because narrowing of the epidural space and compression of the nerve roots, due to osteofibrous changes at the lysis, are more consistently demonstrated.

  17. Variant lumbar pedicle

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, M.A.; Feldman, F.

    1982-01-01

    Three cases of aplastic and/or hypoplastic lumbar pedicle are presented and discussed. The importance of plain films, especially the 45/sup 0/ posterior oblique, for making the diagnosis is emphasized. The incidence and embryology of abnormalities of the pedicle are reviewed and the radiological features used to differentiate these congenital abnormalities from neoplasm and trauma are described.

  18. Increase in vertebral body size in postmenopausal women with osteoporosis.

    Science.gov (United States)

    Briot, K; Kolta, S; Fechtenbaum, J; Said-Nahal, R; Benhamou, C L; Roux, C

    2010-08-01

    Bone geometry plays a prominent role in bone strength. Cross-sectional studies have shown that advancing age is associated with increasing diameter of long bones, related to both periostal apposition and endosteal resorption. However, there are few data provided by prospective studies, especially concerning the changes in vertebral body dimensions. The objective of this prospective study was to measure the changes occurring in the vertebral body size of women with postmenopausal osteoporosis. Three-year data from placebo groups of the SOTI and TROPOS trials, performed in women with postmenopausal osteoporosis, were used for this study. In these trials, patients underwent lateral radiographs of the thoracic and lumbar spine at baseline and annually over 3 years, according to standardized procedures. Six-point digitization method was used: the four corner points of the vertebral body from T4 to L4 are marked, as well as an additional point in the middle of the upper and lower endplates. From these 6 points, the vertebral body perimeter, area and depth were measured at baseline and at 3 years. The analysis excluded all vertebrae with prevalent or incident fracture. A total of 2017 postmenopausal women (mean age 73.4+/-6.1 years) with a mean lumbar spine T score of -3.1+/-1.5, and a mean femoral neck T score of -3.0+/-0.7 are included in the analysis. Vertebral body dimensions increased over 3 years, by 2.1+/-5.5% (mean depth+/-SD), by 1.7+/-8.3% (mean area+/-SD) and by 1.5+/-4.9% (mean perimeter+/-SD) at the thoracic level (T4 to T12). At the lumbar level (L1 to L4), these dimensions increased as well: 1.4+/-3.6% (mean depth+/-SD), 1.4+/-5.7% (mean area+/-SD), 0.7+/-2.9% (mean perimeter+/-SD). A significant increase in vertebral body size was observed for each vertebral level from T5 to L4 for each of these parameters (p<0.01). These prospective results demonstrate that vertebral body dimensions increase over 3 years in women with postmenopausal osteoporosis

  19. Dimensions of the lumbar spinal canal: variations and correlations with somatometric parameters using CT

    Energy Technology Data Exchange (ETDEWEB)

    Karantanas, A.H. [Department of CT-MRI, Larissa General Hospital (Greece); Zibis, A.H.; Papaliaga, M.; Georgiou, E.; Rousogiannis, S. [Larissa Medical School, University of Thessaly, Larissa (Greece)

    1998-12-01

    The aim of this study was to investigate the correlation of vertebral dimensions with somatometric parameters in patients without clinical symptoms and radiological signs of central lumbar spinal stenosis. One hundred patients presenting with low back pain or sciatica were studied with CT. In each of the L3, L4 and L5 vertebra three slices were taken with the following measurements: 1. Slice through the intervertebral disc: (a) spinal canal area; (b) interarticular diameter; (c) interligamentous diameter. 2. Slice below the vertebral arcus: (a) dural sac area; (b) vertebral body area. 3. Pediculolaminar level: (a) anteroposterior diameter and interpedicular diameter of the spinal canal; (b) spinal canal area; (c) width of the lateral recesses. The Jones-Thomson index was also estimated. The results of the present study showed that there is a statistically significant correlation of height, weight and age with various vertebral indices. The conventional, widely accepted, anteroposterior diameter of 11.5 mm of the lumbar spinal canal is independent of somatometric parameters, and it is the only constant measurement for the estimation of lumbar spinal stenosis with a single value. The present study suggests that there are variations of the dimensions of the lumbar spinal canal and correlations with height, weight and age of the patient. (orig.) With 1 fig., 6 tabs., 24 refs.

  20. Nonlinear finite-element analysis and biomechanical evaluation of the lumbar spine

    DEFF Research Database (Denmark)

    Wong, Christian; Gehrchen, P Martin; Darvann, Tron;

    2003-01-01

    A finite-element analysis (FEA) model of an intact lumbar disc-body unit was generated. The vertebral body of the FEA model consisted of a solid tetrahedral core of trabecular bone surrounded by a cortical shell. The disc consisted of an incompressible nucleus surrounded by nonlinear annulus fibers...

  1. Dual-energy X-ray absorptiometry assessment of postmenopausal women with vertebral fragility fracture and its relationship with serum bone turnover and bone metabolism indexes

    Institute of Scientific and Technical Information of China (English)

    Wei Li

    2016-01-01

    Objective:To study the relationship between dual-energy X-ray bone mass density measurement results of postmenopausal women with vertebral fragility fracture and the serum bone turnover as well as bone metabolism indexes.Methods:A total of 158 postmenopausal women who received DXA tests in our hospital between April 2012 and December 2015 were selected, were divided into osteoporosis group, osteopenia group and normal bone mass group according to the bone mineral density measurement results, and were divided into no vertebral fracture group, thoracic vertebral fracture group, lumbar vertebral fracture group and thoracolumbar vertebral fracture group according to the thoracolumbar vertebral anterioposterior and lateral film results, and serum was collected to determine bone turnover and bone metabolism indexes.Results: Femoral neck, hip and lumbar vertebra L1-4 bone mineral density of subjects with thoracic vertebral fracture and thoracolumbar vertebral fracture were significantly lower than those of the subjects without vertebral fracture, and femoral neck, hip and lumbar vertebra L1-4 bone mineral density of subjects with lumbar vertebral fracture were not significantly different from those of the subjects without vertebral fracture; serum PINP, ICTP, CTX, TRACP-5b, MMP13, OPG and OPN content of osteoporosis group and osteopenia group were significantly higher than those of normal bone mass group while 25(OH)D, BGP and ON content were significantly lower than those of normal bone mass group; serum PINP, ICTP, CTX, TRACP-5b, MMP13, OPG and OPN content of osteoporosis group were significantly higher than those of osteopenia group while 25(OH)D, BGP and ON content were significantly lower than those of osteopenia group.Conclusions: Dual-energy X-ray bone densitometry has clear prediction value for postmenopausal women with thoracic vertebral fragility fracture and thoracolumbar vertebral fragility fracture, and is closely related to the changes of bone turnover and

  2. An analysis of vertebral axial rotation in adolescent idiopathic scoliosis based on EOSTM%基于 EOSTM 的青少年特发性脊柱侧凸椎体轴面旋转分析

    Institute of Scientific and Technical Information of China (English)

    秦乐; 严福华; 杜联军; 师小凤

    2016-01-01

    . According to the location of the major curve, coronal Cobb’s angle, axial rotation parameters including apical vertebral rotation, superior end vertebral rotation, inferior end vertebral rotation, superior end interverbral rotation, inferior end interverbral rotation, sagittal T4-12 kyphosis and pelvic parameters involving pelvic incidence and sagittal pelvic tilt were taken. Relations between different axial rotation parameters and Cobb’s angle or pelvic parameters were evaluated by Pearson correlation analysis. The correlation was investigated between apical vertebral rotation of major thoracic, thoracolumbar and lumbar curve, and sagittal thoracic kyphosis, respectively.Results Strong and signiifcant correlations were observed between apical vertebral rotation and Cobb’s angle (r = 0.792,P < 0.001 ). Slight and moderate correlations existed between axial rotation including superior end vertebral rotation, inferior end vertebral rotation, superior end interverbral rotation, inferior end interverbral rotation and Cobb’s angle, respectively (r = 0.419,P= 0.003;r = 0.320,P= 0.025;r = 0.366,P< 0.01;r = 0.345,P= 0.015 ). Except for the slight correlation between apical vertebral rotation and pelvic tilt (r = 0.330,P< 0.021), no signiifcant correlations were found between axial vertebral rotation and pelvic parameters. There were also no significant correlations between apical vertebral rotation of different major curves and T4-12 kyphosis.Conclusions Axial vertebral rotation is closely related to the spinal coronal Cobb’s angle. However, relations are failed to be found between the axial vertebral rotation and thoracic kyphosis or pelvic deformity.

  3. FIFTH LUMBAR VERTEBRA ASSOCIATED WITH ABSENCE OF SPINOUS PROCESS, LAMINAE AND INFERIOR ARTICULAR PROCESSES. – CASE REPORT

    Directory of Open Access Journals (Sweden)

    Prathap Kumar

    2013-09-01

    Full Text Available Background: The vertebral disorders are the ones which lead to disability and lot of health problems. Since the lumbar part of the vertebral column is the main weight bearing and weight transmitting region, if there is a defective development, the area for muscle attachment and the strong bony structure for the transmission of weight would be missing leading to instability at an early age. In the present case dry and processed fifth lumbar vertebra, of unknown sex which presented the features with absence of spinous process, laminae and the inferior articular processes on both sides which were obtained for teaching the medical undergraduate students in M.S.Ramaiah Medical College, Bangalore. There was absence of spinous process, laminae and the inferior articular processes of fifth lumbar vertebra leading to a wide spina bifida with absence of laminae, inferior articular processes on both sides and spinous process of fifth lumbar vertebra which could be a developmental anomaly.

  4. Prevalent morphometric vertebral fractures in professional male rugby players.

    Directory of Open Access Journals (Sweden)

    Karen Hind

    Full Text Available There is an ongoing concern about the risk of injury to the spine in professional rugby players. The objective of this study was to investigate the prevalence of vertebral fracture using vertebral fracture assessment (VFA dual energy X-ray absorptiometry (DXA imaging in professional male rugby players. Ninety five professional rugby league (n = 52 and union (n = 43 players (n = 95; age 25.9 (SD 4.3 years; BMI: 29.5 (SD 2.9 kg.m2 participated in the research. Each participant received one VFA, and one total body and lumbar spine DXA scan (GE Lunar iDXA. One hundred and twenty vertebral fractures were identified in over half of the sample by VFA. Seventy four were graded mild (grade 1, 40 moderate (grade 2 and 6 severe (grade 3. Multiple vertebral fractures (≥2 were found in 37 players (39%. There were no differences in prevalence between codes, or between forwards and backs (both 1.2 v 1.4; p>0.05. The most common sites of fracture were T8 (n = 23, T9 (n = 18 and T10 (n = 21. The mean (SD lumbar spine bone mineral density Z-score was 2.7 (1.3 indicating high player bone mass in comparison with age- and sex-matched norms. We observed a high number of vertebral fractures using DXA VFA in professional rugby players of both codes. The incidence, aetiology and consequences of vertebral fractures in professional rugby players are unclear, and warrant timely, prospective investigation.

  5. Prevalence of osteoporosis and vertebral fractures and related factors in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    Mehmet Ali Ulu; (I)brahim Batmaz; Banu Dilek; Remzi (C)evik

    2014-01-01

    Background Osteoporosis and vertebral factures are well recognized features in patients with ankylosing spondylitis (AS).The aim of this study was to investigate the prevalence and risk factors of osteoporosis and vertebral fractures in patients with AS.Methods Fifty-nine AS patients and 40 healthy controls were enrolled.Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DEXA) at posterior-anterior (PA) lumbar,lateral lumbar and hip regions.Thoracic and lumbar X-rays were obtained for morphometric measurements.Clinical,biological and radiological statuses were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),Bath Ankylosing Spondylitis Metrology Index (BASMI),Bath Ankylosing Spondylitis Functional Index (BASFI),Bath Ankylosing Spondylitis Radiology Index-total (BASRI-t),erythrocyte sedimentation rate (ESR) and the C-reactive protein levels.Results Osteoporosis was present in 32% of patients and 5% of controls according to lateral vertebral BMD measurements.Fracture was present in 31% of patients.The effect of some clinical and laboratory parameters on BMD status and vertebral fractures was analyzed in the patient group.Osteoporosis in lateral lumbar DEXA was associated with higher BASMI,BASFI,BASRI-t scores and ESR level.Low hip BMD was associated with low BMI and high BASFI and BASRI-t scores.Vertebral fractures were associated with advanced age,longer disease duration,longer duration since diagnosis,higher BASMI and BASRI-t scores,higher ESR level,reduced femoral and lateral lumbar BMD.Logistic regression analysis revealed that only BASRI-t score was significantly associated with low lateral spinal BMD and BMI and BASFI score were independently associated with low hip BMD.The presence of compression fractures was independently associated with BASRI-t score and low lateral lumbar BMD.Conclusions Osteoporosis and vertebral fractures in AS seem to be related to the extent of radiological involvement.A low

  6. Identifying osteoporotic vertebral fracture

    OpenAIRE

    Griffith, James F.

    2015-01-01

    Osteoporosis per se is not a harmful disease. It is the sequela of osteoporosis and most particularly the occurrence of osteoporotic fracture that makes osteoporosis a serious medical condition. All of the preventative measures, investigations, treatment and research into osteoporosis have one primary goal and that is to prevent the occurrence of osteoporotic fracture. Vertebral fracture is by far and away the most prevalent osteoporotic fracture. The significance and diagnosis of vertebral f...

  7. [Mechanical studies of lumbar interbody fusion implants].

    Science.gov (United States)

    Bader, R J; Steinhauser, E; Rechl, H; Mittelmeier, W; Bertagnoli, R; Gradinger, R

    2002-05-01

    In addition to autogenous or allogeneic bone grafts, fusion cages composed of metal or plastic are being used increasingly as spacers for interbody fusion of spinal segments. The goal of this study was the mechanical testing of carbon fiber reinforced plastic (CFRP) fusion cages used for anterior lumbar interbody fusion. With a special testing device according to American Society for Testing and Materials (ASTM) standards, the mechanical properties of the implants were determined under four different loading conditions. The implants (UNION cages, Medtronic Sofamor Danek) provide sufficient axial compression, shear, and torsional strength of the implant body. Ultimate axial compression load of the fins is less than the physiological compression loads at the lumbar spine. Therefore by means of an appropriate surgical technique parallel grooves have to be reamed into the endplates of the vertebral bodies according to the fin geometry. Thereby axial compression forces affect the implants body and the fins are protected from damaging loading. Using a supplementary anterior or posterior instrumentation, in vivo failure of the fins as a result of physiological shear and torsional spinal loads is unlikely. Due to specific complications related to autogenous or allogeneic bone grafts, fusion cages made of metal or carbon fiber reinforced plastic are an important alternative implant in interbody fusion.

  8. Automatic lumbar vertebra segmentation from clinical CT for wedge compression fracture diagnosis

    Science.gov (United States)

    Ghosh, Subarna; Alomari, Raja'S.; Chaudhary, Vipin; Dhillon, Gurmeet

    2011-03-01

    Lumbar vertebral fractures vary greatly in types and causes and usually result from severe trauma or pathological conditions such as osteoporosis. Lumbar wedge compression fractures are amongst the most common ones where the vertebra is severely compressed forming a wedge shape and causing pain and pressure on the nerve roots and the spine. Since vertebral segmentation is the first step in any automated diagnosis task, we present a fully automated method for robustly localizing and segmenting the vertebrae for preparation of vertebral fracture diagnosis. Our segmentation method consists of five main steps towards the CAD(Computer-Aided Diagnosis) system: 1) Localization of the intervertebral discs. 2) Localization of the vertebral skeleton. 3) Segmentation of the individual vertebra. 4) Detection of the vertebrae center line and 5) Detection of the vertebrae major boundary points. Our segmentation results are promising with an average error of 1.5mm (modified Hausdorff distance metric) on 50 clinical CT cases i.e. a total of 250 lumbar vertebrae. We also present promising preliminary results for automatic wedge compression fracture diagnosis on 15 cases, 7 of which have one or more vertebral compression fracture, and obtain an accuracy of 97.33%.

  9. Lumbar CT findings of patients with low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Chul; Kim, Yang Soo; Kim, Kyun Sang [Chung-Ang University, Seoul (Korea, Republic of)

    1986-04-15

    Low back pain is probably the second most common disease entity to upper respiratory infection in developed country. We were missing at least 50% of the pathologic conditions by using conventional diagnostic modalities in low back pain. They did tell us nothing or little about facet abnormalities, lateral recesses, vertebral canal and soft tissue surrounding lumbar spines. High resolutional CT has been the biggest turning point in the diagnosis and management of low back pain. CT make a contribution to reducing the morbidity and probably the cost of evaluating patients with low back pain, and to increasing diagnostic accuracy. We observed 100 cases of lumbar CT using TCT 80A scanner for the evaluation of low back pain during the period from Apr. 1985 to Sept. 1985 at Chung-Ang University Hospital. Lumbar CT scan reveals high-positive findings (98%) in low back pain patients. Common low back disorders in CT are disc bulging (53%), herniated nucleus pulposus (32%), degenerative arthritis in posterior facet joints (27%), spinal stenosis (20%) and postoperative spines (15%). Uncommon low back disorders in CT are compression fracture of vertebral bodies, spondylolysis or spondylolisthesis, tropism, transitional vertebra, Scheueman's disease, limbic fracture, transverse process or articular process fracture, sacroiliac joint subluxation, conjoined nerve root and meningocele.

  10. Feasibility of vertebral internal fixation using deer and sheep as animal models

    Institute of Scientific and Technical Information of China (English)

    LIU Guo-min; LI You-qiong; XU Chuan-jie; ZHU Xiao-min; LIU Yi

    2010-01-01

    Backgroud Studies on new vertebral internal fixations of animals are very important prior to clinical application. This study aimed to determine the feasibility of vertebral internal fixation on morphologic and biomechanical properties using deer and sheep as animal models and comparing to human data.Methods Thirty sets of fresh Sika deer lumbar, 30 sets of fresh sheep lumbar, and 20 sets of fresh lumbar from male cadavers were used. We examined the morphology of the centra and pedicles of the three groups, and determined the cancellous bone density and biomechanical properties in all groups.Results There were marked differences in all parameters measured between the different species. The sizes of the upper, middle, and lower transverse diameter were largest in the human, followed by the deer, then the sheep. The index of centrum transverse diameters and sagittal diameters were less than 0.8 (a triangle), and the deer was more similar to the human. The heights of the right vertebral pedicles and the anterior disc heights (IDH) were largest in the human, followed by the deer, then the sheep. The apparent density, elastic modulus, and ultimate load were largest in the sheep, followed by the deer, then the human. The range of motion (ROM) of functional lumbar units (FLUs) with a combined flexion-extension moment was largest in the human, followed by the deer then the sheep. Conclusions The deer lumbar is more similar to that of human in anatomical form and biomechanics than the sheep lumbar. As such, deer is more appropriate as an animal model for use in vertebral internal fixation studies.

  11. Relationships between Severity of Scoliosis and Efficacy of Treatment with Manipulation on Middle-Aged and Elderly Patients with Degenerative Lumbar Scoliosis%推拿治疗中老年退行性腰椎侧凸的疗效及与侧凸程度的关系

    Institute of Scientific and Technical Information of China (English)

    袁仕国; 邹宇聪; 陈超; 张志伟; 李义凯

    2016-01-01

    Objective To investigate the efficacy of degenerative lumbar scoliosis and its relationships with scoliosis derection, Cobb's angle, apical vertebral. Methods The middle-aged and elderly patients with DLS were divided into groups according to scoliosis derection, Cobb's angle, apical vertebral. The gender, age, lumbago time were analyzed. Relationships between location and direction of the apex of curvature, coronal Cobb's angle and VAS, ODI were also analyzed statistically. Results Seventy-six cases were included. The average Cobb's angle was 18.30°±4.11° with 56 cases, 10°~20° group with 56 cases, and >20° group with 20 cases. There were 44 cases with apex of curves on the left side, 32 cases on the right side, 31 cases in superior lumbar and 45 cases in inferior lumbar. The Cobb's angle was not statistically significant (t=1.88, P=0.06), VAS and ODI were decreased after treatment (t=24.64, 19.37, P20°组20例;左侧凸44例,右侧凸32例;顶椎位置中,上腰椎31例,下腰椎45例。治疗前后Cobb角差异均无统计学意义(t=1.88,P=0.06),VAS、ODI治疗后均减小(t=24.64、19.37,P<0.01)。 Cobb角与腰痛时间具有相关性(r=0.52,P<0.01),Cobb角、侧凸方向、顶椎位置与VAS、ODI无明显相关性。结论推拿治疗DLS可缓解疼痛、改善功能,但不能改善Cobb角,侧凸方向、Cobb角、顶椎位置与疗效无关,疼痛时间越长则相应侧凸程度越大。

  12. Lumbar facet syndromes.

    Science.gov (United States)

    Beresford, Zach M; Kendall, Richard W; Willick, Stuart E

    2010-01-01

    Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. The facet joints may account for 15%-40% of low back pain. It can be challenging at times to establish a firm diagnosis of facet pain. Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.

  13. Vertebral osteomyelitis without disc involvement

    Energy Technology Data Exchange (ETDEWEB)

    Kamani, I.; Syed, I.; Saifuddin, A. E-mail: asaifuddin@aol.com; Green, R.; MacSweeney, F

    2004-10-01

    Vertebral osteomyelitis is most commonly due to pyogenic or granulomatous infection and typically results in the combined involvement of the intervertebral disc and adjacent vertebral bodies. Non-infective causes include the related conditions of chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. Occasionally, these conditions may present purely within the vertebral body, resulting in various combinations of vertebral marrow oedema and sclerosis, destructive lesions of the vertebral body and pathological vertebral collapse, thus mimicking neoplastic disease. This review illustrates the imaging features of vertebral osteomyelitis without disc involvement, with emphasis on magnetic resonance imaging (MRI) findings.

  14. Ossification of the vertebral column in human foetuses: histological and computed tomography studies.

    Science.gov (United States)

    Skórzewska, A; Grzymisławska, M; Bruska, M; Lupicka, J; Woźniak, W

    2013-08-01

    There is no agreement in the literature as to the time of the onset and progress of the vertebral column ossification. The aim of the present study was to determine the precise sequence of ossification of the neural arches and vertebral centra.Histological and radiographic studies were performed on 27 human foetuses aged from 9 to 21 weeks. It was found that the ossification of vertebrae commences in foetuses aged 10 and 11 weeks. Ossification centres appear first for neuralarches in the cervical and upper thoracic vertebrae and by the end of 11th week they are present in all thoracic and lumbar neural arches. In the vertebral centrain foetus of 10 weeks ossification was found in the lower 7 thoracic and first lumbar vertebrae. By the end of 11th week ossification is present in the lower 4 cervical, all thoracic, all lumbar and 4 sacral vertebral centra. The study indicates that ossification of the neural arches proceeds in the craniocaudal direction,whereas in the vertebral centra it progresses from the lower thoracic vertebrae into both directions. Different shapes of ossification centres were also described.

  15. Lumbar-sacral dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, M.; Thron, A.

    1984-09-01

    By means of some selected examples, the myelographic and CT characteristics are presentated of different lumbar-sacral dysplasias. The advantage of the different methods of examination (CT, CT myelography and myelography) and the improved presentation of pathological-anatomical details by means of a combination of these methods in the diagnosis of hyperplasia of the filum terminale, diastematomyelia, tethered conus, intracorporal and anterior sacral meningocele have been shown.

  16. Electrodiagnosis of lumbar radiculopathy.

    Science.gov (United States)

    Barr, Karen

    2013-02-01

    The evaluation of patients with suspected lumbar radiculopathy is one of the most common reasons patients are referred for electrodiagnostic testing. The utility of this study depends on the expertise of the physician who plans, performs, and completes the study. This article reviews the strengths and weaknesses of electrodiagnosis to make this diagnosis, as well as the clinical reasoning of appropriate study planning. The current use of electrodiagnostic testing to determine prognosis and treatment outcomes is also discussed.

  17. A Comparative Study of Apical Healing of Open Apices Using MTA and Ca(OH2 Apical Plugs in Cats

    Directory of Open Access Journals (Sweden)

    M. H. Zarrabi

    2005-06-01

    Full Text Available Statement of problem: Endodontic treatment of necrotic teeth with open apices is a challenge. After ruling out surgery as a treatment scheme and introduction of the multivisit apexification which in turn had its disadvantages, apical plug seems to be a suitable substitute treatment plan for such cases. Apical plug makes the treatment through formation of a barrier against the obturating material in a single visit.Purpose: The purpose of this study was to compare histologically the periapical healing using MTA and calcium hydroxide apical plugs after intervals of 4 and 12 weeks in cats.Materials and Methods: In this clinical trial study 64 canines of 16 healthy and mature cats were divided into 3 groups after a periapical lesion formation by over instrumentation in the apical area with files up to no.120. The first group included 24 teeth on which MTA apical plug was applied. The second group included 24 teeth on which Ca (OH 2 apical plug was applied. In both groups the canals were filled with gutta percha and sealer. The third group included 16 control teeth whose canals were left empty after instrumentation and debridement. The access cavities of all teeth were sealed with varnish and amalgam and the vital perfusion of cats was performed in 4 and 12 week intervals. Statistical analysis was established by χ2 and independence test.Results: After 4 weeks, periapical healing in the first group was 90%, in the second group 80% and in the third group, it was only 12.5 %. After 12 weeks, periapical healing occurred in 100% of the MTA group, while it was 57.1% in the second and 40%in the third group .Generally, in the study of histological parameters of healing, no statistical significant difference was observed between the 2 experimental groups,although the MTA group results were much better than the Ca (OH 2 group especially at 12 weeks.Conclusion: The use of MTA apical plug is more effective than Ca (OH 2 in treatment of necrotic teeth with open

  18. 腰椎压缩性骨折后路椎弓根固定3种固定节段方式有限元分析%Finite element analysis for 3 kinds of posterior pedicle fixation to treat lumbar vertebral compression fractures

    Institute of Scientific and Technical Information of China (English)

    李鹏飞; 彭昊

    2014-01-01

    目的 通过有限元分析方法评估腰椎压缩性骨折后路短节段4钉固定、伤椎6钉固定及长节段6钉固定的生物力学.方法 选取1例男性腰2椎体压缩性骨折患者,进行CT扫描,数据输入Mimics软件,构建腰2椎体压缩性骨折的有限元模型,在此模型基础上模拟A组短节段4钉内固定、B组伤椎置6钉、C组长节段6钉固定,在有限元软件中对3组固定模式分别施加垂直压缩、前屈、后伸、侧屈载荷.结果 3组固定模式各种载荷下的应力均集中在螺钉根部,上位螺钉较下位螺钉应力大(P<0.05).在前屈负荷下B组[(0.89 ±0.08) mPa]、C组[(0.80±0.11) mPa]上位螺钉应力较A组[(1.12±0.13) mPa]小(P<0.05).在前屈负荷下腰2上终板上位移结果为0.000 1 mm A组87.00±3.06、B组41.00±5.33、C组13.80±8.20,B、C组较A组小(P<0.05),C组较B组小(P<0.05).结论 伤椎固定及长节段固定可以优化内固定的载荷,减少断钉率,伤椎固定及长节段固定可以减少伤椎的变形,有利于骨折愈合及矫正.%Objective To investigate the biomechanical mechanism of the treatment about lumbar vertebral compression fractures with pedicle screws in injured level,short segment 4-screws and long segment 6-screws by finite element analysis.Methods The ultrathin CT scan data obtained from one male patient with the compression fractures of L2 were put into the Materialise Mimics to reconstruct a compression fracture model of L2.The fracture model was treated respectively with A group pedicle screws in injured level,B group short segment 4-screws and C group long segment 6-screws.Flexion,extension,bending loadings were performed.Results The largest stress was measured in the screw root for three groups.The stress of the superior screw was larger than that of the subordinate screw (P < 0.05).The stress in the A group was larger than that in B and C group (P < 0.05).The deflection of the superior endplate in L2 under flexion

  19. Microtubules, polarity and vertebrate neural tube morphogenesis.

    Science.gov (United States)

    Cearns, Michael D; Escuin, Sarah; Alexandre, Paula; Greene, Nicholas D E; Copp, Andrew J

    2016-07-01

    Microtubules (MTs) are key cellular components, long known to participate in morphogenetic events that shape the developing embryo. However, the links between the cellular functions of MTs, their effects on cell shape and polarity, and their role in large-scale morphogenesis remain poorly understood. Here, these relationships were examined with respect to two strategies for generating the vertebrate neural tube: bending and closure of the mammalian neural plate; and cavitation of the teleost neural rod. The latter process has been compared with 'secondary' neurulation that generates the caudal spinal cord in mammals. MTs align along the apico-basal axis of the mammalian neuroepithelium early in neural tube closure, participating functionally in interkinetic nuclear migration, which indirectly impacts on cell shape. Whether MTs play other functional roles in mammalian neurulation remains unclear. In the zebrafish, MTs are important for defining the neural rod midline prior to its cavitation, both by localizing apical proteins at the tissue midline and by orienting cell division through a mirror-symmetric MT apparatus that helps to further define the medial localization of apical polarity proteins. Par proteins have been implicated in centrosome positioning in neuroepithelia as well as in the control of polarized morphogenetic movements in the neural rod. Understanding of MT functions during early nervous system development has so far been limited, partly by techniques that fail to distinguish 'cause' from 'effect'. Future developments will likely rely on novel ways to selectively impair MT function in order to investigate the roles they play.

  20. Metastatic tumor of thoracic and lumbar spine: prospective study comparing the surgery and radiotherapy vs external immobilization with radiotherapy; Metastases do segmento toracico e lombar da coluna vertebral: estudo prospectivo comparativo entre o tratamento cirurgico e radioterapico com a imobilizacao externa e radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Falavigna, Asdrubal; Ioppi, Ana Elisa Empinotti; Grasselli, Juliana [Universidade de Caxias do Sul, RS (Brazil). Faculdade de Medicina]. E-mail: asdrubal@doctor.com; Righesso Neto, Orlando [Faculdade Federal de Ciencias Medicas da Santa Casa de Sao Paulo, SP (Brazil)

    2007-09-15

    Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)

  1. Posterior pedicle screw fixation and interbody fusion in the treatment of recurrent lumbar disc herniation:an evaluation of vertebral stability%后路钉棒内固定椎间融合治疗复发性腰椎间盘突出症:椎体稳定性评价

    Institute of Scientific and Technical Information of China (English)

    刘凤松; 王凯; 景成伟; 张亮; 刘宾; 杨亚林

    2014-01-01

    BACKGROUND:Discectomy is an important therapy for lumbar disc herniation, but a smal number of patients undergoing discectomy wil relapse. OBJECTIVE:To investigate the spinal stability fol owing posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation. METHODS:Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrol ed and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 12-36 months. After treatment, al patients effectively al eviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation.%背景:腰椎间盘突出症治疗的重要方法是椎间盘切除,但有少部分患者会出现复发现象。  目的:探讨后路椎弓根钉棒内固定联合cage植入椎间融合治疗复发性腰椎间盘突出症后的脊柱稳定性。  方法:选择2007年1月至2011年12月复发性腰椎间盘突出症患者26例,应用后路减压cage植入椎间融合加钉棒系统内固定治疗复发性腰椎间盘突出症进行再手术治疗,观察患者治疗后疼痛症状缓解情况以及腰椎稳定性。通过数据库文献检索的方法分析后路钉棒内固定椎间融合治疗复发性腰椎间盘突出症的椎

  2. Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, Eilish L.; Iemsawatdikul, Kriengkrai; Stephens, Boyd G.; Gooding, Charles A. [Department of Radiology, University of California at San Francisco, 505 Parnassus Avenue, Box 0628, 94143-0628, San Francisco, CA (United States)

    2004-08-01

    We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented. (orig.)

  3. 退变性腰椎侧凸的影像学和临床特点的相关性研究%Correlation Study of Degenerative Lumbar Scoliosis with Radiological and Clinical Features

    Institute of Scientific and Technical Information of China (English)

    唐金平; 刘晓岚; 陈群

    2016-01-01

    Objective To observe radiological and clinical features of degenerative lumbar scoliosis,investigate theircor-relation and close degree,provide theoretical basis for prevention and treatment of degenerative lumbar scoliosis. Methods Ww used multipleline arregression to analyze the degenerative lumbar lateral convex(DLS)lumbocrural pain VAS scores and SRS-22 score and imaging parameters.Results a)Lumbago had significant correlation with the maximum lateral displace-ment、the stability of lumbar spine、foraminal area、lumbar lordosis. Leg pain had significant correlation with foraminal area、cone of vertebral rotation、the area of the spinal canal. Quality of life SRS-22 score had significant correlation with foraminal ar-ea、the stability of lumbar spine、the area of the spinal canal、lumbar lordosis the maximum lateral displacement and cone of vertebral rotation. b)On the basis of full decompression and stabilization of spine. Lumbago improvement rate had significant correlation with the rate of correction of the maximum lateral displacement and lumbar lordosis. Lower limb pain improvement rate had significant correlation with the rate of correction of cone of vertebral rotation and the lateral displacement. Quality of life SRS-22 score had significant correlation with the rate of correction of lumbar lordosis、cone of vertebral rotation and the lat-eral displacement.Conclusion a)Clinical symptoms have obvious correlation with the area of intervertebral foramen,thesta-bility of spinal,the degree of rotation Apical vertebra and the area of spinal and Lordosis angle. b)Surgery Decompression suffi-ciently,stabilizing the spine,restoring Lumbar lordosis angle,improving the degree of vertebra rotation and the maximum Later-al displacement are powerful guarantee to obtain good curative effect.%目的 通过观察退变性腰椎侧凸的影像学和临床特点,探讨二者的相关性及密切程度,为退变性腰椎侧凸的预防和

  4. Training for motor function after removal of nucleus pulposus in protrusion of lumbar intervertebral discs%腰椎间盘突出症髓核摘除术后运动功能训练

    Institute of Scientific and Technical Information of China (English)

    王媛

    2003-01-01

    @@ INTRODUCIION Protrusion of lumbar intervertebral discs is a kind of disease causedby protrusion of nucleus pulposus to vertebral canal due to degen-eration and rupture of lumbar intervertebral discs and stimulationand compression on neighboring nerve roots. Therapeutic effects afteroperation has a direct relationship with postoperative rehabilitationnursing.

  5. The cat vertebral column: stance configuration and range of motion

    Science.gov (United States)

    Macpherson, J. M.; Ye, Y.; Peterson, B. W. (Principal Investigator)

    1998-01-01

    This study examined the configuration of the vertebral column of the cat during independent stance and in various flexed positions. The range of motion in the sagittal plane is similar across most thoracic and lumbar joints, with the exception of a lesser range at the transition region from thoracic-type to lumbar-type vertebrae. The upper thoracic column exhibits most of its range in dorsiflexion and the lower thoracic and lumbar in ventroflexion. Lateral flexion is limited to less than 5 degrees at all segments. The range in torsion is almost 180 degrees and occurs primarily in the midthoracic region, T4-T11. Contrary to the depiction in most atlases, the standing cat exhibits several curvatures, including a mild dorsiflexion in the lower lumbar segments, a marked ventroflexion in the lower thoracic and upper lumbar segments, and a profound dorsiflexion in the upper thoracic (above T9) and cervical segments. The curvatures are not significantly changed by altering stance distance but are affected by head posture. During stance, the top of the scapula lies well above the spines of the thoracic vertebrae, and the glenohumeral joint is just below the bodies of vertebrae T3-T5. Using a simple static model of the vertebral column in the sagittal plane, it was estimated that the bending moment due to gravity is bimodal with a dorsiflexion moment in the lower thoracic and lumbar region and a ventroflexion moment in the upper thoracic and cervical region. Given the bending moments and the position of the scapula during stance, it is proposed that two groups of scapular muscles provide the major antigravity support for the head and anterior trunk. Levator scapulae and serratus ventralis form the lateral group, inserting on the lateral processes of cervical vertebrae and on the ribs. The major and minor rhomboids form the medial group, inserting on the spinous tips of vertebrae from C4 to T4. It is also proposed that the hypaxial muscles, psoas major, minor, and quadratus

  6. Neurons derive from the more apical daughter in asymmetric divisions in the zebrafish neural tube.

    Science.gov (United States)

    Alexandre, Paula; Reugels, Alexander M; Barker, David; Blanc, Eric; Clarke, Jonathan D W

    2010-06-01

    In the developing CNS, asymmetric cell division is critical for maintaining the balanced production of differentiating neurons while renewing the population of neural progenitors. In invertebrates, this process depends on asymmetric inheritance of fate determinants during progenitor divisions. A similar mechanism is widely believed to underlie asymmetrically fated divisions in vertebrates, but compelling evidence for this is missing. We used live imaging of individual progenitors in the intact zebrafish embryo CNS to test this hypothesis. We found that asymmetric inheritance of a subcellular domain is strongly correlated with asymmetric daughter fates and our results reveal an unexpected feature of this process. The daughter cell destined to become a neuron was derived from the more apical of the two daughters, whereas the more basal daughter inherited the basal process and replenished the apical progenitor pool.

  7. Apical root resorption in orthodontically treated adults.

    Science.gov (United States)

    Baumrind, S; Korn, E L; Boyd, R L

    1996-09-01

    This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the

  8. Microbiology and Treatment of Acute Apical Abscesses

    Science.gov (United States)

    Rôças, Isabela N.

    2013-01-01

    SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease. PMID:23554416

  9. Apical domain polarization localizes actin-myosin activity to drive ratchet-like apical constriction.

    Science.gov (United States)

    Mason, Frank M; Tworoger, Michael; Martin, Adam C

    2013-08-01

    Apical constriction promotes epithelia folding, which changes tissue architecture. During Drosophila gastrulation, mesoderm cells exhibit repeated contractile pulses that are stabilized such that cells apically constrict like a ratchet. The transcription factor Twist is required to stabilize cell shape. However, it is unknown how Twist spatially coordinates downstream signals to prevent cell relaxation. We find that during constriction, Rho-associated kinase (Rok) is polarized to the middle of the apical domain (medioapical cortex), separate from adherens junctions. Rok recruits or stabilizes medioapical myosin II (Myo-II), which contracts dynamic medioapical actin cables. The formin Diaphanous mediates apical actin assembly to suppress medioapical E-cadherin localization and form stable connections between the medioapical contractile network and adherens junctions. Twist is not required for apical Rok recruitment, but instead polarizes Rok medioapically. Therefore, Twist establishes radial cell polarity of Rok/Myo-II and E-cadherin and promotes medioapical actin assembly in mesoderm cells to stabilize cell shape fluctuations.

  10. CT diagnosis in the evaluation of vertebral trauma

    Energy Technology Data Exchange (ETDEWEB)

    Emori, Takumi; Kadoya, Satoru; Nakamura, Tsutomu; Ito, Shotaro; Kwak, Ryungchan

    1984-12-01

    The diagnostic capability of the CT scan of the vertebral trauma and a comparison with the results of a routine roentgenogram and tomogram were studied in 11 patients. In total, there were 15 fractured vertebrae: 3 in the upper cervical, 3 in the lower cervical, and 9 in the thoracic and thoraco-lumbar vertebrae. In the detailed evaluation of the vertebral fractures, CT provided more information than plain films in all 15 fractured vertebrae, with a better visualization of the spinal bony details, particularly at the upper cervical, thoracic, and thoraco-lumbar levels, where the interpretation of the spinal abnormalities is usually difficult because of adjacent structures such as the skull and thorax. Only CT was able to demonstrate impingements on the vertebral canal by bony fragments. Post-traumatic syringomyelia was incidentally demonstrated in one patient on a plain CT. In 6 patients, conventional tomography was done, but no additional information with regard to spinal instability and spinal-cord compression was obtained. The usage of sagittal tomography was also limited, because it required a change in the patient's position, which might worsen the neurological deficits. On the other hand, a plain roentgenogram and conventional tomography were superior in the evaluation of spinal malalignment and fractures running horizontally. In summary, both plain roentgenograms and CT images provided detailed information about vertebral injury, whereas conventional tomography is judged to be inferior and not always necessary. Based on these results, our new diagnostic and therapeutic approaches using CT for the vertebral injuries were presented.

  11. Diagnosis of vertebral fractures on lateral chest X-ray: Intraobserver agreement of semi-quantitative vertebral fracture assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jagt-Willems, H.C. van der, E-mail: Hvanderjagt@spaarneziekenhuis.nl [Department of Geriatrics, Slotervaart Hospital, Amsterdam (Netherlands); Department of Internal Medicine, Spaarne Hospital, Hoofddorp (Netherlands); Munster, B.C. van [Department of Internal Medicine, Academic Medical Center, Amsterdam (Netherlands); Department of Geriatrics, Gelre Hospitals, Apeldoorn (Netherlands); Leeflang, M. [Department of Geriatrics, Gelre Hospitals, Apeldoorn (Netherlands); Beuerle, E. [Department of Radiology, Slotervaart Hospital, Amsterdam (Netherlands); Tulner, C.R. [Department of Geriatrics, Slotervaart Hospital, Amsterdam (Netherlands); Lems, W.F. [Department of Rheumatology, VU Medical Center, Amsterdam (Netherlands)

    2014-12-15

    Highlights: • (Lateral) chest X-ray's are often performed in older individuals for various reasons. • Vertebral fractures are visualized on lateral chest X-ray, but the diagnosis of vertebral fractures is until now only validated on (lateral) spine X-ray's. • This study shows that a (lateral) chest X-ray is sufficient for the diagnosis of vertebral fractures. • Older individuals with a vertebral fracture on a (lateral) chest X-ray do not need further radiography with thoracic spine X-ray or vertebral fracture assessment with DXA. - Abstract: Background: In clinical practice lateral images of the chest are performed for various reasons. As these lateral chest X rays show the vertebrae of the thoracic and thoraco-lumbar region, we wondered if these X-rays can be used for evaluation of vertebral fractures instead of separate thoracic spine X-rays. Methods: To evaluate the agreement and intraobserver reliability of the semi-quantitative method for vertebral fractures on the lateral chest X-ray (X-chest) in comparison to the lateral thoracic spine X-ray (X-Tspine), two observers scored vertebral fractures on X-Tspine and twice on X-chest, separately, blinded and in different time periods. Agreement and Cohens’ kappa were calculated for a diagnosis of any fracture on patient level and on vertebral body level. The study was done in patients visiting an outpatient geriatric day clinic, with a high prevalence of vertebral fractures. Results: 109 patients were included. The intraobserver agreement for X-chest versus X-Tspine was 95–98% for the two levels of fracturing, with a Cohen's kappa of 0.88–0.91. The intraobserver agreement and reliability of the re-test on the X-chest showed an agreement between 91 and 98% with a Cohen's kappa of 0.81–0.93. More vertebrae were visible on the X-chest, mean 10.2, SD 0.66 versus mean 9.8, SD 0.73 on the X-Tspine (p < 0.001). Conclusion: The results show good agreement and intraobserver reliability on

  12. An extensive vertebral hydatidosis revealed by a lumbosciatica.

    Science.gov (United States)

    Rkain, H; Bahiri, R; Benbouazza, K; Hajjaj-Hassouni, N

    2007-08-01

    The vertebral hydatidosis is uncommon. It causes problems in diagnosis and in management. A case of an extensive vertebral hydatidosis with few symptoms is reported. A 21-year-old man has consulted for recurrent lumbosciatica that has been evolving for 1 year. Clinical exam was normal. Plain radiographic films disclosed a lytic lesion throughout the bodies of L4 and L5 and calcifications thrown on the liver area. The computed tomography (CT) and the magnetic resonance (MR) images revealed multicystic bony lesions involving the lumbar spine with extension into the spinal canal. Abdominal ultrasound showed also cyst lesions in the right kidney and in the liver. The diagnosis of vertebral and abdominal (liver and kidney) hydatidosis was retained. Four sets of 4-week albendazole cures were given with a 2-week interval in between. Our case of extended vertebral hydatidosis with few symptoms confirms the clinical latency and diagnosis difficulties usually encountered in this disease. This often leads to a late diagnosis of the stage of spinal cord compression. Radiological diagnosis and determination of extension of the hydatid cyst are usually provided by CT and MRI. Vertebral hydatidosis should be evoked in lumbosciatica especially in endemic regions.

  13. The Downside of Right Ventricular Apical Pacing

    Directory of Open Access Journals (Sweden)

    Andrew Brenyo, MD

    2012-05-01

    Full Text Available The right ventricular (RV apex has been the standard pacing site since the development of implantable pacemaker technology. Although RV pacing was initially only utilized for the treatment of severe bradyarrhythmias usually due to complete heart block, today the indications for and implantation of RV pacing devices is dramatically larger. Recently, the adverse effects of chronic RV apical pacing have been described including an increased risk of heart failure and death. This review details the detrimental effects of RV apical pacing and their shared hemodynamic pathophysiology. In particular, the role of RV apical pacing induced ventricular dyssynchrony is highlighted with a specific focus on differential outcome based upon QRS morphology at implant.

  14. Lumbar lordosis and pars interarticularis fractures: a case-control study.

    Science.gov (United States)

    Bugg, William G; Lewis, Mark; Juette, Arne; Cahir, John G; Toms, Andoni P

    2012-07-01

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9° (SD = 6.5°) in the pars interarticularis fracture group, and 30.1° (SD = 6.4°) in the control group. The difference between the two groups was significant (mean difference 6.8°, Student's t test: P lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis.

  15. An intrinsic timer specifies distal structures of the vertebrate limb.

    Science.gov (United States)

    Saiz-Lopez, Patricia; Chinnaiya, Kavitha; Campa, Victor M; Delgado, Irene; Ros, Maria A; Towers, Matthew

    2015-09-18

    How the positional values along the proximo-distal axis (stylopod-zeugopod-autopod) of the limb are specified is intensely debated. Early work suggested that cells intrinsically change their proximo-distal positional values by measuring time. Recently, however, it is suggested that instructive extrinsic signals from the trunk and apical ectodermal ridge specify the stylopod and zeugopod/autopod, respectively. Here, we show that the zeugopod and autopod are specified by an intrinsic timing mechanism. By grafting green fluorescent protein-expressing cells from early to late chick wing buds, we demonstrate that distal mesenchyme cells intrinsically time Hoxa13 expression, cell cycle parameters and the duration of the overlying apical ectodermal ridge. In addition, we reveal that cell affinities intrinsically change in the distal mesenchyme, which we suggest results in a gradient of positional values along the proximo-distal axis. We propose a complete model in which a switch from extrinsic signalling to intrinsic timing patterns the vertebrate limb.

  16. Pulmonary edema following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Gupta D

    1977-01-01

    Full Text Available In a boy of 17 years with disseminated tuberculosis, sudden onset of pulmonary edema following lumbar puncture is described. Possible pat ho-mechanisms have been discussed. The link bet-ween the lumbar puncture and the development of pulmonary edema is not casual.

  17. Differential segmental growth of the vertebral column of the rat (Rattus norvegicus).

    Science.gov (United States)

    Bergmann, Philip J; Melin, Amanda D; Russell, Anthony P

    2006-01-01

    Despite the pervasive occurrence of segmental morphologies in the animal kingdom, the study of segmental growth is almost entirely lacking, but may have significant implications for understanding the development of these organisms. We investigate the segmental and regional growth of the entire vertebral column of the rat (Rattus norvegicus) by fitting a Gompertz curve to length and age data for each vertebra and each vertebral region. Regional lengths are calculated by summing constituent vertebral lengths and intervertebral space lengths for cervical, thoracic, lumbar, sacral, and caudal regions. Gompertz curves allow for the estimation of parameters representing neonatal and adult vertebral and regional lengths, as well as initial growth rate and the rate of exponential growth decay. Findings demonstrate differences between neonatal and adult rats in terms of relative vertebral lengths, and differential growth rates between sequential vertebrae and vertebral regions. Specifically, relative differences in the length of vertebrae indicate increasing differences caudad. Vertebral length in neonates increases from the atlas to the middle of the thoracic series and decreases in length caudad, while adult vertebral lengths tend to increase caudad. There is also a general trend of increasing vertebral and regional initial growth and rate of growth decay caudad. Anteroposterior patterns of growth are sexually dimorphic, with males having longer vertebrae than females at any given age. Differences are more pronounced (a) increasingly caudad along the body axis, and (b) in adulthood than in neonates. Elucidated patterns of growth are influenced by a combination of developmental, functional, and genetic factors.

  18. Dumb-bell-type teratoma in the lumbar spine.

    Science.gov (United States)

    Okuyama, K; Abe, E; Hoshi, N; Misawa, A; Tamura, Y; Chiba, M

    2000-02-01

    We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment.

  19. Dumb-bell-type teratoma in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Koichiro; Misawa, Akiko; Tamura, Yasuki; Chiba, Mitsuho [Dept. of Orthopaedic Surgery, Akita Rosai Hospital, Odate City (Japan); Abe, Eiji [Dept. of Orthopaedic Surgery, Akita University School of Medicine (Japan); Hoshi, Naoto [2. Dept. of Pathology, Akita University School of Medicine (Japan)

    2000-02-01

    We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment. (orig.)

  20. Vertebral Fracture Prediction

    DEFF Research Database (Denmark)

    2008-01-01

    Vertebral Fracture Prediction A method of processing data derived from an image of at least part of a spine is provided for estimating the risk of a future fracture in vertebraeof the spine. Position data relating to at least four neighbouring vertebrae of the spine is processed. The curvature...

  1. Lumbar degenerative spinal deformity: Surgical options of PLIF, TLIF and MI-TLIF

    Directory of Open Access Journals (Sweden)

    Hey Hwee Weng

    2010-01-01

    Full Text Available Degenerative disease of the lumbar spine is common in ageing populations. It causes disturbing back pain, radicular symptoms and lowers the quality of life. We will focus our discussion on the surgical options of posterior lumbar interbody fusion (PLIF and transforaminal lumbar interbody fusion (TLIF and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF for lumbar degenerative spinal deformities, which include symptomatic spondylolisthesis and degenerative scoliosis. Through a description of each procedure, we hope to illustrate the potential benefits of TLIF over PLIF. In a retrospective study of 53 ALIF/PLIF patients and 111 TLIF patients we found reduced risk of vessel and nerve injury in TLIF patients due to less exposure of these structures, shortened operative time and reduced intra-operative bleeding. These advantages could be translated to shortened hospital stay, faster recovery period and earlier return to work. The disadvantages of TLIF such as incomplete intervertebral disc and vertebral end-plate removal and potential occult injury to exiting nerve root when under experienced hands are rare. Hence TLIF remains the mainstay of treatment in degenerative deformities of the lumbar spine. However, TLIF being a unilateral transforaminal approach, is unable to decompress the opposite nerve root. This may require contralateral laminotomy, which is a fairly simple procedure.The use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF to treat degenerative lumbar spinal deformity is still in its early stages. Although the initial results appear promising, it remains a difficult operative procedure to master with a steep learning curve. In a recent study comparing 29 MI-TLIF patients and 29 open TLIF, MI-TLIF was associated with longer operative time, less blood loss, shorter hospital stay, with no difference in SF-36 scores at six months and two years. Whether it can replace traditional TLIF as the surgery of

  2. Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis

    Directory of Open Access Journals (Sweden)

    Lúcia Costa Paiva

    2002-01-01

    Full Text Available CONTEXT: Measurements of bone density taken by dual-energy x-ray absorptiometry are the most accurate procedure for the diagnosis of osteoporosis. This procedure has the disadvantage of measuring the density of all mineral components, including osteophytes, vascular and extra vertebral calcifications. These alterations can influence bone density results and densitometry interpretation. OBJECTIVE: To correlate radiography and densitometry findings from women with osteoporosis, analyzing the influence of degenerative processes and vertebral fractures on the evaluation of bone density. DESIGN: Retrospective study. SETTING: Osteoporosis outpatients' clinic at Hospital das Clínicas, Universidade Estadual de Campinas. PARTICIPANTS: Ninety-six postmenopausal women presenting osteoporosis diagnosed by bone density. MAIN MEASUREMENTS: Bone mineral density of the lumbar spine and femoral neck were measured by the technique of dual-energy x-ray absorptiometry, using a LUNAR-DPX densitometer. Fractures, osteophytes and aortic calcifications were evaluated by simple x-rays of the thoracic and lumbar spine. RESULTS: The x-rays confirmed vertebral fractures in 41.6%, osteophytes in 33.3% and calcifications of the aorta in 30.2%. The prevalence of fractures and aortic calcifications increased with age. The mean bone mineral density was 0.783g/cm² and the mean T-score was --3.47 DP. Neither fractures nor aortic calcifications had significant influence on bone mineral density (P = 0.36 and P = 0.09, respectively, despite the fractured vertebrae having greater bone mineral density (P < 0.02. Patients with lumbar spine osteophytes showed greater bone mineral density (P = 0.04. Osteophytosis was associated with lumbar spine bone mineral density after adjustment for fractures and aortic calcifications by multiple regression (P = 0.01. CONCLUSION: Osteophytes and lumbar spine fractures can overestimate bone density interpretation. The interpretation of densitometry

  3. Brucellar discitis as a cause of lumbar disc herniation: a case report.

    Science.gov (United States)

    Yilmaz, Cem; Akar, Aykan; Civelek, Erdinç; Köksay, Berkay; Kabatas, Serdar; Cansever, Tufan; Caner, Hakan

    2010-01-01

    Brucellosis is an infectious disease spread by consumption of non-pasteurized milk products or through contact with infected animals. Spinal involvement is one of the most important complications and the lumbar area is the most frequently affected site. Among the neurological consequences, nerve root compression can be a result of epidural abscess, granuloma or discitis secondary to vertebral body involvement. In this case report we present a 50-year-old male patient with brucellar discitis without spondylitis which caused lumbar disc herniation. We want to emphasize that discitis should also be considered in differential diagnosis of nerve root compression in suspected cases.

  4. Intercostal variant of lumbar hernia in lumbocostovertebral syndrome: our experience with 6 cases.

    Science.gov (United States)

    Sengar, Mamta; Manchanda, Vivek; Mohta, Anup; Jain, Vishesh; Das, Swarup

    2011-10-01

    Lumbocostovertebral syndrome (LCVS) is a rare type of congenital lumbar hernia. Its features include lumbar hernia associated with genitourinary, vertebral, and rib anomalies. Less than 25 cases have been reported to date. We describe the clinical manifestations and associated anomalies in 6 cases of LCVS managed by us. The patients with suspected LCVS syndrome should be evaluated by detailed clinical history, examination, conventional radiography, magnetic resonance imaging spine, ultrasound abdomen, and echocardiography. The defect can be repaired using local tissues in infancy. There is a need for long-term follow-up for possible late recurrence and scoliosis.

  5. An unexpected lumbar lesion

    Directory of Open Access Journals (Sweden)

    Laura Beard

    2016-01-01

    Full Text Available This case report details an interesting case of suspected spinal bifida in an obstetric patient who presented for an elective cesarean section. A large scarred/dimpled area, surrounded by significant hair growth in the region of the lumbar spine had been missed in multiple antenatal and preoperative assessments and was recognized on the day of the surgery as the patient was being prepared for spinal anesthesia. The patient was uncertain regarding the pathology of the lesion, and all investigations relating to this had been undertaken in Pakistan where she lived as a child. General anesthesia was undertaken because magnetic resonance imaging had not been performed and tethering of the spinal cord could not be ruled out clinically. The patient suffered from significant blood loss intra and postoperatively, requiring a two unit blood transfusion. She was discharged after 5 days in the hospital. This case highlights the need for thorough examination in all obstetric patients presenting to the preoperative clinic, focusing on the airway, vascular access, and lumbar spine. Patients may not always disclose certain information due to a lack of understanding, embarrassment, forgetfulness, or language barriers. Significant aspects of their care may have been undertaken abroad and access to these notes is often limited. Preoperative detection of the lesion would have allowed further investigation and imaging of the lesion and enabled more comprehensive discussions with the patient regarding anesthetic options and risk.

  6. Benign versus malignant osseous lesions in the lumbar vertebrae: differentiation by means of bone SPET

    Energy Technology Data Exchange (ETDEWEB)

    Reinartz, P.; Sabri, O.; Zimny, M.; Nowak, B.; Ostwald, E.; Cremerius, U.; Buell, U. [Department of Nuclear Medicine, Aachen University of Technology, Aachen (Germany); Schaffeldt, J. [Department of Radiology, Hospital Bardenberg, Aachen (Germany)

    2000-06-01

    Bone scanning is a well-accepted and frequently performed diagnostic procedure with a high sensitivity, especially when single-photon emission tomography (SPET) acquisitions are added. However, the differentiation of benign from malignant osseous lesions often poses difficulty. The purpose of this study was to find out whether the particular localisation of an intraosseous lesion in a lumbar vertebra is an indicator of its aetiology. Bone scintigraphy including planar whole-body scans as well as SPET imaging of the lumbar spine was performed in 109 patients. The diagnoses of osseous lesions in the lumbar vertebrae were made strictly on the basis of the findings of magnetic resonance imaging, computed tomography or plain radiography. Sixteen patients had to be excluded from the study because they did not undergo adequate radiological examination. To determine the particular localisation of vertebral lesions in the bone scan, two experienced nuclear medicine physicians examined the studies independently while blinded to the radiological results. Four anatomical regions were differentiated within the vertebra: the vertebral body, the pedicle, the facet joints and the spinous process. Clopper-Pearson analysis, which takes into account the number of examinations, yielded the following probability intervals for the malignancy of intraosseous lesions in the lumbar spine: vertebral body 36.8%-57.3%, pedicle 87.7%- 100%, facet joints 0.8%-21.4% and spinous process 18.7%-81.3%. It was concluded that lesions affecting the pedicle are a strong indicator for malignancy, whereas involvement of the facet joints is usually related to benign disease. Lesions affecting the vertebral body or the spinous process do not show a clear tendency towards either malignancy or benignity. In contrast to other studies, a significant probability of malignancy (35.6%) was observed in lesions affecting exclusively the vertebral body. (orig.)

  7. The Lumbar Lordosis in Males and Females, Revisited.

    Directory of Open Access Journals (Sweden)

    Ori Hay

    Full Text Available Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females.Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height.Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined.Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis. The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

  8. The Lumbar Lordosis in Males and Females, Revisited.

    Science.gov (United States)

    Hay, Ori; Dar, Gali; Abbas, Janan; Stein, Dan; May, Hila; Masharawi, Youssef; Peled, Nathan; Hershkovitz, Israel

    2015-01-01

    Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females. Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height. Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined). Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis). The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

  9. Testing biomechanical models of human lumbar lordosis variability.

    Science.gov (United States)

    Castillo, Eric R; Hsu, Connie; Mair, Ross W; Lieberman, Daniel E

    2017-05-01

    Lumbar lordosis (LL) is a key adaptation for bipedalism, but factors underlying curvature variations remain unclear. This study tests three biomechanical models to explain LL variability. Thirty adults (15 male, 15 female) were scanned using magnetic resonance imaging (MRI), a standing posture analysis was conducted, and lumbar range of motion (ROM) was assessed. Three measures of LL were compared. The trunk's center of mass was estimated from external markers to calculate hip moments (Mhip ) and lumbar flexion moments. Cross-sectional areas of lumbar vertebral bodies and trunk muscles were measured from scans. Regression models tested associations between LL and the Mhip moment arm, a beam bending model, and an interaction between relative trunk strength (RTS) and ROM. Hip moments were not associated with LL. Beam bending was moderately predictive of standing but not supine LL (R(2)  = 0.25). Stronger backs and increased ROM were associated with greater LL, especially when standing (R(2)  = 0.65). The strength-flexibility model demonstrates the differential influence of RTS depending on ROM: individuals with high ROM exhibited the most LL variation with RTS, while those with low ROM showed reduced LL regardless of RTS. Hip moments appear constrained suggesting the possibility of selection, and the beam model explains some LL variability due to variations in trunk geometry. The strength-flexibility interaction best predicted LL, suggesting a tradeoff in which ROM limits the effects of back strength on LL. The strength-flexibility model may have clinical relevance for spinal alignment and pathology. This model may also suggest that straight-backed Neanderthals had reduced lumbar mobility. © 2017 Wiley Periodicals, Inc.

  10. Cell division activity during apical hook development

    NARCIS (Netherlands)

    Raz, V.; Koornneef, M.

    2001-01-01

    Growth during plant development is predominantly governed by the combined activities of cell division and cell elongation. The relative contribution of both activities controls the growth of a tissue. A fast change in growth is exhibited at the apical hypocotyl of etiolated seedlings where cells

  11. Cell division activity during apical hook development

    NARCIS (Netherlands)

    Raz, V.; Koornneef, M.

    2001-01-01

    Growth during plant development is predominantly governed by the combined activities of cell division and cell elongation. The relative contribution of both activities controls the growth of a tissue. A fast change in growth is exhibited at the apical hypocotyl of etiolated seedlings where cells gro

  12. Variation in anthropoid vertebral formulae: implications for homology and homoplasy in hominoid evolution.

    Science.gov (United States)

    Williams, Scott A

    2012-03-01

    Variation in vertebral formulae within and among hominoid species has complicated our understanding of hominoid vertebral evolution. Here, variation is quantified using diversity and similarity indices derived from population genetics. These indices allow for testing models of hominoid vertebral evolution that call for disparate amounts of homoplasy, and by inference, different patterns of evolution. Results are interpreted in light of "short-backed" (J Exp Zool (Mol Dev Evol) 302B:241-267) and "long-backed" (J Exp Zool (Mol Dev Evol) 314B:123-134) ancestries proposed in different models of hominin vertebral evolution. Under the long-back model, we should expect reduced variation in vertebral formulae associated with adaptively driven homoplasy (independently and repeatedly reduced lumbar regions) and the relatively strong directional selection presumably associated with it, especially in closely related taxa that diverged relatively recently (e.g., Pan troglodytes and Pan paniscus). Instead, high amounts of intraspecific variation are observed among all hominoids except humans and eastern gorillas, taxa that have likely experienced strong stabilizing selection on vertebral formulae associated with locomotor and habitat specializations. Furthermore, analyses of interspecific similarity support an evolutionary scenario in which the vertebral formulae observed in western gorillas and chimpanzees represent a reasonable approximation of the ancestral condition for great apes and humans, from which eastern gorillas, humans, and bonobos derived their unique vertebral profiles. Therefore, these results support the short-back model and are compatible with a scenario of homology of reduced lumbar regions in hominoid primates. Fossil hominin vertebral columns are discussed and shown to support, rather than contradict, the short-back model.

  13. The Effect of Reduction Mammaplasty on the Vertebral Column: A Radiologic Study

    Directory of Open Access Journals (Sweden)

    Onder Karaaslan

    2013-01-01

    Full Text Available Some studies emphasized that anatomic mechanisms of vertebral aberrations could be associated with large breasts. The effect of mammaplasty operation on the vertebral column and body posture seems to be beneficial; in this trial, it was planned to investigate the objective radiologic effect of reduction mammaplasty on the posture of the vertebral column in a group of patients operated due to the large breasts. Thirty-four white women with large breasts were enrolled in this study. The patients were divided into three groups according to their breast cup sizes. Anteroposterior and lateral radiographs of the lumbosacral and thoracic spine were taken at baseline preoperatively, and the same radiographic images were taken in an average of 12 months later than the reduction mammaplasty operation. All were evaluated and compared for thoracic kyphosis angle and lumbar lordosis angle both preoperatively and postoperatively. The mean thoracic kyphosis angle was 40,53 preoperatively and 39,38 postoperatively. However, there was no statistically significant difference between the preoperative and postoperative measurements in all groups (P>0,05. The mean lumbar lordosis angle was 54,71 preoperatively and 53,18 postoperatively. Regarding the preoperative and postoperative measurements of lumbar lordosis angles, no statistically significant difference was found between the groups (P>0,05. Although breast size may be an important factor that affects body posture, reduction mammaplasty operations have little or no radiologic effect on the vertebral column.

  14. The effect of reduction mammaplasty on the vertebral column: a radiologic study.

    Science.gov (United States)

    Karaaslan, Onder; Demirkiran, H Gokhan; Silistreli, Ozlem; Sonmez, Erhan; Bedir, Yagmur Kaan; Can, Melih; Caliskan, Gorkem; Aslan, Cem; Oral, Meltem Ayhan; Kankaya, Yuksel

    2013-01-01

    Some studies emphasized that anatomic mechanisms of vertebral aberrations could be associated with large breasts. The effect of mammaplasty operation on the vertebral column and body posture seems to be beneficial; in this trial, it was planned to investigate the objective radiologic effect of reduction mammaplasty on the posture of the vertebral column in a group of patients operated due to the large breasts. Thirty-four white women with large breasts were enrolled in this study. The patients were divided into three groups according to their breast cup sizes. Anteroposterior and lateral radiographs of the lumbosacral and thoracic spine were taken at baseline preoperatively, and the same radiographic images were taken in an average of 12 months later than the reduction mammaplasty operation. All were evaluated and compared for thoracic kyphosis angle and lumbar lordosis angle both preoperatively and postoperatively. The mean thoracic kyphosis angle was 40,53 preoperatively and 39,38 postoperatively. However, there was no statistically significant difference between the preoperative and postoperative measurements in all groups (P > 0,05). The mean lumbar lordosis angle was 54,71 preoperatively and 53,18 postoperatively. Regarding the preoperative and postoperative measurements of lumbar lordosis angles, no statistically significant difference was found between the groups (P > 0,05). Although breast size may be an important factor that affects body posture, reduction mammaplasty operations have little or no radiologic effect on the vertebral column.

  15. Normal apical pleural tenting: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Dong Wook; Yoon, Yup; Jeong, Yu Mee; Park, Joo Chul; Cho, Kyu Seok; Ahn, Hee Kyung; Lee, Won Kyu [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-07-01

    To define the anatomy of apical pleural tenting commonly seen in computed tomography(CT) of the upper posterior thorax. Chest CTs of 393 patients with no pleural disease clinically and radiographically were analyzed. GE-9800 Quick and Toshiba-900S were used, employing the usual contrast enhanced CT technique. CT findings of focal pleural tenting on the inner side of the upper posterior thorax(apical pleural tenting) were evalvated and analysed in terms of location and shape. The CT findings were compared with the gross findings of the inner aspect of the posterior cadaveric thorax. Apical pleural tenting was formed by the upper border of the subcostal muscle. It's incidence was 44%(n=171), with bilaterality in 29%(n=49), and unilaterality in 71% of cases(n=122). This tenting was most frequently found between the third rib and the fourth intercostal space(81%), and seen in the outer third(42%) or central third(41%) part of the posterior costal pleura. In fifteen cases(7%), it was directed obliquely and had changed its location from the inner to the central or the central to the outer part. The shapes of the tenting were classified as follows:type 1(convex inner border with sharp apex, 62%); type 2(convex inner border with broad apex, 23%);type 3(undulated contour of apex, 13%);and type 4(two-spike apices, 1%). Apical pleura tenting is a normal CT finding probably demonstrated by the upper border of the subcostal muscle. Misdiagnosis of pleural disease can be avoided by recognition of the location and type of this tenting.

  16. Microbiome in the Apical Root Canal System of Teeth with Post-Treatment Apical Periodontitis

    Science.gov (United States)

    Siqueira, José F.; Antunes, Henrique S.; Rôças, Isabela N.; Rachid, Caio T. C. C.

    2016-01-01

    Introduction Bacteria present in the apical root canal system are directly involved with the pathogenesis of post-treatment apical periodontitis. This study used a next-generation sequencing approach to identify the bacterial taxa occurring in cryopulverized apical root samples from root canal-treated teeth with post-treatment disease. Methods Apical root specimens obtained during periradicular surgery of ten adequately treated teeth with persistent apical periodontitis were cryogenically ground. DNA was extracted from the powder and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Results All samples were positive for the presence of bacterial DNA. Bacterial taxa were mapped to 11 phyla and 103 genera composed by 538 distinct operational taxonomic units (OTUs) at 3% of dissimilarity. Over 85% of the sequences belonged to 4 phyla: Proteobacteria, Firmicutes, Fusobacteria and Actinobacteria. In general, these 4 phyla accounted for approximately 80% of the distinct OTUs found in the apical root samples. Proteobacteria was the most abundant phylum in 6/10 samples. Fourteen genera had representatives identified in all cases. Overall, the genera Fusobacterium and Pseudomonas were the most dominant. Enterococcus was found in 4 cases, always in relatively low abundance. Conclusions This study showed a highly complex bacterial community in the apical root canal system of adequately treated teeth with persistent apical periodontitis. This suggests that this disease is characterized by multispecies bacterial communities and has a heterogeneous etiology, because the community composition largely varied from case to case. PMID:27689802

  17. Apical domain polarization localizes actin-myosin activity to drive ratchet-like apical constriction

    OpenAIRE

    Mason, Frank M.; Tworoger, Michael; Martin, Adam C.

    2013-01-01

    Apical constriction promotes epithelia folding, which changes tissue architecture. During Drosophila gastrulation, mesoderm cells exhibit repeated contractile pulses that are stabilized such that cells apically constrict like a ratchet. The transcription factor Twist is required to stabilize cell shape, however it is unknown how Twist spatially coordinates downstream signals to prevent cell relaxation. We find that during constriction, Rho-associated kinase (Rok) is polarized to the middle of...

  18. The imaging of lumbar spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Butt, S. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom); Saifuddin, A. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom) and Institute of Orthopaedics and Musculo-Skeletal Sciences, University College, London (United Kingdom)]. E-mail: asaifuddin@aol.com

    2005-05-01

    Lumbar spondylolisthesis is a common finding on plain radiographs. The condition has a variety of causes which can be differentiated on the basis of imaging findings. As the treatment is dependent upon the type of spondylolisthesis, it is important for the radiologist to be aware of these features. We present a pictorial review of the imaging features of lumbar spondylolisthesis and explain the differentiating points between different groups of this disorder. The relative merits of the different imaging techniques in assessing lumbar spondylolisthesis are discussed.

  19. Reproduction of the lumbar lordosis

    DEFF Research Database (Denmark)

    Andreasen, Marianne Løgtholt; Langhoff, Lotte; Jensen, Tue Secher;

    2007-01-01

    OBJECTIVE: This study investigates whether it is possible to reproduce the lumbar lordosis in the upright position during magnetic resonance imaging (MRI) by positioning the patient supine with straightened lower extremities and investigates intra- and interexaminer reliability of measurements...... supine with straightened lower extremities. These measurements were compared statistically. Intra- and interexaminer reliability was calculated applying the Bland and Altman method. RESULTS: The lumbar lordosis in the standing position was reproduced in the straightened supine position with a median......: The findings of this study show that lumbar lordosis in the upright position can be reproduced by positioning the patient supine with straightened lower extremities....

  20. LUMBAR CORSETS CAN DECREASE LUMBAR MOTION IN GOLF SWING

    Directory of Open Access Journals (Sweden)

    Koji Hashimoto

    2013-03-01

    Full Text Available Swinging a golf club includes the rotation and extension of the lumbar spine. Golf-related low back pain has been associated with degeneration of the lumbar facet and intervertebral discs, and with spondylolysis. Reflective markers were placed directly onto the skin of 11young male amateur golfers without a previous history of back pain. Using a VICON system (Oxford Metrics, U.K., full golf swings were monitored without a corset (WOC, with a soft corset (SC, and with a hard corset (HC, with each subject taking 3 swings. Changes in the angle between the pelvis and the thorax (maximum range of motion and angular velocity in 3 dimensions (lumbar rotation, flexion-extension, and lateral tilt were analyzed, as was rotation of the hip joint. Peak changes in lumbar extension and rotation occurred just after impact with the ball. The extension angle of the lumbar spine at finish was significantly lower under SC (38° or HC (28° than under WOC (44° conditions (p < 0.05. The maximum angular velocity after impact was significantly smaller under HC (94°/sec than under SC (177°/sec and WOC (191° /sec conditions, as were the lumbar rotation angles at top and finish. In contrast, right hip rotation angles at top showed a compensatory increase under HC conditions. Wearing a lumbar corset while swinging a golf club can effectively decrease lumbar extension and rotation angles from impact until the end of the swing. These effects were significantly enhanced while wearing an HC

  1. [Intradural lumbar disk hernia].

    Science.gov (United States)

    Alonso-Bartolomé, P; Canga, A; Vázquez-Barquero, A; García-Valtuille, R; Abascal, F; Cerezal, L

    2001-04-01

    Intradural disc herniation is a rare complication of degenerative disc disease. A correct diagnosis of this process is frequently difficult. If this entity is not preoperatively diagnosed and is omitted at surgery, severe neurologic sequels may be provoked. We report a case of a pathologically proven intradural disc herniation preoperatively diagnosed by MR imaging. Clinically, it was manifested by sudden onset of right leg ciatalgia and progressive right lower extremity weakness. The patient also referred a one-month history of sexual dysfunction. MR imaging revealed interruption of the low signal of the anulus fibrosus and of the posterior longitudinal ligament at L2-L3 level and a voluminous disc fragment migrated in the dural sac that showed rim enhancement with gadolinium.The clinical, neuroradiological, and surgical management of lumbar intradural disc herniation are reviewed.

  2. Lumbar spondylolysis: a review

    Energy Technology Data Exchange (ETDEWEB)

    Leone, Antonio; Magarelli, Nicola; Bonomo, Lorenzo [Dept. of Bioimaging and Radiological Sciences, Catholic Univ., Rome (Italy); Cianfoni, Alessandro [Dept. of Radiology and Radiological Sciences, Medical Univ. of South Carolina, Charleston (United States); Cerase, Alfonso [General Hospital, Unit Neuroimaging and Neurointervention (NINT), Department of Neurosciences, Azienda Ospedaliera Universitaria Senese, Siena (Italy)

    2011-06-15

    Spondylolysis is an osseous defect of the pars interarticularis, thought to be a developmental or acquired stress fracture secondary to chronic low-grade trauma. It is encountered most frequently in adolescents, most commonly involving the lower lumbar spine, with particularly high prevalence among athletes involved in certain sports or activities. Spondylolysis can be asymptomatic or can be a cause of spine instability, back pain, and radiculopathy. The biomechanics and pathophysiology of spondylolysis are complex and debated. Imaging is utilized to detect spondylolysis, distinguish acute and active lesions from chronic inactive non-union, help establish prognosis, guide treatment, and to assess bony healing. Radiography with satisfactory technical quality can often demonstrate a pars defect. Multislice CT with multiplanar reformats is the most accurate modality for detecting the bony defect and may also be used for assessment of osseous healing; however, as with radiographs, it is not sensitive for detection of the early edematous stress response without a fracture line and exposes the patient to ionizing radiation. Magnetic resonance (MR) imaging should be used as the primary investigation for adolescents with back pain and suspected stress reactions of the lumbar pars interarticularis. Several imaging pitfalls render MR imaging less sensitive than CT for directly visualizing the pars defects (regional degenerative changes and sclerosis). Nevertheless, the presence of bone marrow edema on fluid-sensitive images is an important early finding that may suggest stress response without a visible fracture line. Moreover, MR is the imaging modality of choice for identifying associated nerve root compression. Single-photon emission computed tomography (SPECT) use is limited by a high rate of false-positive and false-negative results and by considerable ionizing radiation exposure. In this article, we provide a review of the current concepts regarding spondylolysis, its

  3. Lumbar peritoneal shunt

    Directory of Open Access Journals (Sweden)

    Yadav Yad

    2010-01-01

    Full Text Available A lumbar peritoneal (LP shunt is a technique of cerebrospinal fluid (CSF diversion from the lumbar thecal sac to the peritoneal cavity. It is indicated under a large number of conditions such as communicating hydrocephalus, idiopathic intracranial hypertension, normal pressure hydrocephalus, spinal and cranial CSF leaks, pseudomeningoceles, slit ventricle syndrome, growing skull fractures which are difficult to treat by conventional methods (when dural defect extends deep in the cranial base or across venous sinuses and in recurrent cases after conventional surgery, raised intracranial pressure following chronic meningitis, persistent bulging of craniotomy site after operations for intracranial tumors or head trauma, syringomyelia and failed endoscopic third ventriculostomy with a patent stoma. In spite of the large number of indications of this shunt and being reasonably good, safe, and effective, very few reports about the LP shunt exist in the literature. This procedure did not get its due importance due to some initial negative reports. This review article is based on search on Google and PubMed. This article is aimed to review indications, complications, results, and comparison of the LP shunt with the commonly practiced ventriculoperitoneal (VP shunt. Shunt blocks, infections, CSF leaks, overdrainage and acquired Chiari malformation (ACM are some of the complications of the LP shunt. Early diagnosis of overdrainage complications and ACM as well as timely appropriate treatment especially by programmable shunts could decrease morbidity. Majority of recent reports suggest that a LP shunt is a better alternative to the VP shunt in communicating hydrocephalus. It has an advantage over the VP shunt of being completely extracranial and can be used under conditions other than hydrocephalus when the ventricles are normal sized or chinked. More publications are required to establish its usefulness in the treatment of wide variety of indications.

  4. Building the Vertebrate Spine

    Science.gov (United States)

    Pourquié, Olivier

    2008-03-01

    The vertebrate body can be subdivided along the antero-posterior (AP) axis into repeated structures called segments. This periodic pattern is established during embryogenesis by the somitogenesis process. Somites are generated in a rhythmic fashion from the paraxial mesoderm and subsequently differentiate to give rise to the vertebrae and skeletal muscles of the body. Somite formation involves an oscillator-the segmentation clock-whose periodic signal is converted into the periodic array of somite boundaries. This clock drives the dynamic expression of cyclic genes in the presomitic mesoderm and requires Notch and Wnt signaling. Microarray studies of the mouse presomitic mesoderm transcriptome reveal that the segmentation clock drives the periodic expression of a large network of cyclic genes involved in cell signaling. Mutually exclusive activation of the Notch/FGF and Wnt pathways during each cycle suggests that coordinated regulation of these three pathways underlies the clock oscillator. In humans, mutations in the genes associated to the function of this oscillator such as Dll3 or Lunatic Fringe result in abnormal segmentation of the vertebral column such as those seen in congenital scoliosis. Whereas the segmentation clock is thought to set the pace of vertebrate segmentation, the translation of this pulsation into the reiterated arrangement of segment boundaries along the AP axis involves dynamic gradients of FGF and Wnt signaling. The FGF signaling gradient is established based on an unusual mechanism involving mRNA decay which provides an efficient means to couple the spatio-temporal activation of segmentation to the posterior elongation of the embryo. Another striking aspect of somite production is the strict bilateral symmetry of the process. Retinoic acid was shown to control aspects of this coordination by buffering destabilizing effects from the embryonic left-right machinery. Defects in this embryonic program controlling vertebral symmetry might lead

  5. A Case of Persistent Apical Ballooning Complicated by Apical Thrombus in Takotsubo Cardiomyopathy of Systemic Lupus Erythematosus Patient

    National Research Council Canada - National Science Library

    Shim, In Kyoung; Kim, Bong-Joon; Kim, Hyunsu; Lee, Jae-Woo; Cha, Tae-Joon; Heo, Jung Ho

    2013-01-01

    .... The prognosis is favorable with the normalization of wall motion abnormalities within weeks. We report a case of persistent apical ballooning complicated by an apical thrombus in Takotsubo cardiomyopathy of systemic lupus erythematous patient...

  6. Osteoimmunological Insight in to Vertebral Fractures in Osteoporosis

    Directory of Open Access Journals (Sweden)

    H Saghafi

    2008-11-01

    Full Text Available Background: The aim of this study was to investigate the relationship among circulating levels of OPG, RANKL, cytokine profiles, bone mineral density (BMD and vertebral fractures in pre and postmenopausal women and comparing these find­ing in three groups including osteoporotic patients with and without fracture and healthy women."nMethods: In a cross-sectional study, 215 women who attended the BMD unit of Endocrinology & Metabolism Research Center (EMRC of Tehran University of medical sciences were recruited. Serum Osteoporotegerin and sRANKL were measured. In addition, cytokines profile evaluated. Lumbar radiographs in the antero-posterior and left lateral projections were acquired following a standardized protocol and bone mineral densitometry was performed."nResults: In X-ray study, 65.2% of postmenopausal women and 34.8% of pre menopausal women had at least one vertebral fracture (P= 0.04. Serum OPG and TNFα concentration significantly correlated with age (OPG: P= 0.001, r= 0.22, TNFα: P=0.04, r= 0.15. In logistic regression model, RANKL/OPG ratio independent of age and BMD was predicted vertebral fractures."nConclusion: Osteoimmunological insight in to vertebral fracture indicated that important role of proinflammatory cytokines and RANKL/OPG pathway in bone remodeling.

  7. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Huwart, Laurent, E-mail: huwart.laurent@wanadoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Foti, Pauline, E-mail: pfoti@hotmail.fr [Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Andreani, Olivier, E-mail: andreani.olivier@gmail.com [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Hauger, Olivier, E-mail: olivier.hauger@chubordeaux.fr [Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux (France); Cervantes, Elodie, E-mail: elodie.cervantes@live.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Brunner, Philippe, E-mail: pbrunner@chpg.mc [Department of Radiology, Hôpital Princesse Grasse de Monaco (Monaco); Boileau, Pascal, E-mail: boileau.p@chu-nice.fr [Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France)

    2014-01-15

    Objective: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P < 0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P < 0.001). Conclusion: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.

  8. [Enlargement in managment of lumbar spinal stenosis].

    Science.gov (United States)

    Steib, J P; Averous, C; Brinckert, D; Lang, G

    1996-05-01

    Lumbar stenosis has been well discussed recently, especially at the 64th French Orthopaedic Society (SOFCOT: July 1989). The results of different surgical treatments were considered as good, but the indications for surgical treatment were not clear cut. Laminectomy is not the only treatment of spinal stenosis. Laminectomy is an approach with its own rate of complications (dural tear, fibrosis, instability... ).Eight years ago, J. Sénégas described what he called the "recalibrage" (enlargement). His feeling was that, in the spinal canal, we can find two different AP diameters. The first one is a fixed constitutional AP diameter (FCAPD) at the cephalic part of the lamina. The second one is a mobile constitutional AP diameter (MCAPD) marked by the disc and the ligamentum flavum. This diameter is maximal in flexion, minimal in extension. The nerve root proceeds through the lateral part of the canal: first above, between the disc and the superior articular process, then below, in the lateral recess bordered by the pedicle, the vertebral body and the posterior articulation. With the degenerative change the disc space becomes shorter, the superior articular process is worn out with osteophytes. These degenerative events are complicated by inter vertebral instability increasing the stenosis. The idea of the "recalibrage" is to remove only the upper part of the lamina with the ligamentum flavum and to cut the hypertrophied anterior part of the articular process from inside. If needed the disc and other osteophytes are removed. The surgery is finished with a ligamentoplasty reducing the flexion and preventing the extension by a posterior wedge.Our experience in spine surgery especially in scoliosis surgery, showed us that it was possible to cure a radicular compression without opening the canal. The compression is then lifted by the 3D reduction and restoration of an anatomy as normal as possible. Lumbar stenosis is the consequence of a degenerative process. Indeed, hip

  9. Type III apical transportation of root canal

    Directory of Open Access Journals (Sweden)

    Shiv P Mantri

    2012-01-01

    Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

  10. Lumbar Aspergillus osteomyelitis mimicking pyogenic osteomyelitis in an immunocompetent adult.

    Science.gov (United States)

    Yoon, Kyeong-Wook; Kim, Young-Jin

    2015-04-01

    Spinal Aspergillus osteomyelitis is rare and occurs mostly in immunocompromised patients, but especially very rare in immunocompetent adult. This report presents a case of lumbar vertebral osteomyelitis in immunocompetent adult. A 53-year-old male who had no significant medical history was admitted due to complaints of back pain radiating to the flank for the last 3 months, followed by a progressive motor weakness of both lower limbs. Lumbar magnetic resonance imaging (MRI) demonstrated osteomyelitis and diskitis, suspected to be a pyogenic condition rather than a tuberculosis infection. Despite antibiotic treatment for several weeks, the symptoms worsened, and finally, open surgery was performed. Surgical biopsy revealed an Aspergillus infection and medical treatment with amphotericin B was started. It can be diagnosed early through an MRI; biopsy is very important but difficult, and making the correct differential diagnosis is essential for avoiding unexpected complications. The authors report a case of lumbar Aspergillus osteomyelitis in an immunocompetent adult and reviewed previously described cases of spinal aspergillosis.

  11. Multiexpandable cage for minimally invasive posterior lumbar interbody fusion

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    Coe JD

    2016-09-01

    Full Text Available Jeffrey D Coe,1 James F Zucherman,2 Donald W Kucharzyk,3 Kornelis A Poelstra,4 Larry E Miller,5 Sandeep Kunwar,6 1Silicon Valley Spine Institute, Campbell, 2San Francisco Orthopaedic Surgeons, San Francisco, CA, 3Orthopaedic Pediatric and Spine, Crown Point, IN, 4Department of Surgery, Sacred Heart Hospital on the Emerald Coast, Miramar Beach, FL, 5Miller Scientific Consulting, Inc., Asheville, NC, 6Bell Neuroscience Institute, Washington Hospital Healthcare System, Fremont, CA, USA Abstract: The increasing adoption of minimally invasive techniques for spine surgery in recent years has led to significant advancements in instrumentation for lumbar interbody fusion. Percutaneous pedicle screw fixation is now a mature technology, but the role of expandable cages is still evolving. The capability to deliver a multiexpandable interbody cage with a large footprint through a narrow surgical cannula represents a significant advancement in spinal surgery technology. The purpose of this report is to describe a multiexpandable lumbar interbody fusion cage, including implant characteristics, intended use, surgical technique, preclinical testing, and early clinical experience. Results to date suggest that the multiexpandable cage allows a less invasive approach to posterior/transforaminal lumbar interbody fusion surgery by minimizing iatrogenic risks associated with static or vertically expanding interbody prostheses while providing immediate vertebral height restoration, restoration of anatomic alignment, and excellent early-term clinical results. Keywords: degenerative disc disease, expandable, low back pain, Luna

  12. MR imaging findings of ring apophyseal fractures in lumbar vertebrae

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yong Soo; Kwon, Soon Tae; Song, Chang Joon; Lee, Young Hwan; Kim, Hyoung Seob; Lee, Hwan Do; Cho, June Sik; Ahn, Jae Sung; Lee, June Kyu [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1997-07-01

    To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7%. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery.

  13. Patient positioning and spinal locking for lumbar spine rotation manipulation.

    Science.gov (United States)

    Gibbons, P; Tehan, P

    2001-08-01

    High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to treat low back pain. There is increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain. HVLA thrust techniques are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes these techniques from other manual therapy interventions. When using long lever HVLA thrust techniques spinal locking is necessary to localize forces and achieve cavitation at a specific vertebral segment. A critical factor in applying lumbar spine manipulation with minimal force is patient positioning and spinal locking. A knowledge of coupled movements of the lumbar spine aids an understanding of the patient positioning required to achieve spinal locking consistent with maximal patient comfort and cooperation. Excessive rotation can result in pain, patient resistance and failed technique. This masterclass presents a model of patient positioning for the lumbar spine that minimizes excessive use of rotation to achieve spinal locking prior to the application of the thrust.

  14. Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

    Science.gov (United States)

    GENÇ, Özgür; ALAÇAM, Tayfun; KAYAOGLU, Guven

    2011-01-01

    Objective The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen) in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. Material and Methods: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. Results All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05). Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05). Conclusions Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups. PMID:21655774

  15. Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

    Directory of Open Access Journals (Sweden)

    Özgür Genç

    2011-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. MATERIAL AND METHODS: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. RESULTS: All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05. Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05. CONCLUSIONS: Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.

  16. Auxin at the shoot apical meristem

    OpenAIRE

    Vernoux, Teva; Besnard, Fabrice; Traas, Jan

    2010-01-01

    Plants continuously generate new tissues and organs through the activity of populations of undifferentiated stem cells, called meristems. Here, we discuss the so-called shoot apical meristem (SAM), which generates all the aerial parts of the plant. It has been known for many years that auxin plays a central role in the functioning of this meristem. Auxin is not homogeneously distributed at the SAM and it is thought that this distribution is interpreted in terms of differential gene expression...

  17. Pathogenesis of Apical Periodontitis: a Literature Review

    OpenAIRE

    2012-01-01

    ABSTRACT Objectives This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period. Material and methods Literature was selected through a search of PubMed electronic database. The keywords...

  18. Analysis of dental root apical morphology: a new method for dietary reconstructions in primates.

    Science.gov (United States)

    Hamon, NoÉmie; Emonet, Edouard-Georges; Chaimanee, Yaowalak; Guy, Franck; Tafforeau, Paul; Jaeger, Jean-Jacques

    2012-06-01

    The reconstruction of paleo-diets is an important task in the study of fossil primates. Previously, paleo-diet reconstructions were performed using different methods based on extant primate models. In particular, dental microwear or isotopic analyses provided accurate reconstructions for some fossil primates. However, there is sometimes difficult or impossible to apply these methods to fossil material. Therefore, the development of new, independent methods of diet reconstructions is crucial to improve our knowledge of primates paleobiology and paleoecology. This study aims to investigate the correlation between tooth root apical morphology and diet in primates, and its potential for paleo-diet reconstructions. Dental roots are composed of two portions: the eruptive portion with a smooth and regular surface, and the apical penetrative portion which displays an irregular and corrugated surface. Here, the angle formed by these two portions (aPE), and the ratio of penetrative portion over total root length (PPI), are calculated for each mandibular tooth root. A strong correlation between these two variables and the proportion of some food types (fruits, leaves, seeds, animal matter, and vertebrates) in diet is found, allowing the use of tooth root apical morphology as a tool for dietary reconstructions in primates. The method was then applied to the fossil hominoid Khoratpithecus piriyai, from the Late Miocene of Thailand. The paleo-diet deduced from aPE and PPI is dominated by fruits (>50%), associated with animal matter (1-25%). Leaves, vertebrates and most probably seeds were excluded from the diet of Khoratpithecus, which is consistent with previous studies.

  19. Degenerative disc disease in the lumbar spine: Another cause for focally reduced activity on marrow scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology); Miles, K.A. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Wraight, E.P. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Dixon, A.K. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Cambridge Univ. (United Kingdom))

    1992-05-01

    A patient is presented in whom a focal reduction in marrow activity in the lumbar spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently shown to be due to fatty infiltration of marrow in association with disc degeneration. Degenerative disease in the lumbar spine has not been previously described as a cause of abnormal bone marrow distribution by such means and needs to be distinguished from a more serious pathology, such as malignant infiltration and vertebral infection, which it may mimic. In a retrospective review of 33 nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of reduced marrow activity in the lumbar spine consistent with that caused by degenerative changes. (orig.).

  20. Shoot Apical Meristem Organization in Several Philippine Species of Selaginella

    Directory of Open Access Journals (Sweden)

    Prescillano Zamora

    1993-06-01

    Full Text Available This paper reports for the first time the occurrence of two types of shoot apical meristem organization on the main and lateral shoots of eight Philippine species of Selaginella: (1 shoot apical meristem with a single lenticular apical cell in S. cupressina and S. delicatula and (a shoot apical meristem with a row of several prominent prismatic apical cells in the lateral plane in S. jagorii, S. halconensis, S. involvens (S. polyura, S. peltata, S. flagellifera (S. biformis, S. nummularia, S. aristata, and S. philippina (endemic.

  1. The vertebral body growth plate in scoliosis: a primary disturbance of growth?

    Directory of Open Access Journals (Sweden)

    Labrom Robert

    2008-01-01

    Full Text Available Abstract Study Design and Aims This was an observational pilot study of the vertebral body growth plates in scoliosis involving high-resolution coronal plane magnetic resonance (MR imaging and histological examination. One aim of this study was to determine whether vertebral body growth plates in scoliosis demonstrated abnormalities on MR imaging. A second aim was to determine if a relationship existed between MR and histological abnormalities in these vertebral body growth plates. Methods MR imaging sequences of 18 patients demonstrated the vertebral body growth plates well enough to detect gross abnormalities/deficient areas/zones. Histological examination of ten vertebral body growth plates removed during routine scoliosis surgery was performed. Observational histological comparison with MR images was possible in four cases. Results Four of the 18 MR images demonstrated spines with normal curvature and normal vertebral body growth plates. In 13 scoliotic spines, convex and concave side growth plate deficiencies were observed most frequently at or near the apex of the curve. One MR image demonstrated a 55° kyphosis and no convex or concave side deficiencies. The degree of vertebral body wedging was independent of the presence of vertebral body growth plate deficiency. Histological abnormalities of the vertebral body growth plates were demonstrated in four with MR imaging abnormalities. Conclusion This study demonstrated MR image abnormalities of scoliotic vertebral body growth plates compared to controls. A qualitative relationship was demonstrated between MR imaging and histological abnormalities. The finding that vertebral body growth plate deficiencies occurred both on the convex and concave sides of the spine, closest to the apical vertebra of the scoliosis curve, implied that they are less likely to be the result of adaptive changes to the physical forces involved in the scoliotic deformity. One explanation is that they represent a

  2. Staphylococcal endogenous endophthalmitis in association with pyogenic vertebral osteomyelitis.

    Science.gov (United States)

    Steeples, L R; Jones, N P

    2016-01-01

    PURPOSE To describe pyogenic vertebral osteomyelitis as a rare infection associated with endogenous endophthalmitis.METHODS A retrospective review of three patients with endogenous endophthalmitis and sepsis due to underlying Staphylococcal vertebral osteomyelitis presenting during a 21-month time period. The ophthalmic and systemic features and management and outcomes are presented.RESULTS One patient developed unilateral endophthalmitis with cervical spine osteomyelitis, Staphylococcus aureus being isolated from blood cultures. The second presented with bilateral endophthalmitis with disseminated Methicillin-resistant S. aureus (MRSA) infection, with thoracic and lumbar discitis and para-spinal abscesses. MRSA was cultured from vitreous, blood, and synovial fluid. Both patients received prolonged courses of intravenous antibiotics. Intravitreal antibiotic therapy was used in the second patient. Excellent visual and systemic outcomes were achieved in both cases with no ocular complications. The third patient developed lumbar osteomyelitis following spinal surgery and presented with disseminated S. aureus sepsis including unilateral endogenous endophthalmitis. Despite systemic antibiotics and intensive care the patient died.CONCLUSIONS Endogenous endophthalmitis should be suspected in septic patients developing eye symptoms. Endogenous endophthalmitis with staphylococcal bone infection is a rare but serious condition. Osteomyelitis should be considered as an infective source in any such patient reporting bone pain or reduced spinal mobility. Prompt investigation and treatment can achieve favourable visual and systemic outcomes.

  3. The vertebral column of the Regourdou 1 Neandertal.

    Science.gov (United States)

    Gómez-Olivencia, Asier; Couture-Veschambre, Christine; Madelaine, Stéphane; Maureille, Bruno

    2013-06-01

    The Regourdou 1 partial skeleton was found in 1957 in level IV of the eponymous site located in Montignac-sur-Vézère (Dordogne, France) and until now it has been only partially published. The ongoing revision of the faunal remains from the site has yielded additional fossils that pertain to this skeleton. Here we study the vertebral column of this individual, providing for the first time detailed descriptions for all of the fossils and reassessing the anatomical position of all of the fragments. The vertebral column of Regourdou 1 is one of the most complete in the Neandertal fossil record with at least 20 pre-sacral vertebrae (seven cervicals, nine thoracic and four lumbars), a partial sacrum and a fragmentary first coccygeal vertebra. When compared with modern humans, the vertebrae of Regourdou 1 display significant metric differences, and fit well within the range of Neandertal variability. A preliminary analysis of the most complete thoracic vertebrae of this individual indicates that Neandertals displayed significant differences from modern humans in the thoracic spine, which adds to the differences already observed in the cervical and lumbar regions. Finally, we have also observed mild signs of osteoarthrosis, albeit to a lower degree of that present in other Neandertals such as La Chapelle-aux-Saints, La Ferrassie 1 or Shanidar 3. This is consistent with the younger adult age for Regourdou 1.

  4. Clinical and Radiographic Outcomes of Transforaminal Lumbar Interbody Fusion in Patients with Osteoporosis

    OpenAIRE

    Formby, Peter M.; Kang, Daniel G.; Helgeson, Melvin D.; Wagner, Scott C.

    2016-01-01

    Study Design Retrospective review. Objective To compare clinical outcomes after transforaminal lumbar interbody fusion (TLIF) in patients with and patients without osteoporosis. Methods We reviewed all patients with 6-month postoperative radiographs and computed tomography (CT) scans for evaluation of the interbody cage. CT Hounsfield unit (HU) measurements of the instrumented vertebral body were used to determine whether patients had osteoporosis. Radiographs and CT scans were evaluated for ...

  5. Transdural epidurography in the diagnosis of lesions of the lumbar intervertebral disks

    Energy Technology Data Exchange (ETDEWEB)

    Matvienko, V.I.; Serikov, Yu.G.; Syuremov, M.N. (Rostovskij-na-Donu Meditsinskij Inst. (USSR))

    The anterior epidural space adjoining directly the posterior parts of the vertebral bodies, was examined with 8-12% solution of verografin in 140 patients with lumbar osteochodrosis. Of them 110 had been previously operated on. The use of low-concentration water-soluble iodine contrast agents makes it possible to avoid the stimulation of the epidural structures. X-ray appearance which is typical of protrusion and hernia of the intervertebral disks is described.

  6. Architecture of apical dendrites in the murine neocortex: dual apical dendritic systems.

    Science.gov (United States)

    Escobar, M I; Pimienta, H; Caviness, V S; Jacobson, M; Crandall, J E; Kosik, K S

    1986-04-01

    A monoclonal antibody (5F9) against microtubule-associated protein 2 is a selective and sensitive marker for neocortical dendrites in the mouse. The marker stains all dendrites. It affords a particularly comprehensive picture of the patterns of arrangements of apical dendrites which are most intensely stained with this antibody. Dual systems of apical dendrites arise from the polymorphic neurons of layer VI, on the one hand, and the pyramidal neurons of layers II-V, on the other. Terminal arborization of the former is concentrated principally at the interface of layers V and IV, while that of the latter is in the molecular layer. Apical dendrites of both systems are grouped into fascicles. In supragranular layers and in upper layer VI-lower layer V, where apical dendrites are most abundant, the fascicles coalesce into septa. These generate a honeycomb-like pattern, subdividing these cortical levels into columnar spaces of approximately 20-40 micron diameter. At the level of layer IV, where the number of apical dendrites is greatly reduced, the fascicles are isolated bundles. These bundles have the form of circular, elliptical or rectangular columns in the primary somatosensory, temporal and frontal regions, respectively. Those in the barrel field are preferentially concentrated in the sides of barrels and the interbarrel septa. The configurations of the dendritic fascicles, particularly the midcortical bundles, may conform to the spatial configuration of investing axons of interneurons.

  7. Thoracolumbar fascia does not influence proprioceptive signaling from lumbar paraspinal muscle spindles in the cat

    Science.gov (United States)

    Cao, Dong-Yuan; Pickar, Joel G

    2009-01-01

    The thoracolumbar fascia attaches to the lumbar spinous processes and encloses the paraspinal muscles to form a muscle compartment. Because muscle spindles can respond to transverse forces applied at a muscle’s surface, we were interested in the mechanical effects this fascia may have on proprioceptive signaling from lumbar paraspinal muscles during vertebral movement. The discharge of paraspinal muscle spindles at rest and in response to muscle history were investigated in the presence and absence of the thoracolumbar fascia in anesthetized cats. Muscle-history was induced by positioning the L6 vertebra in conditioning directions that lengthened and shortened the paraspinal muscles. The vertebra was then returned to an intermediate position for testing the spindles. Neither resting discharge (P= 0.49) nor the effects of muscle history (P>0.30) was significantly different with the fascia intact vs. removed. Our data showed that the thoracolumbar fascia did not influence proprioceptive signaling from lumbar paraspinal muscles spindles during small passive vertebral movements in cats. In addition, comparison of the transverse threshold pressures needed to stimulate our sample of muscle spindles in the cat with the thoracolumbar fascia compartmental pressures measured in humans during previous studies suggests that the thoracolumbar fascia likely does not affect proprioceptive signaling from lumbar paraspinal muscle spindles in humans. PMID:19627391

  8. An image processing technique for the radiographic assessment of vertebral derangements

    Energy Technology Data Exchange (ETDEWEB)

    Breen, A.C. (Anglo-European Coll. of Chiropractic, Bournemouth (UK)); Allen, R. (Southampton Univ. (UK). Dept. of Mechanical Engineering); Morris, A. (Odstock Hospital, Salisbury (UK). Dept. of Radiology)

    1989-01-01

    A technique for measuring inter-vertebral motion by the digitization and processing of intensifier images is described. The technique reduces the time and X-ray dosage currently required to make such assessments. The errors associated with computing kinematic indices at increments of coronal plane rotations in the lumbar spine have been calculated using a calibration model designed to produce a facsimile of in vivo conditions in terms of image quality and geometric distortion. (author).

  9. SECONDARY VERTEBRAL MALIGNOMA - RADIOLOGICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    Rade R. Babic

    2003-04-01

    Full Text Available Vertebral bones are among the bones of osteoarticular system which are most often affected by secondary malignoma.In the paper we present radiodiagnostical aspects of secondary malignoma in vertebral bones by conventional radiograms, and we illustrate and describe radiodiagnostic characteristics of the osteoplastic, osteolytic and osteolytic-osteoplastic metastasis.Author conclude that the diagnosis of metastasis in vertebral bones is always important for TNM classification, and that their character often points to the primary locus of malignoma.

  10. Radiotherapy of vertebral hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo [Dept. of Radiology, Sapporo Medical Univ., School of Medicine (Japan)

    1997-12-31

    Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films, CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy. (orig.).

  11. [Lumbar stabilization exercises].

    Science.gov (United States)

    Vásquez-Ríos, Jorge Rodrigo; Nava-Bringas, Tania Inés

    2014-01-01

    Antecedentes: el ejercicio es la intervención con mayor grado de evidencia de eficacia para el tratamiento del dolor crónico de la espalda baja, con beneficio superior en términos de dolor y funcionalidad, en comparación con cualquiera otra intervención. Existe una amplia variedad de ejercicios diseñados; sin embargo, actualmente los llamados ejercicios de estabilización lumbar adquiririeron una popularidad creciente entre los clínicos que están en contacto con enfermedades de la columna. Sin embargo, existe controversia en cuanto a la prescripción adecuada de los mismos y los múltiples protocolos publicados. Objetivo: analizar la bibliografía científica acerca del uso y prescripción de estos ejercicios para favorecer la mejor toma de decisiones enlos clínicos y diseñar, con base a la evidencia, el programa más adecuado para cada paciente. Conclusión: se encontró que este programa es una herramienta esencial en el tratamiento del dolor de espalda baja, en la etapa terapéutica y en la preventiva.

  12. Lumbar gibbus in storage diseases and bone dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Levin, T.L. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Berdon, W.E. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Lachman, R.S. [International Skeletal Dysplasia Registry, Los Angeles, CA (United States); Anyane-Yeboa, K. [Department of Pediatrics, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Ruzal-Shapiro, C. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Roye, D.P. Jr. [Department of Orthopedic Surgery, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States)

    1997-04-01

    Objective. The objective of this study was to review the problem of lumbar gibbus in children with storage diseases and bone dysplasias utilizing plain films and MR imaging. Materials and methods. Clinical histories and radiographic images in five patients with storage diseases [four mucopolysaccharidosis (MPS) and one mucolipidosis] and two with achondroplasia were reviewed. The International Skeletal Dysplasia Registry (Los Angeles, Calif.), surveyed for all patients with lumbar gibbus and skeletal dysplasias, provided 12 additional cases. Results. All patients had localized gibbus of the upper lumbar spine, characterized by anterior wedging and posterior displacement of the vertebrae at the apex of the curve, producing a beaked appearance. The curve, exaggerated in the sitting or standing position, was most severe in the two patients with MPS-IV (one of whom died). Both developed severe neurologic signs and symptoms requiring surgical intervention. In four patients, MR images demonstrated the apex of the curve to be at or below the conus. Two patients demonstrated anterior herniation of the intervertebral discs at the apex of the curve, though the signal intensity of the intervertebral discs was normal. Conclusion. Lumbar gibbus has important neurologic and orthopedic implications, and is most severe in patients with MPS. The etiology of the gibbus with vertebral beaking is multifactorial and includes poor truncal muscle tone, weight-bearing forces, growth disturbance and anterior disc herniation. The curve is generally at or below the conus. Neurologic complications are unusual, although orthopedic problems can arise. Due to their longer survival, patients with achondroplasia or Morquio`s disease are more vulnerable to eventual gibbus-related musculoskeletal complications. (orig.). With 6 figs., 2 tabs.

  13. Lumbar spine visualisation based on kinematic analysis from videofluoroscopic imaging.

    Science.gov (United States)

    Zheng, Y; Nixon, M S; Allen, R

    2003-04-01

    Low back pain is a significant problem and its cost is enormous to society. However, diagnosis of the underlying causes remains problematic despite extensive study. Reasons for this arise from the deep-rooted situation of the spine and also from its structural complexity. Clinicians have to mentally convert 2-D image information into a 3-D form to gain a better understanding of structural integrity. Therefore, visualisation and animation may be helpful for understanding, diagnosis and for guiding therapy. Some low back pain originates from mechanical disorders, and study of the spine kinematics may provide an insight into the source of the problem. Digital videofluoroscopy was used in this study to provide 2-D image sequences of the spine in motion, but the images often suffer due to noise, exacerbated by the very low radiation dosage. Thus determining vertebrae position within the image sequence presents a considerable challenge. This paper describes a combination of spine kinematic measurements with a solid model of the human lumbar spine for visualisation of spine motion. Since determination of the spine kinematics provides the foundation and vertebral extraction is at the core, this is discussed in detail. Edge detection is a key feature of segmentation and it is shown that phase congruency performs better than most established methods with the rather low-grade image sequences from fluoroscopy. The Hough transform is then applied to determine the positions of vertebrae in each frame of a motion sequence. In the Hough transform, Fourier descriptors are used to represent the vertebral shapes. The results show that the Hough transform is a very promising technique for vertebral extraction from videofluoroscopic images. A dynamic visualisation package has been developed in order to view the moving lumbar spine from any angle and viewpoint. Wire frame models of the vertebrae were built by using CT images from the Visible Human Project and these models are scaled to

  14. Minimal Apical Enlargement for Penetration of Irrigants to the Apical Third of Root Canal System: A Scanning Electron Microscope Study

    Science.gov (United States)

    Srikanth, P; Krishna, Amaravadi Gopi; Srinivas, Siva; Reddy, E Sujayeendranatha; Battu, Someshwar; Aravelli, Swathi

    2015-01-01

    Background: The aim of this study was to determine minimal apical enlargement for irrigant penetration into apical third of root canal system using scanning electron microscope (SEM). Materials and Methods: Distobuccal canals of 40 freshly extracted human maxillary first molar teeth were instrumented using crown-down technique. The teeth were divided into four test groups according to size of their master apical file (MAF) (#20, #25, #30, #35 0.06% taper), and two control groups. After final irrigation, removal of debris and smear layer from the apical third of root canals was determined under a SEM. Data was analyzed using Kruskal–Wallis and Mann–Whitney tests. Results: Smear layer removal in apical third for MAF size #30 was comparable with that of the control group (size #40). Conclusion: Minimal apical enlargement for penetration of irrigants to the apical third of root canal system is #30 size. PMID:26124608

  15. NEUROMUSCULAR CONTROL IN LUMBAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Ville Leinonen

    2004-03-01

    Full Text Available Impaired motor and sensory functions have been associated with low back pain (LBP. This includes disturbances in a wide range of sensorimotor control e.g. sensory dysfunctions, impaired postural responses and psychomotor control. However, the physiological mechanisms, clinical relevance and characteristics of these findings in different spinal pathologies require further clarification. The purposes of this study were to investigate postural control, lumbar muscle function, movement perception and associations between these findings in healthy volunteers (n=35, patients with lumbar disc herniation (n=20 and lumbar spinal stenosis (LSS, n=26. Paraspinal muscle responses for sudden upper limb loading and muscle activation during flexion-extension movement and the lumbar endurance test were measured by surface electromyography (EMG. Postural stability was measured on a force platform during two- and one-footed standing. Lumbar movement perception was assessed in a motorised trunk rotation unit in the seated position. In addition, measurements of motor-(MEP and somatosensory evoked potentials (SEP and needle EMG examination of lumbar multifidus muscles were performed in the LSS patients. Clinical and questionnaire data were also recorded. A short latency paraspinal muscle response (~50 ms for sudden upper limb loading was observed. The latency of the response was shortened by expectation (p=0.017. The response latency for unexpected loading was similar in healthy persons and disc herniation patients but the latency was not shortened by expectation in the patients (p = 0.014. Also impaired postural control (p < 0.05 and lumbar movement perception (p = 0.012 were observed in disc herniation patients. The impaired lumbar movement perception (p=0.054 and anticipatory muscle activation (p = 0.043 tended to be restored after successful surgery but postural control had still not recovered after 3 months of follow-up. The majority of LSS patients were unable

  16. Studies on the pathogenesis of degenerative lumbar canal stenosis by computed tomography, 2. Investigation about measurements of the lumbar canal

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Kenji

    1987-07-01

    To evaluate the significance of measurement parameters for the lumbar canal (LC), a retrospective analysis was made of computed tomography (CT) scans in a total of 129 patients, including 20 with degenerative lumbar canal stenosis (DLCS), 65 with degenerative spondylosis, 21 with disc hernia, and 23 with lumbar pain. The shape of the transverse LC was not reflected by the anteroposterior and transverse diameters of LC, but was somewhat reflected by the transverse area of LC. The transverse area of dural sac (DS) was considered important in determining the degree of stenosis. Regarding the transverse area, the DS correlated more strongly with the LC with soft-tissue windows than that with bone windows. The angle of intervertebral joint was likely to be related to the pathophysiology of the LC. In particular, sagittal tendency was seen at the levels of L3-4 and L4-5 in the DLCS group. There was correlation between the angle of intervertebral joint and the transverse areas of both soft-tissue LC and DS at the levels of L4-5. A multivariate analysis suggested the possibility that the significance of measurement parameters might vary depending on the vertebral level for the lower lumbar spine. The following criteria for indicating DLCS were obtained: 1) a transverse area of less than or equal to 100 mm/sup 2/ for DS or less than or equal to 118 mm/sup 2/ for soft-tissue LC at the levels of L3-4; 2) a transverse area of less than or equal to 90 mm/sup 2/ for DS and an angle of less than or equal to 90 deg for the intervertebral joint at the levels of L4-5; and 3) lateral recess of less than or equal to 3 mm in anteroposterior diameter at the levels of L5-S1. (Namekawa, K.).

  17. Spermatogenesis in nonmammalian vertebrates.

    Science.gov (United States)

    Pudney, J

    1995-12-15

    Spermatogenesis appears to be a fairly conserved process throughout the vertebrate series. Thus, spermatogonia develop into spermatocytes that undergo meiosis to produce spermatids which enter spermiogenesis where they undergo a morphological transformation into spermatozoa. There is, however, variation amongst the vertebrates in how germ cell development and maturation is accomplished. This difference can be broadly divided into two distinct patterns, one present in anamniotes (fish, amphibia) and the other in amniotes (reptiles, birds, mammals). For anamniotes, spermatogenesis occurs in spermatocysts (cysts) which for most species develop within seminiferous lobules. Cysts are produced when a Sertoli cell becomes associated with a primary spermatogonium. Mitotic divisions of the primary spermatogonium produce a cohort of secondary spermatogonia that are enclosed by the Sertoli cell which forms the wall of the cyst. With spermatogenic progression a clone of isogeneic spermatozoa is produced which are released, by rupture of the cyst, into the lumen of the seminiferous lobule. Following spermiation, the Sertoli cell degenerates. For anamniotes, therefore, there is no permanent germinal epithelium since spermatocysts have to be replaced during successive breeding seasons. By contrast, spermatogenesis in amniotes does not occur in cysts but in seminiferous tubules that possess a permanent population of Sertoli cells and spermatogonia which act as a germ cell reservoir for succeeding bouts of spermatogenic activity. There is, in general, a greater variation in the organization of the testis and pattern of spermatogenesis in the anamniotes compared to amniotes. This is primarily due to the fact there is more reproductive diversity in anamniotes ranging from a relatively unspecialized condition where gametes are simply released into the aqueous environment to highly specialized strategies involving internal fertilization. These differences are obviously reflected in the

  18. Preoperative education for lumbar surgery for radiculopathy

    OpenAIRE

    Louw, A; Louw, Q; L. Crous

    2009-01-01

    To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptive...

  19. High prevalence of radiological vertebral fractures in adult patients with Ehlers-Danlos syndrome.

    Science.gov (United States)

    Mazziotti, G; Dordoni, C; Doga, M; Galderisi, F; Venturini, M; Calzavara-Pinton, P; Maroldi, R; Giustina, A; Colombi, M

    2016-03-01

    Previous studies have reported an increased prevalence of osteoporosis in Ehlers–Danlos syndrome (EDS), but these were limited by a small number of patients and lack of information on fragility fractures. In this crosssectional study, we evaluated the prevalence of radiological vertebral fractures (by quantitative morphometry) and bone mineral density (BMD, at lumbar spine, total hip and femoral neck by dual-energy X-ray absorptiometry) in 52 consecutive patientswith EDS (10 males, 42 females; median age 41 years, range: 21–71; 12with EDS classic type, 37 with EDS hypermobility type, 1 with classic vascular-like EDS, and 2 without specific classification) and 197 control subjects (163 females and 34 males; median age 49 years, range: 26–83) attending an outpatient bone clinic. EDS patients were also evaluated for back pain by numeric pain rating scale (NRS- 11).Vertebral fractures were significantly more prevalent in EDS as compared to the control subjects (38.5% vs. 5.1%; p b 0.001) without significant differences in BMD at either skeletal sites. In EDS patients, the prevalence of vertebral fractures was not significantly (p = 0.72) different between classic and hypermobility types. BMD was not significantly different between fractured and non-fractured EDS patients either at lumbar spine (p = 0.14), total hip (p=0.08), or femoral neck (p=0.21). Severe back pain(≥7 NRS)was more frequent in EDS patients with vertebral fractures as compared to thosewithout fractures (60% vs. 28%; p=0.04). Inconclusion, this is the first study showing high prevalence of vertebral fractures in a relatively large population of EDS patients. Vertebral fractures were associated with more severe back pain suggesting a potential involvement of skeletal fragility in determining poor quality of life. The lack of correlation between vertebral fractures and BMD is consistent with the hypothesis that bone quality may be impaired in EDS.

  20. Multimodality imaging in apical hypertrophic cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Rosario; Parisi; Francesca; Mirabella; Gioel; Gabrio; Secco; Rossella; Fattori

    2014-01-01

    Apical hypertrophic cardiomyopathy(AHCM) is a relatively rare morphologic variant of HCM in which the hypertrophy of myocardium is localized to the left ventricular apex. Symptoms of AHCM might vary from none to others mimic coronary artery disease including acute coronary syndrome, thus resulting in inappropriate hospitalization. Transthoracic echocardiography is the firstline imaging technique for the diagnosis of hypertrophic cardiomyopathies. However, when the hypertrophy of the myocardium is localized in the ventricular apex might results in missed diagnosis. Aim of this paper is to review the different imaging techniques used for the diagnosis of AHCM and their role in the detection and comprehension of this uncommon disease.

  1. Vertebral histomorphometry in a child with glucocorticoid-induced osteoporosis.

    Science.gov (United States)

    Hatakeyama, Yuji; Miyakoshi, Naohisa; Kasukawa, Yuji; Watanabe, Arata; Hirayama, Masashi; Senma, Seietsu; Ono, Iwao; Shimada, Yoichi

    2012-08-01

    Vertebral fractures are an under-recognized problem in children with glucocorticoid-induced osteoporosis (GIO). They cause severe back pain and spinal column deformity with a decrease of quality of life. For evaluating the bone mass, bone mineral density measurements have been widely carried out using dual energy X-ray absorptiometry. However, bone histomorphometric analyses of GIO in children are scarce. Bone histomorphometric analyses of vertebral bodies have not been reported. Our aim is to report the first bone histomorphometric data for vertebrae from an autopsied child with GIO. A 15-year-old girl with systemic lupus erythematosus was started on a daily oral dose of 10 mg of prednisolone at 6 years of age. She presented with back pain from 12 years of age. Magnetic resonance imaging at 14 years of age showed a compression fracture of the first lumbar (L1) vertebral body. At 15 years of age, she died of heart failure owing to pulmonary hypertension. Collapsed (L1) and non-collapsed (seventh thoracic vertebrae; T7) vertebral bodies were autopsied for bone histomorphometry and compared. T7 showed severe osteoporosis (bone volume, 4.99%; trabecular thickness, 59 µm; trabecular separation, 1,134 µm). Compared with T7, L1 showed increased bone volume (33.9%) and trabecular thickness (77 µm), and decreased trabecular separation (156 µm) owing to the impact of the vertebral fracture. The bone formation and bone resorption parameters were comparable between the two vertebrae. These histological findings suggest that severe osteoporosis developed after long-term glucocorticoid administration, and that the remodeling activities were similar in the fractured and non-fractured vertebrae.

  2. Relationship between spinal osteoarthritis and vertebral fractures in men older than 50 years: data from the Camargo Cohort Study.

    Science.gov (United States)

    Pariente, Emilio; Olmos, José M; Landeras, Rosa; Nan, Daniel; González-Macías, Jesús; Hernández, José Luis

    2017-01-01

    Spinal osteoarthritis has been suggested as a risk factor for vertebral fractures. However, results are conflicting: most of the data are focused on the lumbar region, and referred to postmenopausal women, whereas data for men are scarce. The aim of this study is to assess the relationship between spinal osteoarthritis and vertebral fractures in men over 50 years of age. We conducted a cross-sectional study, nested in a prospective population-based cohort, including 507 community-dwelling men, 93 of them with at least one vertebral fracture. Vertebral fractures, osteophytosis, and disc space narrowing (DSN) were assessed by lateral thoracic and lumbar radiographs. Anthropometric, clinical, and densitometric variables were also analyzed. A multiple logistic regression model was performed. Eighty-five percent of vertebral fractures were located at the thoracic spine. Osteophytosis and DSN showed a bimodal distribution, with major frequency peaks at mid- and distal lumbar spine. The three distributions overlapped around the T9 vertebra. We did not find any relationship between lumbar osteoarthritis and vertebral fractures. Nevertheless, thoracic osteophytosis (OR, 1.84; 95 % CI, 1.05-3.17; p = 0.03) and DSN (OR, 2.52; 95 % CI, 1.43-4.46; p = 0.001) were found to be independently associated with prevalent vertebral fractures, after adjusting for confounders. Our results suggest a positive relationship between radiologic osteoarthritic changes at the thoracic spine and prevalent vertebral fractures in men more than 50 years of age. Osteoarthritis may act as a local risk factor, in addition to other mechanical factors, resulting in a greater propensity to fracture, especially at the mid-thoracic region.

  3. Segmentalliverincarcerationthrougha recurrent incisional lumbar hernia

    Institute of Scientific and Technical Information of China (English)

    Nikolaos S. Salemis; Konstantinos Nisotakis; Stavros Gourgiotis; Efstathios Tsohataridis

    2007-01-01

    BACKGROUND: Lumbar hernia is a rare congenital or acquired defect of the posterior abdominal wall. The acquired type is more common and occurs mainly as an incisional defect after lfank surgery. Incarceration or strangulation of hernia contents is uncommon. METHOD: Segmental liver incarceration through a recurrent incisional lumbar defect was diagnosed in a 58 years old woman by magnetic resonance imaging. RESULTS: The patient underwent an open repair of the com-plicated hernia. An expanded polytetralfouoroethylene (e-PTFE) mesh was fashioned as a sublay prosthesis. She had an uncomplicated postoperative course. Follow-up examinations revealed no evidence of recurrence. CONCLUSIONS: Although lumbar hernia rarely results in incarceration or strangulation, early repair is necessary because of the risks of complications and the increasing dififculty in repairment as it enlarges. Surgical repair is often dififcult and challenging.

  4. [Congenital lumbar hernia and bilateral renal agenesis].

    Science.gov (United States)

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  5. Chemical ecology of vertebrate carrion

    Science.gov (United States)

    Vertebrate carrion is a nutrient-rich, ephemeral resource that is utilized by many different organisms ranging from vertebrate and invertebrate scavengers to microbes. The organisms that consume carrion play an important ecological role, as decomposition is vital to ecosystem function. Without the...

  6. Opportunistic Identification of Vertebral Fractures.

    Science.gov (United States)

    Adams, Judith E

    2016-01-01

    Vertebral fractures are powerful predictors of future fracture, so, their identification is important to ensure that patients are commenced on appropriate bone protective or bone-enhancing therapy. Risk factors (e.g., low bone mineral density and increasing age) and symptoms (back pain, loss of height) may herald the presence of vertebral fractures, which are usually confirmed by performing spinal radiographs or, increasingly, using vertebral fracture assessment with dual-energy X-ray absorptiometry scanners. However, a large number (30% or more) of vertebral fractures are asymptomatic and do not come to clinical attention. There is, therefore, scope for opportunistic (fortuitous) identification of vertebral fractures from various imaging modalities (radiographs, computed tomography, magnetic resonance imaging, and radionuclide scans) performed for other clinical indications and which include the spine in the field of view, with midline sagittal reformatted images from computed tomography having the greatest potential for such opportunistic detection. Numerous studies confirm this potential for identification but consistently find underreporting of vertebral fractures. So, a valuable opportunity to improve the management of patients at increased risk of future fracture is being squandered. Educational training programs for all clinicians and constant reiteration, stressing the importance of the accurate and clear reporting of vertebral fractures ("you only see what you look for"), can improve the situation, and automated computer-aided diagnostic tools also show promise to solve the problem of this underreporting of vertebral fractures. Copyright © 2016. Published by Elsevier Inc.

  7. Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations

    Directory of Open Access Journals (Sweden)

    Försth Peter

    2011-08-01

    Full Text Available Abstract Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity. At first, conservative treatment still is the method of choice. In case of resulting deformity, sintering and persistent pain vertebral cement augmentation techniques today are widely used. Open correction of resulting deformity by different types of osteotomies addresses sagittal balance, but has comparably high morbidity. Besides conventional vertebral cement augmentation techniques balloon kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures. It showed improved pain reduction and lower complication rates compared to standard vertebroplasty. Interestingly the results of two placebo-controlled vertebroplasty studies question the value of cement augmentation, if compared to a sham operation. Even though there exists now favourable data for kyphoplasty from one randomised controlled trial, the absence of a sham group leaves the placebo effect unaddressed. Technically kyphoplasty can be performed with a transpedicular or extrapedicular access. Polymethyl methacrylate (PMMA-cement should be favoured, since calcium phosphate cement showed inferior biomechanical properties and less effect on pain reduction especially in less stable burst fractures. Common complications of kyphoplasty are cement leakage and adjacent segment fractures. Rare complications are toxic PMMA-monomer reactions, cement embolisation, and infection.

  8. A splice variant of CD44 expressed in the apical ectodermal ridge presents fibroblast growth factors to limb mesenchyme and is required for limb outgrowth

    OpenAIRE

    Sherman, Larry; Wainwright, David; Ponta, Helmut; Herrlich, Peter

    1998-01-01

    Signals from the apical ectodermal ridge (AER) of the developing vertebrate limb, including fibroblast growth factor-8 (FGF-8), can maintain limb mesenchymal cells in a proliferative state. We report here that a specific CD44 splice variant is crucial for the proliferation of these mesenchymal cells. Epitopes carried by this variant colocalize temporally and spatially with FGF-8 in the AER throughout early limb development. A splice variant containing the same sequences expressed on model cel...

  9. Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB: assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

    Directory of Open Access Journals (Sweden)

    Perisano Carlo

    2009-09-01

    Full Text Available Abstract Background The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect. The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS Committee on Bracing and Nonoperative Management Standardisation Criteria. Methods Fifty adolescent females (mean age 11.8 ± 0.5 years with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 ± 44.5 months. Antero-posterior radiographs were used to estimate the curve magnitude (CM and the torsion of the apical vertebra (TA at 5 time points: beginning of treatment (t1, one year after the beginning of treatment (t2, intermediate time between t1 and t4 (t3, end of weaning (t4, 2-year minimum follow-up from t4 (t5. Three situations were distinguished: curve correction, curve stabilisation and curve progression. The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests. Results CM mean value was 29,30 ± 5,16 SD at t1 and 14,67 ± 7,65 SD at t5. TA was 12.70 ± 6,14 SD at t1 and 8,95 ± 5,82 at t5. The variation between measures of Cobb and Perdriolle degrees at t1,2,3,4,5 and between CM t5-t1 and TA t5-t1 were significantly different. Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients. Conclusion The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

  10. Comparative anatomy: all vertebrates do have vertebrae.

    Science.gov (United States)

    Janvier, Philippe

    2011-09-13

    In contrast to lampreys and jawed vertebrates, hagfishes were thought to lack vertebrae. Now, long overlooked vertebral rudiments have been analysed in hagfish, suggesting that vertebrae existed in the last common ancestor of all vertebrates.

  11. Lumbar discography: an update.

    Science.gov (United States)

    Anderson, Mark W

    2004-01-01

    and then come back to reinject more contrast into the disk in question. As radiologists, we tend to focus on the technical aspects of a procedure and the anatomic/morphologic information it provides. However, it cannot be emphasized enough that when performing lumbar discography, the assessment of the patient's pain response during the injection is the most important component of the procedure, and requires not only technical skills, but an understanding of how best to avoid some of the pitfalls that can lead to inaccurate results.

  12. A lumbar disc surgery predictive score card.

    Science.gov (United States)

    Finneson, B E

    1978-06-01

    A lumbar disc surgery predictive score card or questionnaire has been developed to assess potential candidates for excision of a herniated lumbar disc who have not previously undergone lumbar spine surgery. It is not designed to encompass patients who are being considered for other types of lumbar spine surgery, such as decompressive laminectomy or fusion. In an effort to make the "score card" usable by almost all physicians who are involved in lumbar disc surgery, only studies which have broad acceptance and are generally employed are included. Studies which have less widespread use such as electromyogram, discogram, venogram, special psychologic studies (MMPI, pain drawings) have been purposely excluded.

  13. Bone demineralization and vertebral fractures in endogenous cortisol excess: role of disease etiology and gonadal status.

    Science.gov (United States)

    Tauchmanovà, Libuse; Pivonello, Rosario; Di Somma, Carolina; Rossi, Riccardo; De Martino, Maria Cristina; Camera, Luigi; Klain, Michele; Salvatore, Marco; Lombardi, Gaetano; Colao, Annamaria

    2006-05-01

    The effects of endogenous cortisol (F) excess on bone mass and vertebral fractures have still not been thoroughly investigated. The aim of this cross-sectional case-control study was to investigate factors influencing bone demineralization and vertebral fractures in different conditions of F excess, i.e. Cushing's disease and adrenal and ectopic Cushing's syndrome. Eighty consecutive patients and 80 controls were prospectively enrolled: 37 patients (21 females) with pituitary ACTH-secreting adenoma, 18 (14 females) with adrenocortical adenoma, 15 (11 females) with adrenal carcinoma of mixed secretion, and 10 (three females) with ectopic ACTH secretion. The groups had similar age. At diagnosis, bone mineral density (BMD) was determined by the dual-energy x-ray absorptiometry technique at the lumbar spine (L1-L4) and femoral neck; vertebral fractures were investigated by standard spinal radiographs. When comparing the groups with different etiology of F excess, the patients with ectopic ACTH secretion had higher F and lower BMD values than the other subgroups. Morning F (P = 0.03) and testosterone levels (P = 0.04) correlated with lumbar BMD. Vertebral fractures were found in 61 (76%) of the patients, were multiple in 52 (85%) of the cases, and clinically evident in 32 (52%). Only multiple fractures were more frequent in patients with ectopic ACTH hypersecretion (P gonadal status in women.

  14. Lumbar lordosis and pars interarticularis fractures: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Bugg, William G.; Lewis, Mark; Juette, Arne; Cahir, John G.; Toms, Andoni P. [Cotman Centre, Norwich Radiology Academy, Norwich, Norfolk (United Kingdom)

    2012-07-15

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  15. MORPHOMETRIC STUDY OF THE AREOLAR SPACE BETWEEN THE GREAT VESSELS AND THE LUMBAR SPINE

    Directory of Open Access Journals (Sweden)

    Luis Marchi

    2015-12-01

    Full Text Available Objective : This work aims to study the areolar space anterior to the lumbar spine, and also the positioning of the large vessels focusing a lateral approach. Methods :This is a morphometric study of 108 cases based on T2 weighted-MRI images in the supine position. The following measurements were performed: lumbar and segmental lordosis; anteroposterior disc diameter; space between the disc/vertebral body and the vessels; bifurcation between the abdominal aorta and the common iliac veins confluence in relation to the lumbar level. Results :The areolar space with respect to the iliac veins, and with the vena cava increased cranially (p<0.001, starting from average 0.6mm at L4-L5 and reaching 8.4mm at L2, while the abdominal aorta showed no increase or decrease pattern across the different levels (p=0.135 ranging from 1.8 to 4.6mm. The diameter of the discs increased distally (p<0.01 as well as the lordosis (p<0.001. The disc diameter was 11% larger when compared to the adjacent vertebral bodies (p<0.001 and that resulted in a smaller distance of the vessels in the disc level than in the level of the adjacent vertebral bodies (p<0.001. The aortic bifurcation was generally ahead of L4 (52% and less frequently at L3-L4 (28% and L4-L5 (18%. The confluence of the veins was usually at the L4-L5 level (38% and at L5 (37%, and less frequently at L4 (26%. Conclusions : There is an identifiable plane between the great vessels and the lumbar spine which is particularly narrow in its distal portion. It is theoretically feasible to reach this plan, handle the anterior complex disc/ALL and protect the great vessels by lateral approach, however, it is challenging.

  16. Fibrohistiocitoma benigno ósseo na coluna lombar Benign fibrous histiocytoma of the lumbar spine

    Directory of Open Access Journals (Sweden)

    Osmar Avanzi

    2005-01-01

    Full Text Available CONTEXTO: O fibrohistiocitoma benigno intra-ósseo é uma neoplasia rara, caracterizada por proliferação fibroblástica e fibras colágenas. A dor na região lombar é uma queixa freqüente em muitos pacientes, mas, na maioria das vezes está relacionada com causa muscular ou degenerativa. RELATO DE CASO: Relata-se aqui o caso de um paciente com diagnóstico de fibrohistiocitoma benigno ósseo na coluna lombar que apresentava queixa de lombalgia há cinco meses antes do diagnóstico. Foi submetida à biópsia aberta transpedicular na quarta vértebra lombar ,e, posteriormente realizada curetagem da lesão via anterior retroperitonial e artrodese vertebral de L3-L5 com enxerto de fíbula. CONCLUSÃO: Apesar de raro, o fibrohistiocitoma benigno intra-ósseo deve ser uma das hipóteses quando observamos uma lesão primária na coluna vertebral.CONTEXT: Benign intraosseous fibrous histiocytoma is a rare neoplasia, characterized by fibroblastic and collagenous fiber proliferation. Pain in the lumbar region is a frequent complaint in many patients, but most of times it is associated to muscular or degenerative causes. CASE REPORT: Here we report a case of a patient diagnosed with benign bone fibrous histiocytoma in the lumbar spine who complained of lumbar pain dating five months prior to diagnosis. The patient was submitted to open transpedicular biopsy in the forth lumbar vertebra, and subsequently, lesion curettage was performed via anterior retroperitoneal and L3-L5 vertebral arthrodesis using a fibular graft. CONCLUSION: Although rare, benign intraosseous fibrohistiocytoma should be taken into consideration when a primary lesion is observed in the spine.

  17. Lumbar myelography with Omnipaque (iohexol)

    Energy Technology Data Exchange (ETDEWEB)

    Lilleaas, F.; Bach-Gansmo, T.; Weber, H.

    1986-07-01

    Lumbar myelography with iohexol (Omnipaque) was performed in 103 consecutive adult patients with low back pain or sciatica. The patients were observed for 48 h with registration of possible adverse reactions. Mild or moderate transient side effects were recorded in 24 patients. No serious adverse reactions were noted, and EEG recorded in 25 patients showed no changes.

  18. Chondroblastoma of the lumbar vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Leung, L.Y.J.; Shu, S.J.; Chan, M.K.; Chan, C.H.S. [Dept. of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (Hong Kong)

    2001-12-01

    Chondroblastoma of the vertebra is a very rare condition. To our knowledge fewer than 20 cases have been reported in the world literature. We report a 54-year-old man with chondroblastoma of the fifth lumbar vertebra. The clinical and radiological aspects of the tumor are discussed, emphasizing the presence of an extraosseous mass suggestive of locally aggressive behavior. (orig.)

  19. Magnetic resonance imaging of lumbar intervertebral discs in elderly patients with minor trauma

    Energy Technology Data Exchange (ETDEWEB)

    Afzal, Suhail [Orthopaedic Spine Surgeon, Spine Clinic, Srinagar, Kashmir (India)], E-mail: drsuhaila@yahoo.com; Akbar, Saleem [Nehru Hospital, Rose Belle (Mauritius)

    2009-05-15

    Purpose: Vertebral body fractures due to minor trauma, which commonly occur in the elderly, are a frequently encountered clinical problem. We utilized MRI in patients with acute back pain following minor injury to ensure the earliest possible diagnosis. Lumbar discs adjacent to fractured vertebral bodies were evaluated, using magnetic resonance imaging (MRI), to elucidate how often these discs were injured and how the injured discs were depicted by MRI. Materials and methods: We retrospectively reviewed MR images of 74 discs from 37 elderly patients (>65-year-old) with a single level vertebral fracture (fracture group). Patients with multiple-level fractures, burst fractures and/or major trauma, such as that resulting from a traffic accident, were excluded from this study. We also reviewed MR images of 190 discs from 27 elderly patients diagnosed with lumbar stenosis, who had no previous history of vertebral body fractures (stenosis group). Results: In the fracture group, 23% (17/74) of T1-weighted images exhibited a high-intensity area in the disc, whereas only 3% (5/190) exhibited a high-intensity area in the stenosis group. In some cases, in the T2-weighted images we also found a high-intensity zone in discs that showed low- or iso-intensity. This phenomenon was more frequently observed in the fracture group (47%: 35/74) than in the stenosis group. Conclusion: The present study indicates that, in elderly patients, intervertebral discs adjacent to vertebral fractures resulting from minor trauma are often injured. Because hemorrhage is the most likely cause of a high-intensity T1-weighted image, the results indicate that hemorrhage can be induced in a disc adjacent to a vertebral body fractured by even minor trauma.

  20. Primary Ewing's sarcoma of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, Ch2-290 200 First Street, SW, Rochester, 55905, MN (United States); Unni, K.Krishnan [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States); Dekutoski, Mark B. [Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States)

    2004-09-01

    To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three cases were mixed lytic and sclerotic (6%) and one sclerotic. In the nonsacral spine, the majority of lesions (12/20) involved the posterior elements with extension into the vertebral body. Five cases were centered in the vertebral body with extension into the posterior elements. Two cases were limited to the posterior elements, and one case solely involved the vertebral body. Ala was the most frequently affected site in the sacrum (18/26). Spinal canal invasion was frequent (91%). Detailed clinical information was available in 53 patients. Duration of symptoms ranged from 1 to 30 (mean 7) months. Local pain was the first symptom and seen in all cases. Neurological deficits were present in 21 (40%) cases. All patients received radiation in various dosages; 70% additionally received chemotherapy. Twenty-five patients had surgery, and two patients received bone marrow transplantation. Forty-five patients had follow-up; the five-year disease-free survival probability is 0

  1. Early MR changes in vertebral bone marrow for patients following radiotherapy.

    Science.gov (United States)

    Onu, M; Savu, M; Lungu-Solomonescu, C; Harabagiu, I; Pop, T

    2001-01-01

    Our study aimed to evaluate the vertebral marrow changes in patients following radiotherapy (RT) by measuring the T2 relaxation times before and during RT. We were mostly interested in evaluating early MR marrow changes during RT. Fifteen patients treated by RT for cervical cancer were submitted to MR examination before and during RT (5-23 days of RT). T2 values were calculated for irradiated and non-irradiated tissues (lumbar and sacral vertebral bone marrow, symphysis pubis marrow, and regional muscle). Fourteen patients presented increased T2 values for irradiated vertebral bone marrow (VBM), and 3 patients showed increased T2 values even for non-irradiated VBM. We found T2 variations for VBM as early as in the fifth day of RT for an absorbed dose as small as 9 Gy. Calculated T2 values in irradiated and also in non-irradiated tissues prove very early tissue alterations.

  2. Anterior D-rod and titanium mesh fixation for acute mid-lumbar burst fracture with incomplete neurologic deficits A prospective study of 56 consecutive patients

    Directory of Open Access Journals (Sweden)

    Zhe-yuan Huang

    2015-01-01

    Conclusion: Good mid term clinicoradiological results of anterior decompression with D-rod and titanium mesh fixation for suitable patients with mid-lumbar burst fractures with incomplete neurologic deficits can be achieved. The incident rate of complications was low. D-rod is a reliable implant and has some potential advantages in L4 vertebral fractures.

  3. 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 variat...

  4. Behavioral fever in ectothermic vertebrates.

    Science.gov (United States)

    Rakus, Krzysztof; Ronsmans, Maygane; Vanderplasschen, Alain

    2017-01-01

    Fever is an evolutionary conserved defense mechanism which is present in both endothermic and ectothermic vertebrates. Ectotherms in response to infection can increase their body temperature by moving to warmer places. This process is known as behavioral fever. In this review, we summarize the current knowledge on the mechanisms of induction of fever in mammals. We further discuss the evolutionary conserved mechanisms existing between fever of mammals and behavioral fever of ectothermic vertebrates. Finally, the experimental evidences supporting an adaptive value of behavioral fever expressed by ectothermic vertebrates are summarized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. MORPHOMETRIC AND MORPHOLOGICAL STUDY OF ARTICULAR FACETS OF THE THORACOLUMBAR VERTEBRAL COLUMN IN NORTH INDIAN POPULATION

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    Rimpi Gupta

    2015-09-01

    Full Text Available Background: The articular processes of thoracolumbar vertebral column play an important role in weight transmission and determining the range and direction of movements between any two vertebrae. Size of these facets has been correlated with the magnitude of stress imposed on them. Purpose of study: The present study has been conducted on the articular processes of 510 vertebrae (thoracic: 360; lumbar:150 with the aim to provide high quality data sets for constructing the models of spine to study mechanics of spinal instrumentation. The length , width and the distance between the right & left superior & inferior articular processes have been measured with the vernier callipers. The presence/ absence of mamillary tubercle has been observed in the present study. Results: The length of thoracic SAFs was almost same at all levels whereas that of the lumbar SAFs increased gradually from L1-L5. However the width showed a variable trend. In case of thoracic IAFs both these parameters showed a variable trend. Whereas in lumbar region, these increased gradually from L1-L5. The distance between two inferior articular processes was more than that between two superior articular processes at almost all levels except T1-T3 & L1-L4 where reverse was true. The mamillary tubercle/process was altogether absent from T-1 to T-8. From T-9 to T-11, the number of vertebral column showing mamillary tubercle increased from 4-19. However at T-12, it was seen in 29 Vertebral columns. In lumbar region, it was well developed in all vertebrae and termed as mamillary process. Conclusion: The measurements obtained by present study reveals the importance of articular facets in understanding basic spinal mechanics and its application with respect to weight transmission.

  6. Apical-dominant particle swarm optimization

    Institute of Scientific and Technical Information of China (English)

    Zhihua Cui; Xingjuan Cai; Jianchao Zeng; Guoji Sun

    2008-01-01

    Particle swarm optimization (PSO) is a new stochastic population-based search methodology by simulating the animal social behaviors such as birds flocking and fish schooling.Many improvements have been proposed within the framework of this biological assumption.However,in this paper,the search pattern of PSO is used to model the branch growth process of natural plants.It provides a different poten-tial manner from artificial plant.To illustrate the effectiveness of this new model,apical dominance phenomenon is introduced to construct a novel variant by emphasizing the influence of the phototaxis.In this improvement,the population is divided into three different kinds of buds associated with their performances.Furthermore,a mutation strategy is applied to enhance the ability escaping from a local optimum.Sim-ulation results demonstrate good performance of the new method when solving high-dimensional multi-modal problems.

  7. A RARE PRESENTATION OF A CONCOMITANT LUMBAR SPINE BURST FRACTURE WITH A DISTAL CORPUS STERNI FRACTURE DUE TO A FLEXION DISTRACTION INJURY

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    Ravi Kumar TV, GadiDaksh, Jain Vinay, Rangaswamy BT

    2015-04-01

    Full Text Available ABSTRACT Sternum fractures are a rare entity and occur either due to direct trauma or indirectly associated to a flexion compression injury. Earlier literatures used to describe the association of sternum fractures with upper thoracic vertebral fractures. To the best of our knowledge very few cases have been described in literature with concomitant lumbar vertebral fracture with associated sternum fracture. We hereby report a rare presentation of a flexion distraction injury leading to a concomitant sternum fracture with a L1 vertebral burst fracture.

  8. Comparative morphometric study of the australopithecine vertebral series Stw-H8/H41.

    Science.gov (United States)

    Sanders, W J

    1998-03-01

    Lower spinal structure correlates well with positional behavior among mammals. Nonetheless, the functional morphology of the axial post-crania of australopithecines has received less attention than their appendicular skeletons. This paper presents a detailed description and comparative morphometric analysis of the australopithecine thoracolumbar vertebral series Stw-H8/H41, and examines spinal mechanics in early hominids. Stw-H8/H41 is an important specimen, as the australopithecine vertebral sample is small, and vertebral series are more useful than isolated elements for the interpretation of spinal function. Results of the study support the interpretation that australopithecine species are highly sexually dimorphic. The study also reveals a considerable amount of morphometric variation other than size among australopithecine vertebrae, though the sample is too small and incomplete to ascertain whether this indicates significant interspecific differences in spinal function. Most importantly, structural and metric observations confirm that the morphology of the lower spine in australopithecines has no modern analogue in its entirety. Aspects of zygapophyseal structure, numerical composition of the lumbar region, and centrum wedging suggest that the australopithecine vertebral column was adapted to human-like intrinsic lumbar lordosis and stable balance of the trunk over the pelvis in sustained bipedal locomotion. However, relative centrum size in australopithecines indicates that either they had a different mechanism for channeling vertical forces through the vertebral column than humans, or differed behaviorally from humans in ways that produced smaller increments of compression across their centra. These findings have important implications for hypotheses of australopithecine positional behavior, and demonstrate that larger samples and more complete vertebral series are needed to improve our understanding of australopithecine spinal function.

  9. Apical Hypertrophic Cardiomyopathy in Association with PulmonaryArtery Hypertension

    Directory of Open Access Journals (Sweden)

    Mehdi Peighambari

    2012-09-01

    Full Text Available Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  10. Reversible transient apical ballooning syndrome with coronary lesions

    Institute of Scientific and Technical Information of China (English)

    Yunshan Cao; Min Zhang; Xiang Li; Ping Xie; Lynn Cronin

    2009-01-01

    Transient apical ballooning syndrome(Tako-Tsubo syndrome or ampulla cardiomyopathy) occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of a male patient with reversible transient apical ballooning syndrome with significant coronary lesions and other ECG changes that did not explain the clinical symptoms.

  11. Apical Ballooning Syndrome: A Complication of Dual Chamber Pacemaker Implantation

    Science.gov (United States)

    Abu Sham'a, Raed A. H; Asher, Elad; Luria, David; Berger, Michael; Glikson, Michael

    2009-01-01

    Apical ballooning is a cardiac syndrome (Takotsubo Cardiomyopathy) described as a typical form of acute transient left ventricular dysfunction. While its onset has often been associated with emotionally or physically stressful situations, it has an overall favorable prognosis. We describe here a case of transient apical ballooning following permanent pacemaker implantation. PMID:19652736

  12. Apical entry channels in calcium-transporting epithelia.

    Science.gov (United States)

    Peng, Ji-Bin; Brown, Edward M; Hediger, Matthias A

    2003-08-01

    The identification of the apical calcium channels CaT1 and ECaC revealed the key molecular mechanisms underlying apical calcium entry in calcium-transporting epithelia. These channels are regulated directly or indirectly by vitamin D and dietary calcium and undergo feedback control by intracellular calcium, suggesting their rate-limiting roles in transcellular calcium transport.

  13. Evaluations of Computed Tomography Images and Lumbar Specimens in Mimic Operations of Transverse Rotation Laminoplasty for Lumbar Spinal Stenosis

    Institute of Scientific and Technical Information of China (English)

    Xian-Wu Pei; Yong-Hui Liang; Hui Zhang; Zi-Shun Gong; Hong-Xing Song

    2015-01-01

    Background:Laminectomy is a major method to treat lumbar spinal stenosis (LSS),but it has lots of flaws such as scar tissue can form around the dura again or spinal instability.This study aimed to investigate the feasibility of transverse rotation laminoplasty (TRL) in the treatment of LSS.Methods:The mimic operations of TRL were performed both in the computerized image processing and on the lumbar specimen.Computed tomography (CT) images were either collected from 80 clinical patients with complaints of lumbago or obtained from 40 sets of lumbar specimens after rebuild of spinal canals.In the CT image processing the heights of the spinous process and laminae at L3-L5 were measured.The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation.The areas of the vertebral canal were examined before and after the operation.Results:In the CT images,the height of spinous process of L3,L4 and L5 was 24.74 ± 3.45,22.68 ± 5.96 and 21.54 ± 4.12 mm respectively,and that of laminae was 23.66 ± 2.32,22.68 ± 5.36 and 20.99 ± 3.67 mm respectively (P > 0.05).Distance of inner border of pedical of L3,L4 and L5 was 23.01 ± 6.59,24.65 ± 5.54 and 26.03 ± 7.34 mm respectively,and length of spinous process with laminae of those was 29.76 ± 4.91,29.31 ± 6.43 and 32.53 ± 5.76 mm respectively (P < 0.05).Preoperative area of spinal canals of L3,L4 and L5 was 299.81 ± 10.09,297.66 ± 9.54 and 308.22 ± 10.04 mm2 respectively,and postoperative area was 480.01 ± 9.33,487.32 ± 8.65 and 501.03 ± 9.12 mm2 respectively (P < 0.05).In the human lumbar vertebrae specimen,the data similar to the former.Conclusions:The excised canal posterior was covered,and the lumbar canals enlarged by TRL.The TRL provided a new alternative in the treatment of LSS.

  14. The effect of posterior spinal fixation with acrylic cement on the vertebral growth plate and intervertebral disc in dogs.

    Science.gov (United States)

    Moon, M S; Ok, I Y; Ha, K Y

    1986-01-01

    We have attempted to clarify the serial histological changes in the growing spine of dogs following posterior fixation with acrylic cement. Twenty-four male mongrel dogs aged 8 weeks were used for the study. The lumbar spine from L.3 to L.5 was fixed posteriorly with acrylic cement. Three dogs were then sacrificed every four weeks up to 32 weeks, and the histological changes of the vertebral disc, growth plate and vertebral bodies were observed by light microscopy. Thinning of the growth plate and distortion of the cartilage columns has been demonstrated, but premature fusion of the growth plate did not result and vertebral body growth continued. Anterior wedging of the intervertebral disc was seen with some thinning of the bony trabeculae of the vertebral body. Degeneration of the nucleus pulposus resulted, with replacement by fibrous tissue. The normal horizontal arrangement of the fibres of the annulus fibrosus altered to a vertical configuration by 32 weeks.

  15. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    Directory of Open Access Journals (Sweden)

    Koshi Ninomiya

    2014-01-01

    Full Text Available A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI showed a large L2/3 disc hernia descending to the L3/4 level. Compared to the initial MRI, this hernia occurred in an “intact” disc among multilevel severely degenerated discs. Right leg paresis and bladder dysfunction appeared a few days after admission. Microscopic lumbar disc herniotomy was performed. The right leg motor weakness improved just after the operation, but the moderate left leg motor weakness and difficulty in urination persisted.

  16. Establishment of Hox vertebral identities in the embryonic spine precursors.

    Science.gov (United States)

    Iimura, Tadahiro; Denans, Nicolas; Pourquié, Olivier

    2009-01-01

    The vertebrate spine exhibits two striking characteristics. The first one is the periodic arrangement of its elements-the vertebrae-along the anteroposterior axis. This segmented organization is the result of somitogenesis, which takes place during organogenesis. The segmentation machinery involves a molecular oscillator-the segmentation clock-which delivers a periodic signal controlling somite production. During embryonic axis elongation, this signal is displaced posteriorly by a system of traveling signaling gradients-the wavefront-which depends on the Wnt, FGF, and retinoic acid pathways. The other characteristic feature of the spine is the subdivision of groups of vertebrae into anatomical domains, such as the cervical, thoracic, lumbar, sacral, and caudal regions. This axial regionalization is controlled by a set of transcription factors called Hox genes. Hox genes exhibit nested expression domains in the somites which reflect their linear arrangement along the chromosomes-a property termed colinearity. The colinear disposition of Hox genes expression domains provides a blueprint for the regionalization of the future vertebral territories of the spine. In amniotes, Hox genes are activated in the somite precursors of the epiblast in a temporal colinear sequence and they were proposed to control their progressive ingression into the nascent paraxial mesoderm. Consequently, the positioning of the expression domains of Hox genes along the anteroposterior axis is largely controlled by the timing of Hox activation during gastrulation. Positioning of the somitic Hox domains is subsequently refined through a crosstalk with the segmentation machinery in the presomitic mesoderm. In this review, we focus on our current understanding of the embryonic mechanisms that establish vertebral identities during vertebrate development.

  17. Lymphatic regulation in nonmammalian vertebrates.

    Science.gov (United States)

    Hedrick, Michael S; Hillman, Stanley S; Drewes, Robert C; Withers, Philip C

    2013-08-01

    All vertebrate animals share in common the production of lymph through net capillary filtration from their closed circulatory system into their tissues. The balance of forces responsible for net capillary filtration and lymph formation is described by the Starling equation, but additional factors such as vascular and interstitial compliance, which vary markedly among vertebrates, also have a significant impact on rates of lymph formation. Why vertebrates show extreme variability in rates of lymph formation and how nonmammalian vertebrates maintain plasma volume homeostasis is unclear. This gap hampers our understanding of the evolution of the lymphatic system and its interaction with the cardiovascular system. The evolutionary origin of the vertebrate lymphatic system is not clear, but recent advances suggest common developmental factors for lymphangiogenesis in teleost fishes, amphibians, and mammals with some significant changes in the water-land transition. The lymphatic system of anuran amphibians is characterized by large lymphatic sacs and two pairs of lymph hearts that return lymph into the venous circulation but no lymph vessels per se. The lymphatic systems of reptiles and some birds have lymph hearts, and both groups have extensive lymph vessels, but their functional role in both lymph movement and plasma volume homeostasis is almost completely unknown. The purpose of this review is to present an evolutionary perspective in how different vertebrates have solved the common problem of the inevitable formation of lymph from their closed circulatory systems and to point out the many gaps in our knowledge of this evolutionary progression.

  18. Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, J.L.; Kaplan, P.A.; Dussault, R.G.; Anderson, M.W. [Dept. of Radiology, Univ. of Virginia Health System, Charlottesville, VA (United States)

    2000-12-01

    Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease.Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease.Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease.Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. (orig.)

  19. Evaluation of lumbar vertebra injury risk to the seated human body when exposed to vertical vibration

    Science.gov (United States)

    Ayari, H.; Thomas, M.; Doré, S.; Serrus, O.

    2009-03-01

    The objective of this research is to numerically determine the levels of vibration not to exceed accordingly to the corresponding dynamic stresses in the lumbar rachis when exposed to whole-body vibrations in order to identify the risk of adverse health effect to which professional heavy equipment drivers are particularly prone. A parametric finite element model of the lumbar rachis is generated in order to compute the modal parameters, the dynamic stresses and forces under harmonic excitations in a seated posture. The stress analysis reveals that the areas exposed to the highest fracture risk are the cancellous bone of the vertebral body as well as the vertebral endplate when vertical vibrations are transmitted from a seat to the lumbar spine of a driver. An injury risk factor has been developed in order to estimate the risk of adverse health effect arising from mechanical vibrations. It is shown that the injury risk factor increases with the age and consequently that the excitation amplitude must be limited to lower levels when age increases.

  20. Pregnancy-associated osteoporosis presenting severe vertebral fractures.

    Science.gov (United States)

    Ozturk, Cihat; Atamaz, Funda Calis; Akkurt, Halil; Akkoc, Yesim

    2014-01-01

    The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in late pregnancy or early post-partum period leading to fragility fracture(s), most commonly in the vertebral bodies. We presented two cases with PAO who had compression fractures at multiple levels involving five vertebrae in one case and 10 vertebrae in the other. Their spinal bone mineral density values were below -2.5 standard deviations. Anti-osteoporotic treatments with nasal calcitonin 400 IU/day, vitamin D 300.000 IU single dose, calcium 1000 mg/day, vitamin D 880 IU/day were initiated. In one case, kyphoplasty was performed by a spinal surgeon. In addition to a thoracolumbosacral orthosis, a rehabilitation program including muscle strengthening, range of motion, relaxation and weight-bearing exercises was started for both cases. These cases emphasize that all pregnant women with complaints of back/lumbar pain should be carefully evaluated.

  1. Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Mehmet Bani

    2015-01-01

    Full Text Available The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1–4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p<0.05. The apical sealing ability of Biodentine was comparable to MTA at any apical plug thickness.

  2. Examination of a lumbar spine biomechanical model for assessing axial compression, shear, and bending moment using selected Olympic lifts.

    Science.gov (United States)

    Eltoukhy, Moataz; Travascio, Francesco; Asfour, Shihab; Elmasry, Shady; Heredia-Vargas, Hector; Signorile, Joseph

    2016-09-01

    Loading during concurrent bending and compression associated with deadlift, hang clean and hang snatch lifts carries the potential for injury to the intervertebral discs, muscles and ligaments. This study examined the capacity of a newly developed spinal model to compute shear and compressive forces, and bending moments in lumbar spine for each lift. Five male subjects participated in the study. The spine was modeled as a chain of rigid bodies (vertebrae) connected via the intervertebral discs. Each vertebral reference frame was centered in the center of mass of the vertebral body, and its principal directions were axial, anterior-posterior, and medial-lateral. The results demonstrated the capacity of this spinal model to assess forces and bending moments at and about the lumbar vertebrae by showing the variations among these variables with different lifting techniques. These results show the model's potential as a diagnostic tool.

  3. Proximal junctional vertebral fracture-subluxation after adult spine deformity surgery. Does vertebral augmentation avoid this complication? A case report

    Directory of Open Access Journals (Sweden)

    Fernández-Baíllo Nicomedes

    2012-09-01

    Full Text Available Abstract Background To report to the orthopedic community a case of vertebral fracture and adjacent vertebral subluxation through the upper instrumented vertebra after thoracolumbar fusion with augmentation of the cranial level. Methods This report reviewed the patient`s medical record, her imaging studies and related literature. The possible factors contributing to this fracture are hypothesized. Results A 70-year-old woman underwent decompressive surgery and posterolateral fusion for adult lumbar scoliosis. We used pedicular screws from T10 to S1 and iliac screw at the right side, augmented with cement at T10, T11, L1, L5 and S1; and prophylactic vertebroplasty at T9 to avoid the "topping-off syndrome". Thirty days after discharge, without recognizable inciting trauma, the patient complained of pain in the lower thoracic area. The exam revealed overall neurological deficit below the level of fracture. CT scan and MRI demonstrated a T10 vertebral collapse and T9 vertebral subluxation with morphologic features of flexion-distraction fracture through the upper edge of the screw. At this point, the authors performed posterior decompression at T9 to T10 and extended posterolateral arthrodesis from T2 to T10. To our knowledge, this is an unreported fracture. Conclusions Augmentation of the cranial level in a long thoracolumbar fusion has been developed to avoid the junctional kyphosis and compression fractures at that level. We alert the orthopedic community that this augmentation may lead to further and more severe fractures, although this opinion requires investigation for confirmation.

  4. Five-year follow-up of a woman with pregnancy and lactation-associated osteoporosis and vertebral fractures

    Directory of Open Access Journals (Sweden)

    Sato Y

    2012-04-01

    Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, 2Department of Neurology, Mitate Hospital, Fukuoka, 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the 5-year follow-up of a young woman who developed vertebral fractures after pregnancy and lactation and was treated with active vitamin D hormone. A 32-year-old Japanese woman consulted us because of acute lower back pain caused by L2 and L5 vertebral fractures after pregnancy and lactation. Following cessation of breast-feeding, analgesia, bed rest, and wearing of a hard brace, her lower back pain disappeared within 2 months. After 5 years of treatment with alfacalcidol 1 µg daily, the lumbar spine (L1, L3, L4 bone mineral density increased by 21.4% following vigorous reductions in bone turnover markers. No osteoporotic fractures occurred, and the vertebral fractures healed. The patient experienced no side effects, including hypercalcemia. Thus, the present case report shows long-term changes in bone turnover markers and lumbar spine bone mineral density, as well as long-term safety of alfacalcidol treatment in a young woman with pregnancy and lactation-associated osteoporosis and vertebral fractures.Keywords: young woman, pregnancy, alfacalcidol, bone mineral density, osteoporosis, vertebral fracture

  5. Safe zone for retractor placement to the lumbar spine via the transpsoas approach.

    Science.gov (United States)

    Spivak, Jeffery M; Paulino, Carl B; Patel, Ashish; Shanti, Nael; Pathare, Neil

    2013-04-01

    To measure anatomic variations of the lumbar plexus within the psoas in relation to the L2/3, L3/4, and L4/5 disc spaces and to delineate a safe zone to avoid nerve injury during retractor placement via the transpsoas approach. Six male and 6 female cadavers (24 psoas/ lumbar plexuses) aged 35 to 74 years were dissected. The lumbar plexus was isolated bilaterally. The L2, L3, and L4 nerve roots were identified and isolated without disturbing their natural anatomic course. The anteroposterior (AP) diameter of each intervertebral disc at L2/3, L3/4, and L4/5 was used as a reference. Four measurements were made using a caliper: the AP and mediolateral (ML) diameters of the psoas and AP and ML excursions of each nerve root. Percentages were calculated for the 4 measurements using the reference of the AP diameter of the intervertebral disc at each level. Comparison between left and right sides, between males and females, and between excursions of nerve roots were made. The AP diameter of the psoas increased from L2 to L4, with a mean vertebral body coverage of 80%, 86%, and 85% at L2/3, L3/4, and L4/5, respectively. Both the L2 and L3 nerve roots demonstrated substantial anterior trajectories as they coursed distally in the lumbar spine. No nerve root encroached anteriorly beyond 33% of the intervertebral disc space at L2 to L5. The lumbar plexus area corresponding to the anterior half of the intervertebral disc was the safe zone. Procedures to the lumbar spine via the transpsoas approach should be performed within the safe zone to avoid nerve injury.

  6. Diagnostic accuracy of magnetic resonance imaging versus computed tomography in stress fractures of the lumbar spine

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    Ganiyusufoglu, A.K., E-mail: kursady33@yahoo.co [Department of Radiology, Florence Nightingale Hospital, Istanbul (Turkey); Onat, L. [Department of Radiology, Florence Nightingale Hospital, Istanbul (Turkey); Karatoprak, O.; Enercan, M.; Hamzaoglu, A. [Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul (Turkey)

    2010-11-15

    Aim: To compare the diagnostic accuracy of magnetic resonance imaging (MRI) with computed tomography (CT) in stress fractures of the lumbar spine. Materials and methods: Radiological and clinical data from 57 adolescents and young adults with a diagnosis of stress injury of the lumbar spine were retrospectively reviewed. All cases had undergone both 1.5 T MRI and 16-section CT examinations. All MRI and CT images were retrospectively reviewed and evaluated in separate sessions. The fracture morphology (complete/incomplete, localization) and vertebral levels were noted at both the CT and MRI examinations. Bone marrow/peri-osseous soft-tissue oedema was also determined at MRI. Results: In total, 73 complete and 32 incomplete stress fractures were detected with CT. Sixty-seven complete, 24 incomplete fractures and eight stress reactions were detected using MRI in the same study group. Marrow oedema was also seen in eight of the complete and 20 of the incomplete fractures. The specificity, sensitivity, and accuracy of MRI in detecting fracture lines were 99.6, 86.7, and 97.2%, respectively. MRI was more accurate at the lower lumbar levels in comparison to upper lumbar levels. Conclusion: MRI has a similar diagnostic accuracy to CT in determining complete fractures with or without accompanying marrow oedema and incomplete fractures with accompanying marrow oedema, especially at the lower lumbar levels, which constitutes 94% of all fractures. At upper lumbar levels and in the incomplete fractures of the pars interarticularis with marked surrounding sclerosis, MRI has apparent limitations compared to CT imaging.

  7. Influence of Physiological Loading on the Lumbar Spine of National Level Athletes in Different Sports

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    Rozan Mansoorehossadat

    2016-04-01

    Full Text Available The lumbar spine is subjected to considerable stress during many athletic efforts. The purpose of this study was to assess the effects of physiological loading on the lumbar spine in national male players of different games, which may be predictive of the future development of low back pain and injury symptoms. Thirty-four national players (12 cricket players, 12 field hockey players, and 10 basketball players underwent magnetic resonance imaging, and selected geometric variables including intervertebral disc angles, the Farfan ratio, the lumbar body index, the compression deformity ratio, the biconcave deformity ratio and the anterior wedge deformity ratio were measured using KINOVEA-0.8.15 software and syngo fast view software and calculated using specific formulas. The results indicated a significant difference in the intervertebral disc angle between the three groups at the L2/3, L3/4 and L4/5 levels. In relation to the lumbar vertebral body shape and size, significant differences were found in the lumbar index at the L2 level, in the biconcave deformity at the L1 and L2 levels and in relation to the anterior wedge deformity at L2 between the three selected groups. Our data suggest that the different physiological loadings in the selected sports play an important role in the development of degenerative changes of the lumbar spine, which may be considered a risk factor for future injury and/or low back pain in each specific sport because of the unique demands of each discipline.

  8. Lumbar disc excision through fenestration

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    Sangwan S

    2006-01-01

    Full Text Available Background : Lumbar disc herniation often causes sciatica. Many different techniques have been advocated with the aim of least possible damage to other structures while dealing with prolapsed disc surgically in the properly selected and indicated cases. Methods : Twenty six patients with clinical symptoms and signs of prolapsed lumbar intervertebral disc having radiological correlation by MRI study were subjected to disc excision by interlaminar fenestration method. Results : The assessment at follow-up showed excellent results in 17 patients, good in 6 patients, fair in 2 patients and poor in 1 patient. The mean preoperative and postoperative Visual Analogue Scores were 9.34 ±0.84 and 2.19 ±0.84 on scale of 0-10 respectively. These were statistically significant (p value< 0.001, paired t test. No significant complications were recorded. Conclusion : Procedures of interlaminar fenestration and open disc excision under direct vision offers sufficient adequate exposure for lumbar disc excision with a smaller incision, lesser morbidity, shorter convalescence, early return to work and comparable overall results in the centers where recent laser and endoscopy facilities are not available.

  9. Case report and review of lumbar hernia.

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    Walgamage, Thilan B; Ramesh, B S; Alsawafi, Yaqoob

    2015-01-01

    Lumbar hernias are uncommon and about 300 cases have been reported till date. They commonly occur due to trauma, surgery and infection. They are increasingly being reported after motor vehicle collision injuries. However, spontaneous lumbar hernias are rare and are reported infrequently. It is treated with different surgical approaches and methods. We report a case of primary spontaneous lumbar hernia which was repaired by transperitonial laparoscopic approach using Vypro (polypropylene/polyglactin) mesh and covered with a peritoneal flap.

  10. Thoracic meningocele in lumbo-costo-vertebral syndrome in a child: possible enlargement with repeated motion by anchoring to the diaphragm.

    Science.gov (United States)

    Wataya, Takafumi; Horikawa, Kyohei; Kitagawa, Masashi; Tashiro, Yuzuru

    2016-08-01

    Lumbo-costo-vertebral syndrome (LCVS) is a rare disorder in children that is characterized by hemivertebrae, congenital absence of ribs, meningocele, and hypoplasia of the truncal and abdominal wall presenting as a congenital lumbar hernia. An otherwise healthy 12-month-old girl was referred to the authors' hospital with soft swelling on her left middle back; scoliosis had been present since birth. Imaging revealed a thoracic meningocele, ectopia of the spleen suggesting lumbar hernia, multiple anomalies of the thoracic vertebral columns, and defects of the ribs; thus, LCVS was diagnosed. Surgical observation revealed that the meningocele was firmly anchored to part of the diaphragm, which created stretching tension in the meningocele continuously with exhalation. Once detached, the meningocele shrank spontaneously and never developed again after cauterization. In this case, continuous or pulsatile pressure in the presence of a vertebral defect was thus considered to be an important factor for formation of the thoracic meningocele.

  11. CT检查在牵引治疗腰椎间盘突出症中的评估作用%Evaluation function of CT examination to traction therapy to lumbar disc protrusion

    Institute of Scientific and Technical Information of China (English)

    丁长伟; 刘丽君; 林楠; 王天君

    2002-01-01

    Objective To investigate whether there is morphological change at intervertebral disc after traction therapy to lumbar disc protrusion. Methods We observed 58 lumbar disc protrusion cases diagnosed by CT and treated with traction therapy with CT again, and compared morphological change of intervertebral disc on CT image before and after treatment. Result Effective rate of traction therapy to lumbar disc protrusion was 84.48% , there was no apparent difference in degree of lumbar disc protrusion, anterior posterior diameter of vertebral canal and lateral crypt width between before and after treatment. Conclusion Traction can relieve effectively clinical symptoms of lumbar disc protrusion, but can't make great change in shape of protruded intervertebral disc.

  12. Assessment of Lumbar Lordosis and Lumbar Core Strength in Information Technology Professionals.

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    Mehta, Roma Satish; Nagrale, Sanket; Dabadghav, Rachana; Rairikar, Savita; Shayam, Ashok; Sancheti, Parag

    2016-06-01

    Observational study. To correlate lumbar lordosis and lumbar core strength in information technology (IT) professionals. IT professionals have to work for long hours in a sitting position, which can affect lumbar lordosis and lumbar core strength. Flexicurve was used to assess the lumbar lordosis, and pressure biofeedback was used to assess the lumbar core strength in the IT professionals. All subjects, both male and female, with and without complaint of low back pain and working for two or more years were included, and subjects with a history of spinal surgery or spinal deformity were excluded from the study. Analysis was done using Pearson's correlation. For the IT workers, no correlation was seen between lumbar lordosis and lumbar core strength (r=-0.04); however, a weak negative correlation was seen in IT people who complained of pain (r=-0.12), while there was no correlation of lumbar lordosis and lumbar core in IT people who had no complains of pain (r=0.007). The study shows that there is no correlation of lumbar lordosis and lumbar core strength in IT professionals, but a weak negative correlation was seen in IT people who complained of pain.

  13. Scaled, patient-specific 3D vertebral model reconstruction based on 2D lateral fluoroscopy.

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    Zheng, Guoyan; Nolte, Lutz-P; Ferguson, Stephen J

    2011-05-01

    Accurate three-dimensional (3D) models of lumbar vertebrae are required for image-based 3D kinematics analysis. MRI or CT datasets are frequently used to derive 3D models but have the disadvantages that they are expensive, time-consuming or involving ionizing radiation (e.g., CT acquisition). An alternative method using 2D lateral fluoroscopy was developed. A technique was developed to reconstruct a scaled 3D lumbar vertebral model from a single two-dimensional (2D) lateral fluoroscopic image and a statistical shape model of the lumbar vertebrae. Four cadaveric lumbar spine segments and two statistical shape models were used for testing. Reconstruction accuracy was determined by comparison of the surface models reconstructed from the single lateral fluoroscopic images to the ground truth data from 3D CT segmentation. For each case, two different surface-based registration techniques were used to recover the unknown scale factor, and the rigid transformation between the reconstructed surface model and the ground truth model before the differences between the two discrete surface models were computed. Successful reconstruction of scaled surface models was achieved for all test lumbar vertebrae based on single lateral fluoroscopic images. The mean reconstruction error was between 0.7 and 1.6 mm. A scaled, patient-specific surface model of the lumbar vertebra from a single lateral fluoroscopic image can be synthesized using the present approach. This new method for patient-specific 3D modeling has potential applications in spine kinematics analysis, surgical planning, and navigation.

  14. Maxillary first premolars: I. Morphology of the apical constriction

    Institute of Scientific and Technical Information of China (English)

    Daming Wu; Younong Wu; Ming Hu

    2009-01-01

    Objective: To investigated the apical constriction morphology of maxillary first premolars in the Chinese population. Methods: Eighty recently extracted human maxillary first premolars from a native Chinese population were used. The number and shape of apical constrictions were recorded under a dental operating microscope (DOM) at 12.5X2.5 magnification. After access preparation, a new K-file was inserted into the canal until the tip of the file was just seen at the apical constriction under the DOM. The teeth with files in the canals were X-rayed from a mesiodistal direction using a direct digital radiography (DDR) system, and the distance between the file tip and the center of radiographic apex was directly measured from the computer screen using DDR measurement software. Results: The percentage of teeth with an apical constriction was 78.5% (102/130). The most common apical constriction shapes were oval (55.9%) and round (35.3%). The mean distance between the apical constriction and the anatomical tip of the root was 0.61 mm, and 84.3% (86/102) were within 1 mm. Conclusion: The most common shape of an apical constriction was oval or round, and the distance to the apex was mostly within 1 mm, indicating that root canal therapy should stop 1 mm from the radiographic apex.

  15. Virus interaction with the apical junctional complex.

    Science.gov (United States)

    Gonzalez-Mariscal, Lorenza; Garay, Erika; Lechuga, Susana

    2009-01-01

    In order to infect pathogens must breach the epithelial barriers that separate the organism from the external environment or that cover the internal cavities and ducts of the body. Epithelia seal the passage through the paracellular pathway with the apical junctional complex integrated by tight and adherens junctions. In this review we describe how viruses like coxsackie, swine vesicular disease virus, adenovirus, reovirus, feline calcivirus, herpes viruses 1 and 2, pseudorabies, bovine herpes virus 1, poliovirus and hepatitis C use as cellular receptors integral proteins present at the AJC of epithelial cells. Interaction with these proteins contributes in a significant manner in defining the particular tropism of each virus. Besides these proteins, viruses exhibit a wide range of cellular co-receptors among which proteins present in the basolateral cell surface like integrins are often found. Therefore targeting proteins of the AJC constitutes a strategy that might allow viruses to bypass the physical barrier that blocks their access to receptors expressed on the basolateral surface of epithelial cells.

  16. Auxin at the Shoot Apical Meristem

    Science.gov (United States)

    Vernoux, Teva; Besnard, Fabrice; Traas, Jan

    2010-01-01

    Plants continuously generate new tissues and organs through the activity of populations of undifferentiated stem cells, called meristems. Here, we discuss the so-called shoot apical meristem (SAM), which generates all the aerial parts of the plant. It has been known for many years that auxin plays a central role in the functioning of this meristem. Auxin is not homogeneously distributed at the SAM and it is thought that this distribution is interpreted in terms of differential gene expression and patterned growth. In this context, auxin transporters of the PIN and AUX families, creating auxin maxima and minima, are crucial regulators. However, auxin transport is not the only factor involved. Auxin biosynthesis genes also show specific, patterned activities, and local auxin synthesis appears to be essential for meristem function as well. In addition, auxin perception and signal transduction defining the competence of cells to react to auxin, add further complexity to the issue. To unravel this intricate signaling network at the SAM, systems biology approaches, involving not only molecular genetics but also live imaging and computational modeling, have become increasingly important. PMID:20452945

  17. Factors for Predicting Favorable Outcome of Percutaneous Epidural Adhesiolysis for Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Sang Ho Moon

    2017-01-01

    Full Text Available Background. Lower back pain is a common reason for disability and the most common cause is lumbar disc herniation. Percutaneous epidural adhesiolysis has been applied to relieve pain and increase the functional capacity of patients who present this condition. Objectives. In this study, we retrospectively evaluated the factors which predict the outcome of percutaneous epidural adhesiolysis in patients who were diagnosed with lumbar disc herniation. Methods. Electronic medical records of patients diagnosed with lumbar disc herniation who have received percutaneous epidural adhesiolysis treatment were reviewed. The primary outcome was the factors that were associated with substantial response of ≥4 points or ≥50% of pain relief in the numerical rating scale pain score 12 months after the treatment. Results. Multivariate logistic regression analysis demonstrated that the presence of high-intensity zone (HIZ at magnetic resonance imaging was a predictor of substantial response to percutaneous epidural adhesiolysis for 12 months (P=0.007. The presence of a condition involving the vertebral foramen was a predictor for unsuccessful response after 12 months (P=0.02. Discussion and Conclusion. The presence of HIZ was a predictor of favorable long-term outcome after percutaneous epidural adhesiolysis for the treatment of lower back pain with radicular pain caused by lumbar disc herniation.

  18. PARAMETERS OF NUCLEAR MAGNETIC RESONANCE IN PATIENTS WITH CONGENITAL NARROWING OF THE LUMBAR SPINAL CANAL

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    ELIU HAZAEL MORALES-RANGEL

    Full Text Available ABSTRACT Objective: To compare the morphological parameters of magnetic resonance in patients with congenital narrowing of the lumbar spinal canal with patients with low back pain. Methods: A descriptive, retrospective, observational study was conducted with measurements in the axial and sagittal magnetic resonance sections of the vertebral body and canal of the lumbar spine of 64 patients with diagnosis of low back pain, which were compared with resonance images taken from 31 Mexican patients with congenital narrowing of the lumbar spinal canal. Results: The results show that patients with congenital narrowing of the lumbar spinal canal in the axial sections have a difference in diameters, being L2<13.9 mm, L3<13.3 mm, L4<12.9 mm, L5<13.1 mm, compared with controls L2<20.5 mm, L3<20.5 mm, L4<19.3 mm, L5<18.1 mm with p = 0.000. Conclusions: We found different measurements in the Mexican population compared to those found by similar studies. With the parameters obtained, it would be possible to make the proper diagnosis, surgical planning, and treatment.

  19. Minimally invasive lateral trans-psoas approach for tuberculosis of lumbar spine

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    Nitin Garg

    2014-01-01

    Full Text Available Anterior, posterolateral and posterior approaches are used for managing lumbar tuberculosis. Minimally invasive methods are being used increasingly for various disorders of the spine. This report presents the utility of lateral trans-psoas approach to the lumbar spine (LS using minimal access techniques, also known as direct lateral lumbar interbody fusion in 2 cases with tuberculosis of LS. Two patients with tuberculosis at L2-3 and L4-5 presented with back pain. Both had destruction and deformity of the vertebral body. The whole procedure comprising debridement and placement of iliac crest graft was performed using tubular retractors and was augmented by posterior fixation using percutaneous transpedicular screws. Both patients recovered well with no significant procedure related morbidity. Post-operative computed tomography scans showed appropriate position of the graft and instrumentation. At follow-up, both patients are ambulant with no progression of the deformity. Minimal access direct lateral transpsoas approach can be used for debridement and reconstruction of ventral column in tuberculous of Lumbar spine. This paper highlights the growing applications of minimal access surgery for spine.

  20. Spinal muscles can create compressive follower loads in the lumbar spine in a neutral standing posture.

    Science.gov (United States)

    Han, Kap-Soo; Rohlmann, Antonius; Yang, Seok-Jo; Kim, Byeong Sam; Lim, Tae-Hong

    2011-05-01

    The ligamentous spinal column buckles under compressive loads of even less than 100N. Experimental results showed that under the follower load constraint, the ligamentous lumbar spine can sustain large compressive loads without buckling, while at the same time maintaining its flexibility reasonably well. The purpose of this study was to investigate the feasibility of follower loads produced by spinal muscles in the lumbar spine in a quiet standing posture. A three-dimensional static model of the lumbar spine incorporating 232 back muscles was developed and utilized to perform the optimization analysis in order to find the muscle forces, and compressive follower loads (CFLs) along optimum follower load paths (FLPs). The effect of increasing external loads on CFLs was also investigated. An optimum solution was found which is feasible for muscle forces producing minimum CFLs along the FLP located 11 mm posterior to the curve connecting the geometrical centers of the vertebral bodies. Activation of 30 muscles was found to create CFLs with zero joint moments in all intervertebral joints. CFLs increased with increasing external loads including FLP deviations from the optimum location. Our results demonstrate that spinal muscles can create CFLs in the lumbar spine in a neutral standing posture in vivo to sustain stability. Therefore, its application in experimental and numerical studies concerning loading conditions seems to be suitable for the attainment of realistic results. Published by Elsevier Ltd.

  1. Bony change of apical lesion healing process using fractal analysis

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    Lee, Ji Min; Park, Hyok; Jeong, Ho Gul; Kim, Kee Deog; Park, Chang Seo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    To investigate the change of bone healing process after endodontic treatment of the tooth with an apical lesion by fractal analysis. Radiographic images of 35 teeth from 33 patients taken on first diagnosis, 6 months, and 1 year after endodontic treatment were selected. Radiographic images were taken by JUPITER computerized Dental X-ray System. Fractal dimensions were calculated three times at each area by Scion Image PC program. Rectangular region of interest (30 x 30) were selected at apical lesion and normal apex of each image. The fractal dimension at apical lesion of first diagnosis (L{sub 0}) is 0.940 {+-} 0.361 and that of normal area (N{sub 0}) is 1.186 {+-} 0.727 (p<0.05). Fractal dimension at apical lesion of 6 months after endodontic treatment (L{sub 1}) is 1.076 {+-} 0.069 and that of normal area (N{sub 1}) is 1.192 {+-} 0.055 (p<0.05). Fractal dimension at apical lesion of 1 year after endodontic treatment (L{sub 2}) is 1.163 {+-} 0.074 and that of normal area (N{sub 2}) is 1.225 {+-} 0.079 (p<0.05). After endodontic treatment, the fractal dimensions at each apical lesions depending on time showed statistically significant difference. And there are statistically significant different between normal area and apical lesion on first diagnosis, 6 months after, 1 year after. But the differences were grow smaller as time flows. The evaluation of the prognosis after the endodontic treatment of the apical lesion was estimated by bone regeneration in apical region. Fractal analysis was attempted to overcome the limit of subjective reading, and as a result the change of the bone during the healing process was able to be detected objectively and quantitatively.

  2. Pregnancy related symptomatic vertebral hemangioma

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    Meena Gupta

    2014-01-01

    Full Text Available Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  3. Pregnancy related symptomatic vertebral hemangioma.

    Science.gov (United States)

    Gupta, Meena; Nayak, Rajeev; Singh, Hukum; Khwaja, Geeta; Chowdhury, Debashish

    2014-01-01

    Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI) revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  4. [Serine proteinases of lower vertebrates].

    Science.gov (United States)

    Kolodzeĭskaia, M V

    1986-01-01

    Recent data on the effect of serine proteinases of lower vertebrates are generalized. Hydrolysis specificity and kinetics of different synthetic substrates, dependence of the activity of enzymes on pH, their irreversible inhibition by chloromethyl ketones of amino acids and peptides as well as high-molecular proteinase inhibitors are considered in detail. The data testify to the fact that chymotrypsins and trypsins of higher vertebrates and serine proteinases of lower vertebrates act as an acid-base catalysis. Enzymes in the pyloric cacca of fishes are in the state of proenzymes and are transformed into an active form with the aid of their own proteolytic factors. The esterase and proteolytic activity of fish proteinases is concentrated in the same active site and reaches the highest values at pH 7,8. New data are presented on particularities of the lower vertebrate proteinases, on the similarity and differences in their specificity. A distinct difference is shown in the nature of the binding site of the active centre in a number of serine proteinases of fishes as compared to chymotrypsin and trypsin of higher vertebrates.

  5. Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial

    Science.gov (United States)

    Vittinghoff, E.; Kado, D. M.; Lane, N. E.; Ensrud, K. E.; Shipp, K.

    2016-01-01

    Summary Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Introduction Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. Methods We used data from the Fracture Intervention Trial among 3038 women 55–81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Results Mean baseline kyphosis was 48° (SD = 12) (range 7–83). At baseline, 962 (32 %) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95 % CI 2.8–4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22 % increase (95 % CI 8–38 %, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8 % per 10° kyphosis (95 % CI −4 to 22 %, p = 0.18). Conclusions While greater kyphosis increased the rate of

  6. Repeated adjacent-segment degeneration after posterior lumbar interbody fusion.

    Science.gov (United States)

    Okuda, Shinya; Oda, Takenori; Yamasaki, Ryoji; Maeno, Takafumi; Iwasaki, Motoki

    2014-05-01

    One of the most important sequelae affecting long-term results is adjacent-segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF). Although several reports have described the incidence rate, there have been no reports of repeated ASD. The purpose of this report was to describe 1 case of repeated ASD after PLIF. A 62-year-old woman with L-4 degenerative spondylolisthesis underwent PLIF at L4-5. At the second operation, L3-4 PLIF was performed for L-3 degenerative spondylolisthesis 6 years after the primary operation. At the third operation, L2-3 PLIF was performed for L-2 degenerative spondylolisthesis 1.5 years after the primary operation. Vertebral collapse of L-1 was detected 1 year after the third operation, and the collapse had progressed. At the fourth operation, 3 years after the third operation, vertebral column resection of L-1 and replacement of titanium mesh cages with pedicle screw fixation between T-4 and L-5 was performed. Although the patient's symptoms resolved after each operation, the time between surgeries shortened. The sacral slope decreased gradually although each PLIF achieved local lordosis at the fused segment.

  7. Tactics of surgical treatment for thoracic and lumbar spinal injuries

    Directory of Open Access Journals (Sweden)

    V. D. Usikov

    2013-01-01

    Full Text Available The analysis of results of surgical treatment of 154 patients with a vertebral and spinal trauma of chest and lumbar departments of a backbone aged from 16 till 75 years is carried out. All patients were operated in Bryansk city hospital N 1. The volume and sequence of surgeries, and existence were defined with the combined damages, character of an injury of a backbone and a spinal cord or absence free part bone bodies of the injured vertebra compressing a spinal cord defined different accesses on a backbone. So, surgeries at 125 (81,2 % patients were carried out from one back access, at 23 (14,9 % patients - to the combined back and lobbies and at 6 (3,9 % patients - front and back access. In all cases for fixing of a spine implants “Sintez” firm (St. Petersburg were used. Results of treatment were estimated on neurologic dynamics, restoration of an axis of a backbone, a gleam of the vertebral channel and restoration possibility of a support of a backbone. Good results of treatment are received at 87 (56,5 %, satisfactory - at 55 (35,7 % and unsatisfactory - at 12 (7,8 % patients.

  8. Balloon kyphoplasty: an experience of 38 patients with painful osteoporotic vertebral compressive fractures

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qiang; ZOU De-wei; HAI Yong; MA Hua-song; BAI Ke-wen

    2006-01-01

    Objective: To evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine.Methods: A retrospective analysis was conducted in 38 consecutive patients (28 females, 10 males), whose ages ranged from 56 to 82 years (mean age 72 years). The symptom- and sign-positive spinal segment was identified by MRI. The time between onset of symptoms and surgical intervention ranged from 2 days to 1 year. 62 segments (36 thoracic, 26 lumbar) were treated in this cohort. The pain score estimated by Visual Analog Scale and activity degree were assessed immediately after operation and at 1-, 6-,and 12-month postoperative follow-up. Preoperative and postoperative anterior, midline vertebral heights in fractured vertebrae were measured on lateral radiographs to evaluate the effect of the procedure.Results: The method achieved a swift pain relief associated with an evidently increased weight-bearing ability. The pain score was reduced from 8. 2 to 2.4 points.The anterior and midline vertebral heights in 62 fractured vertebral bodies increased up to 82.76% ±26.84%,88.82 % ± 21.75 % and the wedge decreased from 15 to 8 degrees. This effect persisted at least over a period of two years. The procedure did not induce narrowing of the spinal canal and no severe complications occurred.Conclusions: Balloon kyphoplasty can result in immediate clinical improvement of mobility and pain relief,increase vertebral body height, and quickly return patient's activity. The short-term results are approved excellent, and the long-term results need further judgment.

  9. Association between CT-evaluated lumbar lordosis and features of spinal degeneration, evaluated in supine position

    Science.gov (United States)

    Kalichman, Leonid; Li, Ling; Hunter, David; Been, Ella

    2013-01-01

    Background Context Few studies have directly evaluated the association of lumbar lordosis and segmental wedging of the vertebral bodies and intervertebral disks with prevalence of spinal degenerative features. Purpose To evaluate the association of CT-evaluated lumbar lordosis, segmental wedging of the vertebral bodies and that of the intervertebral disks with various spinal degeneration features. Study design This cross-sectional study was a nested project to the Framingham Heart Study. Sample A random consecutive subset of 191 participants chosen from the 3590 participants enrolled in the Framingham Heart Study who underwent multi-detector CT to assess aortic calcification. Outcome Measures Physiologic Measures Dichotomous variables indicating the presence of intervertebral disc narrowing, facet joint osteoarthritis, spondylolysis, spondylolisthesis and spinal stenosis and density (in Hounsfield units) of multifidus and erector spinae muscles were evaluated on supine CT, as well as the lordosis angle (LA) and the wedging of the vertebral bodies and intervertebral disks. Sum of vertebral bodies wedging (ΣB) and sum of intervertebral discs wedging (ΣD) were used in analyses. Methods Mean values (±SD) of LA, ΣB and ΣD were calculated in males and females and compared using the t-test. Mean values (±SD) of LA, ΣB and ΣD in 4 age groups: 0.05) with increasing age. LA showed statistically significant association with presence of spondylolysis (OR(95%CI): 1.08(1.02–1.14)) and with density of multifidus (1.06 (1.01–1.11). as well as a marginally significant association with isthmic spondylolisthesis (1.07(1.00–1.14). ΣB showed a positive association with degenerative spondylolisthesis and disc narrowing ((1.14(1.06–1.23) and 1.04 (1.00–1.08), correspondingly), whereas ΣD showed negative one (0.93(0.87–0.98) and (0.93(0.89–0.97), correspondingly). Conclusions Significant associations were found between lumbar lordosis evaluated in supine position

  10. Vertebrate pressure-gradient receivers

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2011-01-01

    The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum and stro......The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum....... Recent vertebrates form a continuum from perfect interaural transmission (0 dB in a certain frequency band) and pronounced eardrum directionality (30-40 dB) in the lizards, over somewhat attenuated transmission and limited directionality in birds and frogs, to the strongly attenuated interaural...

  11. Use of CT scanning for the study of posterior lumbar intervertebral articulations

    Energy Technology Data Exchange (ETDEWEB)

    Hermanus, N.; de Becker, D.; Baleriaux, D.; Hauzeur, J.P.

    1983-01-01

    CT scan is peculiarly effective in the study of architectural pathologies of the column; it appears that a number of etiological factors of low back pain are involved and they are often related. Indeed, dis herniation, for instance, is frequently associated with facetal asymmetry, the first signs of arthroses and ligamentous calcification after treatment. The three vertebral axes must be evaluated, one discal and two facetal, the slightest defect in one of which can affect the two others. Moreover, in view of the complexity of the innervation, the entire lumbar column from L1 to L5 S1 must be investigated: it is not uncommonly that low sciatica is caused by a more cranial lumbar pathology. This systematic study promotes better understanding of the etiology of low back pain and suggests a stet judicious therapeutic attitude.

  12. On the creation of a segmentation library for digitized cervical and lumbar spine radiographs.

    Science.gov (United States)

    Gururajan, Arunkumar; Kamalakannan, Sridharan; Sari-Sarraf, Hamed; Shahriar, Muneem; Long, Rodney; Antani, Sameer

    2011-06-01

    In this paper, we address the issue of computer-assisted indexing in one specific case, i.e., for the 17,000 digitized images of the spine acquired during the National Health and Nutrition Examination Survey (NHANES). The crucial step in this process is to accurately segment the cervical and lumbar spine in the radiographic images. To that end, we have implemented a unique segmentation system that consists of a suite of spine-customized automatic and semi-automatic statistical shape segmentation algorithms. Using the aforementioned system, we have developed experiments to optimally generate a library of spine segmentations, which currently include 2000 cervical and 2000 lumbar spines. This work is expected to contribute toward the creation of a biomedical Content-Based Image Retrieval system that will allow retrieval of vertebral shapes by using query by image example or query by shape example.

  13. Vertebral anatomy in the Florida manatee, Trichechus manatus latirostris: a developmental and evolutionary analysis.

    Science.gov (United States)

    Buchholtz, Emily A; Booth, Amy C; Webbink, Katherine E

    2007-06-01

    The vertebral column of the Florida manatee presents an unusual suite of morphological traits. Key among these are a small precaudal count, elongate thoracic vertebrae, extremely short neural spines, lack of a sacral series, high lumbar variability, and the presence of six instead of seven cervical vertebrae. This study documents vertebral morphology, size, and lumbar variation in 71 skeletons of Trichechus manatus latirostris (Florida manatee) and uses the skeletons of Trichechus senegalensis (west African manatee) and Dugong dugon (dugong) in comparative analysis. Vertebral traits are used to define morphological, and by inference developmental, column modules and to propose their hierarchical relationships. A sequence of evolutionary innovations in column morphology is proposed. Results suggest that the origin of the fluke and low rates of cervical growth originated before separation of trichechids (manatees) and dugongids (dugongs). Meristic reduction in count is a later, trichechid innovation and is expressed across the entire precaudal column. Elongation of thoracic vertebrae may be an innovative strategy to generate an elongate column in an animal with a small precaudal count. Elimination of the lumbus through both meristic and homeotic reduction is currently in progress.

  14. Seven years’ experience with etidronate in a woman with anorexia nervosa and vertebral fractures

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2011-07-01

    Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Tsuyoshi Takeda1, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, Japan; 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the case of a 30-year-old Japanese woman with anorexia nervosa and vertebral fractures who was treated with etidronate. She had a history of anorexia nervosa, chronic back pain, osteoporosis, and multiple vertebral fractures (morphometric fractures that responded poorly to treatment with alfacalcidol (1 µg daily for 1 year and was treated with cyclical etidronate (200 mg for 2 weeks every 3 months for 7 years. The lumbar spine bone mineral density (BMD increased, and the serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen levels and back pain decreased. During the 7-year period of treatment with etidronate, no osteoporotic fractures occurred. The patient experienced neither renal dysfunction nor hyperparathyroidism caused by osteomalacia. No gastrointestinal tract symptoms were observed. Thus, etidronate was effective for increasing the lumbar spine BMD and reducing back pain over a 7-year period without causing either osteoporotic fractures or adverse events.Keywords: anorexia nervosa, bulimia, etidronate, bone mineral density, osteoporosis, vertebral fracture

  15. Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study.

    Science.gov (United States)

    Bani, Mehmet; Sungurtekin-Ekçi, Elif; Odabaş, Mesut Enes

    2015-01-01

    The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany) 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1-4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p Biodentine was comparable to MTA at any apical plug thickness.

  16. Indication of posterior lumbar interbody fusion for lumbar disc herniation.

    Science.gov (United States)

    Satoh, Iwao; Yonenobu, Kazuo; Hosono, Noboru; Ohwada, Tetsuo; Fuji, Takeshi; Yoshikawa, Hideki

    2006-04-01

    To examine whether lumbar disc herniation with massive extrusion and/or segmental instability can be an indicator for spinal fusion or not, by comparing the outcome of posterior lumbar interbody fusion (PLIF) and discectomy alone. One hundred seventy-four patients with PLIF and 177 patients with discectomy were retrospectively analyzed. We hypothesized two criteria for fusion: massive herniation and segmental instability. The patients were divided into four groups according to our original criteria: group F-F (n = 96) consisted of the patients who fulfilled the criteria for fusion and underwent PLIF; group nF-F (n = 78) consisted of those who did not fulfill the criteria but had PLIF; group F-nF (n = 30) consisted of those who fulfilled the criteria but underwent discectomy; group nF-nF (n = 147) comprised those who did not fulfill the criteria and underwent discectomy. Each patient was evaluated clinically and radiologically at 5 years after operation. Groups F-F and nF-F had significantly superior results on low back pain compared with group F-nF (F-F vs F-nF, P < 0.05; nF-F vs F-nF, P < 0.01). The frequency of additional operation at the involved level was significantly higher in group F-nF (10.0%) than in group F-F (2.0%) (P < 0.05). Postoperative instability of the adjacent segment developed in 15 cases (8.6%) in groups F-F and nF-F and in 3 cases (1.7%) in groups F-nF and nF-nF (P < 0.01). Lumbar disc herniation with massive herniation or segmental instability can be well treated with PLIF.

  17. Surgery for women with apical vaginal prolapse.

    Science.gov (United States)

    Maher, Christopher; Feiner, Benjamin; Baessler, Kaven; Christmann-Schmid, Corina; Haya, Nir; Brown, Julie

    2016-10-01

    Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched July 2015) and ClinicalTrials.gov (searched January 2016). We included randomised controlled trials (RCTs). We used Cochrane methods. Our primary outcomes were awareness of prolapse, repeat surgery and recurrent prolapse (any site). We included 30 RCTs (3414 women) comparing surgical procedures for apical vaginal prolapse. Evidence quality ranged from low to moderate. Limitations included imprecision, poor methodological reporting and inconsistency. Vaginal procedures versus sacral colpopexy (six RCTs, n = 583; one to four-year review). Awareness of prolapse was more common after vaginal procedures (risk ratio (RR) 2.11, 95% confidence interval (CI) 1.06 to 4.21, 3 RCTs, n = 277, I(2) = 0%, moderate-quality evidence). If 7% of women are aware of prolapse after sacral colpopexy, 14% (7% to 27%) are likely to be aware after vaginal procedures. Repeat surgery for prolapse was more common after vaginal procedures (RR 2.28, 95% CI 1.20 to 4.32; 4 RCTs, n = 383, I(2) = 0%, moderate-quality evidence). The confidence interval suggests that if 4% of women require repeat prolapse surgery after sacral colpopexy, between 5% and 18% would require it after vaginal procedures.We found no conclusive evidence that vaginal procedures increaserepeat surgery for stress urinary incontinence (SUI) (RR 1.87, 95% CI 0.72 to 4.86; 4 RCTs, n = 395; I(2) = 0%, moderate

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

    Science.gov (United States)

    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.

  19. Vacuolar processing enzyme activates programmed cell death in the apical meristem inducing loss of apical dominance.

    Science.gov (United States)

    Teper-Bamnolker, Paula; Buskila, Yossi; Belausov, Eduard; Wolf, Dalia; Doron-Faigenboim, Adi; Ben-Dor, Shifra; Van der Hoorn, Renier A L; Lers, Amnon; Eshel, Dani

    2017-10-01

    The potato (Solanum tuberosum L.) tuber is a swollen underground stem that can sprout in an apical dominance (AD) pattern. Bromoethane (BE) induces loss of AD and the accumulation of vegetative vacuolar processing enzyme (S. tuberosum vacuolar processing enzyme [StVPE]) in the tuber apical meristem (TAM). Vacuolar processing enzyme activity, induced by BE, is followed by programmed cell death in the TAM. In this study, we found that the mature StVPE1 (mVPE) protein exhibits specific activity for caspase 1, but not caspase 3 substrates. Optimal activity of mVPE was achieved at acidic pH, consistent with localization of StVPE1 to the vacuole, at the edge of the TAM. Downregulation of StVPE1 by RNA interference resulted in reduced stem branching and retained AD in tubers treated with BE. Overexpression of StVPE1 fused to green fluorescent protein showed enhanced stem branching after BE treatment. Our data suggest that, following stress, induction of StVPE1 in the TAM induces AD loss and stem branching. © 2017 John Wiley & Sons Ltd.

  20. Static histomorphometry of human iliac crest and vertebral trabecular bone: a comparative study.

    Science.gov (United States)

    Thomsen, J S; Ebbesen, E N; Mosekilde, Li

    2002-01-01

    We recently developed a new, rapid method for conducting static histomorphometry on large histologic sections. This method has now been applied on both iliac crest and lumbar vertebral bone to compare the age-related changes at these two skeletal sites and to investigate the correlation between the histomorphometric measures at the iliac crest and the vertebral body. The material comprised matched sets of unilateral transiliac crest bone biopsies and lumbar vertebral bodies (L-2) from 24 women (19-96 years) and 24 men (23-95 years) selected from a larger autopsy material. Three female subjects (80, 88, and 90 years) had a known vertebral fracture of L-2. The iliac crest biopsies and 9-mm-thick mediolateral slices of half the entire vertebral bodies were embedded in methylmetacrylate, stained with aniline blue, and scanned into a computer with a flatbed image scanner at a high resolution. With a custom-made computer program the following static histomorphometric measures were determined: trabecular bone volume; marrow and bone space star volume; node-strut analysis; trabecular bone pattern factor; trabecular thickness; trabecular number; trabecular separation; and anisotropy of bone and marrow phase. In addition, connectivity density was measured (ConnEulor method). The results showed that the age-related changes in the static histomorphometric measures are generally similar in the iliac crest and the vertebral body, and that these age-related changes are independent of gender. An exception, however, is connectivity density, where the age-related changes are similar for women and men in the vertebral body but significantly different in the iliac crest. Furthermore, the results showed that the histomorphometric measures were weakly intercorrelated between the iliac crest and the vertebral body, despite the generally similar pattern in age-related changes at these two skeletal sites. The highest correlation coefficient was found for trabecular separation (Tb.Sp; r = 0

  1. Effect of cytokinins on shoot apical meristem in Nicotiana tabacum

    Directory of Open Access Journals (Sweden)

    Uzelac Branka

    2012-01-01

    Full Text Available Cytokinins are involved in plant cell proliferation leading to plant growth and morphogenesis. The size, activity and maintenance of the shoot apical meristem (SAM are defined by a balanced rate of mitotic cell divisions and functional cell differentiation that are controlled by cytokinins. In order to investigate the effect of exogenous cytokinin on SAM, morpho-anatomical changes in the shoot apices of tobacco treated with benzyladenine (BA were compared to those of untreated control plants.

  2. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  3. Multiple thoracic vertebral metastases of thyroid follicular carcinoma:1 case report%甲状腺滤泡癌多发胸椎转移一例

    Institute of Scientific and Technical Information of China (English)

    魏波; 顾强荣; 杜小涛; 李栋; 王黎明

    2014-01-01

    Objective To diagnose and treat multiple thoracic vertebral metastases of thyroid follicular carcinoma accompanied by vertebral instability. Methods On December 9th, 2013, a patient with multiple thoracic vertebral metastases of thyroid follicular carcinoma was adopted and treated, whose clinical data were analyzed. Results The patient was diagnosed as multiple thoracic vertebral metastases of thyroid follicular carcinoma by single-Photon Emission Computed Tomography ( SPECT ) and whole-body Magnetic Resonance Imaging ( MRI ). Due to the presence of vertebral instability, the risk of vertebral collapse or spinal cord injury existed. Open reduction and internal ifxation were performed under general anesthesia. Moreover, palliative care of tumors was temporarily carried out, and thoracic vertebral metastases were further treated after the operation. The general condition of the patient was good postoperatively. Additionally, the X-ray showed good position of the pedicle screw system. Reexamination was performed at 1 month after the operation. The spinal stability recovered, and the range of motion of the lumbar was not obviously limited. No complications such as incision infections, nerve injuries or deep venous thrombosis of lower limbs were noticed. The postoperative X-ray showed good position of the pedicle screw system and no lossening, bending or breakage of the internal ifxator. Conclusions For the patients with multiple thoracic vertebral metastases of thyroid follicular carcinoma accompanied by vertebral instability, surgical operation is an optimal option. With more secure and targeted therapy, satisfactory stability of the spine will be obtained.

  4. Remote cerebellar hemorrhage after lumbar spinal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Cevik, Belma [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: belmac@baskent-ank.edu.tr; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)

    2009-04-15

    Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

  5. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjaer, Per

    2012-01-01

    Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans....

  6. Primary lumbar hernia: A rarely encountered hernia

    Directory of Open Access Journals (Sweden)

    Sharada Sundaramurthy

    2016-01-01

    Conclusion: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.

  7. [Neonatal occlusion due to a lumbar hernia].

    Science.gov (United States)

    Hunald, F A; Ravololoniaina, T; Rajaonarivony, M F V; Rakotovao, M; Andriamanarivo, M L; Rakoto-Ratsimba, H

    2011-10-01

    A Petit lumbar hernia is an uncommon hernia. Congenital forms are seen in children. Incarceration may occur as an unreducible lumbar mass, associated with bilious vomiting and abdominal distention. Abdominal X-ray shows sided-wall bowel gas. In this case, reduction and primary closure must be performed as emergency repair.

  8. Traumatic lumbar spondylolisthesis without facet fracture at L4/L5. A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Dominique N’Dri-Oka; Souleymane Issa Sarki; Landry Konan; Yacouba Haro

    2016-01-01

    L4–L5 traumatic spondylolisthesis has been rarely reported in the literature. At lumbar spine level traumatic dislocation lesion realizes“traumatic spondylolisthesis or traumatic bilateral lumbar facet locked syndrome”. The aim of the present paper is to report this rare lesion and discuss its mechanism and management. A case report is followed by Literature review made on Medline and scholar google database from 2000 to 2015. The case report concerned a 33-year-old man, who refused to wear a seat belt, injured his lumbar spine following a motor vehicle accident. L4-L5 spondylolisthesis occurred after the vehicle rolled over several times. Sixteen months after the accident the patient had a favorable outcome. Literature review on Medline and scholar google database from 2000 to 2015 was carried out and five cases of traumatic spondylolisthesis were found. The Sex ratio was 3/2. Surgical treatment consisted of posterolateral interbody fusion. Traumatic lumbar spine spondylolisthesis is rare. When it occurs, it is always associated with vertebral lumbar fracture. L4-L5 traumatic spondylolisthesis was caused by a high-energy mechanism and improper use of seat belt.

  9. Development of apical blebbing in the boar epididymis.

    Directory of Open Access Journals (Sweden)

    Jennifer Hughes

    Full Text Available Microvesicles are of increasing interest in biology as part of normal function of numerous systems; from the immune system (T cell activation to implantation of the embryo (invasion of the trophoblasts and sperm maturation (protein transfer in the epididymis. Yet, the mechanisms involved in the appearance of apical blebbing from healthy cells as part of their normal function remain understudied. Microvesicles are produced via one of two pathways: exocytosis or apical blebbing also termed ectocytosis. This work quantifies the histological appearance of apical blebbing in the porcine epididymis during development and examines the role of endogenous estrogens in regulating this blebbing. Apical blebbing appears at puberty and increases in a linear manner into sexual maturity suggesting that this blebbing is a mature phenotype. Endogenous estrogen levels were reduced with an aromatase inhibitor but such a reduction did not affect apical blebbing in treated animals compared with their vehicle-treated littermates. Epididymal production of apical blebs is a secretion mechanism of functionally mature principal cells regulated by factors other than estradiol.

  10. Haemostatic agents in apical surgery. A systematic review

    Science.gov (United States)

    Clé-Ovejero, Adrià

    2016-01-01

    Background Blood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing ability. Objetive To describe which are the most effective and safest haemostatic agents to control bleeding in patients undergoing apical surgery. Material and Methods TWe carried out a systematic review, using Medline and Cochrane Library databases, of human clinical studies published in the last 10 years. Results The agents that proved more effective in bleeding control were calcium sulphate (100%) and collagen plus epinephrine (92.9%) followed by ferric sulphate (60%), gauze packing (30%) and collagen (16.7%). When using aluminium chloride (Expasyl®), over 90% of the apical lesions improved, but this agent seemed to increase swelling. Epinephrine with collagen did not significantly raise either blood pressure or heart rate. Conclusions Despite the use of several haemostatic materials in apical surgery, there is little evidence on their effectiveness and safety. The most effective haemostatic agents were calcium sulphate and epinephrine plus collagen. Epinephrine plus collagen did not seem to significantly raise blood pressure or heart rate during surgery. Aluminium chloride did not increase postoperative pain but could slightly increase postoperative swelling. Randomized clinical trials are needed to assess the haemostatic effectiveness and adverse effects of haemostatic materials in apical surgery. Key words:Haemostasis, apical surgery. PMID:27475689

  11. Lumbar Epidural Varix Mimicking Disc Herniation.

    Science.gov (United States)

    Bursalı, Adem; Akyoldas, Goktug; Guvenal, Ahmet Burak; Yaman, Onur

    2016-07-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

  12. Functional morphology and three-dimensional kinematics of the thoraco-lumbar region of the spine of the two-toed sloth.

    Science.gov (United States)

    Nyakatura, John A; Fischer, Martin S

    2010-12-15

    Given the importance of thoraco-lumbar spine movements in the locomotion of mammals, it is surprising that in vivo three-dimensional (3-D) data on the intervertebral movement of the mammalian thoraco-lumbar vertebral column during symmetrical gaits is limited to horses and dogs. To test whether kinematic patterns similar to those published for these cursorial species are also present during a contrasting mode of quadrupedalism, we quantified thoraco-lumbar intervertebral movements, the resulting pelvic displacements and relative femoral movements during the trot-like steady-state suspensory quadrupedal locomotion of the two-toed sloth (Xenarthra, Choloepus didactylus). Scientific rotoscoping, a new, non-invasive approach that combines synchronous biplanar high speed X-ray videos and the reconstruction of skeletal elements from computed tomography bone scans, was used to quantify 3-D kinematics. An analysis of vertebral anatomy and epaxial muscle topography suggests that the thoraco-lumbar spine of sloths is well suited to producing lateral bending and long-axis rotation, but limits powerful sagittal extension. Sloths exhibit complex 3-D movements in the thoraco-lumbar spine that are comparable to those observed in other arboreal quadrupedal mammals. Monophasic lateral bending and long-axis rotation, biphasic sagittal bending and maximal amplitude of sagittal bending at the lumbo-sacral joint were also found in other quadruped mammals and may represent general aspects of mammalian symmetric gaits. Maximal amplitude of lateral bending and long-axis rotation vary in regard to the vertebral level. It is suggested that a cranio-caudal pattern of angular deflections of the spine results from the out-of-phase movement of diagonal forelimbs and hindlimbs in other walking gaits, because it is not evident in the trot-like locomotion analyzed here. The analysis also illustrates the difficulties that arise when lumbar movement is deduced from intervertebral joint morphology

  13. Vertebrate Embryonic Cleavage Pattern Determination.

    Science.gov (United States)

    Hasley, Andrew; Chavez, Shawn; Danilchik, Michael; Wühr, Martin; Pelegri, Francisco

    2017-01-01

    The pattern of the earliest cell divisions in a vertebrate embryo lays the groundwork for later developmental events such as gastrulation, organogenesis, and overall body plan establishment. Understanding these early cleavage patterns and the mechanisms that create them is thus crucial for the study of vertebrate development. This chapter describes the early cleavage stages for species representing ray-finned fish, amphibians, birds, reptiles, mammals, and proto-vertebrate ascidians and summarizes current understanding of the mechanisms that govern these patterns. The nearly universal influence of cell shape on orientation and positioning of spindles and cleavage furrows and the mechanisms that mediate this influence are discussed. We discuss in particular models of aster and spindle centering and orientation in large embryonic blastomeres that rely on asymmetric internal pulling forces generated by the cleavage furrow for the previous cell cycle. Also explored are mechanisms that integrate cell division given the limited supply of cellular building blocks in the egg and several-fold changes of cell size during early development, as well as cytoskeletal specializations specific to early blastomeres including processes leading to blastomere cohesion. Finally, we discuss evolutionary conclusions beginning to emerge from the contemporary analysis of the phylogenetic distributions of cleavage patterns. In sum, this chapter seeks to summarize our current understanding of vertebrate early embryonic cleavage patterns and their control and evolution.

  14. Surgical management of an unusual osteomyelitis involving posterior elements in lumbar spine. A case report.

    Science.gov (United States)

    Chang, C K; Tsai, W S; Liu, H J; Pan, W C

    1992-06-01

    Improper and invasive management of low back pain may lead to an unexpected tragedy, vertebral osteomyelitis. A 30-year-old female patient suffering from low back pain after a lumbar strain called on a herbal therapist and was given a herb massage with some unknown medication. Unfortunately, a persistent painful ulcer with discharge developed over her back. She was referred to our clinic shortly after where x-ray showed bony destruction over the spinous process, facet, and lamina of L4. Fistulectomy, debridement and spinal fusion were performed. A satisfactory outcome was finally achieved.

  15. [Features of the clinical course of intravertebral disk herniation in degenerative lumbar stenosis].

    Science.gov (United States)

    Kariev, M Kh; Norov, A U; Ishmukhamedov, S N; Iugaĭ, I A

    2001-01-01

    The paper presents a clinical and neurological analysis of 110 patients with discal hernias who were divided into 2 groups: 1) 50 patients with normal sizes of the vertebral column; 2) 51 patients with its stenosis. Compression syndromes were major in all cases. In patients in whom discal hernia was concurrent with lumbar stenosis, the clinical course was characterized by dull or aching pains in the low back and legs, by symptoms of dysbasia neurasthenica intermittens, severe motor and sensory disorders with autonomic impositions.

  16. Vertebral classification using localized pathology-related shape model

    Science.gov (United States)

    Zewail, R.; Elsafi, A.; Durdle, N.

    2008-03-01

    Radiographs of the spine are frequently examined for assessment of vertebral abnormalities. Features like osteophytes (bony growth of vertebra's corners), and disc space narrowing are often used as visual evidence of osteoarthris or degenerative joint disease. These symptoms result in remarkable changes in the shapes of the vertebral body. Statistical analysis of anatomical structure has recently gained increased popularity within the medical imaging community, since they have the potential to enhance the automated diagnosis process. In this paper, we present a novel method for computer-assisted vertebral classification using a localized, pathology-related shape model. The new classification scheme is able to assess the condition of multiple vertebrae simultaneously, hence is possible to directly classify the whole spine anatomy according to the condition of interest (anterior osteophites). At the core of this method is a new localized shape model that uses concepts of sparsity, dimension reduction, and statistical independence to extract sets of localized modes of deformations specific to each of the vertebrae under investigation. By projection of the shapes onto any specific set of deformation modes (or basis), we obtain low-dimensional features that are most directly related to the pathology of the vertebra of interest. These features are then used as input to a support vector machine classifier to classify the vertebra under investigation as normal or upnormal. Experiments are conducted using contours from digital x-ray images of five vertebrae of lumbar spine. The accuracy of the classification scheme is assessed using the ROC curves. An average specifity of 96.8 % is achieved with a sensitivity of 80 %.

  17. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Ponrartana, Skorn; Fisher, Carissa L.; Aggabao, Patricia C. [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Chavez, Thomas A. [Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Broom, Alexander M.; Wren, Tishya A.L.; Skaggs, David L. [Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Gilsanz, Vicente [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States)

    2016-09-15

    When compared to boys, girls have smaller vertebral cross-sectional area, which conveys a greater spinal flexibility, and a higher prevalence of adolescent idiopathic scoliosis. To test the hypothesis that small vertebral cross-sectional area and tall intervertebral disc height are structural characteristics of patients with adolescent idiopathic scoliosis. Using multiplanar imaging techniques, measures of vertebral cross-sectional area, vertebral height and intervertebral disc height in the lumbar spine were obtained in 35 pairs of girls and 11 pairs of boys with and without adolescent idiopathic scoliosis of the thoracic spine matched for age, height and weight. Compared to adolescents without spinal deformity, girls and boys with adolescent idiopathic scoliosis had, on average, 9.8% (6.68 ± 0.81 vs. 7.40 ± 0.99 cm{sup 2}; P = 0.0007) and 13.9% (8.22 ± 0.84 vs. 9.55 ± 1.61 cm{sup 2}; P = 0.009) smaller vertebral cross-sectional dimensions, respectively. Additionally, patients with adolescent idiopathic scoliosis had significantly greater values for intervertebral disc heights (9.06 ± 0.85 vs. 7.31 ± 0.62 mm and 9.09 ± 0.87 vs. 7.61 ± 1.00 mm for girls and boys respectively; both P ≤ 0.011). Multiple regression analysis indicated that the presence of scoliosis was negatively associated with vertebral cross-sectional area and positively with intervertebral disc height, independent of sex, age and body mass index. We provide new evidence that girls and boys with adolescent idiopathic scoliosis have significantly smaller vertebral cross-sectional area and taller intervertebral disc heights - two major structural determinants that influence trunk flexibility. With appropriate validation, these findings may have implications for the identification of children at the highest risk for developing scoliosis. (orig.)

  18. Population=stratified analysis of bone mineral density distribution in cervical and lumbar vertebrae of chinese from quantitative computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yong; Cheng, Xiaoguang; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chen Xin [Dept. of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing (China); Zhou, Zhuang [Dept. of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang (China); Wu, Cheng' ai; Zhao, Danhui; Wang, Chao [Beijing Institute of Traumatology and Orthopedics, Beijing (China); Tian, Wei [Dept. of Spine Surgery, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing (China)

    2016-09-15

    To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

  19. Population-Stratified Analysis of Bone Mineral Density Distribution in Cervical and Lumbar Vertebrae of Chinese from Quantitative Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yong [Department of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Zhou, Zhuang [Department of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051 (China); Wu, Cheng' ai; Zhao, Danhui; Wang, Chao [Beijing Institute of Traumatology and Orthopedics, Beijing 100035 (China); Cheng, Xiaoguang; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chenxin [Department of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Tian, Wei [Department of Spine Surgery, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China)

    2016-11-01

    To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

  20. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

    Science.gov (United States)

    Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

    2017-12-01

    A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P  0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

  1. Vertebral Geometry Parameters Can Predict Fractures

    Directory of Open Access Journals (Sweden)

    P Tofighi

    2007-01-01

    Conclusion: Vertebral fractures are common fractures in postmenopausal women. There was a correlation between verte¬bral height and fractures. Vertebral geometric parameters especially height T score can be used for fracture screening.

  2. Early development of the vertebral column.

    Science.gov (United States)

    Scaal, Martin

    2016-01-01

    The segmental organization of the vertebrate body is most obviously visible in the vertebral column, which consists of a series of vertebral bones and interconnecting joints and ligaments. During embryogenesis, the vertebral column derives from the somites, which are the primary segments of the embryonic paraxial mesoderm. Anatomical, cellular and molecular aspects of vertebral column development have been of interest to developmental biologists for more than 150 years. This review briefly summarizes the present knowledge on early steps of vertebral column development in amniotes, starting from sclerotome formation and leading to the establishment of the anatomical bauplan of the spine composed of vertebral bodies, vertebral arches, intervertebral discs and ribs, and their specific axial identities along the body axis.

  3. Effect of apical clearing technique on the treatment outcome of teeth with asymptomatic apical periodontitis: A randomized clinical trial

    Science.gov (United States)

    Mittal, Priya; Logani, Ajay; Shah, Naseem; Pandey, R. M.

    2016-01-01

    Aim: This study aims to compare the periapical healing of teeth with asymptomatic apical periodontitis treated either by conventional apical preparation (CAP) or apical clearing technique (ACT). Materials and Methods: Twenty subjects with bilateral nonvital similar teeth exhibiting comparable periapical index (PAI) score were enrolled and randomly allocated. Group I (CAP, n = 20): Apical preparation three sizes greater (master apical file [MAF]) than the first binding file at the established working length. Group II (ACT, n = 20): Apical preparation three sizes greater than the MAF that was followed by dry reaming. Root canal therapy was accomplished in single-visit for all the teeth. They were pursued radiographically at 3, 6, 9 and 12 months. Pre- and post-treatment PAI scores were compared. To ascertain the proportion of healed teeth between the two groups, McNemar Chi-square test was applied. Results: At 3, 6, and 9 months’ time interval the proportion of healed teeth for Group II (ACT) was greater in comparison to Group I (CAP) (P < 0.05). However, at 12 months follow-up period this difference was not significant (P = 0.08). Conclusion: ACT enhanced the healing kinetics. However, the long-term (12 months) radiographic outcome was similar for either technique. PMID:27656054

  4. Differentiation of Apical Bud Cells in a Newly Developed Apical Bud Transplantation Model Using GFP Transgenic Mice as Donor

    Science.gov (United States)

    Sakagami, Ryuji; Yoshinaga, Yasunori; Okamura, Kazuhiko

    2016-01-01

    Rodent mandibular incisors have a unique anatomical structure that allows teeth to grow throughout the lifetime of the rodent. This report presents a novel transplantation technique for studying the apical bud differentiation of rodent mandibular incisors. Incisal apical end tissue with green fluorescent protein from transgenic mouse was transplanted to wild type mice, and the development of the transplanted cells were immunohistologically observed for 12 weeks after the transplantation. Results indicate that the green fluorescent apical end tissue replaced the original tissue, and cells from the apical bud differentiated and extended toward the incisal edge direction. The immunostaining with podoplanin also showed that the characteristics of the green fluorescent tissue were identical to those of the original. The green fluorescent cells were only found in the labial side of the incisor up to 4 weeks. After 12 weeks, however, they were also found in the lingual side. Here the green fluorescent cementocyte-like cells were only present in the cementum close to the dentin surface. This study suggests that some of the cells that form the cellular cementum come from the apical tissue including the apical bud in rodent incisors. PMID:26978064

  5. Differentiation of Apical Bud Cells in a Newly Developed Apical Bud Transplantation Model Using GFP Transgenic Mice as Donor.

    Directory of Open Access Journals (Sweden)

    Naoki Maruo

    Full Text Available Rodent mandibular incisors have a unique anatomical structure that allows teeth to grow throughout the lifetime of the rodent. This report presents a novel transplantation technique for studying the apical bud differentiation of rodent mandibular incisors. Incisal apical end tissue with green fluorescent protein from transgenic mouse was transplanted to wild type mice, and the development of the transplanted cells were immunohistologically observed for 12 weeks after the transplantation. Results indicate that the green fluorescent apical end tissue replaced the original tissue, and cells from the apical bud differentiated and extended toward the incisal edge direction. The immunostaining with podoplanin also showed that the characteristics of the green fluorescent tissue were identical to those of the original. The green fluorescent cells were only found in the labial side of the incisor up to 4 weeks. After 12 weeks, however, they were also found in the lingual side. Here the green fluorescent cementocyte-like cells were only present in the cementum close to the dentin surface. This study suggests that some of the cells that form the cellular cementum come from the apical tissue including the apical bud in rodent incisors.

  6. Changes of the Unique Odontogenic Properties of Rat Apical Bud Cells under the Developing Apical Complex Microenvironment

    Institute of Scientific and Technical Information of China (English)

    Jun Fang; Liang Tang; Xiao-hui Liu; Ling-ying Wen; Yan Jin

    2009-01-01

    Aim To characterize the odontogenic capability of apical bud and phenotypical change of apical bud cells (ABCs) in different microenvironment. Methodology Incisor apical bud tissues from neonatal SD rat were dissected and transplanted into the renal capsules to determine their odontogenic capability. Meanwhile ABCs were cultured and purified by repeated differential trypsinization. Then ABCs were cultured with conditioned medium from developing apical complex cells (DAC-CM). Immunocytochemistry, reverse transcriptase polymerase chain reaction (RT-PCR) and scanning electron microscope (SEM) were performed to compare the biological change of ABC treated with or without DAC-CM. Results First we confirmed the ability of apical bud to form crown-like structure ectopically. Equally important, by using the developing apical complex (DAC) conditioned medium, we found the microenvironment created by root could abrogate the "crown" features of ABCs and promote their proliferation and differentiation. Conclusion ABCs possess odontogenic capability to form crown-like tissues and this property can be affected by root-produced microenvironment.

  7. Five-year longitudinal assessment of the prognosis of apical microsurgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Jensen, Simon S; Hänni, Stefan

    2012-01-01

    Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort...

  8. Computed tomography in lumbar canal stenosis. Relationship between its findings and clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Shu; Baba, Itsushi; Ishida, Akihisa; Sumida, Tadayuki; Sasaki, Seishu (Hiroshima Shiritsu Asa Shimin Hospital (Japan))

    1984-09-01

    Preoperative CT was done in 39 patients with lumbar canal stenosis. Marked symmetrical narrowing of the whole vertebral canal was seen in the group with nervous symptoms in the cauda equina. Deformed bilateral intervertebral joints were seen in the group with both nervous symptoms in the cauda equina and radicular sciatica. The lateral recess on the affected side was markedly narrowed by the projection of the upper and lower joints and herniation. In the group with radicular sciatica, the vertebral canal itself was not so narrowed, but the unilateral intervertebral joint was extremely deformed, causing a narrowing of the lateral recess. There were large differences in the angle of the left and right intervertebral joints.

  9. MRI of degenerative lumbar spine disease: comparison of non-accelerated and parallel imaging

    Energy Technology Data Exchange (ETDEWEB)

    Noelte, Ingo; Gerigk, Lars; Brockmann, Marc A.; Kemmling, Andre; Groden, Christoph [Medical Faculty Mannheim of the University of Heidelberg, Department of Neuroradiology, Mannheim (Germany)

    2008-05-15

    Parallel imaging techniques such as GRAPPA have been introduced to optimize image quality and acquisition time. For spinal imaging in a clinical setting no data exist on the equivalency of conventional and parallel imaging techniques. The purpose of this study was to determine whether T1- and T2-weighted GRAPPA sequences are equivalent to conventional sequences for the evaluation of degenerative lumbar spine disease in terms of image quality and artefacts. In patients with clinically suspected degenerative lumbar spine disease two neuroradiologists independently compared sagittal GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (25 patients) and transverse GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (23 lumbar segments in six patients). Comparative analyses included the minimal diameter of the spinal canal, disc abnormalities, foraminal stenosis, facet joint degeneration, lateral recess, nerve root compression and osteochondrotic vertebral and endplate changes. Image inhomogeneity was evaluated by comparing the nonuniformity in the two techniques. Image quality was assessed by grading the delineation of pathoanatomical structures. Motion and aliasing artefacts were classified from grade 1 (severe) to grade 5 (absent). There was no significant difference between GRAPPA and non-accelerated MRI in the evaluation of degenerative lumbar spine disease (P > 0.05), and there was no difference in the delineation of pathoanatomical structures. For inhomogeneity there was a trend in favour of the conventional sequences. No significant artefacts were observed with either technique. The GRAPPA technique can be used effectively to reduce scanning time in patients with degenerative lumbar spine disease while preserving image quality. (orig.)

  10. A new diagnostic score to detect osteoporosis in patients undergoing lumbar spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Bandirali, Michele; Messina, Carmelo [Universita degli Studi di Milano, Scuola di Specializzazione in Radiodiagnostica, Milano (Italy); Di Leo, Giovanni; Papini, Giacomo Davide Edoardo [IRCCS Policlinico San Donato, Radiology Unit, San Donato Milanese (Italy); Sconfienza, Luca Maria; Sardanelli, Francesco [IRCCS Policlinico San Donato, Radiology Unit, San Donato Milanese (Italy); Universita degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, San Donato Milanese (Italy); Ulivieri, Fabio Massimo [IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Mineralometria Ossea Computerizzata e Ambulatorio Malattie Metabolismo Minerale e Osseo, Servizio di Medicina Nucleare, Milano (Italy)

    2015-10-15

    Signal intensity of lumbar-spine at magnetic resonance imaging (MRI) correlates to bone mineral density (BMD). Our aim was to define a quantitative MRI-based score to detect osteoporosis on lumbar-spine MRI. After Ethics Committee approval, we selected female patients who underwent both lumbar-spine MRI and dual-energy X-ray absorptiometry (DXA) and a reference group of 131 healthy females (20-29 years) who underwent lumbar-spine MRI. We measured the intra-vertebral signal-to-noise ratio in L1-L4. We introduced an MRI-based score (M-score), on the model of T-score. M-score diagnostic performance in diagnosing osteoporosis was estimated against DXA using receiver operator characteristic (ROC) analysis. We included 226 patients (median age 65 years), 70 (31 %) being osteoporotic at DXA. MRI signal-to-noise ratio correlated to BMD (r = -0.677, P < 0.001). M-score negatively correlated to T-score (r = -0.682, P < 0.001). Setting a 90 %-specificity, an M-score threshold of 5.5 was found, distinguishing osteoporosis from non-osteoporosis (sensitivity 54 %; ROC AUC 0.844). Thirty-one (14 %) patients had a fragility fracture, with osteoporosis detected in 15 (48 %) according to M-score and eight (26 %) according to T-score (P = 0.016). M-score obtained on lumbar spine MRI is a quantitative method correlating with osteoporosis. Its diagnostic value remains to be demonstrated on a large prospective cohort of patients. (orig.)

  11. Evolution of endothelin receptors in vertebrates.

    Science.gov (United States)

    Braasch, Ingo; Schartl, Manfred

    2014-12-01

    Endothelin receptors are G protein coupled receptors (GPCRs) of the β-group of rhodopsin receptors that bind to endothelin ligands, which are 21 amino acid long peptides derived from longer prepro-endothelin precursors. The most basal Ednr-like GPCR is found outside vertebrates in the cephalochordate amphioxus, but endothelin ligands are only present among vertebrates, including the lineages of jawless vertebrates (lampreys and hagfishes), cartilaginous vertebrates (sharks, rays, and chimaeras), and bony vertebrates (ray-finned fishes and lobe-finned vertebrates including tetrapods). A bona fide endothelin system is thus a vertebrate-specific innovation with important roles for regulating the cardiovascular system, renal and pulmonary processes, as well as for the development of the vertebrate-specific neural crest cell population and its derivatives. Expectedly, dysregulation of endothelin receptors and the endothelin system leads to a multitude of human diseases. Despite the importance of different types of endothelin receptors for vertebrate development and physiology, current knowledge on endothelin ligand-receptor interactions, on the expression of endothelin receptors and their ligands, and on the functional roles of the endothelin system for embryonic development and in adult vertebrates is very much biased towards amniote vertebrates. Recent analyses from a variety of vertebrate lineages, however, have shown that the endothelin system in lineages such as teleost fish and lampreys is more diverse and is divergent from the mammalian endothelin system. This diversity is mainly based on differential evolution of numerous endothelin system components among vertebrate lineages generated by two rounds of whole genome duplication (three in teleosts) during vertebrate evolution. Here we review current understanding of the evolutionary history of the endothelin receptor family in vertebrates supplemented with surveys on the endothelin receptor gene complement of

  12. Interventional Management of Vertebral Body Metastases

    OpenAIRE

    Prince, Ethan A.; Ahn, Sun Ho

    2013-01-01

    Metastases to the vertebral column are often due to hypervascular primary tumors, the most common of which is renal cell carcinoma. Clinical symptoms attributed to vertebral body metastases include localized pain, mechanical instability of the vertebral column, and neurologic deficits resulting from mass effect. Treatment options include targeted radiotherapy, percutaneous vertebral augmentation with or without thermal ablation, and surgical resection with subsequent fusion. Overall, surgical...

  13. Functional myelographic differentiation of lumbar bulging annulus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Choong Ki; Kim, Hong Kil; Park, Sang Gyu; Lee, Young Jung; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Herniated disk and bulging annulus are the major causes of lower back pain. It is necessary to differentiate bulging annulus from herniated disk because of their different methods of treatment. Myelography is one of the useful diagnostic methods for disk diseases even though advanced diagnostic modalities such as CT and MRI are more accurate. Functional myelography is not a new technology expect for two additional views, flexion and extension, are obtained with conventional myelography. Differentiation between bulging annulus and herniated disk by conventional myelography is based on the extent and multiplicity of extradural deformity of the contrast filled dural sac and neural sleeve as well as the changes of nerve root. There is no previous report about differential points between bulging annulus and herniated disk according to functional myelography. It is the purpose of this study to find any additional differential points on functional myelography between bulging annulus and herniated disk over convectional myelography. Authors analysed functional myelographic findings of 152 cases from July 1986 to July 1987. Among them, 22 cases who had been suffered from cervical abnormality or vague lower back pain were diagnosed as normal by myelography, and 30 cases of L4-5 herniated disk and 21 cases of L4-5 bulging annulus which had been finally diagnosed by operation were studied. The results were as follows. 1. In normal group, anterior epidural space was gradually widened from the upper lumbar vertebra downward. And anterior epidural space was more sidened at the disk level in extension view than in flexion except for L5-S1 lever. 2. In bulging annulus group, the shape of anterior epidural space in flexion state was as similar as normal. Anoterior epidural space in extension state was more sidened at the buldging annulus than normal, but lesser than herniated disk. 3. In herniated disk group, widening of anterior epidural space at the herniated disk level was

  14. MANAGEMENT OF LUMBAR SPINAL CANAL STENOSIS

    Directory of Open Access Journals (Sweden)

    Mukhergee G. S

    2016-06-01

    Full Text Available BACKGROUND Spinal stenosis is one of the most common conditions in the elderly. It is defined as a narrowing of the spinal canal. The term stenosis is derived from the Greek word for narrow, which is “Stenos”. The first description of this condition is attributed to Antoine portal in 1803. Verbiest is credited with coining the term spinal stenosis and the associated narrowing of the spinal canal as its potential cause. [1-10] Kirkaldy–Willis subsequently described the degenerative cascade in the lumbar spine as the cause for the altered anatomy and pathophysiology in spinal stenosis. [11-15] If compression does not occur, the canal should be described as narrow but not stenotic. Some studies defined lumbar spinal stenosis as a “narrowing of the osteoligamentous vertebral canal and/or the intervertebral foramina causing compression of the thecal sac and/or the caudal nerve roots; at a single vertebral level, narrowing may affect the whole canal or part of it” (Postacchini 1983. This definition distinguished between disc herniation and stenosis. [16] . The most common type of spinal stenosis is caused by degenerative arthritis of the spine. Hypertrophy and ossification of the posterior longitudinal ligament which usually are confined to the cervical spine, and diffuse idiopathic skeletal hyperostosis (DISH syndrome also may result in an acquired form of spinal stenosis. Congenital forms caused by disorders such as achondroplasia and dysplastic spondylolisthesis are much less common. Congenital spinal stenosis usually is central and is evident or imaging studies. Idiopathic congenital narrowing usually involves the anteroposterior dimension of the canal secondary to short pedicles; the patient otherwise is normal. In contrast, in achondroplasia, the canal is narrowed in the anteroposterior plane owing to shortened pedicles and in lateral dimension because of diminished interpedicular distance. Acquired forms of spinal stenosis usually are

  15. An invertebrate stomach's view on vertebrate ecology

    DEFF Research Database (Denmark)

    Calvignac-Spencer, Sebastien; Leendertz, Fabian H.; Gilbert, M. Thomas P.

    2013-01-01

    Recent studies suggest that vertebrate genetic material ingested by invertebrates (iDNA) can be used to investigate vertebrate ecology. Given the ubiquity of invertebrates that feed on vertebrates across the globe, iDNA might qualify as a very powerful tool for 21st century population...

  16. The vertebral remains of the late Miocene great ape Hispanopithecus laietanus from Can Llobateres 2 (Vallès-Penedès Basin, NE Iberian Peninsula).

    Science.gov (United States)

    Susanna, Ivette; Alba, David M; Almécija, Sergio; Moyà-Solà, Salvador

    2014-08-01

    Here we describe the vertebral fragments from the partial skeleton IPS18800 of the fossil great ape Hispanopithecus laietanus (Hominidae: Dryopithecinae) from the late Miocene (9.6 Ma) of Can Llobateres 2 (Vallès-Penedès Basin, Catalonia, Spain). The eight specimens (IPS18800.5-IPS18800.12) include a fragment of thoracic vertebral body, three partial bodies and four neural arch fragments of lumbar vertebrae. Despite the retention of primitive features (moderately long lumbar vertebral bodies with slightly concave ventrolateral sides), these specimens display a suite of derived, modern hominoid-like features: thoracic vertebrae with dorsally-situated costal foveae; lumbar vertebrae with non-ventrally-oriented transverse processes originating from a robust pedicle, caudally-long laminae with caudally-oriented spinous process, elliptical end-plates, and moderately stout bodies reduced in length and with no ventral keel. These features, functionally related to orthograde behaviors, are indicative of a broad and shallow thorax with a moderately short and stiff lumbar region in Hispanopithecus. Despite its large body mass (ca. 39-40 kg), its vertebral morphology is more comparable to that of hylobatids and Ateles than to extant great apes. This is confirmed by our morphometric analyses, also indicating that Hispanopithecus most closely resembles Pierolapithecus and Morotopithecus among Miocene apes, whereas Proconsul and Nacholapithecus resemble pronograde monkeys. Only in a few features (craniocaudally short and transversely wide pedicles, transverse processes situated on the pedicle, and slight ventral wedging), Hispanopithecus is more derived towards the extant great ape condition than other Miocene apes. Overall, the vertebral morphology of Hispanopithecus supports previous inferences of an orthograde body plan with suspensory and climbing adaptations. However, given similarities with Ateles and the retention of a longer and more flexible spine than in extant

  17. Determination of the intervertebral disc space from CT images of the lumbar spine

    Science.gov (United States)

    Korez, Robert; Å tern, Darko; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2014-03-01

    Degenerative changes of the intervertebral disc are among the most common causes of low back pain, where for individuals with significant symptoms surgery may be needed. One of the interventions is the total disc replacement surgery, where the degenerated disc is replaced by an artificial implant. For designing implants with good bone contact and continuous force distribution, the morphology of the intervertebral disc space and vertebral body endplates is of considerable importance. In this study we propose a method for the determination of the intervertebral disc space from three-dimensional (3D) computed tomography (CT) images of the lumbar spine. The first step of the proposed method is the construction of a model of vertebral bodies in the lumbar spine. For this purpose, a chain of five elliptical cylinders is initialized in the 3D image and then deformed to resemble vertebral bodies by introducing 25 shape parameters. The parameters are obtained by aligning the chain to the vertebral bodies in the CT image according to image intensity and appearance information. The determination of the intervertebral disc space is finally achieved by finding the planes that fit the endplates of the obtained parametric 3D models, and placing points in the space between the planes of adjacent vertebrae that enable surface reconstruction of the intervertebral disc space. The morphometric analysis of images from 20 subjects yielded 11:3 +/- 2:6, 12:1 +/- 2:4, 12:8 +/- 2:0 and 12:9 +/- 2:7 cm3 in terms of L1-L2, L2-L3, L3-L4 and L4-L5 intervertebral disc space volume, respectively.

  18. Effective automated prediction of vertebral column pathologies based on logistic model tree with SMOTE preprocessing.

    Science.gov (United States)

    Karabulut, Esra Mahsereci; Ibrikci, Turgay

    2014-05-01

    This study develops a logistic model tree based automation system based on for accurate recognition of types of vertebral column pathologies. Six biomechanical measures are used for this purpose: pelvic incidence, pelvic tilt, lumbar lordosis angle, sacral slope, pelvic radius and grade of spondylolisthesis. A two-phase classification model is employed in which the first step is preprocessing the data by use of Synthetic Minority Over-sampling Technique (SMOTE), and the second one is feeding the classifier Logistic Model Tree (LMT) with the preprocessed data. We have achieved an accuracy of 89.73 %, and 0.964 Area Under Curve (AUC) in computer based automatic detection of the pathology. This was validated via a 10-fold-cross-validation experiment conducted on clinical records of 310 patients. The study also presents a comparative analysis of the vertebral column data with the use of several machine learning algorithms.

  19. Lumbar pedicle cortical bone trajectory screw

    Institute of Scientific and Technical Information of China (English)

    Song Tengfei; Wellington K Hsu; Ye Tianwen

    2014-01-01

    Objective The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique,a new fixation technique for lumbar surgery.Data sources The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014.Study selection Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected.Results CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009.The concepts,morphometric study,biomechanical characteristics and clinical applications of CBT technique were reviewed.The insertional point of CBT screw is located at the lateral point of the pars interarticularis,and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane.CBT technique can be used for posterior fixation during lumbar fusion procedures.This technique is a minimally invasive surgery,which affords better biomechanical stability,fixation strength and surgical safety.Therefore,CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity.Conclusion CBT technique is a better alternative option of lumbar pedicle fixation,especially for patients with osteoporosis and obesity.

  20. Atividade eletromiográfica dos músculos extensores do tronco durante exercícios de estabilização lumbar do método Pilates

    Directory of Open Access Journals (Sweden)

    G.A. Paz

    2014-06-01

    Conclusión: Por lo tanto, los ejercicios anteriores se pueden realizar buscando mejorar la activación de los músculos del tronco y la estabilidad de la columna vertebral. Asimismo, los resultados encontrados en el estudio actual pueden ser una referencia para seleccionar los ejercicios durante los programas de entrenamiento para los músculos de la espalda lumbar.

  1. 胸腰椎爆裂骨折并术后功能训练对脊髓功能恢复的作用%Effect of functional exercises on spinal function recovery after thoracic and lumbar fracture operation

    Institute of Scientific and Technical Information of China (English)

    黄国忠; 韦敢; 苏士乐; 钟贵彬

    2003-01-01

    @@ INTRODUCTION Thoracic and lumbar vertebrae fracture accompanied with spinal cordinjury is rarely seen in clinics. Most of the scholars taken operation toreplace, to return normal volume of the vertebral cannal, to regen-erate stability of the spine and to promote early recovery of spine andrehabilitation[1], thus make a better clinical effects.

  2. Lumbar interspinous bursitis in active polymyalgia rheumatica.

    Science.gov (United States)

    Salvarani, Carlo; Barozzi, Libero; Boiardi, Luigi; Pipitone, Nicolò; Bajocchi, Gian Luigi; Macchioni, Pier Luigi; Catanoso, Mariagrazia; Pazzola, Giulia; Valentino, Massimo; De Luca, Carlo; Hunder, Gene G

    2013-01-01

    To evaluate the inflammatory involvement of lumbar interspinous bursae in patients with polymyalgia rheumatica (PMR) using magnetic resonance imaging (MRI). Ten consecutive, untreated new patients with PMR and pain in the shoulder and pelvic girdles were investigated. Seven patients with spondyloarthritis (4 with psoriatic spondyloarthrits, one with entheropatic spondyloarthritis, and 2 with ankylosing spondylitis) as well as 2 patients with spinal osteoarthritis and 2 patients with rheumatoid arthritis with lumbar pain served as controls. MRI of lumbar spine was performed in all PMR patients and controls. Nine patients (5 PMR patients and 4 controls) also had MRI of the thoracic spine. MRI evidence of interspinous lumbar bursitis was found in 9/10 patients with PMR and in 5/11 controls. A moderate to marked (grade ≥2 on a semiquantitative 0-3 scale) lumbar bursitis occurred significantly more frequently in patients with PMR than in control patients (60% vs. 9%, p=0.020). In most of the patients and controls lumbar bursitis was found at the L3-L5 interspaces. Only 2 patients had bursitis at a different level (one patient had widespread lumbar bursitis, and one control at L2-L4). No interspinous bursitis was demonstrated by MRI of the thoracic spine in patients and controls. Inflammation of lumbar bursae may be responsible for the low back pain reported by patients with PMR. The prominent inflammatory involvement of bursae including those of the lumbar spine supports the hypothesis that PMR may be a disorder affecting predominantly extra-articular synovial structures.

  3. The implantation of a Nickel-Titanium shape memory alloy ameliorates vertebral body compression fractures: a cadaveric study.

    Science.gov (United States)

    Chen, Bo; Zheng, Yue-Huang; Zheng, Tao; Sun, Chang-Hui; Lu, Jiong; Cao, Peng; Zhou, Jian-Hua

    2015-01-01

    To evaluate the effect of a Nickel-Titanium (Ni-Ti) shape memory alloy in the treatment of vertebral body compression fractures. The experimental thoracic-lumbar fracture units were made with adult human fresh-frozen vertebral specimens. A total of 30 fresh-frozen vertebral units were randomly assigned to 3 experimental groups: control group, percutaneous kyphoplasty group (PKP group), and percutaneous Ni-Ti shape memory alloys implant group (Ni-Ti implant group). Vertebral height and ultimate compression load of the vertebral body before and after procedures were measured to determine the restoration of vertebral heights and compressive strength, respectively. The Ni-Ti implant group achieved a vertebrae endplate reduction effect comparable to the PKP group. The vertebral height of the PKP group was restored from 2.01±0.21 cm to 2.27±0.18 cm after procedure, whereas that of the Ni-Ti implant group was restored from 2.00±0.18 cm to 2.31±0.17 cm. The ultimate loads of the vertebrae body of the PKP and the Ni-Ti implant groups were 2880.75±126.17 N and 2888.00±144.69 N, respectively, both of which were statistically significantly higher than that of the control group (2017.17±163.71 N). There was no significant difference in ultimate compression load of vertebrae body between the Ni-Ti implant and PKP groups. The implantation of Ni-Ti shape memory alloys of vertebral body induced effective endplate reduction, restored vertebral height, and provided immediate biomechanical spinal stability.

  4. 成人腰椎侧凸椎弓根螺钉误置模式%Misplacement patterns of pedicle screws in surgical correction for adult lumbar scoliosis

    Institute of Scientific and Technical Information of China (English)

    丁旗; 邱勇; 孙旭; 朱峰; 王斌; 朱泽章; 吴涛; 徐磊磊

    2011-01-01

    Objective To identify the patterns and risk factors of pedicle screw misplacement in adults with lumbar scoliosis. Methods Form August 2010 to June 2011, 49 patients with lumbar scoliosis were treated by posterior fusion with using pedicle screws. There were 14 males and 35 females with an average age of 39. 2 ± 13. 8 years. Pedicle screws were inserted by freehand technique according to the anatomic landmarks. Postoperative CT scans were conducted. Pedicle perforations were assessed after measurement, and were classified as medial, lateral or anterior. Screw malpositionwas categorized into four grades: Grade 1, ≤5 2 mm; Grade 2, 2. 1-4. Omm; Grade 3, 4. 1-6. 0 mm; and Grade 4, ≥6. 1mm. Screw perforation >2mm of either pedicular or vertebral cortex were considered at potential risk, and with > 4mm of medial pedicular cortex perforation or contour of aorta was considered at high risk. The perforation rates of different groups were compared to analyze the risk factors. Results A total of 353 screws were inserted, and the average was 7. 2 per patient 316 screws (89. 5% ) were fully contained within the cortical boundaries of the pedicle. The remaining 37 (10.5% ) screws breached pedicle walls, and there were 25 screws with Grade 1, 8 with Grade 2, 1 with Grade 3 and 3 with Grade 4 perforation. Among the penetrations of the 12 screws at potential risk, 6 were lateral, 3 were medial, and 3 were anterior. No malpostioned screws were found at high risk. The screw perforation rate was similar between patients with age >50 years and patients with ages≤50 years (9. 9% versus 10.9% , P=0. 860). More perforations were found at the apical vertebra than the other levels of lumbar spine. Moreover, there was significant difference with regard to the perforation rate between the concave side (15.6% , 26/167) and the convex side (5.9% , 11/186) of the lumbar spine (P = 0.005). Significant difference ( P 60° (20.2%, 22/109) and patients with Cobb angled60° (6.1%, 15/244). In

  5. [Design and biomechanical analysis of nickel-titanium open shape memory alloy artificial vertebral body].

    Science.gov (United States)

    Liu, Hui; Lian, Kejian; Liao, Lijun; Zhai, Wenliang; Ding, Zhenqi

    2010-10-01

    To design an open shape memory alloy artificial vertebral body that can be used to reconstruct the vertebral body in spine diseases, such as thoracic-lumbar spine tumors, burst fracture of the vertebrae, kyphosis and scoliosis, and to evaluate the biomechanical stability of lumbar functional segment unit after insertion with the shape memory alloy artificial vertebral body. The open shape memory alloy artificial vertebral body with nickel-titanium (NiTi) alloy was made. Eight fresh spine specimens (T14-L5) from normal adult porcine were used to detect the range of motion (ROM) in 4 models and were divided into 4 groups: intact vertebrae served as group A; pedicle screw fixation of T15, L1, L3, and L4 was given in group B; after total resection of L2, it was reconstructed by open shape memory alloy artificial vertebral body combined with pedicle screw fixation of T15, L1, L3, and L4 in group C; and after total resection of L2, it was reconstructed by titanium cage vertebral body combined with pedicle screw fixation of T15, L1, L3, and L4 in group D. The three-dimensional ROM of flexion, extension, left/right lateral bending, and left/right rotation in T15-L1, L1-3, and L3,4 segments were detected in turn by the spinal three-dimensional test machine MTS-858 (load 0-8 N x m). Compared with group A, groups B, C, and D had good stability in flexion, extension, left/right lateral bending, and left/right rotation, showing significant differences (P 0.05). Group C had less degree of motion in T15-L1 and L3,4 segments than group D, showing significant differences (P 0.05). The open shape memory alloy artificial vertebral body has a reasonable structure and good biomechanical stability, it can be used to stabilize the spinal segment with pedicle screw fixation.

  6. Sagittal spinopelvic parameters in 2-level lumbar degenerative spondylolisthesis

    Science.gov (United States)

    Wang, Tao; Wang, Hui; Liu, Huan; Ma, Lei; Liu, Feng-Yu; Ding, Wen-Yuan

    2016-01-01

    Abstract The purpose of our study is to evaluate sagittal parameters in 2-level lumbar degenerative spondylolisthesis (DS) (TLDS). A total of 15 patients with TLDS, 40 patients with single-level DS (SLDS), and 30 normal volunteers as control were included in our study. All subjects performed on full spine X-ray. Two categorized data were analyzed: patient characteristics—age, sex, body mass index, radiographic parameters-pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), sacral slope (SS), PI–LL, Cobb between the fifth thoracic vertebral and 12th thoracic vertebral (T5–T12), sagittal vertical axis (SVA) Cobb angle of spondylolisthesis level (CSL), ratio of PT to SS (PT/SS), CSL/LL, variation trend of SS over PI, and LL over PI. The PI (73.1° vs 52.9°), SS (50.8° vs 32.2°), LL (53.1° vs 46.9°), SVA (66.1 vs 22.0 mm), PI–LL (20.0° vs 6.0°), and CSL (23.6° vs 20.0°) in TLDS were significantly larger than these in SLDS. The PI (73.1° vs 40.6°), PT (22.3° vs 17.1°), SS (50.8° vs 23.5°), LL (53.1° vs 32.5°), PI–LL (20.0° vs 8.1°), and SVA (66.1 vs 17.0 mm) in TLDS were significantly larger than those in the normal group (NG). The PI (52.9° vs 40.6°), PT (21.0° vs 17.1°), SS (32.2° vs 23.5°), LL (46.9° vs 32.5°), and SVA (22.0 vs 17.0 mm) in SLDS were significantly higher than those in NG. However, PT/SS (44.0%), LL over PI (y = 0.39x + 24.25), SS over PI (y = 10.79 + 0.55x) were lower in TLDS than these in SLDS (63.8%, y = 0.41x + 25, y = 0.65x − 2.09, respectively), and the similar tend between SLDS and NG (74.0%, y = 0.49x + 13.09, y = 0.67x − 3.9, respectively). Our results showed that 2-level lumbar DS, which was caused by multiple-factors, has a severe sagittal imbalance, but single-level has not any. When we plan for surgical selection for 2-level lumbar DS, global sagittal balance must be considered. PMID:27977581

  7. Axial loaded MRI of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, A. E-mail: asaifuddin@aol.com; Blease, S.; MacSweeney, E

    2003-09-01

    Magnetic resonance imaging is established as the technique of choice for assessment of degenerative disorders of the lumbar spine. However, it is routinely performed with the patient supine and the hips and knees flexed. The absence of axial loading and lumbar extension results in a maximization of spinal canal dimensions, which may in some cases, result in failure to demonstrate nerve root compression. Attempts have been made to image the lumbar spine in a more physiological state, either by imaging with flexion-extension, in the erect position or by using axial loading. This article reviews the literature relating to the above techniques.

  8. Lumbar hernia: a short historical survey.

    Science.gov (United States)

    Cavallaro, Antonino; De Toma, Giorgio; Cavallaro, Giuseppe

    2012-01-01

    Lumbar hernia is a rare form of abdominal hernia, which has been recognized later along the early development of the modern surgery. it has been, on many occasions, the object of heavy debate regarding its anatomical background and as well its etiology. The authors reports the historical aspects of this rare pathology, focusing on the earliest descriptions of hernia arising in lumbar regions, on the first reports of surgical repair, and on the anatomical description of the lumbar weakness areas, that are currently named Petit's triangle and Grynfeltt and Lesshaft's triangle.

  9. Minimal Invasive Decompression for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Victor Popov

    2012-01-01

    Full Text Available Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

  10. Axial allometry in a neutrally buoyant environment: effects of the terrestrial-aquatic transition on vertebral scaling.

    Science.gov (United States)

    Jones, K E; Pierce, S E

    2016-03-01

    Ecological diversification into new environments presents new mechanical challenges for locomotion. An extreme example of this is the transition from a terrestrial to an aquatic lifestyle. Here, we examine the implications of life in a neutrally buoyant environment on adaptations of the axial skeleton to evolutionary increases in body size. On land, mammals must use their thoracolumbar vertebral column for body support against gravity and thus exhibit increasing stabilization of the trunk as body size increases. Conversely, in water, the role of the axial skeleton in body support is reduced, and, in aquatic mammals, the vertebral column functions primarily in locomotion. Therefore, we hypothesize that the allometric stabilization associated with increasing body size in terrestrial mammals will be minimized in secondarily aquatic mammals. We test this by comparing the scaling exponent (slope) of vertebral measures from 57 terrestrial species (23 felids, 34 bovids) to 23 semi-aquatic species (pinnipeds), using phylogenetically corrected regressions. Terrestrial taxa meet predictions of allometric stabilization, with posterior vertebral column (lumbar region) shortening, increased vertebral height compared to width, and shorter, more disc-shaped centra. In contrast, pinniped vertebral proportions (e.g. length, width, height) scale with isometry, and in some cases, centra even become more spool-shaped with increasing size, suggesting increased flexibility. Our results demonstrate that evolution of a secondarily aquatic lifestyle has modified the mechanical constraints associated with evolutionary increases in body size, relative to terrestrial taxa.

  11. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Directory of Open Access Journals (Sweden)

    Marília Pacífico Lucisano

    2016-01-01

    Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

  12. Characterization of rat apical tissues in different root development stage.

    Science.gov (United States)

    Xu, Lin; Yang, Zhenhua; Jin, Fang; Duan, Yinzhong; Jin, Yan

    2011-10-01

    In this study, we try to compare the histological characteristics and the odontogenic capability of apical tissues (AT) at different root development stages of rat molar teeth. AT of mandibular first molars from 8-day-old, 21-day-old, and 35-day-old Sprague-Dawley rats were selected as being representative of root-initiating, root-forming, and root-completing stages, respectively. Cell counting, flow cytometry assays, alkaline phosphatase activity, alizarin red staining, and reverse transcription polymerase chain reaction were performed to assess the proliferation and mineralization potential of apical tissue cells at different stages of root development in vitro. In vivo transplantation of apical tissue cells combined with ceramic bovine bone was used to characterize the differentiation capacity. It was shown that there was a structurally and functionally dynamic change in the apical tissue of developing tooth root of rats, of which the unique developmental potential will reduce gradually with the ending up of root development. The AT of root-initiating and root-forming stage exhibited much higher proliferation and tissue-regenerative capacity than those of root-completing stage. Our present results indicate that the apical tissue, with the sustainable developmental ability throughout almost the whole process of tooth development, can yet be regarded as a competent candidate source for root/periodontal tissues regeneration.

  13. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Science.gov (United States)

    Nelson-Filho, Paulo; Silva, Lea Assed Bezerra; Silva, Raquel Assed Bezerra; de Carvalho, Fabricio Kitazono; de Queiroz, Alexandra Mussolino

    2016-01-01

    The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA) was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months. PMID:27882250

  14. [Mineral trioxide aggregate (MTA) a success story in apical surgery].

    Science.gov (United States)

    von Arx, Thomas

    2016-01-01

    The objective of apical surgery is to retain teeth with persistent apical pathosis following orthograde root canal treatment if endodontic non-surgical revision is difficult or associated with risks, or is even declined by the patient. Since the most frequent cause of recurrent apical disease is bacterial reinfection from the (remaining) root canal system, the bacteria-tight root-end filling is the most important step in apical surgery. In the early 1990s, mineral trioxide aggregate (MTA) was developed at the Loma Linda University in California/USA. Preclinical studies clearly showed that MTA has a high sealing capability, a good material stability and an excellent biocompatbility. Multiple experimental studies in animals highlighted the mild tissue reactions observed adjacent to this material. Furthermore, histological analysis of the periapical regions demonstrated a frequent deposition of new cementum not only onto the resection plane (cut dentinal surface), but also directly onto MTA. For these reasons, MTA is considered a bioactive material. In 1997 MTA was cleared for clinical use in patients. Multiple prospective clinical and randomized studies have documented high and constant success rates of MTA-treated teeth in apical surgery. A recently published longitudinal study showed that MTA-treated teeth remained stable over five years; hence the high healed rates documented after one year are maintained during long-term observation.

  15. An experimental and morphometric test of the relationship between vertebral morphology and joint stiffness in Nile crocodiles (Crocodylus niloticus).

    Science.gov (United States)

    Molnar, Julia L; Pierce, Stephanie E; Hutchinson, John R

    2014-03-01

    Despite their semi-aquatic mode of life, modern crocodylians use a wide range of terrestrial locomotor behaviours, including asymmetrical gaits otherwise only found in mammals. The key to these diverse abilities may lie in the axial skeleton. Correlations between vertebral morphology and both intervertebral joint stiffness and locomotor behaviour have been found in other animals, but the vertebral mechanics of crocodylians have not yet been experimentally and quantitatively tested. We measured the passive mechanics and morphology of the thoracolumbar vertebral column in Crocodylus niloticus in order to validate a method to infer intervertebral joint stiffness based on morphology. Passive stiffness of eight thoracic and lumbar joints was tested in dorsal extension, ventral flexion and mediolateral flexion using cadaveric specimens. Fifteen measurements that we deemed to be potential correlates of stiffness were taken from each vertebra and statistically tested for correlation with joint stiffness. We found that the vertebral column of C. niloticus is stiffer in dorsoventral flexion than in lateral flexion and, in contrast to that of many mammals, shows an increase in joint stiffness in the lumbar region. Our findings suggest that the role of the axial column in crocodylian locomotion may be functionally different from that in mammals, even during analogous gaits. A moderate proportion of variation in joint stiffness (R(2)=0.279-0.520) was predicted by centrum width and height, neural spine angle and lamina width. These results support the possible utility of some vertebral morphometrics in predicting mechanical properties of the vertebral column in crocodiles, which also should be useful for forming functional hypotheses of axial motion during locomotion in extinct archosaurs.

  16. Improvements in the management of rheumatic patients from vertebral image obtained through dual-energy X-ray absorptiometry

    Directory of Open Access Journals (Sweden)

    D. Gatti

    2011-09-01

    Full Text Available The diagnosis of asymptomatic vertebral fracture is clinically useful and the identification of new fractures may influences the choice of appropriate therapeutic measures. In order to identify moderate and asymptomatic vertebral deformities in an objective and reproducible manner, vertebral morphometry is performed. This method measures the vertebral body’s anterior, middle and posterior heights at the dorsal and lumbar level. Currently this technique is performed on lateral images of the spine obtained through the traditional X-ray method (radiological morphometry or morphometric X-ray radiography, MRX and, more recently from images obtained through dual-energy X-ray absorptiometry (DXA machines (visual assessment of x-ray absoptiometry scans or morphometric X-ray absorptiometry, MXA, commonly used to measure bone mineral density. The main advantage of MXA relative to MRX is the lower radiation dose to which the patient is exposed during the exam. In addition, MXA scans offers the advantage of acquiring a single image of thoracic and lumbar spine, without any distortion (e.g.: coning. The most obvious advantage of MXA is the opportunity of obtaining during the same session a bone mineral density evaluation, and digital images that are easily processable, manageable, recordable and comparable for the patient’s follow up. A limitation of the MXA technique is the inferior quality of the images, that make often impossible the detection of the vertebral edges, and the impossibility to visualize the upper thoracic vertebral bodies. MXA, despite its intrinsic limitations, when carried out by trained personnel may provide substantial improvements in the management (diagnosis and follow-up of rheumatic patients.

  17. MR imaging of epidural hematoma in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Dorsay, Theodore A.; Helms, Clyde A. [Duke University Medical Center, Department of Radiology, Erwin Road, Room 1504, Durham, NC 27710 (United States)

    2002-12-01

    To bring attention to the MR imaging appearance of epidural hematoma (EDH) in the lumbar spine as a small mass often associated with disk herniation or an acute event. This paper will show our experience with this entity and describe criteria for its MR imaging appearance. Design and patients. Thirteen cases of prospectively diagnosed EDH of the lumbar spine were compared with 12 cases of prospectively diagnosed prominent epidural extrusion. Our criteria were retrospectively evaluated by the two authors for their presence or absence in each case. The chi-square test for nominal data was applied. MR imaging criteria utilized to distinguish EDH from disk herniation at our institution include: (1) signal different from disk, (2) high signal on T1-weighted images, either centrally or peripherally, (3) teardrop- or egg-shaped mass, in the sagittal plane, (4) size greater than half the vertebral body height in a craniocaudal dimension, (5) primarily retrosomatic epidural location, (6) plasticity - the mass is seen to conform closely to the contours of bone (e.g., in the lateral recess), (7) little or no disk space narrowing unless associated with disc herniation. Chi-square analysis demonstrated each criterion to significantly differentiate between EDH and extrusion. Only six of 13 EDH cases went to surgery in spite of their relatively large size. Two of six patients were diagnosed as having epidural clot consistent with hematoma at the time of surgery. The four patients who were not diagnosed at surgery revealed only small disk herniations or fragments of disk. The occurrence of EDH is more frequent than previously suspected. Spontaneous EDH is frequently associated with disk herniation and acute events such as sneezing or coughing. Most cases of spontaneous EDH will resolve prior to surgery with only the minority becoming chronic in order to be seen at surgery as an encapsulated mass. MR imaging can reliably identify EDH and distinguish between EDH and large disk

  18. MRI of the lumbar spine at 7 Tesla in healthy volunteers and a patient with congenital malformations

    Energy Technology Data Exchange (ETDEWEB)

    Grams, Astrid E. [University Hospital Giessen and Marburg, Campus, Department of Neuroradiology, Giessen (Germany); University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Giessen, Justus Liebig University, Department of Neuroradiology, Giessen (Germany); Kraff, Oliver; Umutlu, Lale; Maderwald, Stefan; Ladd, Mark E.; Forsting, Michael [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Dammann, Philipp [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Neurosurgery, Essen (Germany); Gizewski, Elke R. [University Hospital Giessen and Marburg, Campus, Department of Neuroradiology, Giessen (Germany); University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2012-05-15

    The aim of this study was to evaluate sequences that are established at lower magnetic field strengths for lumbar spine imaging at 7 Tesla (7 T) MR imaging. The lumbar spine of five healthy volunteers and a patient with spina bifida and meningocele were evaluated at 7 T. The examination included a T2-TSE (turbo spin echo), a 3D-DESS (double-echo steady-state sequence), a 3D-CISS (constructive interference in steady-state sequence), and a 3D-VIBE (volumetric interpolated breath hold examination) sequence. Imaging quality was evaluated by two raters on a three-level scale. The assessment included visualization of intraforaminal structures, the cauda equina, facet joints, and any abnormalities. Contrast ratios for intervertebral discs/vertebral bodies, vertebral bodies/cerebrospinal fluid (CSF) and CSF/spinal cord were calculated. The 3D-VIBE sequence provided best differentiation between intraforaminal structures. Visualization of the facet joints was reliable with VIBE, DESS, and CISS. Individual nerve roots of the cauda equina could only be delineated with the 3D-CISS sequence. CISS and DESS provided good contrast between vertebral bodies and intervertebral discs. Contrast between CSF and vertebral bodies was most pronounced for the T2-TSE sequence. Sufficient contrast between CSF and the spinal cord was only achieved with the T2-TSE sequence. VIBE and DESS sequences demonstrated best the bony malformations. Visualization of the meningocele was only possible with the 3D-CISS sequence. At 7 T most structures of the lumbar spine were visualized with a combination of sequences. At present, imaging quality is not superior to 1.5 T or 3 T, precluding routine clinical use. (orig.)

  19. MRI of the lumbar spine at 7 Tesla in healthy volunteers and a patient with congenital malformations.

    Science.gov (United States)

    Grams, Astrid E; Kraff, Oliver; Umutlu, Lale; Maderwald, Stefan; Dammann, Philipp; Ladd, Mark E; Forsting, Michael; Gizewski, Elke R

    2012-05-01

    The aim of this study was to evaluate sequences that are established at lower magnetic field strengths for lumbar spine imaging at 7 Tesla (7 T) MR imaging. The lumbar spine of five healthy volunteers and a patient with spina bifida and meningocele were evaluated at 7 T. The examination included a T2-TSE (turbo spin echo), a 3D-DESS (double-echo steady-state sequence), a 3D-CISS (constructive interference in steady-state sequence), and a 3D-VIBE (volumetric interpolated breath hold examination) sequence. Imaging quality was evaluated by two raters on a three-level scale. The assessment included visualization of intraforaminal structures, the cauda equina, facet joints, and any abnormalities. Contrast ratios for intervertebral discs/vertebral bodies, vertebral bodies/cerebrospinal fluid (CSF) and CSF/spinal cord were calculated. The 3D-VIBE sequence provided best differentiation between intraforaminal structures. Visualization of the facet joints was reliable with VIBE, DESS, and CISS. Individual nerve roots of the cauda equina could only be delineated with the 3D-CISS sequence. CISS and DESS provided good contrast between vertebral bodies and intervertebral discs. Contrast between CSF and vertebral bodies was most pronounced for the T2-TSE sequence. Sufficient contrast between CSF and the spinal cord was only achieved with the T2-TSE sequence. VIBE and DESS sequences demonstrated best the bony malformations. Visualization of the meningocele was only possible with the 3D-CISS sequence. At 7 T most structures of the lumbar spine were visualized with a combination of sequences. At present, imaging quality is not superior to 1.5 T or 3 T, precluding routine clinical use.

  20. A CLINICAL STUDY OF OPERATIVE TREATMENT FOR LUMBAR INTERVERTEBRAL DISC PROLAPSE

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    Anilkumar S. D

    2016-09-01

    Full Text Available BACKGROUND Amongst painful diseases, sciatica occupies a foremost place by reason of its prevalence, its production by a great variety of conditions, the great disablement it may produce and its tending to relapse all of which have led to its recognition as one of the great scourges of humanity. Intervertebral disc prolapse is the important and common cause of low back pain and sciatica. Here, the subject of laminectomy and discectomy in the treatment of proven intervertebral disc prolapse in the lower lumbar region is reviewed and its results examined. AIM OF STUDY This study was undertaken in order to evaluate the following objectives. PRIMARY Analysis of clinical parameters and per operative findings of lumbar intervertebral disc prolapse. SECONDARY Analysis of clinical parameters and surgical outcome in lumbar intervertebral disc prolapse with respect to improvement in pain and neurological status. MATERIALS AND METHODS The study was undertaken in 22 patients who attended the Orthopaedic Department of Mount Zion Medical College, Adoor, between August 2014 to July 2015. All of them were suffering from a prolapsed lumbar vertebral disc as shown by clinical examination and investigations. Lumbar laminectomy and discectomy constituted the operative procedure for all of them. RESULTS In acute onset cases and cases with short duration, results were good. By six months, 80% of patients recorded of good pain relief, 80% of patients returned to work within six 6 months, 60% of patients showed good neurological recovery by 6 months. Laminectomy and discectomy in proven cases of lumbar intervertebral disc prolapse is a rewarding procedure. LT definitely relieved pain in all cases and improved morbidity and neurological deficits in most of the cases. CONCLUSION 1. Laminectomy and discectomy is an effective method of treatment in herniation of lumbar intervertebral disc. 2. The procedure is ideally done in those with the disc prolapse proved with the

  1. Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis.

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    Makirov, Serik K; Yuz, Andrew A; Jahaf, Mohammed T; Nikulina, Anastasia A

    2015-01-01

    This study intends to develop a method of quantitative sagittal balance parameters assessment, based on a geometrical model of lumbar spine and sacrum. 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. 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. 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 LSB of 0.2 or less, so this value can be predictable

  2. Association of Posterior Reversible Encephalopathy Syndrome and Transient Apical Ballooning Syndrome (Takotsubo): First Case Report of a Man and Review of the Literature.

    Science.gov (United States)

    Grimaldi, Stephan; Doche, Emilie; Rey, Caroline; Laksiri, Nadia; Boussen, Salah; Quilici, Jacques; Robinet, Emmanuelle; Devemy, Fabien; Pelletier, Jean

    2017-01-01

    An association of posterior reversible encephalopathy syndrome (PRES) and takotsubo is rare. We present the first case of a male patient. A 69-year-old man presented to the hospital in a persistent comatose state following a generalized tonic-clonic seizure with high blood pressure. The electrocardiogram revealed transient left bundle branch block. Troponin and BNP were elevated. Cardiac ultrasound showed large apical akinesia with altered left ventricular ejection fraction, and the left ventriculogram showed characteristic regional wall motion abnormalities involving the mid and apical segments. Brain MRI showed bilateral, cortical, and subcortical vasogenic edema predominant in the posterior right hemisphere. The lumbar puncture and cerebral angiography were normal. Paraclinical abnormalities were reversible within 2 weeks with a clinical recovery in 3 months, confirming the takotsubo and the PRES diagnoses. Several theories hypothesize the underlying pathophysiology of takotsubo or PRES. Circulating catecholamines are up to 3 times higher in patients with takotsubo causing impaired microcirculation and apical hypokinesia. An association of both takotsubo and asthma crisis and PRES and asthma crisis underlines the role of catecholamines in the occurrence of these disorders. Early recognition of this rare association, in which heart and neurological damage may require rapid intensive care support, is needed.

  3. Lumbar herniated disc: spontaneous regression

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    Yüksel, Kasım Zafer

    2017-01-01

    Background Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods This retrospective cohort was carried out in the neurosurgery departments of hospitals in Kahramanmaraş city and 23 patients diagnosed with LDH at the levels of L3−L4, L4−L5 or L5−S1 were enrolled. Results The average age was 38.4 ± 8.0 and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. Laségue tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3−L4, L4−L5, and L5−S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was 13.6 ± 5.4 months (range: 5−22). Conclusions It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery. PMID:28119770

  4. Cryopreservation of Pelargonium apices by droplet-vitrification.

    Science.gov (United States)

    Gallard, Anthony; Panis, Bart; Dorion, Nöelle; Swennen, Rony; Grapin, Agnès

    2008-01-01

    The droplet-vitrification method was adapted to Pelargonium apices by optimizing the duration of the loading solution (LS) as well as the plant vitrification solution 2 (PVS2). The excised apices were dehydrated in two steps (20 min in LS and 15 min in PVS2) and then immersed directly in liquid nitrogen (LN). After thawing and unloading in the recovery solution at room temperature for 15 min, apices were plated onto semi-solid Murashige and Skoog medium. This simple protocol without any pretreatment was successfully applied to eight cultivars with a survival level ranging between 55.6 - 96.2 percent and a regrowth level between 9.1 and 70.6 percent. These results prove the feasibility of the long-term storage of Pelargonium germplasm through cryopreservation.

  5. GUIDELINES FOR TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

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    CARMEN YOSSALETH BRICEÑO-GONZÁLEZ

    Full Text Available ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft. Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

  6. Lumbar Epidural Varix Mimicking Perineural Cyst

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    Pusat, Serhat; Kural, Cahit; Aslanoglu, Atilla; Kurt, Bulent

    2013-01-01

    Lumbar epidural varices are rare and usually mimick lumbar disc herniations. Back pain and radiculopathy are the main symptoms of lumbar epidural varices. Perineural cysts are radiologically different lesions and should not be confused with epidural varix. A 36-year-old male patient presented to us with right leg pain. The magnetic resonance imaging revealed a cystic lesion at S1 level that was compressing the right root, and was interpreted as a perineural cyst. The patient underwent surgery via right L5 and S1 hemilaminectomy, and the lesion was coagulated and removed. The histopathological diagnosis was epidural varix. The patient was clinically improved and the follow-up magnetic resonance imaging showed the absence of the lesion. Lumbar epidural varix should be kept in mind in the differential diagnosis of the cystic lesions which compress the spinal roots. PMID:23741553

  7. Comparative analysis of morphological and topometric parameters of lumbar spine in normal state and in degenerative-dystrophic changes

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    Anisimova Е.А.

    2015-12-01

    Full Text Available Objective: to carry out comparative analysis and identify patterns of topographic variation patterns of lumbar spine in normal and degenerative changes. Material and methods. CT- and MRT-grams for men and women I (M1-22-35 years; W — 21-35 years and II (M2-36-60 years; W2-36-55 years periods of mature age with no signs of trauma, scoliosis and systemic diseases of the spine (n=140 and CT- and MRT-grams in patients with revealed degenerative changes in the lumbar spine degree II-III (n=120. The pictures with digital PACS system measure the height of the vertebral body, intervertebral disc height, vertical, horizontal diameter and the area of intervertebral foramen. Results. The height of the lumbar vertebral bodies normally increased from27,90±0,38mmatthe level of L, to 29,93±0,33 mm Lm, and then decreased to 24,35±0,27 mm at level L^, in osteochondrosis it is statistically significantly lower at all levels on average by 20%. The height of the intervertebral disc with osteochondrosis below at all levels by an average of 25% of its value in the range 5,27±0,19 to 6,13±0,17mm, while the normal disc height varies from 6,88±030 to 9,36±0,28mm. The area of intervertebral holes normally ranging from 103,29±5,78 to 127,99±5,92mm2, with osteochondrosis aperture area is reduced to a greater extent by decreasing the vertical diameter in comparison with the horizontal. Conclusion. For the studied parameters characteristic topographic variability has been determined. The maximum values parameters are marked at the top of the lumbar lordosis, at chest height, lumbar and lumbosacral junctions sizes are reduced. In osteochondrosis the intervertebral disc height and the height of lumbar vertebral bodies are reduced; intervertebral foramina area is also reduced to a greater extent by reducing the vertical diameter than the horizontal one.

  8. Vertebral body or intervertebral disc wedging: which contributes more to thoracolumbar kyphosis in ankylosing spondylitis patients?

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    Liu, Hao; Qian, Bang-Ping; Qiu, Yong; Wang, Yan; Wang, Bin; Yu, Yang; Zhu, Ze-Zhang

    2016-01-01

    Abstract Both vertebral body wedging and disc wedging are found in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis. However, their relative contribution to thoracolumbar kyphosis is not fully unders