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Sample records for lumbar vertebral body

  1. The characteristic of rBMD distribution in lumbar vertebral body

    International Nuclear Information System (INIS)

    Wang Chenguang; Xiao Xiangsheng; Chen Xingrong; Shen Tianzhen; Liu Guanghua; Hong Qingjian; Ji Rongming; Zhou Weiming

    1998-01-01

    Purpose: To determine the distribution and variation of rBMD in human lumbar vertebral body. Methods: The BMD and rBMD of 28 samples of lumbar body were measured with QCT. The rBMD was measured in the regions of anterior, anterolateral, posterolateral and central, superior-level, middle-level and inferior-level of the vertebral bodies. The relationship between BMD and rBMD were statistically analysed with multiple regression. Results: The rBMD of the inferior vertebral body was higher than that of the superior and middle portions (P<0.05); the central and posterolateral higher than the anterior and anterolateral (P<0.05). The rBMD of posterioinferior vertebral body was the highest. The multiple regression showed that the standard partial regression coefficient of inferior was larger than the superior and middle; the anterior and central were larger than the other regions of the vertebra. Variations of the BMD of vertebral body were mostly related to the rBMD of anterior and central parts. Conclusion: The distribution of BMD are heterogeneous in vertebral body. The anterior and central part of vertebral body are most sensitive to bone loss in osteoporosis. It is emphasized that the rBMD of anterior and central part of vertebral body should be measured for following the osteoporosis

  2. Technical strategies and anatomic considerations for parapedicular access to thoracic and lumbar vertebral bodies

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Martin, Hal D.; Stapp, Annette M.; Puckett, Timothy A.; Stechison, M.T.; Braswell, John J.

    2007-01-01

    To investigate and illustrate a variation on the traditional percutaneous access to the vertebral body via a parapedicular approach. An effective parapedicular access technique that could safely and reliably guide the needle tip into the center of the vertebral body was developed from cadaver dissection observations for the purpose of clinical use. A total of 102 vertebral compression fractures from T-4 to L-5 were treated via the parapedicular access at our institution between July 2005 and March 2006. There were 72 patients between the ages of 17 and 96 years (mean age: 68.2 years) who underwent treatment. The cadaver dissection revealed a relatively avascular and aneural portion of the vertebral body along the superior margin of the vertebral body-pedicle junction. A total 102 vertebral fractures were treated using the parapedicular access technique without any recognized clinical complications from the needle access or the instrumentation. The thoracic and lumbar vertebral bodies may be safely, reliably, and reproducibly accessed using a percutaneous parapedicular access technique. The technique presented represents a relatively avascular and aneural approach to vertebral body. (orig.)

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

    International Nuclear Information System (INIS)

    Cristante, Alexandre Fogaca; Barros Filho, Tarcisio; Oliveira, Reginaldo Perilo de; Babrabrini, Almir F.; Teixeira, William G.J.

    2007-01-01

    A case of Osteoid osteoma, a rare bone tumor, is studied in a 44-year-old female patient. Scintigraphy using Tc 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)

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

    International Nuclear Information System (INIS)

    Toyoda, Keiko; Ida, Masahiro; Murakami, Yoshitaka; Harada, Junta; Tada, Shimpei

    1992-01-01

    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)

  5. Determination of bone mineral density in the third lumbar vertebral body using photon absorptiometry techniques

    International Nuclear Information System (INIS)

    Swanpalmer, Janos; Kullenberg, Ragnar; Hansson, Tommy

    1998-01-01

    Dual-photon absorptiometry and triple-energy X-ray absorptiometry were used to investigate the total bone mineral content and density as well as the trabecular bone mineral density in the third lumbar vertebral body. Both anteroposterior (AP) and lateral (LAT) measurements were performed. By combining the two projections it was found that the mean trabecular bone mineral density for all 202 subjects included in the study was 52% (SD±20%) of the total bone mineral density in the third lumbar vertebral body. The mean trabecular bone mineral density as a fraction of the total vertebral body bone mineral density decreased as a function of age. The relative annual change in this fraction differed between males and females. It was also found that neither trabecular nor total bone mineral density differed significantly between male and female subjects aged 25-35 years, and bone mineral density (BMD), expressed in g/cm 3 , showed no correlation to subject height, body weight or body mass index (BMI). Male and female individuals showed different rates of change of trabecular bone mineral density with age

  6. Monostotic fibrous dysplasia of a lumbar vertebral body with secondary aneurysmal bone cyst formation: a case report

    Directory of Open Access Journals (Sweden)

    Snieders Marieke N

    2009-06-01

    Full Text Available Abstract We report the case of a 25-year-old Caucasian woman with symptomatic monostotic fibrous dysplasia of the fourth lumbar vertebral body. The patient suffered from a five-week history of progressive low back pain, radiating continuously to the left leg. Her medical history and physical and neurological examination did not demonstrate any significant abnormalities. Radiographs, computed tomography and magnetic resonance imaging revealed an osteolytic expansive lesion with a cystic component of the fourth lumbar vertebral body. Percutaneous transpedicular biopsy showed histological characteristics of fibrous dysplasia superimposed by the formation of aneurysmal bone cyst components. The patient was treated by subtotal vertebrectomy of the L4 vertebral body with anterior reconstruction and her postoperative course was uncomplicated. To our knowledge, this is the first reported case of a monostotic fibrous dysplasia with superimposed secondary aneurysmal bone cysts of a lumbar vertebral body.

  7. Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT study.

    Science.gov (United States)

    Gezer, Naciye Sinem; Balcı, Ali; Kalemci, Orhan; Köremezli, Nevin; Başara Akın, Işıl; Ur, Koray

    2017-01-01

    Spondylolysis is known to be a part of a disease process, which describes a defect in the pars interarticularis of vertebra. We aimed to use quantitative computed tomography (QCT) to measure vertebral body bone mineral density (BMD) in patients with lumbar spondylolysis and compare it with readings in controls. Forty symptomatic patients with lumbar spondylolysis aged 18-52 years and 40 matched controls of same sex and approximate age (±2 years) were included in the study. Measurements of BMD were performed by QCT analysis for each vertebral body from T12 to L5 and mean BMD was calculated for each case. Of 40 patients, 22 (55%) demonstrated L5 spondylolysis, 14 (35%) L4 spondylolysis, three (7.5%) L3 spondylolysis, and one (2.5%) L2 spondylolysis. Spondylolisthesis was found in 29 patients (73%). Patients with spondylolisthesis were significantly older than patients without spondylolisthesis (42±6.9 vs. 37.2±5.4, P = 0.024). Mean BMD value of the patient group was significantly lower than that of the controls (105±24 mg/cm³ vs. 118.7±25.6 mg/cm³, P = 0.015). Subgroup analysis of 19 patients and 19 controls under the age of 40 revealed that the mean BMD value of the patients was significantly lower than that of the controls in the younger age group as well (108.7±23.5 mg/cm³ vs. 130±25.8 mg/cm³, P = 0.009). This study demonstrated that patients with spondylolysis had significantly lower mean vertebral body BMD compared with controls.

  8. Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report

    Science.gov (United States)

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

    2014-01-01

    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. PMID:25620987

  9. Monostotic fibrous dysplasia of a lumbar vertebral body with secondary aneurysmal bone cyst formation: a case report

    NARCIS (Netherlands)

    Snieders, N.M.E.; Kemenade, van F.J.; Royen, van B.J.

    2009-01-01

    We report the case of a 25-year-old Caucasian woman with symptomatic monostotic fibrous dysplasia of the fourth lumbar vertebral body. The patient suffered from a five-week history of progressive low back pain, radiating continuously to the left leg. Her medical history and physical and neurological

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

    International Nuclear Information System (INIS)

    Wilms, Guido E.; Demaerel, Philippe; Keyzer, Frederik de; Willems, Endry

    2012-01-01

    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.)

  11. 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.)

  12. Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study.

    Science.gov (United States)

    Been, Ella; Li, Ling; Hunter, David J; Kalichman, Leonid

    2011-07-01

    The objective is to evaluate the geometric parameters of vertebral bodies and intervertebral discs in spinal segments adjacent to spondylolysis and spondylolisthesis. This pilot cross-sectional study was an ancillary project to the Framingham Heart Study. The presence of spondylolysis and spondylolisthesis as well as measurements of spinal geometry were identified on CT imaging of 188 individuals. Spinal geometry measurements included lordosis angle, wedging of each lumbar vertebra and intervertebral disc. Last measurements were used to calculate ΣB, the sum of the lumbar L1-L5 body wedge angles; and ΣD, the sum of the lumbar L1-L5 intervertebral disc angles. Using Wilcoxon-Mann-Whitney test we compared the geometric parameters between individuals with no pathology and ones with spondylolysis (with no listhesis) at L5 vertebra, ones with isthmic spondylolisthesis at L5-S1 level, and ones with degenerative spondylolisthesis at L5-S1 level. Spinal geometry in individuals with spondylolysis or listhesis at L5 shows three major patterns: In spondylolysis without listhesis, spinal morphology is similar to that of healthy individuals; In isthmic spondylolisthesis there is high lordosis angle, high L5 vertebral body wedging and very high L4-5 disc wedging; In degenerative spondylolisthesis, spinal morphology shows more lordotic wedging of the L5 vertebral body, and less lordotic wedging of intervertebral discs. In conclusion, there are unique geometrical features of the vertebrae and discs in spondylolysis or listhesis. These findings need to be reproduced in larger scale study.

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

    International Nuclear Information System (INIS)

    Kikuchi, Tetsujiro

    1988-01-01

    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)

  14. 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

  15. Automated Detection, Localization, and Classification of Traumatic Vertebral Body Fractures in the Thoracic and Lumbar Spine at CT.

    Science.gov (United States)

    Burns, Joseph E; Yao, Jianhua; Muñoz, Hector; Summers, Ronald M

    2016-01-01

    To design and validate a fully automated computer system for the detection and anatomic localization of traumatic thoracic and lumbar vertebral body fractures at computed tomography (CT). This retrospective study was HIPAA compliant. Institutional review board approval was obtained, and informed consent was waived. CT examinations in 104 patients (mean age, 34.4 years; range, 14-88 years; 32 women, 72 men), consisting of 94 examinations with positive findings for fractures (59 with vertebral body fractures) and 10 control examinations (without vertebral fractures), were performed. There were 141 thoracic and lumbar vertebral body fractures in the case set. The locations of fractures were marked and classified by a radiologist according to Denis column involvement. The CT data set was divided into training and testing subsets (37 and 67 subsets, respectively) for analysis by means of prototype software for fully automated spinal segmentation and fracture detection. Free-response receiver operating characteristic analysis was performed. Training set sensitivity for detection and localization of fractures within each vertebra was 0.82 (28 of 34 findings; 95% confidence interval [CI]: 0.68, 0.90), with a false-positive rate of 2.5 findings per patient. The sensitivity for fracture localization to the correct vertebra was 0.88 (23 of 26 findings; 95% CI: 0.72, 0.96), with a false-positive rate of 1.3. Testing set sensitivity for the detection and localization of fractures within each vertebra was 0.81 (87 of 107 findings; 95% CI: 0.75, 0.87), with a false-positive rate of 2.7. The sensitivity for fracture localization to the correct vertebra was 0.92 (55 of 60 findings; 95% CI: 0.79, 0.94), with a false-positive rate of 1.6. The most common cause of false-positive findings was nutrient foramina (106 of 272 findings [39%]). The fully automated computer system detects and anatomically localizes vertebral body fractures in the thoracic and lumbar spine on CT images with a

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-01

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

  18. Reproducibility of central lumbar vertebral BMD

    International Nuclear Information System (INIS)

    Chan, F.; Pocock, N.; Griffiths, M.; Majerovic, Y.; Freund, J.

    1997-01-01

    Full text: Lumbar vertebral bone mineral density (BMD) using dual X-ray absorptiometry (DXA) has generally been calculated from a region of interest which includes the entire vertebral body. Although this region excludes part of the transverse processes, it does include the outer cortical shell of the vertebra. Recent software has been devised to calculate BMD in a central vertebral region of interest which excludes the outer cortical envelope. Theoretically this area may be more sensitive to detecting osteoporosis which affects trabecular bone to a greater extent than cortical bone. Apart from the sensitivity of BMD estimation, the reproducibility of any measurement is important owing to the slow rate of change of bone mass. We have evaluated the reproducibility of this new vertebral region of interest in 23 women who had duplicate lumbar spine DXA scans performed on the same day. The patients were repositioned between each measurement. Central vertebral analysis was performed for L2-L4 and the reproducibility of area, bone mineral content (BMC) and BMD calculated as the coefficient of variation; these values were compared with those from conventional analysis. Thus we have shown that the reproducibility of the central BMD is comparable to the conventional analysis which is essential if this technique is to provide any additional clinical data. The reasons for the decrease in reproducibility of the area and hence BMC requires further investigation

  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. 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.

  1. 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.

  2. The shape of the human lumbar vertebral canal

    OpenAIRE

    Zarzur,Edmundo

    1996-01-01

    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 t...

  3. Lumbar Vertebral Canal Diameters in Adult Ugandan Skeletons ...

    African Journals Online (AJOL)

    Background: Normal values of lumbar vertebral canal diameters are useful in facilitating diagnosis of lumbar vertebral canal stenosis. Various studies have established variation on values between different populations, gender, age, and ethnic groups. Objectives: To determine the lumbar vertebral canal diameters in adult ...

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

    Science.gov (United States)

    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.

  5. 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...... are consistent with the corresponding results of Han et al. (2012) and Niemeyer et al. (2012). As mentioned above, the vertebral body depth showed a recognizable effect for the flexed and lateral bended postures, too. These characteristics can be justified with increasing moments due to the changed offset...

  6. Evaluation of lumbar vertebral bone marrow changes with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kakitsubata, Yousuke; Nabeshima, Kazuki; Kakitsubata, Sachiko; Watanabe, Katsushi (Miyazaki Medical Coll., Kiyotake (Japan))

    1993-11-01

    Seven hundred nine magnetic resonance (MR) imaging studies of the lumbar spine were reviewed to assess the signal intensity (SI) changes in vertebral bone marrow. Marrow changes were classified into four types according to their SI changes on T1-weighted images (T1-WI) and T2-WI. Type 1 changes (decreased SI on T1-WI and increased SI on T2-WI) were identified in 28 patients (3.9%), type 2 changes (increased SI on T1-WI and isointense or slightly increased SI on T2-WI) in 184 (26%), type 3 changes (decreased SI on both T1-WI and T2-WI) in 71 (10%), and type 4 changes (linearly increased SI on T1-WI in the center of the vertebral body) in 142 (20%). Plain radiographs showed sclerotic changes in patients with type 3. In patients with type 1 or 4 changes, no focal abnormalities were observed. Histological evaluation of type 1 change revealed fibrous tissue including cartilaginous formation. Focal replacement by fatty tissue was observed in type 2 and type 4 changes. Bone sclerosis was observed in type 4 change. Type 1, type 2 and type 3 changes, which occurred commonly in the old and in the lower lumbar level, appear to reflect a spectrum of degenerative changes of the bone marrow including both pathological and physiological ones. (author).

  7. Vertebral body osteomyelitis in the horse

    International Nuclear Information System (INIS)

    Markel, M.D.; Madigan, J.E.; Lichtensteiger, C.A.; Large, S.M.; Hornof, W.J.

    1986-01-01

    The clinical signs, laboratory data, results of nuclear scintigraphy and radiographic examination of five horses with vertebral body osteomyelitis are described together with response to treatment. Three horses were less than five months of age. Four horses demonstrated hindlimb paresis and in three a focus of pain in the thoracolumbar region could be identified. An umbilical abscess, a caudal lobe lung abscess and a patent urachus were considered primary niduses of infection in each of three horses. Leucocytosis, neutrophilia, anaemia and elevated fibrinogen were the most consistent laboratory abnormalities. Nuclear scintigraphy was performed in three horses and identified the site of the vertebral lesion which was subsequently evaluated radiographically. In the other two horses radiographic examination in the region of areas of focal pain identified a lesion. Radiographic abnormalities included compression fractures of vertebral bodies (two), proliferative new bone (three) and soft tissue swelling ventral to a vertebral body (one). Two horses, including one with a compression fracture of the second lumbar vertebra, received parenteral antimicrobial therapy for 40 and 74 days, respectively. When re-examined six months later they showed no neurological abnormalities. The other three horses failed to respond to antimicrobial treatment and were humanely destroyed. The horse with a lung abscess also had an abscess cranial to the right tuber coxae which extended into the vertebral bodies of the third and fourth lumbar vertebrae from which Streptococcus zooepidemicus was cultured. A horse with proliferative new bone on the ventral aspect of the fifth and sixth thoracic vertebrae had a mediastinal mass associated with these vertebrae and fungal granulomas, from which Aspergillus species was cultured, in the heart and aorta, trachea, spleen and kidney. The horse with a patent urachus and soft tissue swelling ventral to the vertebral body of the 12th thoracic vertebra

  8. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Tishya A L Wren

    Full Text Available 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

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

    Science.gov (United States)

    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

  13. Magnetic resonance imaging of lumbar vertebral apophyseal ring fractures

    International Nuclear Information System (INIS)

    Peh, W.C.G.

    1998-01-01

    Posterior lumbar vertebral apophyseal ring fractures are described in three adolescents presenting with severe low back pain, spinal tenderness and lower limb neurological deficit. Magnetic resonance imaging showed severe L4/5 posterior disc protrusion in all three patients. The actual fracture fragment was visualized with difficulty on MRI alone. The diagnosis of apophyseal ring fracture was made by either radiography or CT. Computed tomography delineated the size, shape and site of the fracture fragment. Surgical confirmation was obtained in all cases. Posterior lumbar vertebral apophyseal ring fractures may be difficult to visualize on MR imaging. Careful review of radiographs, supplemented by targeted CT, is necessary for the correct diagnosis and management of this entity. Copyright (1998) Blackwell Science Pty Ltd

  14. Magnetic resonance imaging of lumbar vertebral apophyseal ring fractures

    Energy Technology Data Exchange (ETDEWEB)

    Peh, W.C.G. [University of Hong Kong (Hong Kong). Department of Diagnostics Radiology and Organ Imaging; Yip, D.K.H.; Leong, J.C.Y. [University of Hong Kong (Hong Kong). Department of Orthopaedic Surgery; Griffith, J.F. [Chinese University of Hong Kong (Hong Kong)

    1998-02-01

    Posterior lumbar vertebral apophyseal ring fractures are described in three adolescents presenting with severe low back pain, spinal tenderness and lower limb neurological deficit. Magnetic resonance imaging showed severe L4/5 posterior disc protrusion in all three patients. The actual fracture fragment was visualized with difficulty on MRI alone. The diagnosis of apophyseal ring fracture was made by either radiography or CT. Computed tomography delineated the size, shape and site of the fracture fragment. Surgical confirmation was obtained in all cases. Posterior lumbar vertebral apophyseal ring fractures may be difficult to visualize on MR imaging. Careful review of radiographs, supplemented by targeted CT, is necessary for the correct diagnosis and management of this entity. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 3 figs.

  15. Delayed vertebral diagnosed L4 pincer vertebral fracture, L2-L3 ruptured vertebral lumbar disc hernia, L5 vertebral wedge fracture - Case report

    OpenAIRE

    Balasa D; Schiopu M; Tunas A; Baz R; Hancu Anca

    2016-01-01

    An association between delayed ruptured lumbar disc hernia, L5 vertebral wedge fracture and posttraumaticL4 pincer vertebral fracture (A2.3-AO clasification) at different levels is a very rare entity. We present the case of a 55 years old male who falled down from a bicycle. 2 months later because of intense and permanent vertebral lumbar and radicular L2 and L3 pain (Visual Scal Autologus of Pain7-8/10) the patient came to the hospital. He was diagnosed with pincer vertebral L4 fracture (A2....

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Delayed vertebral diagnosed L4 pincer vertebral fracture, L2-L3 ruptured vertebral lumbar disc hernia, L5 vertebral wedge fracture - Case report

    Directory of Open Access Journals (Sweden)

    Balasa D

    2016-08-01

    Full Text Available An association between delayed ruptured lumbar disc hernia, L5 vertebral wedge fracture and posttraumaticL4 pincer vertebral fracture (A2.3-AO clasification at different levels is a very rare entity. We present the case of a 55 years old male who falled down from a bicycle. 2 months later because of intense and permanent vertebral lumbar and radicular L2 and L3 pain (Visual Scal Autologus of Pain7-8/10 the patient came to the hospital. He was diagnosed with pincer vertebral L4 fracture (A2.3-AO clasification and L2-L3 right ruptured lumbar disc hernia in lateral reces. The patient was operated (L2-L3 right fenestration, and resection of lumbar disc hernia, bilateral stabilisation, L3-L4-L5 with titan screws and postero-lateral bone graft L4 bilateral harvested from iliac crest.

  18. Comparison of vertebral morphometry in the lumbar vertebrae by T1-weighted sagittal MRI and radiograph

    International Nuclear Information System (INIS)

    Tomomitsu, Tatsushi; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

    2005-01-01

    Purpose: In this study, we investigated the usefulness of T1-weighted sagittal MR images at the lumbar vertebrae in the vertebral morphometry, in comparison with lateral radiographs. Subjects and methods: The subjects were 42 men (mean age: 53.0 years) and 41 women (mean age: 57.9 years). Both MRI and radiography of the lumbar spine were performed within 1 month. The vertebral body heights and their ratios were measured by the semi-automatic measuring system. The frequency of a vertebral fracture and the absolute value of vertebral body height in both morphometry were compared. Results: Based on the criteria for prevalent vertebral fracture using vertebral height ratios, the vertebrae were classified into four groups. Group 1 was defined as the vertebrae without fracture (n = 347 vertebrae). Groups 2-4 were defined as the vertebrae with fracture; Group 2 by both MRI and X-ray morphometry (n = 17), Group 3 by MRI morphometry alone (n = 17), and Group 4 by X-ray morphometry alone (n = 4). The rate of prevalent vertebral fracture diagnosed by MRI morphometry (8.8%) was higher than that by X-ray morphometry (5.5%). In Group 1, the values of anterior and posterior vertebral height obtained by MRI morphometry were greater than those obtained by X-ray morphometry. On the other hand, the values of central vertebral height obtained by MRI morphometry were smaller than those obtained by X-ray morphometry. Conclusion: Severe biconcave deformity of vertebra can be detected by both MRI and X-ray morphometry, although mild biconcave deformity can be detected only by MRI morphometry

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. Measurements of vertebral shape by r[iographic morphometry: sex differences and relationships with vertebral level and lumbar lordosis

    International Nuclear Information System (INIS)

    Cheng, X.G.; Sun, Y.; Boonen, S.; Nicholson, P.H.F.; Dequeker, J.; Brys, P.; Felsenberg, D.

    1998-01-01

    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 r[iographs 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 r[iographs. 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.)

  1. Three-dimensional motion pattern of the caudal lumbar and lumbosacral portions of the vertebral column of dogs.

    Science.gov (United States)

    Benninger, Monika I; Seiler, Gabriela S; Robinson, Leanne E; Ferguson, Stephen J; Bonél, Harald M; Busato, André R; Lang, Johann

    2004-05-01

    To evaluate the 3-dimensional motion pattern including main and coupled motions of the caudal lumbar and lumbosacral portions of the vertebral column of dogs. Vertebral columns of 9 German Shepherd Dogs (GSDs) and 16 dogs of other breeds with similar body weights and body conditions. Main and coupled motions of the caudal lumbar and lumbosacral portions of the vertebral column (L4 to S1) were determined by use of a testing apparatus that permitted precise application of known pure moments to the vertebral column. Motion was compared between GSDs and dogs of other breeds. All specimens had a similar motion pattern consisting of main motion and a certain amount of coupled motion including translation. Vertebral columns of GSDs had significantly less main motion in all directions than that of dogs of other breeds. Translation was similar in GSDs and dogs of other breeds and was smallest at the lumbosacral motion segment. Results indicated that motion in the caudal lumbar and lumbosacral portions of the vertebral column of dogs is complex and provided a basis for further studies evaluating abnormal vertebral columns.

  2. Asymptomatic Lumbar Vertebral Erosion from Inferior Vena Cava Filter Perforation

    International Nuclear Information System (INIS)

    Fang, Wayne; Hieb, Robert A.; Olson, Eric; Carrera, Guillermo F.

    2007-01-01

    In 2002, a 24-year-old female trauma patient underwent prophylactic inferior vena cava filter placement. Recurrent bouts of renal stones prompted serial CT imaging in 2004. In this brief report, we describe erosion and ossification of the L3 vertebral body by a Greenfield filter strut

  3. Thoracic and lumbar vertebral bone mineral density changes in a natural occurring dog model of diffuse idiopathic skeletal hyperostosis.

    Directory of Open Access Journals (Sweden)

    Steven De Decker

    Full Text Available Ankylosing spinal disorders can be associated with alterations in vertebral bone mineral density (BMD. There is however controversy about vertebral BMD in patients wuse idiopathic skeletal hyperostosis (DISH. DISH in Boxer dogs has been considered a natural occurring disease model for DISH in people. The purpose of this study was to compare vertebral BMD between Boxers with and without DISH. Fifty-nine Boxers with (n=30 or without (n=29 DISH that underwent computed tomography were included. Vertebral BMD was calculated for each thoracic and lumbar vertebra by using an earlier reported and validated protocol. For each vertebral body, a region of interest was drawn on the axial computed tomographic images at three separate locations: immediately inferior to the superior end plate, in the middle of the vertebral body, and superior to the inferior end plate. Values from the three axial slices were averaged to give a mean Hounsfield Unit value for each vertebral body. Univariate statistical analysis was performed to identify factors to be included in a multivariate model. The multivariate model including all dogs demonstrated that vertebral DISH status (Coefficient 24.63; 95% CI 16.07 to 33.19; p <0.001, lumbar vertebrae (Coefficient -17.25; 95% CI -23.42 to -11.09; p < 0.01, and to a lesser extent higher age (Coefficient -0.56; 95% CI -1.07 to -0.05; p = 0.03 were significant predictors for vertebral BMD. When the multivariate model was repeated using only dogs with DISH, vertebral DISH status (Coefficient 20.67; 95% CI, 10.98 to 30.37; p < 0.001 and lumbar anatomical region (Coefficient -38.24; 95% CI, -47.75 to -28.73; p < 0.001 were again predictors for vertebral BMD but age was not. The results of this study indicate that DISH can be associated with decreased vertebral BMD. Further studies are necessary to evaluate the clinical importance and pathophysiology of this finding.

  4. Intercellular signaling pathways active during and after growth and differentiation of the lumbar vertebral growth plate.

    Science.gov (United States)

    Dahia, Chitra Lekha; Mahoney, Eric J; Durrani, Atiq A; Wylie, Christopher

    2011-06-15

    Vertebral growth plates at different postnatal ages were assessed for active intercellular signaling pathways. To generate a spatial and temporal map of the major signaling pathways active in the postnatal mouse lumbar vertebral growth plate. The growth of all long bones is known to occur by cartilaginous growth plates. The growth plate is composed of layers of chondrocyets that actively proliferate, differentiate, die and, are replaced by bone. The role of major cell signaling pathways has been suggested for regulation of the fetal long bones. But not much is known about the molecular or cellular signals that control the postnatal vertebral growth plate and hence postnatal vertebral bone growth. Understanding such molecular mechanisms will help design therapeutic treatments for vertebral growth disorders such as scoliosis. Antibodies against activated downstream intermediates were used to identify cells in the growth plate responding to BMP, TGFβ, and FGF in cryosections of lumbar vertebrae from different postnatal age mice to identify the zones that were responding to these signals. Reporter mice were used to identify the chondrocytes responding to hedgehog (Ihh), and Wnt signaling. We present a spatial/temporal map of these signaling pathways during growth, and differentiation of the mouse lumbar vertebral growth plate. During growth and differentiation of the vertebral growth plate, its different components respond at different times to different intercellular signaling ligands. Response to most of these signals is dramatically downregulated at the end of vertebral growth.

  5. Significance of angular mismatch between vertebral endplate and prosthetic endplate in lumbar total disc replacement.

    Science.gov (United States)

    Lee, Chong Suh; Chung, Sung Soo; Oh, Sung Kyun; You, Je Wook

    2011-05-01

    A retrospective study. To determine whether angular mismatch between the vertebral endplate and prosthetic endplate during lumbar total disc replacement (L-TDR) affects the radiological and clinical outcomes. A prosthesis anchored to the vertebral body by using a large central keel carries an inherent risk of angular mismatch between the vertebral endplate and prosthetic endplate at a segment with a greater degree of lordosis, such as L5-S1. Theoretically, this angular mismatch can cause several problems, such as segmental hyperlordosis, anterior positioning of the upper prosthesis, posterior prosthetic edge subsidence, decreased range of motion (ROM), and a poor clinical outcome. This study evaluated 64 prosthetic levels of 56 patients who were implanted with L-TDR between June 2002 and February 2006. There were 38 and 26 prosthetic levels at the L4-5 and L5-S1, respectively. The mean follow-up period was 25.6 (12 to 49) months. The angle of mismatch between the lower endplate of the upper vertebral body and the upper prosthetic plate, segmental flexion/extension ROM, segmental lordosis angle at extension, distance from the posterior wall of the vertebral body to the posterior prosthetic edge were measured by obtaining radiographs. Clinically, the Visual Analogue Scale and Oswestry Disability Index were also evaluated. The angular mismatches between the upper vertebra and prosthesis at L4-5 and L5-S1 were 1.6 degree and 5.6 degree, respectively (P body to the posterior edge of the prosthesis in L5-S1 were 6.8 degree (4 to 13), 12.8 degree (8 to 17), and 3.8 mm (1 to 6 mm) in patients with an angular mismatch of 0.05). Angular mismatch was more common in L5-S1 than in L4-5. L-TDR at the most lordotic level, L5-S1, and implantation of an upper prosthesis with a mismatched angle seem to be the causes of a reduced segmental ROM, increased segmental lordosis, and anterior malpositioning of the prosthesis. However, these changes do not affect the clinical outcomes of

  6. Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion

    OpenAIRE

    du Rose, Alister; Breen, Alan

    2016-01-01

    Abstract: Control of the lumbar spine requires contributions from both the active and passive sub-systems. Identifying interactions between these systems may provide insight into the mechanisms of low back pain. However, as a first step it is important to investigate what is normal. The purpose of this study was to explore the relationships between the lumbar inter-vertebral range of motion and paraspinal muscle activity during weight-bearing flexion in healthy controls using quantitative flu...

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

    International Nuclear Information System (INIS)

    Savvopoulou, Vasiliki; Vlahos, Lampros; Moulopoulos, Lia Angela; Maris, Thomas G.

    2008-01-01

    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 (0.22< r<0.32, p<0.05). Our results indicate increased perfusion of the upper compared to the lower lumbar spine, of younger compared to older subjects and of females compared to males. (orig.)

  8. 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.)

  9. Effects of anatomic conformation on three-dimensional motion of the caudal lumbar and lumbosacral portions of the vertebral column of dogs.

    Science.gov (United States)

    Benninger, Monika I; Seiler, Gabriela S; Robinson, Leanne E; Ferguson, Stephen J; Bonél, Harald M; Busato, André R; Lang, Johann

    2006-01-01

    To determine the association between the 3-dimensional (3-D) motion pattern of the caudal lumbar and lumbosacral portions of the canine vertebral column and the morphology of vertebrae, facet joints, and intervertebral disks. Vertebral columns of 9 German Shepherd Dogs and 16 dogs of other breeds with similar body weights and body conditions. Different morphometric parameters of the vertebral column were assessed by computed tomography (CT) and magnetic resonance imaging. Anatomic conformation and the 3-D motion pattern were compared, and correlation coefficients were calculated. Total range of motion for flexion and extension was mainly associated with the facet joint angle, the facet joint angle difference between levels of the vertebral column in the transverse plane on CT images, disk height, and lever arm length. Motion is a complex process that is influenced by the entire 3-D conformation of the lumbar portion of the vertebral column. In vivo dynamic measurements of the 3-D motion pattern of the lumbar and lumbosacral portions of the vertebral column will be necessary to further assess biomechanics that could lead to disk degeneration in dogs.

  10. Anatomical study of lumbar vertebral pedicle and adjacent neural structures

    Directory of Open Access Journals (Sweden)

    Matuoka Cláudia Maria

    2002-01-01

    Full Text Available For the evaluation of the Lumbar pedicle morphometry and its relation to the neural structures, 14 male adult cadavers were dissected, and the size of the lumbar pedicle was assessed by measuring its sagittal and transversal diameter. It was found that the size of the pedicle increases from L2 to L5, both in the sagittal and transversal diameter, the first bigger. The relation of the lumbar pedicle to the neural structures was evaluated by measuring the distance between dura-mater and the pedicle medial area, the distance between the most distal area of the pedicle and the nerve root that appears under it, and , to obtain in an indirect way, the distance between the pedicle apex and the nerve root that appears over it. The acquired results showed that the distance between the most distal area of the pedicle and the nerve root that appears under it, and the distance between the pedicle medial area and dura-mater, do not increase from L2 to L5, and they are in average 1,98 and 3,02 respectively. The distance between the pedicle apex and the nerve root that appears over it, increases from L2 to L5, varying from 13,64 in L2 to 21,62 in L5. The location of the spinal ganglion in relation to the pedicle has also been found, and 87% of the spinal ganglions are located in the foraminal zone.

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

    Science.gov (United States)

    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.

  12. A lumbar body support (KBS 2000) alters lumbar muscle recruitment ...

    African Journals Online (AJOL)

    random order) either a flat conventional mattress or a LBS placed on top of the ... mirrored these changes and were higher in patients only when lying on the flat ... While studies have examined the effect of lumbar support on LBP during sitting ... measured using a 4-channel EMG and customised software programme (EM8 ...

  13. Disturbance of growth of the vertebral bodies in children and adolescents with hematogenous osteomyelitis of the vertebral column

    International Nuclear Information System (INIS)

    Sizov, V.A.

    1987-01-01

    Clinicoroentgenological changes were studied over time in 72 children and adolescents with localized hematogenous osteomyelitis of the lumbar spine. The duration of clinicoroengenological observation ranged from 1 year to 15 years. The dynamic roentgenological followup of a course of hematogenous osteomyelitis developing in the period of growth, made it possible to reveal and describe for the first time an increase in the height of the vertebral bodies which hitherto was regarded in literature as a pathognomonic sign of tuberculous spondylitis. Unlike tuberculosis, in hematogenous osteomyelitis there was an increase in the height not only of the adjacent unaffected but also of the affected vertebrae in case of their superficial or localized focal involvement

  14. 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.

  15. Hernia of intervertebral disk in the lumbar vertebral column

    International Nuclear Information System (INIS)

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

    1986-01-01

    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. (orig.) [de

  16. [Development and application of artificial vertebral body].

    Science.gov (United States)

    Liu, Jian-Tao; Zhang, Feng; Gao, Zheng-Chao; Niu, Bin-Bin; Li, Yu-Huan; He, Xi-Jing

    2017-12-25

    Artificial vertebral body has achieved good results in treating spinal tumors, tuberculosis, fracture and other diseases. Currently, artificial vertebral body with variety of kinds and pros and cons, is generally divided into two types: fusion type and movable type. The former according to whether the height could be adjusted and strength of self-stability is divided into three types: support-fixed type, adjust-fixed type and self-fixed type. Whether the height of self-fixed type could be adjusted is dependent on structure of collar thread rotation. The latter is due to mobile device of ball-and-socket joints or hollow structures instead of the disc which retains the activity of the spine to some extent. Materials of artificial vertebral body include metals, ceramics, biomaterials, polymer composites and other materials. Titanium with a dominant role in the metal has developed to the third generation, but there are still defects such as poor surface bioactivity; ceramics with the representative of hydroxyapatite composite, magnetic bioceramics, polycrystalline alumina ceramics and so on, which have the defects of processing complex and uneven mechanical properties; biological material is mainly dominated by xenogeneic bone, which is closest to human bone in structure and properties, but has defects of low toughness and complex production; polymer composites according to biological characteristics in general consists of biodegradable type and non-biodegradable type which are respectively represented by poly-lactide and polyethylene, each with advantages and disadvantages. Although the design and materials of prosthesis have made great progress, it is difficult to fully meet requirements of spinal implants and they need be further optimized. 3D printing technology makes process of the complex structure of prosthesis and individual customization possible and has broad development prospects. However, long production cycles and high cost of defect should be overcome

  17. Assessing the effects of lumbar posterior stabilization and fusion to vertebral bone density in stabilized and adjacent segments by using Hounsfield unit

    Science.gov (United States)

    Öksüz, Erol; Deniz, Fatih Ersay; Demir, Osman

    2017-01-01

    Background Computed tomography (CT) with Hounsfield unit (HU) is being used with increasing frequency for determining bone density. Established correlations between HU and bone density have been shown in the literature. The aim of this retrospective study was to determine the bone density changes of the stabilized and adjacent segment vertebral bodies by comparing HU values before and after lumbar posterior stabilization. Methods Sixteen patients who had similar diagnosis of lumbar spondylosis and stenosis were evaluated in this study. Same surgical procedures were performed to all of the patients with L2-3-4-5 transpedicular screw fixation, fusion and L3-4 total laminectomy. Bone mineral density measurements were obtained with clinical CT. Measurements were obtained from stabilized and adjacent segment vertebral bodies. Densities of vertebral bodies were evaluated with HU before the surgeries and approximately one year after the surgeries. The preoperative HU value of each vertebra was compared with postoperative HU value of the same vertebrae by using statistical analysis. Results The HU values of vertebra in the stabilized and adjacent segments consistently decreased after the operations. There were significant differences between the preoperative HU values and the postoperative HU values of the all evaluated vertebral bodies in the stabilized and adjacent segments. Additionally first sacral vertebra HU values were found to be significantly higher than lumbar vertebra HU values in the preoperative group and postoperative group. Conclusions Decrease in the bone density of the adjacent segment vertebral bodies may be one of the major predisposing factors for adjacent segment disease (ASD). PMID:29354730

  18. Initial non-weight-bearing therapy is important for preventing vertebral body collapse in elderly patients with clinical vertebral fractures

    Directory of Open Access Journals (Sweden)

    Kishikawa Y

    2012-04-01

    Full Text Available Yoichi KishikawaKishikawa Orthopaedic Clinic, Saga City, Saga, JapanPurpose: The aim of the present conventional observational study was to compare the clinical outcomes of initial non-weight-bearing therapy and conventional relative rest therapy among elderly patients with clinical vertebral fractures.Methods: In total, 196 consecutive patients with clinical vertebral fractures (mean age: 78 years who were hospitalized for treatment between January 1999 and March 2007 were analyzed. Initial non-weight-bearing therapy consisted of complete bed rest allowing rolling on the bed without any weight-bearing to the spine for 2 weeks, followed by rehabilitation wearing a soft brace. The indications for initial non-weight-bearing therapy were vertebral fracture involving the posterior portion of the vertebral body at the thoraco-lumbar spine, mild neurological deficit, instability of the fracture site, severe pain, multiple vertebral fractures arising from trauma, malalignment at the fracture site, and mild spinal canal stenosis caused by the fracture. Patients who met the indication criteria were treated with initial non-weight-bearing therapy (n = 103, while the other patients were treated with conventional relative rest (n = 93. All the patients were uniformly treated with intramuscular elcatonin to relieve pain. The primary endpoint was progression of the vertebral fracture. The secondary endpoints included bony union and subjective back pain. The follow-up period was 12 weeks.Results: Compared with the conventional relative rest group, the collapse rate of the anterior and posterior portions of the vertebral body was significantly smaller in the initial non-weight-bearing group. The bony union rate was 100% in the initial non-weight-bearing group and 97% in the conventional relative rest group. The number of patients who experienced back pain was significantly lower in the initial non-weight-bearing group than in the conventional relative rest

  19. 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.

  20. The change and differential findings of lumbar vertebral endplate on MRI

    International Nuclear Information System (INIS)

    Kanamori, Masahiko; Nobukiyo, Masanori; Shigeta, Tetsuya; Ishihara, Hirokazu; Kawaguchi, Yoshiharu; Yoshino, Osamu

    2004-01-01

    The purpose of this study is to evaluate the differential findings of vertebral endplate of lumbar spine on MRI. Infected disc showed the T1 low/T2 high (Modic type I) to T2 iso-signal intensity on MRI. Post-operated disc showed the Modic type I findings, although the degenerative disc showed the various kinds of types according to the Modic's classification (type I to III). The characteristics findings of the infected disc were T2-high signal intensity of nucleus purposes and the wide affected area of vertebra including endplate on T1 image compared with T2 image. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    Hamada, Yoshitaka; Henmi, Tatsuhiko; Sakamoto, Rintaro; Hiasa, Masahiko

    1998-01-01

    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 1 -low finding over the entire vertebra within one month after injury and fractures of Th 12 or L 1 vertebra. Areas of T 1 -low and T 2 -low intensity adjacent to the vertebral disc presented no improvement in signal intensity and often caused persistent back pain. (author)

  3. Clinical correlation of radiological spinal stenosis after standardization for vertebral body size

    International Nuclear Information System (INIS)

    Athiviraham, A.; Yen, D.; Scott, C.; Soboleski, D.

    2007-01-01

    Aim: To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis. Materials and methods: one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined. These parameters were then correlated with patients' symptoms using the modified Roland-Morris questionnaire (RMQ) disability score. Results: No statistically significant inverse correlation was found between the TSD and RMQ score (p = 0.433), between the CSA and RMQ score (p = 0.124), or between the TSD:VBD ratio and RMQ score (p = 0.109). There was a significant positive correlation between the CSA:VBD ratio and RMQ score (p = .036), and therefore, there was no statistical support for an inverse relationship between the two. There was a significant difference in mean RMQ scores when the patients were divided into those with CSA greater than or equal to 70 mm 2 and those less than 70 mm 2 , with T = -2.104 and p = 0.038. Conclusion: The degree of radiographic lumbar spinal stenosis, even with the use of an internal control of vertebral body size and standardized disability questionnaires, does not correlate with clinical symptoms. However, patients with more severe stenosis below a CSA critical threshold of 70 mm 2 , have significantly greater functional disability

  4. Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion

    Directory of Open Access Journals (Sweden)

    Alister du Rose

    2016-01-01

    Full Text Available Control of the lumbar spine requires contributions from both the active and passive sub-systems. Identifying interactions between these systems may provide insight into the mechanisms of low back pain. However, as a first step it is important to investigate what is normal. The purpose of this study was to explore the relationships between the lumbar inter-vertebral range of motion and paraspinal muscle activity during weight-bearing flexion in healthy controls using quantitative fluoroscopy (QF and surface electromyography (sEMG. Contemporaneous lumbar sEMG and QF motion sequences were recorded during controlled active flexion of 60° using electrodes placed over Longissimus thoracis pars thoracis (TES, Longissimus thoracis pars lumborum (LES, and Multifidus (LMU. Normalised root mean square (RMS sEMG amplitude data were averaged over five epochs, and the change in amplitude between epochs was calculated. The sEMG ratios of LMU/LES LMU/TES and LES/TES were also determined. QF was used to measure the maximum inter-vertebral range of motion from L2-S1, and correlation coefficients were calculated between sEMG amplitude variables and these measurements. Intra- and inter-session sEMG amplitude repeatability was also assessed for all three paraspinal muscles. The sEMG amplitude measurements were highly repeatable, and sEMG amplitude changes correlated significantly with L4-5 and L5-S1 IV-RoMmax (r = −0.47 to 0.59. The sEMG amplitude ratio of LES/TES also correlated with L4-L5 IV-RoMmax (r = −0.53. The relationships found may be important when considering rehabilitation for low back pain.

  5. Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion.

    Science.gov (United States)

    du Rose, Alister; Breen, Alan

    2016-01-05

    Control of the lumbar spine requires contributions from both the active and passive sub-systems. Identifying interactions between these systems may provide insight into the mechanisms of low back pain. However, as a first step it is important to investigate what is normal. The purpose of this study was to explore the relationships between the lumbar inter-vertebral range of motion and paraspinal muscle activity during weight-bearing flexion in healthy controls using quantitative fluoroscopy (QF) and surface electromyography (sEMG). Contemporaneous lumbar sEMG and QF motion sequences were recorded during controlled active flexion of 60° using electrodes placed over Longissimus thoracis pars thoracis (TES), Longissimus thoracis pars lumborum (LES), and Multifidus (LMU). Normalised root mean square (RMS) sEMG amplitude data were averaged over five epochs, and the change in amplitude between epochs was calculated. The sEMG ratios of LMU/LES LMU/TES and LES/TES were also determined. QF was used to measure the maximum inter-vertebral range of motion from L2-S1, and correlation coefficients were calculated between sEMG amplitude variables and these measurements. Intra- and inter-session sEMG amplitude repeatability was also assessed for all three paraspinal muscles. The sEMG amplitude measurements were highly repeatable, and sEMG amplitude changes correlated significantly with L4-5 and L5-S1 IV-RoMmax (r = -0.47 to 0.59). The sEMG amplitude ratio of LES/TES also correlated with L4-L5 IV-RoMmax (r = -0.53). The relationships found may be important when considering rehabilitation for low back pain.

  6. Posterior-only approach for lumbar vertebral column resection and expandable cage reconstruction for spinal metastases.

    Science.gov (United States)

    Jandial, Rahul; Kelly, Brandon; Chen, Mike Yue

    2013-07-01

    The increasing incidence of spinal metastasis, a result of improved systemic therapies for cancer, has spurred a search for an alternative method for the surgical treatment of lumbar metastases. The authors report a single-stage posterior-only approach for resecting any pathological lumbar vertebral segment and reconstructing with a medium to large expandable cage while preserving all neurological structures. The authors conducted a retrospective consecutive case review of 11 patients (5 women, 6 men) with spinal metastases treated at 1 institution with single-stage posterior-only vertebral column resection and reconstruction with an expandable cage and pedicle screw fixation. For all patients, the indications for operative intervention were spinal cord compression, cauda equina compression, and/or spinal instability. Neurological status was classified according to the American Spinal Injury Association impairment scale, and functional outcomes were analyzed by using a visual analog scale for pain. For all patients, a circumferential vertebral column resection was achieved, and full decompression was performed with a posterior-only approach. Each cage was augmented by posterior pedicle screw fixation extending 2 levels above and below the resected level. No patient required a separate anterior procedure. Average estimated blood loss and duration of each surgery were 1618 ml (range 900-4000 ml) and 6.6 hours (range 4.5-9 hours), respectively. The mean follow-up time was 14 months (range 10-24 months). The median survival time after surgery was 17.7 months. Delayed hardware failure occurred for 1 patient. Preoperatively, 2 patients had intractable pain with intact lower-extremity strength and 8 patients had severe intractable pain, lower-extremity paresis, and were unable to walk; 4 of whom regained the ability to walk after surgery. Two patients who were paraplegic before decompression recovered substantial function but remained wheelchair bound, and 2 patients

  7. Rapid estimation of the vertebral body volume: a combination of the Cavalieri principle and computed tomography images

    International Nuclear Information System (INIS)

    Odaci, Ersan; Sahin, Buenyamin; Sonmez, Osman Fikret; Kaplan, Sueleyman; Bas, Orhan; Bilgic, Sait; Bek, Yueksel; Erguer, Hayati

    2003-01-01

    Objective: The exact volume of the vertebral body is necessary for the evaluation, treatment and surgical application of related vertebral body. Thereby, the volume changes of the vertebral body are monitored, such as infectious diseases of vertebra and traumatic or non-traumatic fractures and deformities of the spine. Several studies have been conducted for the assessment of the vertebral body size based on the evaluation of the different criteria of the spine using different techniques. However, we have not found any detailed study in the literature describing the combination of the Cavalieri principle and vertebral body volume estimation. Materials and methods: In the present study we describe a rapid, simple, accurate and practical technique for estimating the volume of vertebral body. Two specimens were taken from the cadavers including ten lumbar vertebras and were scanned in axial, sagittal and coronal section planes by a computed tomography (CT) machine. The consecutive sections in 5 and 3 mm thicknesses were used to estimate the total volume of the vertebral bodies by means of the Cavalieri principle. Furthermore, to evaluate inter-observer differences the volume estimations were carried out by three performers. Results: There were no significant differences between the performers' estimates and real volumes of the vertebral bodies (P>0.05) and also between the performers' volume estimates (P>0.05). The section thickness and the section plains did not affect the accuracy of the estimates (P>0.05). A high correlation was seen between the estimates of performers and the real volumes of the vertebral bodies (r=0.881). Conclusion: We concluded that the combination of CT scanning with the Cavalieri principle is a direct and accurate technique that can be safely applied to estimate the volume of the vertebral body with the mean of 5 min and 11 s workload per vertebra

  8. Rapid determination of vertebral fat fraction over a large range of vertebral bodies

    International Nuclear Information System (INIS)

    Martin, Jarad; Nicholson, Geoffrey; Cowin, Gary; Ilente, Clare; Wong, Winnie; Kennedy, Dominic

    2014-01-01

    Vertebral body fat fraction (FF) has been found to vary between lumbar vertebrae using magnetic resonance spectroscopy (MRS). We aim to more quickly assess a larger number of adjacent vertebrae using a single T2-weighted iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) sequence. Five men had dual-energy X-ray absorptometry (DEXA) and 1.5-T MR scans performed. MRS was performed at L3, and a sagittal IDEAL sequence was also performed, resulting in separate fat-only and water-only readings from T10 to S2. For the IDEAL measurements, two independent observers followed a set reading protocol, with five observations each per vertebra. Intra- and interobserver variability were assessed as deviations from the mean within and between observers, respectively. For FF measurements there was limited intra-observer variation, with observers being on average within 3.4% of the pooled mean value. Similarly, there was good interobserver agreement, with an average variation of 2.1%. All men showed a reduction in FF of 1.6–7% between L5 and S1. Otherwise, there was a trend of increasing FF moving inferiorly from T10 to S2. This averaged 2.7% per vertebra (range 1.1–3.8%) and may not have been dependent on MRS-measured FF at the L3 level. There was poor correlation between MRS-measured FF at L2–4 and bone mineral density measured using DEXA (R2=0.06). IDEAL measurements are generally reproducible between observers following a set protocol. There appears to be a gradient in FF moving from T10 to S2, with S1 showing a consistent decrease. This variation may better describe overall marrow function than a single-vertebra reading.

  9. The variability of vertebral body volume and pain associated with osteoporotic vertebral fractures: conservative treatment versus percutaneous transpedicular vertebroplasty.

    Science.gov (United States)

    Andrei, Diana; Popa, Iulian; Brad, Silviu; Iancu, Aida; Oprea, Manuel; Vasilian, Cristina; Poenaru, Dan V

    2017-05-01

    Osteoporotic vertebral fractures (OVF) can lead to late collapse which often causes kyphotic spinal deformity, persistent back pain, decreased lung capacity, increased fracture risk and increased mortality. The purpose of our study is to compare the efficacy and safety of vertebroplasty against conservative management of osteoporotic vertebral fractures without neurologic symptoms. A total of 66 patients with recent OVF on MRI examination were included in the study. All patients were admitted from September 2009 to September 2012. The cohort was divided into two groups. The first study group consisted of 33 prospectively followed consecutive patients who suffered 40 vertebral osteoporotic fractures treated by percutaneous vertebroplasty (group 1), and the control group consisted of 33 patients who suffered 41 vertebral osteoporotic fractures treated conservatively because they refused vertebroplasty (group 2). The data collection has been conducted in a prospective registration manner. The inclusion criteria consisted of painful OVF matched with imagistic findings. We assessed the results of pain relief and minimal sagittal area of the vertebral body on the axial CT scan at presentation, after the intervention, at six and 12 months after initial presentation. Vertebroplasty with poly(methyl methacrylate) (PMMA) was performed in 30 patients on 39 VBs, including four thoracic vertebras, 27 vertebras of the thoracolumbar jonction and eight lumbar vertebras. Group 2 included 30 patients with 39 OVFs (four thoracic vertebras, 23 vertebras of the thoracolumbar junction and 11 lumbar vertebras). There was no significant difference in VAS scores before treatment (p = 0.229). The mean VAS was 5.90 in Group 1 and 6.28 in Group 2 before the treatment. Mean VAS after vertebroplasty was 0.85 in Group 1. The mean VAS at six months was 0.92 in Group 1 and 3.00 in Group 2 (p pain and avoid VB collapse, vertebroplasty is the recommended treatment in OCFs. Considering the

  10. Rod rotation and differential rod contouring followed by direct vertebral rotation for treatment of adolescent idiopathic scoliosis: effect on thoracic and thoracolumbar or lumbar curves assessed with intraoperative computed tomography.

    Science.gov (United States)

    Seki, Shoji; Kawaguchi, Yoshiharu; Nakano, Masato; Makino, Hiroto; Mine, Hayato; Kimura, Tomoatsu

    2016-03-01

    Although direct vertebral rotation (DVR) is now used worldwide for the surgical treatment of adolescent idiopathic scoliosis (AIS), the benefit of DVR in reducing vertebral body rotation in these patients has not been determined. We investigated a possible additive effect of DVR on further reduction of vertebral body rotation in the axial plane following intraoperative rod rotation or differential rod contouring in patients undergoing surgical treatment for AIS. The study was a prospective computed tomography (CT) image analysis. We analyzed the results of the two intraoperative procedures in 30 consecutive patients undergoing surgery for AIS (Lenke type I or II: 15; Lenke type V: 15). The angle of reduction of vertebral body rotation taken by intraoperative CT scan was measured and analyzed. Pre- and postoperative responses to the Scoliosis Research Society 22 Questionnaire (SRS-22) were also analyzed. To analyze the reduction of vertebral body rotation with rod rotation or DVR, intraoperative cone-beam CT scans of the three apical vertebrae of the major curve of the scoliosis (90 vertebrae) were taken pre-rod rotation (baseline), post-rod rotation with differential rod contouring, and post-DVR in all patients. The angle of vertebral body rotation in these apical vertebrae was measured and analyzed for statistical significance. Additionally, differences between thoracic curve scoliosis (Lenke type I or II; 45 vertebrae) and thoracolumbar or lumbar curve scoliosis (Lenke type V; 45 vertebrae) were analyzed. Pre- and postoperative SRS-22 scores were evaluated in all patients. The mean (90 vertebrae) vertebral body rotation angles at baseline, post-rod rotation or differential rod contouring, and post-rod rotation or differential rod contouring or post-DVR were 17.3°, 11.1°, and 6.9°, respectively. The mean reduction in vertebral body rotation with the rod rotation technique was 6.8° for thoracic curves and 5.7° for thoracolumbar or lumbar curves (pself

  11. A new method for lumbar herniated inter-vertebral disc diagnosis based on image analysis of transverse sections.

    Science.gov (United States)

    Tsai, Ming Dar; Jou, Shyan Bin; Hsieh, Ming Shium

    2002-01-01

    This paper describes an image analysis method that uses automatic algorithms for the evaluation of herniation classification and geometry in the diagnosis of lumbar herniated inter-vertebral disc (HIVD). The method uses boundary approximation that uses a B-spline curve to approximate circle-like disc boundary and excludes the herniation from other normal parts of the disc boundary and, feature recognition that classifies the herniation, and herniation shape reconstruction that infers the 3D geometry from one or more transverse sections. This method can be used as a qualitative and quantitative tool for the diagnosis of lumbar HIVD using transverse sections.

  12. Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease.

    Science.gov (United States)

    Jabłońska, Renata; Ślusarz, Robert; Królikowska, Agnieszka; Haor, Beata; Antczak, Anna; Szewczyk, Maria

    2017-01-01

    The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease. The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140). Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery ( p =0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery ( p =0.368). This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.

  13. [Correlation analysis of cement leakage with volume ratio of intravertebral bone cement to vertebral body and vertebral body wall incompetence in percutaneous vertebroplasty for osteoporotic vertebral compression fractures].

    Science.gov (United States)

    Liang, De; Ye, Linqiang; Jiang, Xiaobing; Huang, Weiquan; Yao, Zhensong; Tang, Yongchao; Zhang, Shuncong; Jin, Daxiang

    2014-11-01

    To investigate the risk factors of cement leakage in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF). Between March 2011 and March 2012, 98 patients with single level OVCF were treated by PVP, and the clinical data were analyzed retrospectively. There were 13 males and 85 females, with a mean age of 77.2 years (range, 54-95 years). The mean disease duration was 43 days (range, 15-120 days), and the mean T score of bone mineral density (BMD) was -3.8 (range, -6.7- -2.5). Bilateral transpedicular approach was used in all the patients. The patients were divided into cement leakage group and no cement leakage group by occurrence of cement leakage based on postoperative CT. Single factor analysis was used to analyze the difference between 2 groups in T score of BMD, operative level, preoperative anterior compression degree of operative vertebrae, preoperative middle compression degree of operative vertebrae, preoperative sagittal Cobb angle of operative vertebrae, preoperative vertebral body wall incompetence, cement volume, and volume ratio of intravertebral bone cement to vertebral body. All relevant factors were introduced to logistic regression analysis to analyze the risk factors of cement leakage. All procedures were performed successfully. The mean operation time was 40 minutes (range, 30-50 minutes), and the mean volume ratio of intravertebral bone cement to vertebral body was 24.88% (range, 7.84%-38.99%). Back pain was alleviated significantly in all the patients postoperatively. All patients were followed up with a mean time of 8 months (range, 6-12 months). Cement leakage occurred in 49 patients. Single factor analysis showed that there were significant differences in the volume ratio of intravertebral bone cement to vertebral body and preoperative vertebral body wall incompetence between 2 groups (P 0.05). The logistic regression analysis showed that the volume ratio of intravertebral bone cement to vertebral body (P

  14. Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

    International Nuclear Information System (INIS)

    Pitton, Michael B.; Morgen, Nadine; Herber, Sascha; Dueber, Christoph; Drees, Philipp; Boehm, Bertram

    2008-01-01

    The height gain of vertebral bodies after vertebroplasty and geometrical stability was evaluated over a one-year period. Osteoporotic fractures were treated with vertebroplasty. The vertebral geometry and disc spaces were analysed using reformatted computed tomography (CT) images: heights of the anterior, posterior, and lateral vertebral walls, disc spaces, endplate angles, and minimal endplate distances. Vertebrae were assigned to group I [severe compression (anterior height/posterior height) 0.75). A total of 102 vertebral bodies in 40 patients (12 men, 28 women, age 70.3 ± 9.5) were treated with vertebroplasty and prospectively followed for 12 months. Group I showed a greater benefit compared with group II with respect to anterior height gain (+2.1 ± 1.9 vs +0.7 ± 1.6 mm, P < 0.001), reduction of endplate angle (-3.6 ± 4.2 vs -0.8 ± 2.3 , P < 0.001), and compression index (+0.09 ± 0.11 vs +0.01 ± 0.06, P < 0.001). At one-year follow-up, group I demonstrated preserved anterior height gain (+1.5 ± 2.8 mm, P < 0.015) and improved endplate angle (-3.4 ± 4.9 , P < 0.001). In group II, the vertebral heights returned to and were fixed at the pre-interventional levels. Vertebroplasty provided vertebral height gain over one year, particularly in cases with severe compression. Vertebrae with moderate compression were fixed and stabilized at the pre-treatment level over one year. (orig.)

  15. 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 %.

  16. Micromechanics of the human vertebral body for forward flexion.

    Science.gov (United States)

    Yang, Haisheng; Nawathe, Shashank; Fields, Aaron J; Keaveny, Tony M

    2012-08-09

    To provide mechanistic insight into the etiology of osteoporotic wedge fractures, we investigated the spatial distribution of tissue at the highest risk of initial failure within the human vertebral body for both forward flexion and uniform compression loading conditions. Micro-CT-based linear elastic finite element analysis was used to virtually load 22 human T9 vertebral bodies in either 5° of forward flexion or uniform compression; we also ran analyses replacing the simulated compliant disc (E=8 MPa) with stiff polymethylmethacrylate (PMMA, E=2500 MPa). As expected, we found that, compared to uniform compression, forward flexion increased the overall endplate axial load on the anterior half of the vertebra and shifted the spatial distribution of high-risk tissue within the vertebra towards the anterior aspect of the vertebral body. However, despite that shift, the high-risk tissue remained primarily within the central regions of the trabecular bone and endplates, and forward flexion only slightly altered the ratio of cortical-to-trabecular load sharing at the mid-vertebral level (mean±SD for n=22: 41.3±7.4% compression; 44.1±8.2% forward flexion). When the compliant disc was replaced with PMMA, the anterior shift of high-risk tissue was much more severe. We conclude that, for a compliant disc, a moderate degree of forward flexion does not appreciably alter the spatial distribution of stress within the vertebral body. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Lumbar vertebral haemangioma causing pathological fracture, epidural haemorrhage, and cord compression: a case report and review of literature.

    Science.gov (United States)

    Vinay, S; Khan, S K; Braybrooke, J R

    2011-01-01

    Vertebral haemangiomas are recognized to be one of the commonest benign tumours of the vertebral column, occurring mostly in the thoracic spine. The vast majority of these are asymptomatic. Infrequently, these can turn symptomatic and cause neurological deficit (cord compression) through any of four reported mechanisms: (1) epidural extension; (2) expansion of the involved vertebra(e) causing spinal canal stenosis; (3) spontaneous epidural haemorrhage; (4) pathological burst fracture. Thoracic haemangiomas have been reported to be more likely to produce cord compression than lumbar haemangiomas. A forty-nine year old male with acute onset spinal cord compression from a pathological fracture in a first lumbar vertebral haemangioma. An MRI delineated the haemangioma and extent of bleeding that caused the cord compression. These were confirmed during surgery and the haematoma was evacuated. The spine was instrumented from T12 to L2, and a cement vertebroplasty was performed intra-operatively. Written consent for publication was obtained from the patient. The junctional location of the first lumbar vertebra, and the structural weakness from normal bone being replaced by the haemangioma, probably caused it to fracture under axial loading. This pathological fracture caused bleeding from the vascularized bone, resulting in cord compression.

  18. MRI Evaluation of Spinal Length and Vertebral Body Angle During Loading with a Spinal Compression Harness

    Science.gov (United States)

    Campbell, James A.; Hargens, Alan R.; Murthy, G.; Ballard, R. E.; Watenpaugh, D. E.; Hargens, Alan, R.; Sanchez, E.; Yang, C.; Mitsui, I.; Schwandt, D.; hide

    1998-01-01

    Weight bearing by the spinal column during upright posture often plays a role in the common problem of low back pain. Therefore, we developed a non-ferromagnetic spinal compression harness to enable MRI investigations of the spinal column during axial loading. Human subjects were fitted with a Nest and a footplate which were connected by adjustable straps to an analog load cell. MRI scans of human subjects (5 males and 1 female with age range of 27-53 yrs) during loaded and unloaded conditions were accomplished with a 1.5 Tesla GE Signa scanner. Studies of two subjects undergoing sequentially increasing spinal loads revealed significant decreases (r(sup 2) = 0.852) in spinal length between T4 and L5 culminating in a 1.5 to 2% length decrease during loading with 75% body weight. Sagittal vertebral body angles of four subjects placed under a constant 50% body weight load for one hour demonstrated increased lordotic and kyphotic curvatures. In the lumbar spine, the L2 vertebral body experienced the greatest angular change (-3 deg. to -5 deg.) in most subjects while in the thoracic spine, T4 angles increased from the unloaded state by +2 deg. to +9 deg. Overall, our studies demonstrate: 1) a progressive, although surprisingly small, decrease in spinal length with increasing load and 2) relatively large changes in spinal column angulation with 50% body weight.

  19. Deep learning for automatic localization, identification, and segmentation of vertebral bodies in volumetric MR images

    Science.gov (United States)

    Suzani, Amin; Rasoulian, Abtin; Seitel, Alexander; Fels, Sidney; Rohling, Robert N.; Abolmaesumi, Purang

    2015-03-01

    This paper proposes an automatic method for vertebra localization, labeling, and segmentation in multi-slice Magnetic Resonance (MR) images. Prior work in this area on MR images mostly requires user interaction while our method is fully automatic. Cubic intensity-based features are extracted from image voxels. A deep learning approach is used for simultaneous localization and identification of vertebrae. The localized points are refined by local thresholding in the region of the detected vertebral column. Thereafter, a statistical multi-vertebrae model is initialized on the localized vertebrae. An iterative Expectation Maximization technique is used to register the vertebral body of the model to the image edges and obtain a segmentation of the lumbar vertebral bodies. The method is evaluated by applying to nine volumetric MR images of the spine. The results demonstrate 100% vertebra identification and a mean surface error of below 2.8 mm for 3D segmentation. Computation time is less than three minutes per high-resolution volumetric image.

  20. Percutaneous vertebroplasty in the treatment of vertebral body compression fracture secondary to osteogenesis imperfecta

    International Nuclear Information System (INIS)

    Rami, Parag M.; Heatwole, Eric V.; Boorstein, Jeffrey M.; McGraw, Kevin J.

    2002-01-01

    Percutaneous vertebroplasty, a minimally invasive interventional radiological procedure, has recently been used effectively for the treatment of symptomatic vertebral body compression fractures. Primary indications for vertebroplasty include osteoporotic compression fracture, osteolytic vertebral metastasis and myeloma, and vertebral hemangioma. We present a case and extend the indication of percutaneous vertebroplasty in a patient with a vertebral body compression fracture secondary to osteogenesis imperfecta. (orig.)

  1. Percutaneous vertebroplasty in the treatment of vertebral body compression fracture secondary to osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Rami, Parag M.; Heatwole, Eric V.; Boorstein, Jeffrey M. [Center for Vascular and Interventional Radiology, St. Vincent Mercy Medical Center, Toledo, OH (United States); McGraw, Kevin J. [Riverside Methodist Hospital, Columbus, OH (United States)

    2002-03-01

    Percutaneous vertebroplasty, a minimally invasive interventional radiological procedure, has recently been used effectively for the treatment of symptomatic vertebral body compression fractures. Primary indications for vertebroplasty include osteoporotic compression fracture, osteolytic vertebral metastasis and myeloma, and vertebral hemangioma. We present a case and extend the indication of percutaneous vertebroplasty in a patient with a vertebral body compression fracture secondary to osteogenesis imperfecta. (orig.)

  2. Quantitative image analysis of vertebral body architecture - improved diagnosis in osteoporosis based on high-resolution computed tomography

    International Nuclear Information System (INIS)

    Mundinger, A.; Wiesmeier, B.; Dinkel, E.; Helwig, A.; Beck, A.; Schulte Moenting, J.

    1993-01-01

    71 women, 64 post-menopausal, were examined by single-energy quantitative computed tomography (SEQCT) and by high-resolution computed tomography (HRCT) scans through the middle of lumbar vertebral bodies. Computer-assisted image analysis of the high-resolution images assessed trabecular morphometry of the vertebral spongiosa texture. Texture parameters differed in women with and without age-reduced bone density, and in the former group also in patients with and without vertebral fractures. Discriminating parameters were the total number, diameter and variance of trabecular and intertrabecular spaces as well as the trabecular surface (p < 0.05)). A texture index based on these statistically selected morphometric parameters identified a subgroup of patients suffering from fractures due to abnormal spongiosal architecture but with a bone mineral content not indicative for increased fracture risk. The combination of osteodensitometric and trabecular morphometry improves the diagnosis of osteoporosis and may contribute to the prediction of individual fracture risk. (author)

  3. 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.

  4. [Stability of ventral, dorsal and combined spondylodesis in vertebral body prosthesis implantation].

    Science.gov (United States)

    Vahldiek, M; Gossè, F; Panjabi, M M

    2002-05-01

    The purpose of this study was to evaluate the biomechanical characteristics of short-segment anterior, posterior, and combined instrumentations in lumbar spine vertebral body replacement surgery. Eight fresh frozen human cadaveric thoracolumbar spine specimens (T12-L4) were prepared for biomechanical testing. Pure moments (2.5, 5, and 7.5 Nm) of flexion-extension, left-right axial torsion, and left-right lateral bending were applied to the top vertebra in a flexibility machine and the motions of L1 vertebra with respect to L3 were recorded with an optoelectronic motion measurement system after preconditioning. One anterior, two posterior pedicle screw systems, and two combined instrumentations were tested. Load-displacement curves were recorded and neutral zone (NZ) and range of motion (ROM) were determined. The anterior instrumentation, after vertebral body replacement, showed greater motion than the intact spine, especially in axial torsion. Posterior instrumentation provided greater rigidity than the anterior instrumentation, especially in flexion-extension. The combined instrumentation provided superior rigidity in all directions compared to all other instrumentations.

  5. Posterior Vertebral Column Resection Through Unilateral Osteotomy Approach for Old Lumbar Fracture Combined with Kummell Disease.

    Science.gov (United States)

    Wang, Hui; Ding, Wenyuan

    2018-01-01

    Kummell disease is a clinical syndrome characterized by minor spinal trauma with a symptom-free period from months to years, followed by progressive painful kyphosis. Many surgical options for Kummell disease have been reported in the previous literature; however, no study has mentioned the surgical strategy for patients whose fractured vertebrae were severely compressed and only a slice of superior and inferior end plate was left. Here we report the case of a 69-year-old woman who suffered persistent severe back pain since she slipped and fell 1 year before medical consult. The patient presented with constrained body posture and pressure pain on the thoracolumbar region. Visual analog scale pain under weight bearing was 90/100, and her Oswestry Disability Index score was 74%. Kummell disease was diagnosed on the basis of clinical presentation, trauma history, radiograph, computed tomography, and magnetic resonance imaging. We performed the posterior vertebral column resection through the unilateral osteotomy approach for the patient, and the clinical outcome and radiologic restoration were recorded. One year after the surgery, outpatient follow-up review revealed that the visual analog scale reduced to 10/100 and Oswestry Disability Index reduced to 13%. The posteroanterior and lateral radiograph in the standing position showed bony fusion was achieved at the osteotomy site. No pseudarthrosis or instrumentation-related failure occurred. Posterior vertebral column resection through unilateral osteotomy approach is an effective method for patients with Kummell disease, especially when the fractured vertebrae compressed severely and only a slice of superior and inferior end plate was left. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The evolutionary origin of the vertebrate body plan: the problem of head segmentation.

    Science.gov (United States)

    Onai, Takayuki; Irie, Naoki; Kuratani, Shigeru

    2014-01-01

    The basic body plan of vertebrates, as typified by the complex head structure, evolved from the last common ancestor approximately 530 Mya. In this review, we present a brief overview of historical discussions to disentangle the various concepts and arguments regarding the evolutionary development of the vertebrate body plan. We then explain the historical transition of the arguments about the vertebrate body plan from merely epistemological comparative morphology to comparative embryology as a scientific treatment on this topic. Finally, we review the current progress of molecular evidence regarding the basic vertebrate body plan, focusing on the link between the basic vertebrate body plan and the evolutionarily conserved developmental stages (phylotypic stages).

  7. Examination of the lumbar vertebral column using large-screen image intensifier photofluorography

    International Nuclear Information System (INIS)

    Soimakallio, S.; Manninen, H.; Mahlamaeki, S.; Kuopio Central Hospital

    1985-01-01

    The OPTILUX 57 device with its large image intensifying screen is very efficient in visualizing the lumbar vertebrae. The article explains the techniques and summarizes results obtained in the examination of young sportsmen. (orig.) [de

  8. Examination of the lumbar vertebral column using large-screen image intensifier photofluorography

    Energy Technology Data Exchange (ETDEWEB)

    Soimakallio, S.; Manninen, H.; Mahlamaeki, S.

    1985-01-01

    The OPTILUX 57 device with its large image intensifying screen is very efficient in visualizing the lumbar vertebrae. The article explains the techniques and summarizes results obtained in the examination of young sportsmen.

  9. Percutaneous Vertebroplasty for Compression Fracture: Analysis of Vertebral Body Volume by CT Volumetry

    International Nuclear Information System (INIS)

    Komemushi, A.; Tanigawa, N.; Kariya, S.; Kojima, H.; Shomura, Y.; Sawada, S.

    2005-01-01

    Purpose: To evaluate the relationships between volume of vertebral bodies with compression fracture (measured by CT volumetry) before percutaneous vertebroplasty, the amount of bone cement injected, and the effect of treatment. Material and Methods: We examined 49 consecutive patients, with 104 vertebral body compression fractures, who underwent percutaneous injection of bone cement. Vertebral body volume was measured by CT volumetry. The patient's pain level was assessed using a visual analog scale (VAS) before and after the procedure. Improvement in VAS was defined as the decrease in VAS after the procedure. Relationships between vertebral body volume, the amount of bone cement, and the effect of treatment were evaluated using Pearson's correlation coefficient test. Results: Average vertebral body volume was 26.3 ±8.1 cm 3 ; average amount of bone cement was 3.2 ±1.1 ml; and average improvement in VAS was 4.9 ±2.7. The vertebral body volume was greater if a larger amount of bone cement was injected. There was a significant positive correlation between vertebral body volume and amount of bone cement ( r ∼ 0.44; P <0.0001). However, there was no correlation between vertebral body volume and improvement in VAS, or between amount of bone cement and improvement in VAS. Conclusion: In percutaneous vertebroplasty for vertebral body compression fracture, there is a positive correlation between vertebral body volume and amount of bone cement, but improvement in VAS does not correlate with vertebral body volume or amount of bone cement

  10. Evaluation on vertebral endplate injury and adjacent intervertebral disk injury of patients with osteoporotic vertebral compression fractures by MRI and its clinical significance

    International Nuclear Information System (INIS)

    Shen Yu; Shen Huiliang; Fang Xiutong; Zhang Wenbo

    2012-01-01

    Objective: To investigate the relationship between vertebral endplate injury and adjacent intervertebral disk injury of patients with acute or sub-acute osteoporotic vertebral compression fractures (OVC-F) by MRI, and to provide basis for diagnosis of OVCF. Methods: The clinical data of a total of 66 patients with OVCF underwent vertebroplasty (76 fracture of vertebral bodies) were selected. The vertebral endplate injury and adjacent intervertebral disk injury of OVCF patients were detected by MRI. Results: There were 57 vertebral endplate injury in 76 fracture vertebral bodies (75% ). There were only 27 vertebral bodies with vertebral endplate injury in 57 fracture vertebral bodies with endplate injury (47% ), and 22 vertebral with superior and inferior vertebral endplate injury (39% ), and 8 vertebral bodies with inferior vertebral endplate injury (14% ). There were 48 vertebral bodies with intervertebral disc injury in 76 fracture vertebral bodies (63% ). There were 22 intervertebral disc injury located above the fracture of the lumbar spine in 48 vertebral bodies with intervertebral disc injury (45% ), and 19 fracture vertebral bodies with upper and lower intervertebral disc injury (40% ), and 7 intervertebral injuries located below the fracture of the lumbar spine (15% ). Conclusion: Vertebral endplate injury is frequently associated with the adjacent intervertebral disk injury. The clinical diagnosis and treatment should be emphasized in the fracture vertebral endplate damage and adjacent intervertebral disc injury. (authors)

  11. [Epidural pharmacotherapy in the treatment of the pain syndrome in osteochondrosis complicated by intervertebral discs protrusion of lumbar part of the vertebral column].

    Science.gov (United States)

    Khizhniak, M V; Priĭmak, E V

    2013-03-01

    Experience of application of intralaminar epidural pharmacotherapy for the treatment of the pain syndrome in the patients, suffering osteochondrosis of lumbar portion of vertebral column, complicated by intervertebral discs protrusion, was summarized. The method introduction permits to escape the operative intervention performance for complicated osteochondrosis.

  12. Comparative micro computed tomography study of a vertebral body

    Science.gov (United States)

    Drews, Susanne; Beckmann, Felix; Herzen, Julia; Brunke, Oliver; Salmon, Phil; Friess, Sebastian; Laib, Andres; Koller, Bruno; Hemberger, Thomas; Müller-Gerbl, Magdalena; Müller, Bert

    2008-08-01

    Investigations of bony tissues are often performed using micro computed tomography based on X-rays, since the calcium distribution leads to superior contrast. Osteoporotic bone, for example, can be well compared with healthy one with respect to density and morphology. Degenerative and rheumatoid diseases usually start, however, at the bone-cartilage-interface, which is hardly accessible. The direct influence on the bone itself becomes only visible at later stage. For the development of suitable therapies against degenerative cartilage damages the exact three-dimensional description of the bone-cartilage interface is vital, as demonstrated for transplanted cartilage-cells or bone-cartilage-constructs in animal models. So far, the morphological characterization was restricted to magnetic resonance imaging (MRI) with poor spatial resolution or to time-consuming histological sectioning with appropriate spatial resolution only in two rather arbitrarily chosen directions. Therefore, one should develop μCT to extract the features of low absorbing cartilage. The morphology and the volume of the inter-vertebral cartilage disc of lumbar motion segments have been determined for one PMMA embedded specimen. Tomograms were recorded using nanotom® (Phoenix|x-ray, Wunstorf, Germany), μCT 35TM (Scanco Medical, Brütisellen, Switzerland), 1172TM and 1174TM (both Skyscan, Kontich, Belgium), as well as using the SRμCT at HASYLAB/DESY. Conventional and SRμCT can provide the morphology and the volume of cartilage between bones. Increasing the acquisition time, the signal-to-noise ratio becomes better and better but the prominent artifacts in conventional μCT as the result of inhomogeneously distributed bony tissue prevents the exact segmentation of cartilage. SRμCT allows segmenting the cartilage but requires long periods of expensive beam-time to obtain reasonable contrast.

  13. Vertebral Adaptations to Large Body Size in Theropod Dinosaurs.

    Directory of Open Access Journals (Sweden)

    John P Wilson

    Full Text Available Rugose projections on the anterior and posterior aspects of vertebral neural spines appear throughout Amniota and result from the mineralization of the supraspinous and interspinous ligaments via metaplasia, the process of permanent tissue-type transformation. In mammals, this metaplasia is generally pathological or stress induced, but is a normal part of development in some clades of birds. Such structures, though phylogenetically sporadic, appear throughout the fossil record of non-avian theropod dinosaurs, yet their physiological and adaptive significance has remained unexamined. Here we show novel histologic and phylogenetic evidence that neural spine projections were a physiological response to biomechanical stress in large-bodied theropod species. Metaplastic projections also appear to vary between immature and mature individuals of the same species, with immature animals either lacking them or exhibiting smaller projections, supporting the hypothesis that these structures develop through ontogeny as a result of increasing bending stress subjected to the spinal column. Metaplastic mineralization of spinal ligaments would likely affect the flexibility of the spinal column, increasing passive support for body weight. A stiff spinal column would also provide biomechanical support for the primary hip flexors and, therefore, may have played a role in locomotor efficiency and mobility in large-bodied species. This new association of interspinal ligament metaplasia in Theropoda with large body size contributes additional insight to our understanding of the diverse biomechanical coping mechanisms developed throughout Dinosauria, and stresses the significance of phylogenetic methods when testing for biological trends, evolutionary or not.

  14. Vertebral Adaptations to Large Body Size in Theropod Dinosaurs.

    Science.gov (United States)

    Wilson, John P; Woodruff, D Cary; Gardner, Jacob D; Flora, Holley M; Horner, John R; Organ, Chris L

    2016-01-01

    Rugose projections on the anterior and posterior aspects of vertebral neural spines appear throughout Amniota and result from the mineralization of the supraspinous and interspinous ligaments via metaplasia, the process of permanent tissue-type transformation. In mammals, this metaplasia is generally pathological or stress induced, but is a normal part of development in some clades of birds. Such structures, though phylogenetically sporadic, appear throughout the fossil record of non-avian theropod dinosaurs, yet their physiological and adaptive significance has remained unexamined. Here we show novel histologic and phylogenetic evidence that neural spine projections were a physiological response to biomechanical stress in large-bodied theropod species. Metaplastic projections also appear to vary between immature and mature individuals of the same species, with immature animals either lacking them or exhibiting smaller projections, supporting the hypothesis that these structures develop through ontogeny as a result of increasing bending stress subjected to the spinal column. Metaplastic mineralization of spinal ligaments would likely affect the flexibility of the spinal column, increasing passive support for body weight. A stiff spinal column would also provide biomechanical support for the primary hip flexors and, therefore, may have played a role in locomotor efficiency and mobility in large-bodied species. This new association of interspinal ligament metaplasia in Theropoda with large body size contributes additional insight to our understanding of the diverse biomechanical coping mechanisms developed throughout Dinosauria, and stresses the significance of phylogenetic methods when testing for biological trends, evolutionary or not.

  15. Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study.

    Science.gov (United States)

    Brink, Rob C; Schlösser, Tom P C; Colo, Dino; Vincken, Koen L; van Stralen, Marijn; Hui, Steve C N; Chu, Winnie C W; Cheng, Jack C Y; Castelein, René M

    2017-01-01

    Cross-sectional. To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p = .005, lumbar: 95.8% vs. 97.2%; p transverse pedicle angle was greater (12.3° vs. 5.7°; p transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level 4. Copyright © 2016 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  16. Multidetector bone densitometer for supine lateral vertebral scanning of the lumbar spine

    International Nuclear Information System (INIS)

    Pommet, R.

    1990-01-01

    ORIS-ODX 240 bone densitometer is used to provide the density values of large group of women obtaining both frontal and lateral projection of the lumbar spine on each of them. This device is the prototype of Sophos L-XRA developed by CEA/DAMRI for SOPHA MEDICAL. It uses as photon source an X-ray tube with K-edge filtration (Neodyme oxide). The multidetector uses 24 NaI (Tl) scintillators, 24 PM tubes and 24 dual channel analyzers

  17. Intra- and interobserver reproducibility of vertebral endplate signal (modic) changes in the lumbar spine

    DEFF Research Database (Denmark)

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

    2007-01-01

    . PURPOSE: To assess the intra- and interobserver reliability of the "Nordic Modic classification" protocol. MATERIAL AND METHODS: MRI scans of 50 individuals representative of the general Danish population aged 40 were evaluated by two observers. Criteria for grading the changes were developed...... 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....... CONCLUSION: In this study, we found convincing reproducibility of a detailed evaluation protocol of vertebral endplate signal changes, the "Nordic Modic Classification." The authors recommend that the evaluation protocol should be used in future studies investigating vertebral endplate signal changes....

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

    International Nuclear Information System (INIS)

    Panow, C.; Valavanis, A.

    2002-01-01

    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.)

  19. Parametric modelling and segmentation of vertebral bodies in 3D CT and MR spine images

    International Nuclear Information System (INIS)

    Štern, Darko; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2011-01-01

    Accurate and objective evaluation of vertebral deformations is of significant importance in clinical diagnostics and therapy of pathological conditions affecting the spine. Although modern clinical practice is focused on three-dimensional (3D) computed tomography (CT) and magnetic resonance (MR) imaging techniques, the established methods for evaluation of vertebral deformations are limited to measuring deformations in two-dimensional (2D) x-ray images. In this paper, we propose a method for quantitative description of vertebral body deformations by efficient modelling and segmentation of vertebral bodies in 3D. The deformations are evaluated from the parameters of a 3D superquadric model, which is initialized as an elliptical cylinder and then gradually deformed by introducing transformations that yield a more detailed representation of the vertebral body shape. After modelling the vertebral body shape with 25 clinically meaningful parameters and the vertebral body pose with six rigid body parameters, the 3D model is aligned to the observed vertebral body in the 3D image. The performance of the method was evaluated on 75 vertebrae from CT and 75 vertebrae from T 2 -weighted MR spine images, extracted from the thoracolumbar part of normal and pathological spines. The results show that the proposed method can be used for 3D segmentation of vertebral bodies in CT and MR images, as the proposed 3D model is able to describe both normal and pathological vertebral body deformations. The method may therefore be used for initialization of whole vertebra segmentation or for quantitative measurement of vertebral body deformations.

  20. Vertebral Body Compression Fractures and Bone Density: Automated Detection and Classification on CT Images.

    Science.gov (United States)

    Burns, Joseph E; Yao, Jianhua; Summers, Ronald M

    2017-09-01

    Purpose To create and validate a computer system with which to detect, localize, and classify compression fractures and measure bone density of thoracic and lumbar vertebral bodies on computed tomographic (CT) images. Materials and Methods Institutional review board approval was obtained, and informed consent was waived in this HIPAA-compliant retrospective study. A CT study set of 150 patients (mean age, 73 years; age range, 55-96 years; 92 women, 58 men) with (n = 75) and without (n = 75) compression fractures was assembled. All case patients were age and sex matched with control subjects. A total of 210 thoracic and lumbar vertebrae showed compression fractures and were electronically marked and classified by a radiologist. Prototype fully automated spinal segmentation and fracture detection software were then used to analyze the study set. System performance was evaluated with free-response receiver operating characteristic analysis. Results Sensitivity for detection or localization of compression fractures was 95.7% (201 of 210; 95% confidence interval [CI]: 87.0%, 98.9%), with a false-positive rate of 0.29 per patient. Additionally, sensitivity was 98.7% and specificity was 77.3% at case-based receiver operating characteristic curve analysis. Accuracy for classification by Genant type (anterior, middle, or posterior height loss) was 0.95 (107 of 113; 95% CI: 0.89, 0.98), with weighted κ of 0.90 (95% CI: 0.81, 0.99). Accuracy for categorization by Genant height loss grade was 0.68 (77 of 113; 95% CI: 0.59, 0.76), with a weighted κ of 0.59 (95% CI: 0.47, 0.71). The average bone attenuation for T12-L4 vertebrae was 146 HU ± 29 (standard deviation) in case patients and 173 HU ± 42 in control patients; this difference was statistically significant (P high sensitivity and with a low false-positive rate, as well as to calculate vertebral bone density, on CT images. © RSNA, 2017 Online supplemental material is available for this article.

  1. Reference values for radiological evaluation of cervical vertebral body shape and spinal canal

    Energy Technology Data Exchange (ETDEWEB)

    Remes, V.M. [Hospital for Children and Adolescents, Helsinki University Central Hospital (Finland); Heinaenen, M.T.; Marttinen, E.J. [Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Kinnunen, J.S. [Department of Radiology, Helsinki University Central Hospital, HYKS (Finland)

    2000-03-01

    Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated. This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.)

  2. Reference values for radiological evaluation of cervical vertebral body shape and spinal canal

    International Nuclear Information System (INIS)

    Remes, V.M.; Heinaenen, M.T.; Marttinen, E.J.; Kinnunen, J.S.

    2000-01-01

    Background. Defining normal values is essential for reliable evaluation of growth disturbances. Previous studies of the cervical spine have mainly focused on the sagittal canal diameter and interpedicular distances. Values for vertebral body height and depth have been published only in adult men and cadavers.Objectives. To define normal values for vertebral body height (H)/vertebral body depth (D) ratio (H/D ratio) and sagittal canal diameter (S)/vertebral body depth ratio (S/D ratio) in C2-7.Materials and methods. Lateral cervical spine radiographs were available from 441 children and 192 adults. Subjects' ages varied from newborn to 39 years. Vertebral body height and depth and sagittal canal diameter were measured and ratios were calculated. This was a cross-sectional and retrospective study.Results. Vertebral bodies grow relatively more in height than in depth, most actively at puberty. At all levels, the H/D ratio remains below 1, indicating that vertebral body depth is greater than height. The SD ratio is quite stable until 7-8 years of age and then it starts to decline slowly.Conclusions. When estimating platyspondyly, the age of the patient must be taken into consideration because vertebral body height is lower in children. Growth of the spinal canal declines after 7-8 years of age. (orig.)

  3. 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.)

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

    International Nuclear Information System (INIS)

    Mitra, D.; Cassar-Pullicino, V.N.; Mccall, I.W.

    2004-01-01

    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.)

  5. Vertebral body trabecular density at the thoracolumbar junction using quantitative computed tomography

    International Nuclear Information System (INIS)

    Singer, K.P.; Breidahl, P.D.; Royal Perth Hospital

    1990-01-01

    Quantitative computed tomography was used to assess vertebral trabecular density in 26 post-mortem spines from individuals aged between 14 and 80 years. All vertebrae from T10 to L1 were scanned transversely near the mid-vertebral level with calculations of trabecular density in HUs averaged and referenced to a mineral equivalent phantom. An age-related decline in trabecular density was recorded (r=0.55, p<0.0001). Density measures from the anterior aspect of the vertebral body were significantly greater than from postero-lateral regions. From T10 to L1, there was a significant decrease in trabecular density, whereas density measures multiplied by vertebral body cross-sectional area were constant. Predictions of vertebral compressive strength using quantitative computed tomography may become more accurate by increasing the sampling area per scan and including vertebral body cross-sectional area as part of the radiologic assessment. (orig.)

  6. Age-related changes of vertical and horizontal lumbar vertebral trabecular 3D bone microstructure is different in women and men.

    Science.gov (United States)

    Thomsen, Jesper Skovhus; Niklassen, Andreas Steenholt; Ebbesen, Ebbe Nils; Brüel, Annemarie

    2013-11-01

    The study presents a 3D method for subdividing a trabecular network into horizontal and vertical oriented bone. This method was used to investigate the age related changes of the bone volume fraction and thickness of horizontal and vertical trabeculae in human lumbar vertebral bone estimated with unbiased 3D methods in women and men over a large age-range. The study comprised second lumbar vertebral body bone samples from 40 women (aged 21.7-96.4years, median 56.6years) and 39 men (aged 22.6-94.6years, median 55.6years). The bone samples were μCT scanned and the 3D microstructure was quantified. A voxel based algorithm inspecting the local neighborhood is presented and used to segment the trabecular network into horizontal and vertical oriented bone. For both women and men BV/TV decreased significantly with age, Tb.Th* was independent of age, while SMI increased significantly with age. Vertical (BV.vert/TV) and horizontal (BV.horz/TV) bone volume fraction decreased significantly with age for both sexes. BV.vert/TV decreased significantly faster with age for women than for men. Vertical (Tb.Th*.vert) and horizontal (Tb.Th*.horz) trabecular thickness were independent of age, while Tb.Th*.horz/Tb.Th*.vert decreased significantly with age for both sexes. Additionally, the 95th percentile of the trabecular thickness distribution increased significantly with age for vertical trabeculae in women, whereas it was independent of age in men. In conclusion, we have shown that vertical and horizontal oriented bone density decreases with age in both women and men, and that vertical oriented bone is lost more quickly in women than in men. Furthermore, vertical and horizontal trabecular thickness were independent of age, whereas the horizontal to vertical trabecular thickness ratio decreased significantly with age indicating a relatively more pronounced thinning of horizontal trabeculae. Finally, the age-related loss of trabecular elements appeared to result in a compensatory

  7. 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

  8. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

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

    2002-01-01

    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....... No gender-related differences were found in any of the relationships. Neither static histomorphometry nor biomechanical testing of iliac crest bone biopsies is a good predictor of vertebral bone strength.......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...

  9. [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.

  10. MDCT after balloon kyphoplasty: analysis of vertebral body architecture one year after treatment of osteoporotic fractures

    International Nuclear Information System (INIS)

    Roehrl, B.; Dueber, C.; Sadick, M.; Brocker, K.; Voggenreiter, G.; Obertacke, U.; Brade, J.

    2006-01-01

    Purpose: to evaluate the value of MDCT in the monitoring of vertebral body architecture after balloon kyphoplasty and observe morphological changes of the vertebral body. Material and methods: during a period of 26 months, 66 osteoporotic fractures of the vertebral bodies were treated with percutanous balloon kyphoplasty. The height of the vertebral body, width of spinal space, sagittal indices, kyphosis und COBB angle, and cement leakage were evaluated by computed tomography before and after treatment and in a long-term follow up. Statistical analysis was performed by calculating quantitative constant parameters of descriptive key data. In addition, parametric and distribution-free procedures were performed for all questions. Results: after kyphoplasty, the treated vertebral bodies showed a significant gain in the height of the leading edge (0.15 cm; p < 0.0001) and in the central part of the vertebral body (0.17 cm; p < 0.0001). The height of the trailing edge did not change significantly. A corresponding gain in the sagittal index was found. The index remained stable during follow-up. Treated vertebral bodies as well as untreated references showed a comparable loss of height over the period of one year. The shape of the vertebral bodies remained stable. In comparison to these findings, treated vertebral bodies showed a reduced loss of height. A significant change in kyphosis und the COBB angle was noted. In total, pallacos leakage was detected in 71% of cases. Conclusion: MDCT is an accurate method for evaluating vertebral body architecture after treatment with balloon kyphoplasty. (orig.)

  11. [Peculiarities of clinico-neurological signs of the intervertebral discs protrusions in lumbar portion of vertebral column in patients of various age].

    Science.gov (United States)

    Khyzniak, M V; Pryĭmak, E V

    2013-11-01

    Clinico-neurological signs of the discogenic pain syndromes, caused by intervertebral disc (IVD) protrusion in a lumbar portion of vertebral column, were analyzed. The strict indications were substantiated for application of the puncture treatment methods for the discogenic pain syndromes in patients of various ages. Clinico-neurological signs of the IVD protrusions constitute the important criterion while the treatment method selection. Differentiated application of the puncture methods permits to improve the treatment results in the patients of various age.

  12. Outcome following kyphoplasty or vertebral body stenting with special regard to associated complications including their treatment strategy

    DEFF Research Database (Denmark)

    Lehmann, C.; Strohm, P.; Knöller, S.

    2011-01-01

    Introduction: Kyphoplasty (KP) and vertebral body stenting (VBS) have been established for treatment of spine fractures in elderly people. There are a lot of studies about the short-term pain reduction in reference to the health-related quality of life (HRQoL). The aim of this study...... patient needed a spinal decompression as a sole treatment and 3 patients additionally needed a spinal decompression. There was a statistically significant difference concerning the HRQoL between patients with or without secondary intervention for the EQ-5d Index and the EQ-5d pain/discomfort survey...... of fractures of the thoracic and lumbar spine remains an important problem, because the necessary surgical effort is significant. The HRQoL of patients with KP or VBS is less than that of the age-matched control sample. For patients with a secondary intervention the result is even worse. Type and reason...

  13. Early prenatal diagnosis of a lumbo-costo-vertebral syndrome.

    Science.gov (United States)

    Pristavu, Anda Ioana; Furnica, Cristina; Ifrim, Mona Mihaela; Popovici, Razvan Mihai

    2018-04-01

    Lumbo-costo-vertebral syndrome (LCVS) is a rare type of lumbar hernia with associated abnormalities of the vertebral bodies, ribs, and trunk muscles. Only a few cases have been reported in the literature, all of which were diagnosed after birth. We present a case of LCVS diagnosed early in the second trimester of pregnancy using two- and three-dimensional ultrasound. In our case, the associated anomalies were: multiple costovertebral anomalies, lumbar hernia, anal imperforation, left hand supernumerary digit, and clubfoot.

  14. Regional disc change in segmental hypoplasia of the lumbosacral vertebral bodies: MR findings

    International Nuclear Information System (INIS)

    Kim, Sung Kyu; Lee Seung Ro; Moon, Won Jin; Park, Dong Woo; Hahm, Chang Kok

    2000-01-01

    To classify types of vertebral hypoplasia and to investigate the prevalence and patterns of associated disc degeneration. Defining vertebral hypoplasia as occurring when the AP diameter of a lower vertebral body is smaller than that of an upper ones, we retrospectively reviewed the MR images obtained in 34 cases of this condition involving young adults. Two major types and two subtypes, a total of four different entities were classified as follows; type I: hypoplasia involving a single vertebral body; type II: hypoplasia involving serial lower segmental vertebral bodies; subtype a: hypoplastic body located anteriorly along the anterior spinal line; subtype b: hypoplastic body located posteriorly along the posterior spinal line. We also investigated each type of vertebral hypoplasia and patterns of associated disc changes. Three different types were observed. In type IIa (n=3D29), posterior disc occurred in 8/29 cases, diffuse degeneration in 21/29 patients, and posterior disc herniation in all. All type Ia cases (3/3) showed diffuse disc degeneration at both upper and lower disc levels, with posterior disc herniation, while both type IIb cases (2/2) showed diffuse disc degeneration, with bidirectional disc herniation. By identifying the exact patterns of vertebral hypoplasia, we were able to predict which portion of the disc was likely to degenerate. (author)

  15. [Experiment of porous calcium phosphate/bone matrix gelatin composite cement for repairing lumbar vertebral bone defect in rabbit].

    Science.gov (United States)

    Wang, Song; Yang, Han; Yang, Jian; Kang, Jianping; Wang, Qing; Song, Yueming

    2017-12-01

    To investigate the effect of a porous calcium phosphate/bone matrix gelatin (BMG) composite cement (hereinafter referred to as the "porous composite cement") for repairing lumbar vertebral bone defect in a rabbit model. BMG was extracted from adult New Zealand rabbits according to the Urist's method. Poly (lactic-co-glycolic) acid (PLGA) microsphere was prepared by W/O/W double emulsion method. The porous composite cement was developed by using calcium phosphate cement (CPC) composited with BMG and PLGA microsphere. The physicochemical characterizations of the porous composite cement were assessed by anti-washout property, porosity, and biomechanical experiment, also compared with the CPC. Thirty 2-month-old New Zealand rabbits were used to construct vertebral bone defect at L 3 in size of 4 mm×3 mm×3 mm. Then, the bone defect was repaired with porous composite cement (experimental group, n =15) or CPC (control group, n =15). At 4, 8, and 12 weeks after implantation, each bone specimen was assessed by X-ray films for bone fusion, micro-CT for bone mineral density (BMD), bone volume fraction (BVF), trabecular thickness (Tb. Th.), trabecular number (Tb.N.), and trabecular spacing (Tb. Sp.), and histological section with toluidine blue staining for new-born bone formation. The study demonstrated well anti-washout property in 2 groups. The porous composite cement has 55.06%±1.18% of porosity and (51.63±6.73) MPa of compressive strength. The CPC has 49.38%±1.75% of porosity and (63.34±3.27) MPa of compressive strength. There were significant differences in porosity and compressive strength between different cements ( t =4.254, P =0.006; t =2.476, P =0.034). X-ray films revealed that the zone between the cement and host bone gradually blurred with the time extending. At 12 weeks after implantation, the zone was disappeared in the experimental group, but clear in the control group. There were significant differences in BMD, BVF, Tb. Th., Tb. N., and Tb. Sp. between

  16. [Morpho-functional characteristic of the lumbar area of the human vertebral column in the individuals with various degrees of lumbar lordosis (on the basis of three-dimensional computer modeling)].

    Science.gov (United States)

    Koveshnikov, V G; Mavrich, V V; Bolgova, E S

    2008-01-01

    This investigation was aimed at the evaluation of the borders of individual variability of the human lumbar spine lordosis. 224 nuclear magnetic tomograms of persons of mature age were analyzed using morphometric, statistical methods, method of three-dimensional (3D) computer modeling and finite-element analysis. During the investigation, a hardware-software complex for morphometric research was created together with the new method of development of 3D computer models of the lumbar spine. The application of 3D modeling allowed to extend the knowledge of human spine biomechanics. Tensions and deformations were calculated in all lumbar vertebrae and intervertebral disks on the basis of spine 3D models developed. Finite-element analysis proved that a normal angle of lumbar lordosis was optimal for the transmission of the adequate compression loads, while the extreme forms of individual variability (high degrees of hyper- and hypolordosis), by changing the geometry of the vertebral column, result in the decrease of the functionality of this system.

  17. Transoral vertebral augmentation with polymethylmethacrylate in the treatment of a patient with a dens fracture nonunion and subarticular vertebral body fracture of C2

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Martin, Hal D.; Stapp, Annette M.; Stanfield, Matthew

    2007-01-01

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive, image-guided procedure used to treat vertebral fractures due to osteoporosis, metastatic lesions, multiple myeloma, and benign but destabilizing bone tumors. The injection of PMMA into the C2 vertebral body using the transoral technique has been reported in three separate patients for treatment of benign tumors (a vertebral hemangioma and an aneurysmal bone cyst) and for multiple myeloma in the third patient. Although the injection of PMMA into the vertebral body is most commonly performed to treat benign vertebral compression fractures, a transoral C2 approach has not been reported in the English literature as a treatment for a benign fracture of C2. We report the treatment of a fracture and nonunion of the base of the dens and a subarticular fracture of the vertebral body of C2 using a bilateral transoral approach. (orig.)

  18. Quantitative morphology of the vertebral body cortex; Quantitative Morphologie der Wirbelkoerperkortikalis

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    Ritzel, H.; Amling, M.; Hahn, M.; Delling, G. [Hamburg Univ. (Germany). Abt. Osteopathologie; Maas, R. [Hamburg Univ. (Germany). Radiologische Klinik

    1998-04-01

    The vertebral bodies consist of two main structures, trabecular and cortical bone. The histological changes within the spine, especially in cortical bone, leading to osteoporotic fractures remain, however, poorly understood. Therefore, the complete front column of the spine was removed in 26 autopsy cases without skeletal diseases and in 11 cases with proven osteoporosis. A sagittal segment prepared through the center of all vertebral bodies was undecalcified embedded in plastic, ground to a 1-mm-thick block and stained using a modification of the von Kossa method. The analysis included measurement of the mean cortical thickness of both ventral and dorsal shell (from C3 to L5). The qualitative investigation of the structure of the cortical ring completed the analysis. The skeletally intact specimens had high cortical thickness values in the cervical spine (285{+-}22 {mu}m), a decrease in the thoracic spine (244{+-}14 {mu}) and an increase in the lumbar spine (290{+-}15 {mu}m). The mean thickness of the ventral shell is in general higher than the thickness of the dorsal shell. The cortical thickness of the spine showed no gender-specific differences (P=n.s.). There was a slight decrease in cortical thickness with age; however, this decrease and the correlation of cortical thickness to age was only significant below vertebral body T8 (r=0.225 to 0.574; P{sub r}<0.05 to P{sub t}<0.005). Most interestingly, osteoporosis is characterized by a significant decrease in cortical thickness throughout the whole spine. This decrease in cortical thickness was more marked in the dorsal shell (P<0.05) than in the ventral shell (ventral from C3 to T6 (P<0.05)) below T6 (P=n.s.). (orig./AJ) [Deutsch] Zielsetzung: Wirbelkoerper bestehen aus den beiden Hauptkomponenten Spongiosa und Kortikalis. Trotz kontroverser Meinungen zur biomechanischen Bedeutung dieser Strukturen fuer die Stabilitaet der Knochen liegen ueber die Dicke der Kortikalis in der Literatur allerdings nur wenige

  19. Evolutionary Transition of Promoter and Gene Body DNA Methylation across Invertebrate-Vertebrate Boundary.

    Science.gov (United States)

    Keller, Thomas E; Han, Priscilla; Yi, Soojin V

    2016-04-01

    Genomes of invertebrates and vertebrates exhibit highly divergent patterns of DNA methylation. Invertebrate genomes tend to be sparsely methylated, and DNA methylation is mostly targeted to a subset of transcription units (gene bodies). In a drastic contrast, vertebrate genomes are generally globally and heavily methylated, punctuated by the limited local hypo-methylation of putative regulatory regions such as promoters. These genomic differences also translate into functional differences in DNA methylation and gene regulation. Although promoter DNA methylation is an important regulatory component of vertebrate gene expression, its role in invertebrate gene regulation has been little explored. Instead, gene body DNA methylation is associated with expression of invertebrate genes. However, the evolutionary steps leading to the differentiation of invertebrate and vertebrate genomic DNA methylation remain unresolved. Here we analyzed experimentally determined DNA methylation maps of several species across the invertebrate-vertebrate boundary, to elucidate how vertebrate gene methylation has evolved. We show that, in contrast to the prevailing idea, a substantial number of promoters in an invertebrate basal chordate Ciona intestinalis are methylated. Moreover, gene expression data indicate significant, epigenomic context-dependent associations between promoter methylation and expression in C. intestinalis. However, there is no evidence that promoter methylation in invertebrate chordate has been evolutionarily maintained across the invertebrate-vertebrate boundary. Rather, body-methylated invertebrate genes preferentially obtain hypo-methylated promoters among vertebrates. Conversely, promoter methylation is preferentially found in lineage- and tissue-specific vertebrate genes. These results provide important insights into the evolutionary origin of epigenetic regulation of vertebrate gene expression. © The Author(s) 2015. Published by Oxford University Press on behalf

  20. Evaluation of the relationship between age, gender, and body mass index, and lumbar facet joint pain

    Directory of Open Access Journals (Sweden)

    Arman Taheri

    2016-01-01

    Full Text Available Introduction: Lumbar facet joint pain accounts for 5-15% of the cases of chronic, axial low back pain. Most commonly, facetogenic pain is the result of repetitive stress and/or cumulative low level trauma, leading to inflammation and stretching of the joint capsule. Patients and Methods: In this descriptive study 76 patients who were diagnosed, after a diagnostic block, as having lumbar facet joint pain were evaluated by their age, sex, and body mass index (BMI. Data were collected according to a checklist and entered to SPSS version 16. Results: The mean age of the participants was 48.53 years; the participants included 44 women and 32 men. Lumbar facet joint pain was more frequent in the age range of 40-55 years. With respect to BMI, lumbar facet joint pain was most frequently seen in patients with BMI of 24.5-29.5 kg/m 2 (40.8%. Conclusion: Based on our findings, the chances of developing lumbar facet joint pain is more in women who are between 40 years and 55 years of age and whose BMI is 24.5-29.5 kg/m 2 .

  1. Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

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    Ashwini Aithal Padur

    2017-10-01

    Full Text Available Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophytes was studied in 40 cadaveric vertebral columns over a period of four years. The lumbar part of the vertebral columns was dissected and examined meticulously. The occurrence of lumbar osteophytes with their vertebral levels and morphometric measurements were recorded. A small excision of the osteophyte was processed histologically to study its microscopic details using routine Haematoxylin & Eosin stain. Results: Lumbar osteophytes were present in 4 specimens (10%. They were mostly found on the right side of the vertebral bodies. Histopathological examination of the osteophytes revealed degenerative osteophytic cartilage and fibrillation overlying the trabecular bone enclosing fatty marrow spaces containing haematopoietic elements. Conclusion: Lumbar osteophytes were found in 10% of the specimens studied and it is assumed that these cadaveric reports deserve further attention given their potential clinical implications. Knowledge regarding occurrence and incidence of osteophytes is essential for management of common degenerative changes of the vertebral column.

  2. Comparison of lumbar force between pubertal and post-pubertal adolescents: interference of physical growth, body fat and lifestyle.

    Directory of Open Access Journals (Sweden)

    Mikael Seabra Moraes

    2018-01-01

    Full Text Available Abstract Aim: To compare performance in the lumbar force test in pubertal and post-pubertal adolescents by controlling the interference of physical growth, body fat, screen time and physical activity. Methods: A cross-sectional study with 933 adolescents (492 girls aged 14-19 from the city of São José, Brazil. Lumbar strength was assessed using the isometric lumbar extension test proposed by the Canadian Society of Exercise Physiology. Sexual maturation was classified according to Tanner’s criteria. Physical growth variables (age, body weight, stature, BMI, body fat (triceps and subscapular skinfolds, sedentary behavior based on screen time and overall physical activity were controlled in the Analysis of Covariance (ANCOVA, with a significance level of 5%. Results: Post-pubertal boys presented higher lumbar force compared to pubertal ones only when interference of BMI, body fat, screen time and physical activity was controlled. Pubertal girls presented higher lumbar force compared to post-pubertal ones, both when controlling the analysis for the studied variables and when not controlled by them. Conclusion: BMI, body fat, screen time and physical activity interfere in the difference in lumbar strength of boys, in which post-pubertal boys presented better performance in lumbar force compared to pubertal ones. Regardless of interference or not of these variables, pubertal girls presented better performance in lumbar force when compared to post-pubertal ones.

  3. Fat body, fat pad and adipose tissues in invertebrates and vertebrates: the nexus

    Science.gov (United States)

    2014-01-01

    The fat body in invertebrates was shown to participate in energy storage and homeostasis, apart from its other roles in immune mediation and protein synthesis to mention a few. Thus, sharing similar characteristics with the liver and adipose tissues in vertebrates. However, vertebrate adipose tissue or fat has been incriminated in the pathophysiology of metabolic disorders due to its role in production of pro-inflammatory cytokines. This has not been reported in the insect fat body. The link between the fat body and adipose tissue was examined in this review with the aim of determining the principal factors responsible for resistance to inflammation in the insect fat body. This could be the missing link in the prevention of metabolic disorders in vertebrates, occasioned by obesity. PMID:24758278

  4. High-resolution computed tomography evaluation of the bronchial lumen to vertebral body diameter and pulmonary artery to vertebral body diameter ratios in anesthetized ventilated normal cats.

    Science.gov (United States)

    Lee-Fowler, Tekla M; Cole, Robert C; Dillon, A Ray; Tillson, D Michael; Garbarino, Rachel; Barney, Sharron

    2017-10-01

    Objectives Bronchial lumen to pulmonary artery diameter (BA) ratio has been utilized to investigate pulmonary pathology on high-resolution CT images. Diseases affecting both the bronchi and pulmonary arteries render the BA ratio less useful. The purpose of the study was to establish bronchial lumen diameter to vertebral body diameter (BV) and pulmonary artery diameter to vertebral body diameter (AV) ratios in normal cats. Methods Using high-resolution CT images, 16 sets of measurements (sixth thoracic vertebral body [mid-body], each lobar bronchi and companion pulmonary artery diameter) were acquired from young adult female cats and 41 sets from pubertal female cats. Results Young adult and pubertal cat BV ratios were not statistically different from each other in any lung lobe. Significant differences between individual lung lobe BV ratios were noted on combined age group analysis. Caudal lung lobe AV ratios were significantly different between young adult and pubertal cats. All other lung lobe AV ratios were not significantly different. Caudal lung lobe AV ratios were significantly different from all other lung lobes but not from each other in both the young adult and pubertal cats. Conclusions and relevance BV ratio reference intervals determined for individual lung lobes could be applied to both young adult and pubertal cats. Separate AV ratios for individual lung lobes would be required for young adult and pubertal cats. These ratios should allow more accurate evaluation of cats with concurrent bronchial and pulmonary arterial disease.

  5. Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease.

    Science.gov (United States)

    Ou, Chien-Yu; Lee, Tao-Chen; Lee, Tsung-Han; Huang, Yu-Hua

    2015-04-01

    Adjacent segment disease is an important complication after fusion of degenerative lumbar spines. However, the role of body mass index (BMI) in adjacent segment disease has been addressed less. To examine the relationship between BMI and adjacent segment disease after lumbar fusion for degenerative spine diseases. For this retrospective study, we enrolled 190 patients undergoing lumbar fusion surgery for degeneration. BMI at admission was documented. Adjacent segment disease was defined by integration of the clinical presentations and radiographic criteria based on the morphology of the dural sac on magnetic resonance images. Adjacent segment disease was identified in 13 of the 190 patients, accounting for 6.8%. The interval between surgery and diagnosis as adjacent segment disease ranged from 21 to 66 months. Five of the 13 patients required subsequent surgical intervention for clinically relevant adjacent segment disease. In the logistic regression model, BMI was a risk factor for adjacent segment disease after lumbar fusion for degenerative spine diseases (odds ratio, 1.68; 95% confidence interval, 1.27-2.21; P disease rate by 67.6%. The patients were subdivided into 2 groups based on BMI, and up to 11.9% of patients with BMI ≥ 25 kg/m were diagnosed as having adjacent segment disease at the last follow-up. BMI is a risk factor for adjacent segment disease in patients undergoing lumbar fusion for degenerative spine diseases. Because BMI is clinically objective and modifiable, controlling body weight before or after surgery may provide opportunities to reduce the rate of adjacent segment disease and to improve the outcome of fusion surgery.

  6. Vertebral lesion distribution in multiple myeloma - assessed by reduced-dose whole-body MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Bier, Georg; Kloth, Christopher; Schabel, Christoph; Bongers, Malte; Nikolaou, Konstantin; Horger, Marius [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-01-15

    To observe the distribution and potential distribution patterns of osteolytic and sclerotic vertebral involvement in a representative collective of multiple myeloma patients. A total of 66 consecutive patients with a diagnosis of multiple myeloma at initial diagnosis or during follow-up were examined by multidetector reduced-dose computed tomography to evaluate the distribution of bone lesions along the spine with focus on size, location, and lesion character. Confirmation of diagnosis was performed by comparison to follow-up computed tomography or magnetic resonance tomography. If >50 % of all detected malignant lesions occurred in one spinal segment, the distribution pattern was called cervical, thoracic, lumbar, or sacral, otherwise a ''mixed'' pattern was classified. Of a total number of 933 osseous spine lesions, 632 (67.7 %) were classified as malignant (98.9 % of them osteolytic) and 293 (31.5 %) as benign. The distribution pattern analysis yielded two patients (3.8 %) with a cervical, 26 (50 %) with a thoracic, 4 (7.7 %) with a lumbar, one (1.9 %) with a sacral pattern, and 19 cases (36.6 %) showed a mixed distribution pattern. Segment-wise, the mean lesion size was 6.52 ± 2.76 mm (cervical), 8.97 ± 5.43 mm (thoracic), 11.97 ± 7.11 mm (lumbar), and 17.5 ± 16.465 (sacral), whilst, related to the vertebra size, the lesion/vertebra size ratio is decreasing through the whole spine beginning from the top. Multiple myeloma bone lesions occur preferably and are larger in the thoracic and lumbar spine. Moreover, a specific distribution pattern is present in about 60 %. (orig.)

  7. Vertebral lesion distribution in multiple myeloma - assessed by reduced-dose whole-body MDCT

    International Nuclear Information System (INIS)

    Bier, Georg; Kloth, Christopher; Schabel, Christoph; Bongers, Malte; Nikolaou, Konstantin; Horger, Marius

    2016-01-01

    To observe the distribution and potential distribution patterns of osteolytic and sclerotic vertebral involvement in a representative collective of multiple myeloma patients. A total of 66 consecutive patients with a diagnosis of multiple myeloma at initial diagnosis or during follow-up were examined by multidetector reduced-dose computed tomography to evaluate the distribution of bone lesions along the spine with focus on size, location, and lesion character. Confirmation of diagnosis was performed by comparison to follow-up computed tomography or magnetic resonance tomography. If >50 % of all detected malignant lesions occurred in one spinal segment, the distribution pattern was called cervical, thoracic, lumbar, or sacral, otherwise a ''mixed'' pattern was classified. Of a total number of 933 osseous spine lesions, 632 (67.7 %) were classified as malignant (98.9 % of them osteolytic) and 293 (31.5 %) as benign. The distribution pattern analysis yielded two patients (3.8 %) with a cervical, 26 (50 %) with a thoracic, 4 (7.7 %) with a lumbar, one (1.9 %) with a sacral pattern, and 19 cases (36.6 %) showed a mixed distribution pattern. Segment-wise, the mean lesion size was 6.52 ± 2.76 mm (cervical), 8.97 ± 5.43 mm (thoracic), 11.97 ± 7.11 mm (lumbar), and 17.5 ± 16.465 (sacral), whilst, related to the vertebra size, the lesion/vertebra size ratio is decreasing through the whole spine beginning from the top. Multiple myeloma bone lesions occur preferably and are larger in the thoracic and lumbar spine. Moreover, a specific distribution pattern is present in about 60 %. (orig.)

  8. Pathological vertebral fracture after stereotactic body radiation therapy for lung metastases. Case report and literature review.

    Directory of Open Access Journals (Sweden)

    Rodríguez-Ruiz María

    2012-03-01

    Full Text Available Abstract Background Stereotactic body radiation therapy (SBRT is a radiation technique used in patients with oligometastatic lung disease. Lung and chest wall toxicities have been described in the patients but pathological vertebral fracture is an adverse effect no reported in patients treated with SBRT for lung metastases. Case presentation A 68-year-old woman with the diagnosis of a recurrence of a single lung metastatic nodule of urothelial carcinoma after third line of chemotherapy. The patient received a hypo-fractionated course of SBRT.A 3D-conformal multifield technique was used with six coplanar and one non-coplanar statics beams. A total dose of 48 Gy in three fractions over six days was prescribed to the 95% of the CTV. Ten months after the SBRT procedure, a CT scan showed complete response of the metastatic disease without signs of radiation pneumonitis. However, rib and vertebral bone toxicities were observed with the fracture-collapse of the 7th and 8th vertebral bodies and a fracture of the 7th and 8th left ribs. We report a unique case of pathological vertebral fracture appearing ten months after SBRT for an asymptomatic growing lung metastases of urothelial carcinoma. Conclusion Though SBRT allows for minimization of normal tissue exposure to high radiation doses SBRT tolerance for vertebral bone tissue has been poorly evaluated in patients with lung tumors. Oncologists should be alert to the potential risk of fatal bone toxicity caused by this novel treatment. We recommend BMD testing in all woman over 65 years old with clinical risk factors that could contribute to low BMD. If low BMD is demonstrated, we should carefully restrict the maximum radiation dose in the vertebral body in order to avoid intermediate or low radiation dose to the whole vertebral body.

  9. Vertebral chondroblastoma

    International Nuclear Information System (INIS)

    Ilaslan, Hakan; Sundaram, Murali; Unni, Krishnan K.

    2003-01-01

    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. Secondary

  10. 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

  11. Caudal epidural injections for lumbar prolapsed inter vertebral disc: assessment with urdu version of oswestry disability index

    International Nuclear Information System (INIS)

    Pasha, I.F.; Qureshi, M.A.; Farooq, M.

    2014-01-01

    Background/Aims: Oswestry Disability index is an established tool for assessment of Spinal Disability. It has been translated into many languages and but not to Urdu. The aim of this prospective observational study was translation, application and validation of Urdu version of the Oswestry Disability Index (Urdu ODI) for our specific cultural background. Methods: Urdu version of ODI was developed and applied for outcome assessment in 50 patients, suffering from lumbar prolapsed inter vertebral discs and treated with caudal epidural steroid injection. All patients having mechanical low backache with radiculopathy and single level disc prolapse at L-4-5 or L5- S 1 on Magnetic Resonance Imaging (MRI) were included in the study. Single Steroid Injection with local anesthetic was injected into sacral caudal epidural space through sacral hiatus. A Performa was made for each patient and records were kept in a custom built Microsoft access database. Outcome was assessed using Urdu ODI and validation by comparing with Numeric rating Scale 0-10 at each visit. Results: Fifty patients received caudal epidural injections, 23 (46%) were male and 27 (54%) were female. The mean age was 34 years, with the range being 21-55. Low mechanical backache with right sided radiculopathy was in 29 (58%) and left sided in 21 (42%) patients. The commonest involved disc was L4-S in 28 (56%) and L5-S1 in 22 (44%) patients Pain was assessed with Numeric Rating Scale (NRS) of ten points. This was mean 7.35, range 9-6 at presentation and mean improvement was 4.15 with range 5-3 at fist week, 3.80 with range 5-2 at first month and 3.05 with range 4-1 after six months. Functional disability assessment was done using Urdu ODI. The mean Urdu ODI at the time of presentation was 66.23% with range 81%-48%. The mean functional status was found to be 38.64% with range 26%-45% at the end of the first week, 43.65% with range 31%-48% after one month and 44.85% with range 28%-48% after six months. So there was

  12. Analysis of Long Bone and Vertebral Failure Patterns.

    Science.gov (United States)

    1983-03-01

    apophyseal joints, lumbar spondylosis and low back pain in Jayson, M.I.V. (ed) The Lumbar Spine and Back Pain, Pitman Medical, pp. 83-114. PUBLICATIONS...NOTES Material in this report was presented at the International Society for the Study of the Lumbar Spine, Toronto, Canada, June 6-10, 1982. 19. KEY...intervertebral disc and end plate fragments were observed in the vertebral bodies (G84 L2 -3 ) of the upper lumbar levels. Also fragments of trabecular bone

  13. On the Health Risk of the Lumbar Spine due to Whole-Body VIBRATION—THEORETICAL Approach, Experimental Data and Evaluation of Whole-Body Vibration

    Science.gov (United States)

    Seidel, H.; Blüthner, R.; Hinz, B.; Schust, M.

    1998-08-01

    The guidance on the effects of vibration on health in standards for whole-body vibration (WBV) does not provide quantitative relationships between WBV and health risk. The paper aims at the elucidation of exposure-response relationships. An analysis of published data on the static and dynamic strength of vertebrae and bone, loaded with various frequencies under different conditions, provided the basis for a theoretical approach to evaluate repetitive loads on the lumbar spine (“internal loads”). The approach enabled the calculation of “equivalent”—with respect to cumulative fatigue failure—combinations of amplitudes and numbers of internal cyclic stress. In order to discover the relation between external peak accelerations at the seat and internal peak loads, biodynamic data of experiments (36 subjects, three somatotypes, two different postures—relaxed and bent forward; random WBV,aw, r.m.s. 1·4 ms-2, containing high transients) were used as input to a biomechanical model. Internal pressure changes were calculated using individual areas of vertebral endplates. The assessment of WBV was based on the quantitative relations between peak accelerations at the seat and pressures predicted for the disk L5/S1. For identical exposures clearly higher rates of pressure rise in the bent forward compared to the relaxed posture were predicted. The risk assessment for internal forces considered the combined internal static and dynamic loads, in relation to the predicted individual strength, and Miner's hypothesis. For exposure durations between 1 min and 8 h, energy equivalent vibration magnitudes (formula B.1, ISO 2631-1, 1997) and equivalent vibration magnitudes according to formula B.2 (time dependence over-energetic) were compared with equivalent combinations of upward peak accelerations and exposure durations according to predicted cumulative fatigue failures of lumbar vertebrae. Formula B.1 seems to underestimate the health risk caused by high magnitudes

  14. Mechanisms of initial endplate failure in the human vertebral body.

    Science.gov (United States)

    Fields, Aaron J; Lee, Gideon L; Keaveny, Tony M

    2010-12-01

    Endplate failure occurs frequently in osteoporotic vertebral fractures and may be related to the development of high tensile strain. To determine whether the highest tensile strains in the vertebra occur in the endplates, and whether such high tensile strains are associated with the material behavior of the intervertebral disc, we used micro-CT-based finite element analysis to assess tissue-level strains in 22 elderly human vertebrae (81.5 ± 9.6 years) that were compressed through simulated intervertebral discs. In each vertebra, we compared the highest tensile and compressive strains across the different compartments: endplates, cortical shell, and trabecular bone. The influence of Poisson-type expansion of the disc on the results was determined by compressing the vertebrae a second time in which we suppressed the Poisson expansion. We found that the highest tensile strains occurred within the endplates whereas the highest compressive strains occurred within the trabecular bone. The ratio of strain to assumed tissue-level yield strain was the highest for the endplates, indicating that the endplates had the greatest risk of initial failure. Suppressing the Poisson expansion of the disc decreased the amount of highly tensile-strained tissue in the endplates by 79.4 ± 11.3%. These results indicate that the endplates are at the greatest risk of initial failure due to the development of high tensile strains, and that such high tensile strains are associated with the Poisson expansion of the disc. We conclude that initial failure of the vertebra is associated with high tensile strains in the endplates, which in turn are influenced by the material behavior of the disc. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. 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

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

    Science.gov (United States)

    Lu, Sheng; Chang, Shan; Zhang, Yuan-zhi; Ding, Zi-hai; Xu, Xin Ming; Xu, Yong-qing

    2011-04-14

    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. 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. 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. 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 operations by its relative position to the lumbar plexus. 3D

  17. Whole spine MRI in the assessment of acute vertebral body trauma

    International Nuclear Information System (INIS)

    Green, R.A.R.; Saifuddin, A.

    2004-01-01

    To determine the incidence and types of multilevel vertebral body injury in association with acute spinal trauma as assessed by whole spine MRI. All acute admissions to a regional spinal injury unit had whole spine MRI carried out, to detect occult vertebral body injury. Two radiologists assessed 127 cases prospectively, over a period of 3 years. All cases had T2-weighted sagittal imaging of the whole spine (where possible using a T2-weighted fat-suppressed sequence), with T1-weighted imaging in both sagittal and axial planes covering the primary injury. The incidence of secondary injury (defined as either bone bruising, wedge compression fracture or burst fracture) was determined and defined by type, site and relationship to the primary injury. Seventy-seven per cent of cases had a secondary injury level. Of these, bone bruising was the commonest but often occurred in combination with secondary wedge compression fracture or burst fracture. MRI detected 27 non-contiguous wedge compression fractures and 16 non-contiguous burst fractures, giving an incidence of secondary level, non-contiguous fracture of approximately 34%. A higher frequency of secondary vertebral body injury may be defined by MRI than has been described in previous studies based on radiographic evaluation of the whole spine. Whole spine MRI in assessment for occult vertebral body fracture enables increased confidence in the conservative or surgical management of patients with severe spinal injury. (orig.)

  18. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    International Nuclear Information System (INIS)

    Pua, Uei; Chan, Stephen Yung-Wei

    2013-01-01

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  19. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Chan, Stephen Yung-Wei [Tan Tock Seng Hospital, Department of Anaesthesiology, Intensive Care and Pain Medicine (Singapore)

    2013-06-15

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  20. Real-time tracking of vertebral body movement with implantable reference microsensors.

    Science.gov (United States)

    Mularski, Sven; Picht, Thomas; Kuehn, Björn; Kombos, Theodoros; Brock, Mario; Suess, Olaf

    2006-05-01

    In the spine, navigation techniques serve mainly to control and accurately target insertion of implants. The main source of error is that the spine is not a rigid organ, but rather a chain of semiflexible movement segments. Any intraoperative manipulation of the patient alters the geometry and volumetry as compared to the 3D volume model created from the image data. Thus, the objective of the study was to implement the theoretical principle of microsensor referencing in a model experiment and to clarify which anatomical structures are suitable for intermittent implantation of positional sensors, as illustrated with cervical vertebral bodies. Laboratory tests were conducted using 70 models of human cervical vertebral bodies. The first experiment investigated whether arbitrary movements of vertebral bodies can be tracked with the positional information from the implanted microsensors. The accuracy of this movement monitoring was determined quantitatively on the basis of positional error measurement. In the second experiment, different ventral and dorsal surgical operations were simulated on five models of the cervical spine. Quantifiable measurement values such as the spatial extension of the intervertebral space and the relative positions of the planes of the upper plates were determined. With respect to the differing anatomy of the individual vertebral bodies of the cervical spine, the sensors could be placed securely with a 5x2 mm drill. The registration error (RE) was determined as a root mean square error. The mean value was 0.9425 mm (range: 0.57-1.2 mm; median: 0.9400 mm; SD: 0.1903 mm). The precision of the movement monitoring of the vertebral body was investigated along its three main axes. The error tolerance between post-interventional 3D reconstruction and direct measurement on the model did not exceed 1.3 mm in the distance measurements or 2.5 degrees in the angular measurements. The tomograms on the system monitor could be updated in close to real time

  1. [Utility of nickel-titanium shape memory alloys of vertebral body reduction fixator with assisted distraction bar].

    Science.gov (United States)

    Man, Yi; Zheng, Yue-huan; Cao, Peng; Chen, Bo; Zheng, Tao; Sun, Chang-hui; Lu, Jiong

    2011-06-07

    To test the nickel-titanium (Ni-Ti) shape memory alloys of vertebral body reduction fixator with assisted distraction bar for the treatment of traumatic and osteoporotic vertebral body fracture. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar was implanted into the compressed fracture specimens through vertebral pedicle with the radiographic monitoring to reduce the collapsed endplate as well as distract the compressed vertebral fracture. Radiographic film and computed tomographic reconstruction technique were employed to evaluate the effects of reduction and distraction. A biomechanic test machine was used to measure the fatigue and the stability of deformation of fixation segments. Relying on the effect of temperature shape memory, such an assembly could basically reduce the collapsed endplate as well as distract the compressed vertebral fracture. And when unsatisfied results of reduction and distraction occurred, its super flexibility could provide additional distraction strength. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar may provide effective endplate reduction, restore the vertebral height and the immediate biomechanic spinal stability. So the above assembly is indicated for the treatment of traumatic and osteoporotic vertebral body fracture.

  2. Measurement of the bone mineral density of the os calcis as an indication of vertebral fracture in women with lumbar osteoarthritis

    International Nuclear Information System (INIS)

    Kotzki, P.-O.; Buyck, D.; Leroux, J.-L.; Thomas, E.; Rossi, M.

    1993-01-01

    In women with lumbar osteoarthritis, measurement of the os calcis bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) as an indication of vertebral fracture was evaluated. The in vivo precision of the method was 1.28%. Age-and sex-matched control curves were evaluated using a control of 193 females. Correlation between spine BMD and os calcis BMD was significant (r = 0.65, p<<0.001). For osteoporotic women without osteoarthritis (34), there was no significant difference in spine and the os calcis Z-score (-1.99SD and -1.83SD respectively). For osteoporotic women with osteoarthritis (30) the spine Z-score was -0.49SD; the os calcis Z-scores was -1.92SD. The difference was significant (p<0.001). Receiver operating characteristic (ROC) curves demonstrate the superiority of the os calcis as a measurement site over the lumbar spine, in correlation with existing crush fractures in the presence of osteoarthritis. (author)

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

    Science.gov (United States)

    Poetscher, Arthur Werner; Ribas, Guilherme Carvalhal; Yasuda, Alexandre; Nishikuni, Koshiro

    2005-03-01

    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 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.

  4. Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic, non-specific low back pain and healthy controls.

    Science.gov (United States)

    Mellor, Fiona E; Thomas, Peter W; Thompson, Paul; Breen, Alan C

    2014-10-01

    Identifying biomechanical subgroups in chronic, non-specific low back pain (CNSLBP) populations from inter-vertebral displacements has proven elusive. Quantitative fluoroscopy (QF) has excellent repeatability and provides continuous standardised inter-vertebral kinematic data from fluoroscopic sequences allowing assessment of mid-range motion. The aim of this study was to determine whether proportional continuous IV rotational patterns were different in patients and controls. A secondary aim was to update the repeatability of QF measurement of range of motion (RoM) for inter-vertebral (IV) rotation. Fluoroscopic sequences were recorded of passive, recumbent coronal and sagittal motion, which was controlled for range and velocity. Segments L2-5 in 40 primary care CNSLBP patients and 40 matched controls were compared. Patients also completed the von Korff Chronic Pain Grade and Roland and Morris Disability Questionnaire. Sequences were processed using automated image tracking algorithms to extract continuous inter-vertebral rotation data. These were converted to continuous proportional ranges of rotation (PR). The continuous proportional range variances were calculated for each direction and combined to produce a single variable representing their fluctuation (CPRV). Inter- and intra-rater repeatability were also calculated for the maximum IV-RoM measurements obtained during controlled trunk motion to provide an updated indication of the reliability and agreement of QF for measuring spine kinematics. CPRV was significantly higher in patients (0.011 vs. 0.008, Mann-Whitney two-sided p = 0.008), implying a mechanical subgroup. Receiver operating characteristic curve analysis found its sensitivity and specificity to be 0.78 % (60-90) and 0.55 % (37-73), respectively (area under the curve 0.672). CPRV was not correlated with pain severity or disability. The repeatability of maximum inter-vertebral range was excellent, but range was only significantly greater in patients

  5. The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet.

    Science.gov (United States)

    Eschler, Anica; Röpenack, Paula; Herlyn, Philipp K E; Roesner, Jan; Pille, Kristin; Büsing, Kirsten; Vollmar, Brigitte; Mittlmeier, Thomas; Gradl, Georg

    2015-10-01

    Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies. This study introduces a standardized animal model of an osteoporotic VCF type A3.1 that may enable further in-depth analysis of the afore mentioned topics. Twenty-four 5-year-old female Merino sheep (mean body weight: 67 kg; range 57-79) were ovariectomized (OP1) and underwent 5.5 months of weekly corticosteroid injections (dexamethasone and dexamethasone-sodium-phosphate), adding to a calcium/phosphorus/vitamin D-deficient diet. Osteoporosis induction was documented by pQCT and micro-CT BMD (bone mineral density) as well as 3D histomorphometric analysis postoperatively of the sheep distal radius and spine. Non osteoporotic sheep served as controls. Induction of a VCF of the second lumbar vertebra was performed via a mini-lumbotomy surgical approach with a standardized manual compression mode (OP2). PQCT analysis revealed osteoporosis of the distal radius with significantly reduced BMD values (0.19 g/cm(3), range 0.13-0.22 vs. 0.27 g/cm(3), range 0.23-0.32). Micro-CT documented significant lowering of BMD values for the second lumbar vertebrae (0.11 g/cm(3), range 0.10-0.12) in comparison to the control group (0.14 g/cm(3), range 0.12-0.17). An incomplete burst fracture type A3.1 was achieved in all cases and resulted in a significant decrease

  6. Analysis of structure of lumbar spine dorsopathy morbidity in able-bodied age patients

    Directory of Open Access Journals (Sweden)

    Manin M.V.

    2015-06-01

    Full Text Available The analysis of structure of lumbar spine dorsopathy morbidity among able-bodied population of the Dnepropetrovsk area for substantiation of differentiated approach to the choice of exercise therapy methods was a research objective. The structure of dorsopathy morbidity in 371 patients in 2009-2013 period is analysed in the work. The paper presents analysis of the most frequent morphological changes in the structures of the spine, their localization and clinical course. Link of clinical manifestations of dorsopathy with structural changes of the backbone, the disease experience is revealed, efficiency of rehabilitation by means of physiotherapy exercises depending on qualitative and quantitative signs of disease is defined. Results of the research specify that more than 40% of patients were on repeated treatment, clinical manifestation in 62% of patients was observed at the most able-bodied age (from 30 to 50 years, according to the disease experience number of aggravations per a year increased, in 57,5% of cases administration of medical physical culture was limited due to development of an accompanying pathology, in 40% of cases against positive dynamics of painful syndrome insufficient changes in volume of movements of the spine segments throughout treatment were marked. It testifies to necessity of working out algorithm of differentiated approach to the choice of means medical physical culture in treatment of lumbar spine dorsopathy.

  7. LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies.

    Science.gov (United States)

    Iacobas, Ionela; Burrows, Patricia E; Frieden, Ilona J; Liang, Marilyn G; Mulliken, John B; Mancini, Anthony J; Kramer, Daniela; Paller, Amy S; Silverman, Robert; Wagner, Annette M; Metry, Denise W

    2010-11-01

    To define the clinical spectrum of regional congenital anomalies associated with large cutaneous hemangiomas of the lower half of the body, clarify risk for underlying anomalies on the basis of hemangioma location, and provide imaging guidelines for evaluation. We conducted a multi-institutional, retrospective case analysis of 24 new patients and review of 29 published cases. Hemangiomas in our series tended to be "segmental" and often "minimal growth" in morphology. Such lesions were often extensive, covering the entire leg. Extensive limb hemangiomas also showed potential for extracutaneous anomalies, including underlying arterial anomalies, limb underdevelopment, and ulceration. The cutaneous hemangioma and underlying anomalies demonstrated regional correlation. Myelopathies were the most common category of associated anomalies. We propose the acronym "LUMBAR" to describe the association of Lower body hemangioma and other cutaneous defects, Urogenital anomalies, Ulceration, Myelopathy, Bony deformities, Anorectal malformations, Arterial anomalies, and Renal anomalies. There are many similarities between LUMBAR and PHACE syndrome, which might be considered regional variations of the same. Although guidelines for imaging are suggested, prospective studies will lead to precise imaging recommendations and help determine true incidence, risk and long-term outcomes. Copyright © 2010 Mosby, Inc. All rights reserved.

  8. Evaluation of changes in vertebral body density following administration of contrast medium during routine CT examination

    International Nuclear Information System (INIS)

    Janicek, M.; Bruna, J.; Stenhova, H.

    1984-01-01

    The possibility is discussed of depicting changes in the density of spongiosis of the vertebral body in normal patients after intravenous administration of a bolus of 40 ml 60% Diazetrizoate in the course of a routine CT examination. The average increase in density immediately after the administration of the contrast medium is 12 H (8%), in the course of 10 minutes is reduced to 5 H (4%) against the initial values in native examination. These average changes are statistically significant, in individual patients, however, the increase in density following the administration of a contrast medium fluctuates considerably (from 0.7% to 10%). Only systematic comparison with various pathological conditions will make it possible to assess the possibilities of the evaluation of the structure of the vertebral body in routine CT with the administration of a contrast medium into the blood flow. (author)

  9. Characteristic features of bone tissue regeneration in the vertebral bodies in the experiment with osteograft

    Science.gov (United States)

    Zaydman, A. M.; Predein, Yu. A.; Korel, A. V.; Shchelkunova, E. I.; Strokova, E. I.; Lastevskiy, A. D.; Rerikh, V. V.; Fomichev, N. G.; Falameeva, O. V.; Shevchenko, A. I.; Shevtcov, V. I.

    2017-09-01

    In the practice of orthopedic and trauma surgeons, there is a need to close bone tissue defects after removal of tumors or traumatic and dystrophic lesions. Currently, as cellular technologies are being developed, stem embryonic and pluripotent cells are widely introduced into practical medicine. The unpredictability of the spectrum of cell differentiations, up to oncogenesis, raised the question of creating biological structures committed toward osteogenic direction, capable of regenerating organo-specific graft at the optimal time. Such osteograft was created at the Novosibirsk Institute of Traumatology and Orthopaedics (patent RU 2574942). Its osteogenic orientation was confirmed by the morphological and immunohistochemical methods, and by the expression of bone genes. The regeneration potential of the osteograft was studied in the vertebral bodies of the mini piglet model. The study revealed that the regeneration of the vertebral body defect and the integration of the osteograft with the bed of the recipient proceeds according to the type of primary angiogenic osteogenesis within 30 days.

  10. Radiographic Morphometry of the Lumbar Spine in Munich Miniature Pigs†

    Science.gov (United States)

    Engelke, Elisabeth C; Post, Christina; Pfarrer, Christiane D; Sager, Martin; Waibl, Helmut R

    2016-01-01

    The incidence of human spinal column disease remains high, and animal models still play important roles in prophylactic, diagnostic, and therapeutic research. Because of their similar size to humans, pigs remain an important spine model. For pigs to serve as a model for the human spine, basic similarities and differences must be understood. In this study, morphometric data of the lumbar spine of Munich miniature pigs (Troll) were recorded radiologically, evaluated, and compared with recorded human data. Whereas humans have a constant number of 5 lumbar vertebrae, Munich minipigs had 5 or 6 lumbar vertebrae. Compared with their human counterparts, the lumbar vertebral bodies of the minipigs were remarkably larger in the craniocaudal (superior–inferior) direction and considerably smaller in the dorsoventral and laterolateral directions. The porcine vertebral canal was smaller than the human vertebral canal. The spinal cord extended into the caudal part of the porcine lumbar vertebral canal and thus did not terminate as cranial, as seen in humans. The lumbar intervertebral spaces of the pig were narrower in craniocaudal direction than human intervertebral spaces. These differences need to be considered when planning surgical actions, not only to avoid pain and irreversible damage to the minipigs but also to achieve accurate scientific results. PMID:27177570

  11. Stereotactic radiotherapy for patients with metallic implants on vertebral body: A dosimetric comparison

    OpenAIRE

    Guzle Adas, Yasemin; Yazici, Omer; Kekilli, Esra; Kiran, Ferat

    2018-01-01

    Objective: Metallic implants have impacts on dose distribution of radiotherapy. Our purpose is evaluating impact of metallic implants with different dose calculation algorithms on dose distribution. Material and Methods: Two patients with metallic implants on vertebral body were included in this study. They were treated with stereotactic radiotherapy. The data of the patients were retrospectively re-calculated with different TPSs and calculation algorithms. Ray-Tracing (Ry-Tc), Mont...

  12. Metameric pattern of intervertebral disc/vertebral body is generated independently of Mesp2/Ripply-mediated rostro-caudal patterning of somites in the mouse embryo.

    Science.gov (United States)

    Takahashi, Yu; Yasuhiko, Yukuto; Takahashi, Jun; Takada, Shinji; Johnson, Randy L; Saga, Yumiko; Kanno, Jun

    2013-08-15

    The vertebrae are derived from the sclerotome of somites. Formation of the vertebral body involves a process called resegmentation, by which the caudal half of a sclerotome is combined with the rostral half of the next sclerotome. To elucidate the relationship between resegmentation and rostro-caudal patterning of somite, we used the Uncx4.1-LacZ transgene to characterize the resegmentation process. Our observations suggested that in the thoracic and lumbar vertebrae, the Uncx4.1-expressing caudal sclerotome gave rise to the intervertebral disc (IVD) and rostral portion of the vertebral body (VB). In the cervical vertebrae, the Uncx4.1-expressing caudal sclerotome appeared to contribute to the IVD and both caudal and rostral ends of the VB. This finding suggests that the rostro-caudal gene expression boundary does not necessarily coincide with the resegmentation boundary. This conclusion was supported by analyses of Mesp2 KO and Ripply1/2 double KO embryos lacking rostral and caudal properties, respectively. Resegmentation was not observed in Mesp2 KO embryos, but both the IVD and whole VB were formed from the caudalized sclerotome. Expression analysis of IVD marker genes including Pax1 in the wild-type, Mesp2 KO, and Ripply1/2 DKO embryos also supported the idea that a metameric pattern of IVD/VB is generated independently of Mesp2/Ripply-mediated rostro-caudal patterning of somite. However, in the lumbar region, IVD differentiation appeared to be stimulated by the caudal property and suppressed by the rostral property. Therefore, we propose that rostro-caudal patterning of somites is not a prerequisite for metameric patterning of the IVD and VB, but instead required to stimulate IVD differentiation in the caudal half of the sclerotome. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    OpenAIRE

    du Rose, A.; Breen, Alan C.

    2016-01-01

    Background 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 l...

  14. 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.

  15. Increasing the number of unloading/reambulation cycles does not adversely impact body composition and lumbar bone mineral density but reduces tissue sensitivity

    Science.gov (United States)

    Gupta, Shikha; Manske, Sarah L.; Judex, Stefan

    2013-11-01

    A single exposure to hindlimb unloading leads to changes in body mass, body composition and bone, but the consequences of multiple exposures are not yet understood. Within a 18 week period, adult C57BL/6 male mice were exposed to 1 (1x-HLU), 2 (2x-HLU) or 3 (3x-HLU) cycles of 2 weeks of hindlimb unloading (HLU) followed by 4 weeks of reambulation (RA), or served as ambulatory age-matched controls. In vivo μCT longitudinally tracked changes in abdominal adipose and lean tissues, lumbar vertebral apparent volumetric bone mineral density (vBMD) and upper hindlimb muscle cross-sectional area before and after the final HLU and RA cycle. During the final HLU cycle, significant decreases in total adipose tissue and vertebral vBMD in the three experimental groups occurred such that there were no significant between-group differences at the beginning of the final RA cycle. However, the magnitude of the HLU induced losses diminished in mice undergoing their 2nd or 3rd HLU cycle. Irrespective of the number of HLU/RA cycles, total adipose tissue and vertebral vBMD recovered and were no different from age-matched controls after the final RA period. In contrast, upper hindlimb muscle cross-sectional area was significantly lower than controls in all unloaded groups after the final RA period. These results suggest that tissues in the abdominal region are more resilient to multiple bouts of unloading and more amenable to recovery during reambulation than the peripheral musculoskeletal system.

  16. X-ray morphology of the eburnated vertebral body - diagnostic and differential diagnostic problems

    Energy Technology Data Exchange (ETDEWEB)

    Krug, B; Lorenz, R; Steinbrich, W

    1988-08-01

    1. Numerous diseases may become manifest as eburnated vertebral bodies, and hence the X-ray morphological sign of eburnation is an unspecific one. Isolated characteristics such as the involvement of one or several vertebrae, an intact vertebral space, a broadening of the paravertebral accompanying shadow, and the remaining radiological skeletal status enable narrowing down the differential diagnosis, although anamnesis and clinical findings will supply the main pointers. 2. In primary tumorous eburnations radiotherapy or chemotherapy will render an X-ray morphological assessment of therapeutic success impossible. 3. In primary diagnosis of an eburnated vertebral body it is possible to apply sonography. CT and MR as diagnostic tools step by step to narrow down the differential diagnosis by detecting or excluding pathological abdominal processes such as liver or lymphatic node metastases, paravertebral or intraspinal soft-part dense space-occupying growths or bone infiltration, but it will only rarely be possible to classify the phenomenon properly as being caused by a well-defined process, even if CT and MR are employed.

  17. Fine needle diagnosis in lumbar osteomyelitis

    International Nuclear Information System (INIS)

    Joshi, K.B.; Brinker, R.A.

    1983-01-01

    Lumbar vertebral body and disk infection, presenting as low back pain, is a relatively uncommon disease but is seen more often in drug addicts. Radiographs show typical changes of infection of the lumbar vertebrae and adjacent disc. Under local anesthesia a fine needle is placed, saline injected, and aspirated. The entire needle-syringe unit is submitted to the bacteriology department. Pseudomonas infection is usually found. This method of diagnosis is simple, cost effective, well accepted by the patients, and can be done on outpatients. (orig.)

  18. Host body size and the diversity of tick assemblages on Neotropical vertebrates

    Directory of Open Access Journals (Sweden)

    Helen J. Esser

    2016-12-01

    Full Text Available Identifying the factors that influence the species diversity and distribution of ticks (Acari: Ixodida across vertebrate host taxa is of fundamental ecological and medical importance. Host body size is considered one of the most important determinants of tick abundance, with larger hosts having higher tick burdens. The species diversity of tick assemblages should also be greater on larger-bodied host species, but empirical studies testing this hypothesis are lacking. Here, we evaluate this relationship using a comparative dataset of feeding associations from Panama between 45 tick species and 171 host species that range in body size by three orders of magnitude. We found that tick species diversity increased with host body size for adult ticks but not for immature ticks. We also found that closely related host species tended to have similar tick species diversity, but correcting for host phylogeny did not alter the relationships between host body size and tick species diversity. The distribution of tick species was highly aggregated, with approximately 20% of the host species harboring 80% of all tick species, following the Pareto principle or 20/80 Rule. Thus, the aggregated pattern commonly observed for tick burdens and disease transmission also holds for patterns of tick species richness. Our finding that the adult ticks in this system preferentially parasitize large-bodied host species suggests that the ongoing anthropogenic loss of large-bodied vertebrates is likely to result in host-tick coextinction events, even when immature stages feed opportunistically. As parasites play critical roles in ecological and evolutionary processes, such losses may profoundly affect ecosystem functioning and services.

  19. The relationship of whole human vertebral body creep to geometric, microstructural, and material properties.

    Science.gov (United States)

    Oravec, Daniel; Kim, Woong; Flynn, Michael J; Yeni, Yener N

    2018-05-17

    Creep, the time dependent deformation of a structure under load, is an important viscoelastic property of bone and may play a role in the development of permanent deformity of the vertebrae in vivo leading to clinically observable spinal fractures. To date, creep properties and their relationship to geometric, microstructural, and material properties have not been described in isolated human vertebral bodies. In this study, a range of image-based measures of vertebral bone geometry, bone mass, microarchitecture and mineralization were examined in multiple regression models in an effort to understand their contribution to creep behavior. Several variables, such as measures of mineralization heterogeneity, average bone density, and connectivity density persistently appeared as significant effects in multiple regression models (adjusted r 2 : 0.17-0.56). Although further work is needed to identify additional tissue properties to fully describe the portion of variability not explained by these models, these data are expected to help understand mechanisms underlying creep and improve prediction of vertebral deformities that eventually progress to a clinically observable fracture. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. The Role of Minimally Invasive Vertebral Body Stent on Reduction of the Deflation Effect After Kyphoplasty: A Biomechanical Study.

    Science.gov (United States)

    Wang, Dalin; Zheng, Shengnai; Liu, An; Xu, Jie; Du, Xiaotao; Wang, Yijin; Wang, Liming

    2018-03-15

    Biomechanical investigation using cadaver spines. The aim of the present study was to assess the magnitude of the deflation effect after balloon kyphoplasty (BKP) or use of minimally invasive vertebral body stent (MIVBS) in in vitro biomechanical condition. BKP is a well-established minimally invasive treatment option for osteoporotic vertebral compression fractures. However, this technique can lead to a secondary height loss-known as the "deflation effect"-causing intrasegmental kyphosis and an overall alignment failure. The study was conducted on 24 human cadaveric vertebral bodies (T12-L5). After creating a compression fracture model, the fractured vertebral bodies were reduced by BKP (n = 12) or by MIVBS (n = 12) and then augmented with polymethyl methacrylate bone cement. Each step of the procedure was performed under fluoroscopic guidance and the results were analyzed quantitatively. Finally, the strength and stiffness of augmented vertebral bodies were measured by biomechanical tests. Complete initial reduction of the fractured vertebral body height was achieved by both systems. Secondary loss of reduction after balloon deflation was significantly greater in the BKP group (2.36 ± 0.63 mm vs. 0.34 ± 0.43 mm in the MIVBS group; P deflation effect after BKP can be significantly decreased with the use of the MIVBS technique. N/A.

  1. Automated 3D closed surface segmentation: application to vertebral body segmentation in CT images.

    Science.gov (United States)

    Liu, Shuang; Xie, Yiting; Reeves, Anthony P

    2016-05-01

    A fully automated segmentation algorithm, progressive surface resolution (PSR), is presented in this paper to determine the closed surface of approximately convex blob-like structures that are common in biomedical imaging. The PSR algorithm was applied to the cortical surface segmentation of 460 vertebral bodies on 46 low-dose chest CT images, which can be potentially used for automated bone mineral density measurement and compression fracture detection. The target surface is realized by a closed triangular mesh, which thereby guarantees the enclosure. The surface vertices of the triangular mesh representation are constrained along radial trajectories that are uniformly distributed in 3D angle space. The segmentation is accomplished by determining for each radial trajectory the location of its intersection with the target surface. The surface is first initialized based on an input high confidence boundary image and then resolved progressively based on a dynamic attraction map in an order of decreasing degree of evidence regarding the target surface location. For the visual evaluation, the algorithm achieved acceptable segmentation for 99.35 % vertebral bodies. Quantitative evaluation was performed on 46 vertebral bodies and achieved overall mean Dice coefficient of 0.939 (with max [Formula: see text] 0.957, min [Formula: see text] 0.906 and standard deviation [Formula: see text] 0.011) using manual annotations as the ground truth. Both visual and quantitative evaluations demonstrate encouraging performance of the PSR algorithm. This novel surface resolution strategy provides uniform angular resolution for the segmented surface with computation complexity and runtime that are linearly constrained by the total number of vertices of the triangular mesh representation.

  2. Analysis of radiological characteristics distribution in the vertebral bodies of the lumbosacral spine of competitive rowers

    Directory of Open Access Journals (Sweden)

    M.B. Ogurkowska

    2010-09-01

    Full Text Available Unfavorable biomechanical situations, usually related to the performance of a profession and competitive sports practice, promote formation of overloads. This problem may be particularly perceptible among sportsmen that practice strength and stamina sports. The present study deals with rowing. The purpose of this study is to evaluate the degree of degenerative changes of the lumbosacral spine in competitive rowers, on the basis of an analysis of changes in the cancellous structure of vertebral bodies. This has been achieved on the basis of radiological density acquired from a CT test.

  3. Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.

    Science.gov (United States)

    Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

    2011-12-01

    Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

  4. "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 lumbar, glutaeus and thigh pain, which improved from 5.09 to 0.79, 5.07 to 0.97 and 4.43 to 0.49 respectively (p < 0.05), and also when compared to usual treatment (p < 0.05) for all body regions. Moreover, we observed a reduction in pain extension (centralization phenomena) (p < 0.001) in comparison with usual treatment. In our study the 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.

  5. Imobilização interna da coluna vertebral lombar com placas de cloreto de polivinila, em cães - parte I: resultados clínico-cirúrgicos Internal immobilization of the lumbar canine spine using polyvinylchloride plates - part I: clinical and surgical results

    Directory of Open Access Journals (Sweden)

    Eduardo Alberto Tudury

    1997-03-01

    Full Text Available Utilizando-se 20 cães, com o segmento lombar da coluna vertebral cirurgicamente desestabilizado na junção das vértebras L2-L3, foi testada a eficiência de placas ortopédicas de cloreto de polivinila (PVC Tigre®, fixadas com parafusos nos corpos vertebrais e com fio ortopédico de aço inoxidável nos processos espinhosos. As placas foram manual e individualmente confeccionadas para cada animal e esterilizadas pelo calor. Apesar de apresentar maleabilidade adequada, a resistência das placas utilizadas no corpos vertebrais deixou a desejar, dado seu rompimento em 40% dos casos. Apesar disto, durante os 45 dias do estudo, verificaram-se resultados favoráveis quanto ao estado clinico-neurológico, resultados de exames laboratoriais, achados radiológicos, estabilidade e alinhamento da coluna vertebral, assim como, quanto a resistência e flexibilidade das placas utilizadas nos processos espinhosos. Os fios ortopédicos de aço inoxidável, utilizados para fixar as placas no compartimento dorsal da coluna vertebral, passaram entre e não através desses processos.The efficiency ofpolyvinylchioride (PVC orthopedic plates, fixed by screws to the vertebral bodies and by cerciage wires to the spinous processes, were tested in twenty dogs with the lumbar spine destabilized at L2-L3. The plates were produced manually and individuatly for each animal and sterilized by heat. The plates exhibited suitable malleabitity but inappropriate strength because 40% ofthose affixed to the vertebral bodies were bmken. Nevertheless, during the 45 days ofthe study, the technique was consideredefective based on stability, clinicai, neurological, laboratory and radiological results. This effïciency was achieved by the technique used m the spinous processes, where the plates were fixed by wires passing between (not through them.

  6. Temporal trends in vertebral size and shape from medieval to modern-day.

    Directory of Open Access Journals (Sweden)

    Juho-Antti Junno

    Full Text Available Human lumbar vertebrae support the weight of the upper body. Loads lifted and carried by the upper extremities cause significant loading stress to the vertebral bodies. It is well established that trauma-induced vertebral fractures are common especially among elderly people. The aim of this study was to investigate the morphological factors that could have affected the prevalence of trauma-related vertebral fractures from medieval times to the present day. To determine if morphological differences existed in the size and shape of the vertebral body between medieval times and the present day, the vertebral body size and shape was measured from the 4th lumbar vertebra using magnetic resonance imaging (MRI and standard osteometric calipers. The modern samples consisted of modern Finns and the medieval samples were from archaeological collections in Sweden and Britain. The results show that the shape and size of the 4th lumbar vertebra has changed significantly from medieval times in a way that markedly affects the biomechanical characteristics of the lumbar vertebral column. These changes may have influenced the incidence of trauma- induced spinal fractures in modern populations.

  7. An instrumented implant for vertebral body replacement that measures loads in the anterior spinal column.

    Science.gov (United States)

    Rohlmann, Antonius; Gabel, Udo; Graichen, Friedmar; Bender, Alwina; Bergmann, Georg

    2007-06-01

    Realistic loads on a spinal implant are required among others for optimization of implant design and preclinical testing. In addition, such data may help to choose the optimal physiotherapy program for patients with such an implant and to evaluate the efficacy of aids like braces or crutches. Presently, no implant is available that can measure loads in the anterior spinal column during activities of daily life. Therefore, an implant instrumented for in vivo load measurement was developed for vertebral body replacement. The aim of this paper is to describe in detail a telemeterized implant that measures forces and moments acting on it. Six load sensors, a nine-channel telemetry unit and a coil for inductive power supply of the electronic circuits were integrated into a modified vertebral body replacement (Synex). The instrumented part of the implant is hermetically sealed. Patients are videotaped during measurements, and implant loads are displayed on and off line. The average accuracy of load measurement is better than 2% for force and 5% for moment components with reference to the maximum value of 3000 N and 20 Nm, respectively. The measuring implant described here will provide additional information on spinal loads.

  8. Vertebral body bone strength: the contribution of individual trabecular element morphology.

    Science.gov (United States)

    Parkinson, I H; Badiei, A; Stauber, M; Codrington, J; Müller, R; Fazzalari, N L

    2012-07-01

    Although the amount of bone explains the largest amount of variability in bone strength, there is still a significant proportion unaccounted for. The morphology of individual bone trabeculae explains a further proportion of the variability in bone strength and bone elements that contribute to bone strength depending on the direction of loading. Micro-CT imaging enables measurement of bone microarchitecture and subsequently mechanical strength of the same sample. It is possible using micro-CT data to perform morphometric analysis on individual rod and plate bone trabeculae using a volumetric spatial decomposition algorithm and hence determine their contribution to bone strength. Twelve pairs of vertebral bodies (T12/L1 or L4/L5) were harvested from human cadavers, and bone cubes (10 × 10 × 10 mm) were obtained. After micro-CT imaging, a volumetric spatial decomposition algorithm was applied, and measures of individual trabecular elements were obtained. Bone strength was measured in compression, where one bone specimen from each vertebral segment was tested supero-inferiorly (SI) and the paired specimen was tested antero-posteriorly (AP). Bone volume fraction was the strongest individual determinant of SI strength (r(2) = 0.77, p body bone architecture into its constituent morphological elements shows that trabecular element morphology has specific functional roles to assist in maintaining skeletal integrity.

  9. 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 fibe...

  10. An expandable prosthesis with dual cage-and-plate function in a single device for vertebral body replacement: the clinical experience on 14 consecutive cases with vertebral tumors.

    Science.gov (United States)

    Ramírez, J J; Ramírez, J J; Chiquete, E; Gómez-Limón, E

    2011-09-01

    The aim of this paper was to test the hypothesis that an expandable prosthesis with dual cage-and-plate function can provide immediate and durable spine stabilization after corpectomy. We designed an expandable vertebral body prosthesis with dual cage-and-plate function in a single device (JR-prosthesis). Anatomical studies were performed to design a titanium-made prosthesis. Cadaver assays were done with a stainless steal device to test fixation and adequacy to the human spine anatomy. Then, 14 patients with vertebral tumors (8 metastatic) underwent corpectomy and vertebral body replacement with the JR-prosthesis. All patients had neurological deficit, severe pain and spine instability (mean follow-up: 25.4 months). Mean pain score before surgery in a visual analog scale improved from 7.6 to 3.0 points after operation (P=0.002). All patients achieved at least one grade of improvement in the Frankel score (P=0.003), excepting the 3 patients with Frankel grade A presurgery. Two patients with renal cell carcinoma died during the following 4 days after surgery (renal failure and massive bleeding), the rest attained a painless and stable spine immediately and maintained for long periods. No significant infections or implant failures were registered. A non-fatal case of inferior vena cava surgical injury was observed (repaired during surgery without further complications). The JR-prosthesis stabilizes the spine immediately after surgery and for the rest of the patients' life. To our knowledge, this is the first report on the clinical experience of any expandable vertebral body prosthesis with dual cage-and-plate function in a single device. These observations await confirmation in different scenarios.

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

    International Nuclear Information System (INIS)

    Nakano, Kazutoshi

    1991-01-01

    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 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∼0.005). The serum Ca levels in each pathology group were significantly lower than those in the control group (p<0.05∼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)

  12. 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).

  13. Repair and regeneration of vertebral body after antero-lateral partial vertebrectomy using beta-tricalcium phosphate

    International Nuclear Information System (INIS)

    Momma, Fumiyuki; Amagasa, Masaharu; Nakazawa, Teruo

    2008-01-01

    Antero-lateral partial vertebrectomy (ALPV) was used for decompression in 91 patients with multilevel cervical disorders. The high-speed drill was used to excise about 1/3 of the vertebral body for relief of anterior compression of the cord and nerve roots under the operating microscope. The key point was opening of the medial wall of the foramen of transverse process at the beginning of the ALPV, allowing the determination of the lateral borders of the ALPVs. To repair and regenerate the vertebral body, a beta-tricalcium phosphate (β-TCP) block was trimmed into a cuneiform shape and implanted into the sites of the ALPV excluding the upper and lowermost vertebral bodies. Postoperative computed tomography confirmed that β-TCP was gradually replaced by newly formed bone from the surface towards the center of the block, and that the affected vertebral body was remodeled by 6 to 12 months after the implantation of β-TCP. The cortical bone borders on the bone marrow at the site of the regeneration. The pedicles on the side of the ALPVs were rebuilt during regeneration of the affected vertebrae. Thus, the vertebral foramen of the cervical spine was widened in the anterior direction at the levels of the ALPVs, resulting in restoration of the physiological size of the cervical cord. The cervical curvature remained unchanged and a certain degree of cervical mobility (mean 86%) was preserved in this series. (author)

  14. Percutaneous Vertebroplasty for Osteoporotic Compression Fracture: Multivariate Study of Predictors of New Vertebral Body Fracture

    International Nuclear Information System (INIS)

    Komemushi, Atsushi; Tanigawa, Noboru; Kariya, Shuji; Kojima, Hiroyuki; Shomura, Yuzo; Komemushi, Sadao; Sawada, Satoshi

    2006-01-01

    Purpose. To investigate the risk factors and relative risk of new compression fractures following vertebroplasty. Methods. Initially, we enrolled 104 consecutive patients with vertebral compression fractures caused by osteoporosis. A total of 83 of the 104 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. Logistic regression analysis of the data obtained from these 83 patients was used to determine relative risks of recurrent compression fractures, using 13 different factors. Results. We identified 59 new fractures in 30 of the 83 patients: 41 new fractures in vertebrae adjacent to treated vertebrae; and 18 new fractures in vertebrae not adjacent to treated vertebrae. New fractures occurred in vertebrae adjacent to treated vertebrae significantly more frequently than in vertebrae not adjacent to treated vertebrae. Only cement leakage into the disk was a significant predictor of new vertebral body fracture after vertebroplasty (odds ratio = 4.633). None of the following covariates were associated with increased risk of new fracture: age, gender, bone mineral density, the number of vertebroplasty procedures, the number of vertebrae treated per procedure, the cumulative number of vertebrae treated, the presence of a single untreated vertebra between treated vertebrae, the presence of multiple untreated vertebrae between treated vertebrae, the amount of bone cement injected per procedure, the cumulative amount of bone cement injected, cement leakage into the soft tissue around the vertebra, and cement leakage into the vein

  15. The value of whole-body bone scan combined with SPECT/CT in diagnosing benign and malignant vertebral fractures

    International Nuclear Information System (INIS)

    Xu Feng; Ma Yubo; Yuan Qi

    2012-01-01

    Objective: To evaluate the value of whole-body bone scan (WBS) combined with SPECT/CT in diagnosing of benign and malignant vertebral fractures. Methods: WBS and SPECT/CT data of 52 cases with vertebral fractures were reviewed and analyzed retrospectively, and the differences between the benign and malignant vertebral fractures were compared. Results: WBS found 78.8% (41/52) patients had lesions in the bones besides the spine, but the benign group was less in number. SPECT/CT found that malignant group was more likely to have bone destructions or pedicle radionuclide uptake than the benign group.Both of them had no radioactivity concentration in the tuberculosis or hyperparathyroidism. Conclusion: Although it still had some limitations,WBS combined with SPECT/CT is valuable in the diagnosis of benign and malignant vertebral fractures. (authors)

  16. Vertebral metastases: characteristic MRI findings due to epidural carcinomatous inflitration

    International Nuclear Information System (INIS)

    Hutzelmann, A.; Palmie, S.; Freund, M.

    1997-01-01

    Purpose: In cases of lumbar vertebral metastasis associated with anterior epidural carcinomatous infiltration, we have observed that infiltrations tend to respect the midline. This study led to the systematic recognition of these phenomena in vertebral metastases. Materials and Methods: 11 Patients with 17 vertebral metastases and adjacent anterior epidural infiltration were reviewed retrospectively. All cases were studied by MRI. The routinely used imaging technique included spin echo (SE) T 1 and T 2 weighted sequences in the sagittal plane native and T 1 -SE without and with Gd-DTPA in the axial planes. The radiological findings of these phenomena and the anatomy were studied. Results: We observed these phenomena to be uni- or bilateral in 88.3% of all cases with intraspinal anterior epidural carcinomatous infiltration, especially in that part of the vertebral body where the basal vertebral venous plexus was located. Conclusion: We conclude that vertebral metastases respect the midline. We interpret this fact as being due the anatomy of the vertebral body and especially its stabilization by the posterior longitudinal ligament. These findings may be helpful in the differential diagnosis of vertebral body metastases with epidural infiltration in contrast to intraspinal processes which proceed with the destruction of the vertebral body. (orig.) [de

  17. Herniated lumbar intervertebral disk

    International Nuclear Information System (INIS)

    Hochhauser, L.; Cacayorin, E.D.; Karcnik, T.J.; McGowan, D.P.; Clark, K.G.; Storrs, D.; Kieffer, S.A.

    1988-01-01

    From a series of 25 patients with low-back pain and sciatica who subsequently underwent surgical exploration, 24 lumbar herniated disks and one asymmetrically bulging disk were correctly diagnosed with use of a 0.5-T MR imaging unit. The radiologic findings on saggital images included a polypoid protrusion beyond the posterior margin of the vertebral bodies more clearly displayed with T1-weighted than with T-2 weighted sequences and a focal extension into the extradural space on axial views. In most, the signal intensity of HNP was isointense to the disk of origin. The study suggests that MR imaging is currently capable of accurately predicting an HNP. The diagnosis is based primarily on morphologic characteristics rather than signal intensity alterations

  18. Vertebral body spread in thoracolumbar burst fractures can predict posterior construct failure.

    Science.gov (United States)

    De Iure, Federico; Lofrese, Giorgio; De Bonis, Pasquale; Cultrera, Francesco; Cappuccio, Michele; Battisti, Sofia

    2018-06-01

    The load sharing classification (LSC) laid foundations for a scoring system able to indicate which thoracolumbar fractures, after short-segment posterior-only fixations, would need longer instrumentations or additional anterior supports. We analyzed surgically treated thoracolumbar fractures, quantifying the vertebral body's fragment displacement with the aim of identifying a new parameter that could predict the posterior-only construct failure. This is a retrospective cohort study from a single institution. One hundred twenty-one consecutive patients were surgically treated for thoracolumbar burst fractures. Grade of kyphosis correction (GKC) expressed radiological outcome; Oswestry Disability Index and visual analog scale were considered. One hundred twenty-one consecutive patients who underwent posterior fixation for unstable thoracolumbar burst fractures were retrospectively evaluated clinically and radiologically. Supplementary anterior fixations were performed in 34 cases with posterior instrumentation failure, determined on clinic-radiological evidence or symptomatic loss of kyphosis correction. Segmental kyphosis angle and GKC were calculated according to the Cobb method. The displacement of fracture fragments was obtained from the mean of the adjacent end plate areas subtracted from the area enclosed by the maximum contour of vertebral fragmentation. The "spread" was derived from the ratio between this subtraction and the mean of the adjacent end plate areas. Analysis of variance, Mann-Whitney, and receiver operating characteristic were performed for statistical analysis. The authors report no conflict of interest concerning the materials or methods used in the present study or the findings specified in this paper. No funds or grants have been received for the present study. The spread revealed to be a helpful quantitative measurement of vertebral body fragment displacement, easily reproducible with the current computed tomography (CT) imaging technologies

  19. Morphometric study of the lumbar spinal canal in the Korean population.

    Science.gov (United States)

    Lee, H M; Kim, N H; Kim, H J; Chung, I H

    1995-08-01

    The anatomic dimensions of the vertebral body and spinal canal of the lumbar spine were analyzed in Koreans. To determine the normal dimension of the lumbar spinal canal in Koreans, to determine whether there are any racial differences in the morphometry of the lumbar spinal canal, and to provide criteria for diagnosing spinal stenosis in the Far Eastern Asian. Some radiologic and anatomic studies have been conducted regarding the size of the lumbar spinal canal of whites and blacks in western and African countries. One-thousand-eight-hundred measurements were performed on the transverse and sagittal diameters of vertebral bodies and spinal canals using complete sets of 90 lumbar vertebrae. The mean mid-sagittal diameter of the lumbar spinal canal in the Korean population was less than that measured in white and African populations, but there was no significant differences between the Korean, white, and African populations regarding the transverse diameter of the lumbar spinal canal. The mid-sagittal diameter of the lumbar spinal canal is narrowest in the Far Eastern Asian population; the radiologic criteria of spinal stenosis should be reconsidered for these people.

  20. Effect of Ex Vivo Ionizing Radiation on Static and Fatigue Properties of Mouse Vertebral Bodies

    Science.gov (United States)

    Emerzian, Shannon R.; Pendleton, Megan M.; Li, Alfred; Liu, Jennifer W.; Alwood, Joshua S.; O’Connell, Grace D.; Keaveny, Tony M.

    2018-01-01

    For a variety of medical and scientific reasons, human bones can be exposed to a wide range of ionizing radiation levels. In vivo radiation therapy (0.05 kGy) is used in cancer treatment, and ex vivo irradiation (25-35 kGy) is used to sterilize bone allografts. Ionizing radiation in these applications has been shown to increase risk of fracture, decrease bone quality and degrade collagen integrity. Past studies have investigated the deleterious effects of radiation on cortical or trabecular bone specimens individually, but to date no studies have examined whole bones containing both cortical and trabecular tissue. Furthermore, a clear relationship between the dose and the mechanical and biochemical response of bone's extracellular matrix has yet to be established for doses ranging from cancer therapy to allograft sterilization (0.05-35 kGy). To gain insight into these issues, we conducted an ex vivo radiation study to investigate non-cellular (i.e. matrix) effects of ionizing radiation dose on vertebral whole bone mechanical properties, over a range of radiation doses (0.05-35 kGy), with a focus on any radiation-induced changes in collagen. With underlying mechanisms of action in mind, we hypothesized that any induced reductions in mechanical properties would be associated with changes in collagen integrity. METHODS: 20-week old female mice were euthanized and the lumbar spine was dissected using IACUC approved protocols. The lumbar vertebrae (L1- S1) were extracted from the spine via cuts through adjacent intervertebral discs, and the endplates, posterior processes, surrounding musculature, and soft tissues were removed (approx. 1.5mm diameter, approx. 2mm height). Specimens were randomly assigned to one of five groups for ex vivo radiation exposure: x-ray irradiation at 0.05, 1, 17, or 35 kGy, or a 0 kGy control. Following irradiation, the vertebrae were imaged using microcomputed tomography (micro-CT) and then subjected to either monotonic compressive loading to

  1. Increased variability of bone tissue mineral density resulting from estrogen deficiency influences creep behavior in a rat vertebral body.

    Science.gov (United States)

    Kim, Do-Gyoon; Navalgund, Anand R; Tee, Boon Ching; Noble, Garrett J; Hart, Richard T; Lee, Hye Ri

    2012-11-01

    Progressive vertebral deformation increases the fracture risk of a vertebral body in the postmenopausal patient. Many studies have observed that bone can demonstrate creep behavior, defined as continued time-dependent deformation even when mechanical loading is held constant. Creep is a characteristic of viscoelastic behavior, which is common in biological materials. We hypothesized that estrogen deficiency-dependent alteration of the mineral distribution of bone at the tissue level could influence the progressive postmenopausal vertebral deformity that is observed as the creep response at the organ level. The objective of this study was thus to examine whether the creep behavior of vertebral bone is changed by estrogen deficiency, and to determine which bone property parameters are responsible for the creep response of vertebral bone at physiological loading levels using an ovariectomized (OVX) rat model. Correlations of creep parameters with bone mineral density (BMD), tissue mineral density (TMD) and architectural parameters of both OVX and sham surgery vertebral bone were tested. As the vertebral creep was not fully recovered during the post-creep unloading period, there was substantial residual displacement for both the sham and OVX groups. A strong positive correlation between loading creep and residual displacement was found (r=0.868, pcreep behavior of the OVX group (pcreep caused progressive, permanent reduction in vertebral height for both the sham and OVX groups. In addition, estrogen deficiency-induced active bone remodeling increased variability of trabecular TMD in the OVX group. Taken together, these results suggest that increased variability of trabecular TMD resulting from high bone turnover influences creep behavior of the OVX vertebrae. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Depression of the Thoracolumbar Posterior Vertebral Body on the Estimation of Cement Leakage in Vertebroplasty and Kyphoplasty Operations

    Directory of Open Access Journals (Sweden)

    Hao Chen

    2015-01-01

    Conclusions: Depression of the thoracolumbar posterior vertebral body may be informative for the estimation of cement location on C-arm images. To reduce type-B leakage, DCPW should be made longer than DBCV on C-arm images for safety during PVP or PKP.

  3. Effects of vertebral-body-sparing proton craniospinal irradiation on the spine of young pediatric patients with medulloblastoma

    Directory of Open Access Journals (Sweden)

    Iain MacEwan, MD

    2017-04-01

    Conclusion: Vertebral-body-sparing CSI with proton beam did not appear to cause increased severe spinal abnormalities in patients treated at our institution. This approach could be considered in future clinical trials in an effort to reduce toxicity and the risk of secondary malignancy and to improve adult height.

  4. Biomechanical simulations of costo-vertebral and anterior vertebral body tethers for the fusionless treatment of pediatric scoliosis.

    Science.gov (United States)

    Aubin, Carl-Éric; Clin, Julien; Rawlinson, Jeremy

    2018-01-01

    Compression-based fusionless tethers are an alternative to conventional surgical treatments of pediatric scoliosis. Anterior approaches place an anterior (ANT) tether on the anterolateral convexity of the deformed spine to modify growth. Posterior, or costo-vertebral (CV), approaches have not been assessed for biomechanical and corrective effectiveness. The objective was to biomechanically assess CV and ANT tethers using six patient-specific, finite element models of adolescent scoliotic patients (11.9 ± 0.7 years, Cobb 34° ± 10°). A validated algorithm simulated the growth and Hueter-Volkmann growth modulation over a period of 2 years with the CV and ANT tethers at two initial tensions (100, 200 N). The models without tethering also simulated deformity progression with Cobb angle increasing from 34° to 56°, axial rotation 11° to 13°, and kyphosis 28° to 32° (mean values). With the CV tether, the Cobb angle was reduced to 27° and 20° for tensions of 100 and 200 N, respectively, kyphosis to 21° and 19°, and no change in axial rotation. With the ANT tether, Cobb was reduced to 32° and 9° for 100 and 200 N, respectively, kyphosis unchanged, and axial rotation to 3° and 0°. While the CV tether mildly corrected the coronal curve over a 2-year growth period, it had sagittal lordosing effect, particularly with increasing initial axial rotation (>15°). The ANT tether achieved coronal correction, maintained kyphosis, and reduced the axial rotation, but over-correction was simulated at higher initial tensions. This biomechanical study captured the differences between a CV and ANT tether and indicated the variability arising from the patient-specific characteristics. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:254-264, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  5. PARAMETRIC MODEL OF LUMBAR VERTEBRA

    Directory of Open Access Journals (Sweden)

    CAPPETTI Nicola

    2010-11-01

    Full Text Available The present work proposes the realization of a parametric/variational CAD model of a normotype lumbar vertebra, which could be used for improving the effectiveness of actual imaging techniques in informational augmentation of the orthopaedic and traumatological diagnosis. In addition it could be used for ergonomic static and dynamical analysis of the lumbar region and vertebral column.

  6. The ablated volume and the thermal field distribution in swine vertebral body created by multi-polar radiofrequency ablation: an experiment in vitro

    International Nuclear Information System (INIS)

    Peng Zhaohong; Zhao Wei; Shen Jin; Hu Jihong; Li Zhaopeng; Wang Tao

    2009-01-01

    Objective: To observe the extent of bone coagulation and the thermal field distribution created in ablating the swine vertebral bodies in vitro with multi-polar radiofrequency and to discuss the correlation between the electrode position in the vertebral body and the safety of the spinal cord as well as the soft tissue injury around the vertebral body. Methods: Thirty fresh adult porcine vertebrae were randomly and equally divided into two groups. The depth of the electrode needle was 10 mm or 20 mm.When the ablation process reached to a stable state, the temperature at the scheduled spots was estimated. Twenty minutes after ablation, the vertebral body was cut along the electrode needle plane and also along the plane perpendicular to the electrode needle to observe the extent of bone coagulation. Results: The temperature at the scheduled spots reached to a stable state in 3.5 minutes. The more close to the electrode the spot was, the more quickly the temperature rose. No soft tissue injury around the vertebral body was observed in both groups and no spinal cord injury occurred when the electrode needle was 10 mm or 20 mm deep in the vertebral body. Conclusion: In treating vertebral metastases, the radiofrequency ablation is safe and reliable if the posterior wall of the vertebral body remains intact. (authors)

  7. 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.

  8. Origin of the vertebrate body plan via mechanically biased conservation of regular geometrical patterns in the structure of the blastula.

    Science.gov (United States)

    Edelman, David B; McMenamin, Mark; Sheesley, Peter; Pivar, Stuart

    2016-09-01

    We present a plausible account of the origin of the archetypal vertebrate bauplan. We offer a theoretical reconstruction of the geometrically regular structure of the blastula resulting from the sequential subdivision of the egg, followed by mechanical deformations of the blastula in subsequent stages of gastrulation. We suggest that the formation of the vertebrate bauplan during development, as well as fixation of its variants over the course of evolution, have been constrained and guided by global mechanical biases. Arguably, the role of such biases in directing morphology-though all but neglected in previous accounts of both development and macroevolution-is critical to any substantive explanation for the origin of the archetypal vertebrate bauplan. We surmise that the blastula inherently preserves the underlying geometry of the cuboidal array of eight cells produced by the first three cleavages that ultimately define the medial-lateral, dorsal-ventral, and anterior-posterior axes of the future body plan. Through graphical depictions, we demonstrate the formation of principal structures of the vertebrate body via mechanical deformation of predictable geometrical patterns during gastrulation. The descriptive rigor of our model is supported through comparisons with previous characterizations of the embryonic and adult vertebrate bauplane. Though speculative, the model addresses the poignant absence in the literature of any plausible account of the origin of vertebrate morphology. A robust solution to the problem of morphogenesis-currently an elusive goal-will only emerge from consideration of both top-down (e.g., the mechanical constraints and geometric properties considered here) and bottom-up (e.g., molecular and mechano-chemical) influences. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Vertebral Fractures and Spondylosis in Men - Original Investigation

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    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

  10. Functional outcome transforaminal lumbar inter body fusion: an experience at a tertiary care centre

    International Nuclear Information System (INIS)

    Talha, M.; Qureshi, M.A.

    2016-01-01

    Objective: To assess functional outcome of transforaminal lumbar inter body fusion (TLIF) with specific reference to improvement in pain by visual analogue score (VAS) and Oswestry disability index (ODI). Study Design: Quasi-experimental study. Place and Duration of Study: The study was conducted at the Department of Spine Surgery of a tertiary care hospital in Rawalpindi from May 2004 to May 2013. Material and Methods: Thirty nine patients who underwent TLIF and completed one year of follow up in our department during the study period were included in the study. Cases were evaluated clinically and radiologically preoperatively and assessed for pain with VAS and general well being with ODI. After TLIF they were reassessed at 1, 3, 6 months and 1 year for improvement in VAS and ODI. Patient satisfaction and work status after surgery was also recorded at 1 year of follow up. Results: Out of 39 cases 19(48.7 percent) were operated for degenerated disc disease (DDD), 11(28.2 percent) for spinal stenosis and 7(17.9 percent) for spondylolisthesis and 2(5.2 percent) for trauma. A total of 28(71.79 percent) were males and 11(28.21 percent) were females. Common levels operated were 12 (30.8 percent) at L4-5, 11 (28.2 percent) at L5-S1, and 12(30.8 percent) at L4,5-S1, 2(5.1 percent) at L2-4 and 1(2.6 percent) each at L3-4 and L3-5. At 1 year of follow up median VAS score improved significantly from 7 to 2 and median ODI improved significantly from 76 to 34. Regarding patient satisfaction 26 (66.7 percent) patients were satisfied, 9 (23.1 percent) were partially satisfied and 4 (10.2 percent) were not satisfied with the surgical outcome. Conclusion: TLIF is a safe and effective procedure for reducing chronic low back pain as a result of DDD, instability and spondylolisthesis. (author)

  11. 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

  12. Depression of the Thoracolumbar Posterior Vertebral Body on the Estimation of Cement Leakage in Vertebroplasty and Kyphoplasty Operations.

    Science.gov (United States)

    Chen, Hao; Jia, Pu; Bao, Li; Feng, Fei; Yang, He; Li, Jin-Jun; Tang, Hai

    2015-12-05

    The cross-section of thoracolumbar vertebral body is kidney-shaped with depressed posterior boundary. The anterior wall of the vertebral canal is separated from the posterior wall of the vertebral body on the lateral X-ray image. This study was designed to determine the sagittal distance between the anterior border of the vertebral canal and the posterior border of the vertebral body (DBCV) and to analyze the potential role of DBCV in the estimation of cement leakage during percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). We retrospectively recruited 233 patients who had osteoporotic vertebral compression fractures and were treated with PVP or PKP. Computed tomography images of T11-L2 normal vertebrae were measured to obtain DBCV. The distance from cement to the posterior wall of the vertebral body (DCPW) of thoracolumbar vertebrae was measured from C-arm images. The selected vertebrae were divided into two groups according to DCPW, with the fracture levels, fracture grades and leakage rates of the two groups compared. A relative operating characteristic (ROC) curve was applied to determine whether the DCPW difference can be used to estimate the degree of cement leakage. The data were processed by statistical software SPSS version 21.0 using independent sample t-test and Chi-square tests. The maximum DBCV was 6.40 mm and the average DBCV was 3.74 ± 0.95 mm. DBCV appeared to be longer in males than in females, but the difference was not statistically significant. The average DCPW of type-B leakage vertebrae (2.59 ± 1.20 mm) was shorter than that of other vertebrae (7.83 ± 2.38 mm, P 6.40 mm for type-C and type-S, but much higher for type-B. ROC curve revealed that DCPW only has a predictive value for type-B leakage (area under the curve: 0.98, 95% confidence interval: 0.95-0.99, P DBCV on C-arm images for safety during PVP or PKP.

  13. Preoperative MRI evaluation of vertebral hemangiomas treated with percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    Liu Xiaoping; Wu Chungen; Li Minghua; Li Yuehua; Gu Yifeng; Cheng Yongde

    2012-01-01

    Objective: To discuss the clinical value of preoperative magnetic resonance imaging examination in guiding the treatment of vertebral hemangiomas with percutaneous vertebroplasty (PVP). Methods: A total of 286 patients with vertebral hemangiomas detected on spine MRI in authors' Department were enrolled in this study. The patient's age, the lesion's size and location, the clinical symptoms, MRI findings, etc. were retrospectively analyzed. Results: A total of 336 vertebral bodies were affected in 286 patients. The lesions were mainly located at the lumbar spine (43.15%) and the thoracic spine (37.80%). The highest incidence of disease was seen in 50-59 years old patients (34.62%). The mean diameter of the lesions was 14.56 mm. Solitary lesion was seen in 85.66% of patients, while two vertebral bodies involved were seen in 10.14% of patients. Twelve cases (4.20%) simply presented as back pain at the related vertebral bodies. Two patients showed signs due to spinal cord compression. All aggressive vertebral hemangiomas were manifested as iso-lower signal on T1-weighted images and higher signal on T2-weighted images. Simple PVP was performed in 4 cases, and subtotal tumor excision together with PVP was carried out in two patients with aggressive vertebral hemangiomas. Conclusion: Evaluation of vertebral hemangiomas with MRI performed prior to percutaneous vertebroplasty is very helpful in guiding the selection of therapeutic scheme. (authors)

  14. Fibrous dysplasia: an unusual case of a very aggressive form with costo-vertebral joint destruction and invasion of the contralateral D7 vertebral body.

    Science.gov (United States)

    Zoccali, Carmine; Attala, Dario; Rossi, Barbara; Zoccali, Giovanni; Ferraresi, Virginia

    2018-05-23

    Fibrous dysplasia (FD) is a benign fibro-osseous disease of the bone that may be solitary or multicentric. It is important to distinguish this type of lesion from low-grade osteosarcomas (LGOS) and from secondary sarcomas, because malignant transformation has rarely been reported. It is classically described as having a ground-glass appearance, endosteal scalloping, and thinning of the cortex. Cortical disruption is considered evidence of malignancy, but it can also be present in benign FD with aggressive behavior. We present an unusual case of aggressive FD of the 7th left rib, already diagnosed more than 22 years ago, where cortical and costo-vertebral joint disruption and 7th thoracic vertebral body involvement were not evidence of malignant behavior. From a histological perspective, FD and LGOS are similar; even if histology is of fundamental importance, the diagnosis has to be made based on the clinical and radiological aspects as well, although at imaging, differentiation between FD and LGOS can be difficult. In the present case, even though the histological examination suggested a benign lesion, the radiological examination instead consistently suggests malignancy. It is for this reason that there should be a high index of suspicion during follow-up and a new biopsy should be scheduled in case any changes occur during follow-up.

  15. Imaging assessment of vertebral burst fracture

    International Nuclear Information System (INIS)

    Ding Jianlin; Liang Lihua; Wang Yujia

    2006-01-01

    Objective: To investigate the diagnostic value of radiography, CT and MRI in diagnosis of vertebral burst fracture. Methods: 51 patients with vertebral burst fracture were evaluated with X-ray, CT and MRI, including 3 cases in cervical vertebra, 18 cases in thoracic vertebra, and 30 cases in lumbar vertebra. The imaging features were comparatively studied. Results: Radiography showed decreased height of the vertebral body, increased antero-posterior diameter and the transverse diameter, and/or the widened interpedicle distance, the inter-spinous distance, as well as the bony fragment inserted into the vertebral canal in 28 cases(54.90%). X-ray findings similar to the compression fracture were revealed in 20 cases(39.21%). And missed diagnosis was made in 3 cases (5.88%). CT clearly demon-strated the vertebral body vertically or transversely burst crack in 49 cases (96.07%); bony fragment inserted into the vertebral canal and narrowed vertebral canal in 35 cases(68. 62% ); fracture of spinal appendix in 22 cases(43.14%). Meanwhile MRI showed abnormal signals within the spinal cord in 35 cases (68.62%),injured intervertebral disk in 29 cases(56.86% ), extradural hematoma in 12 cases(23.52% ) and torn posterior longitudinal ligament in 6 cases (11.76%). Conclusions: Radiography is the routine examination, while with limited diagnostic value in vertebral burst fracture. These patients who have nervous symptoms with simple compression fracture or unremarkable on X-ray should receive the CT or MRI examination. CT is better than MRI in demonstrating the fracture and the displaced bony fragment, while MRI is superior to CT in showing nervous injuries. CT and MRI will provide comprehensive information guiding clinical treatment of vertebral burst fracture. (authors)

  16. 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

    Directory of Open Access Journals (Sweden)

    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

  17. Characterization and prediction of rate-dependent flexibility in lumbar spine biomechanics at room and body temperature.

    Science.gov (United States)

    Stolworthy, Dean K; Zirbel, Shannon A; Howell, Larry L; Samuels, Marina; Bowden, Anton E

    2014-05-01

    The soft tissues of the spine exhibit sensitivity to strain-rate and temperature, yet current knowledge of spine biomechanics is derived from cadaveric testing conducted at room temperature at very slow, quasi-static rates. The primary objective of this study was to characterize the change in segmental flexibility of cadaveric lumbar spine segments with respect to multiple loading rates within the range of physiologic motion by using specimens at body or room temperature. The secondary objective was to develop a predictive model of spine flexibility across the voluntary range of loading rates. This in vitro study examines rate- and temperature-dependent viscoelasticity of the human lumbar cadaveric spine. Repeated flexibility tests were performed on 21 lumbar function spinal units (FSUs) in flexion-extension with the use of 11 distinct voluntary loading rates at body or room temperature. Furthermore, six lumbar FSUs were loaded in axial rotation, flexion-extension, and lateral bending at both body and room temperature via a stepwise, quasi-static loading protocol. All FSUs were also loaded using a control loading test with a continuous-speed loading-rate of 1-deg/sec. The viscoelastic torque-rotation response for each spinal segment was recorded. A predictive model was developed to accurately estimate spine segment flexibility at any voluntary loading rate based on measured flexibility at a single loading rate. Stepwise loading exhibited the greatest segmental range of motion (ROM) in all loading directions. As loading rate increased, segmental ROM decreased, whereas segmental stiffness and hysteresis both increased; however, the neutral zone remained constant. Continuous-speed tests showed that segmental stiffness and hysteresis are dependent variables to ROM at voluntary loading rates in flexion-extension. To predict the torque-rotation response at different loading rates, the model requires knowledge of the segmental flexibility at a single rate and specified

  18. Percutaneous vertebroplasty performed with an 18 G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy

    International Nuclear Information System (INIS)

    Chen Long; Ni Caifang; Wang Zhentang; Liu Yizhi; Jin Yonghai; Zhu Xiaoli; Zou Jianwei; Xiao Xiangsheng

    2010-01-01

    Objective: To investigate the clinical feasibility and efficacy of percutaneous vertebroplasty performed with an 18G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy. Methods: During the period of 2006-2010 percutaneous vertebroplasty was performed in 10 patients with severe compression fracture of cervical vertebral body due to metastatic lesions. A total of 12 diseased vertebral bodies were detected, which distributed in the C 4 (n = 3), C 5 (n = 3), C 6 (n = 4) and C 7 (n = 2) vertebral bodies. Under DSA guidance an 18G needle was punctured into the target vertebral body and then polymethylmethacrylate bone cement was injected in. A follow-up lasting for one month was conducted. Results: The technical success of both needle puncturing and bone cement injection was achieved in all patients. The mean amount of bone cement injected in each diseased vertebra was 2.2 ml(1.5-3.2)ml. Marked pain relief was quickly obtained in al1 10 patients. No major complications occurred in this series, except for asymptomatic bone cement leaking around vertebra which appeared in 4 vertebral bodies. Conclusion: Percutaneous vertebroplasty, which is performed with an 18G needle, is a safe and effective technique for the treatment of severe compression fracture of cervical vertebral body due to malignancy. (authors)

  19. Fluoroscopy-Guided Percutaneous Vertebral Body Biopsy Using a Novel Drill-Powered Device: Technical Case Series

    International Nuclear Information System (INIS)

    Wallace, Adam N.; Pacheco, Rafael A.; Tomasian, Anderanik; Hsi, Andy C.; Long, Jeremiah; Chang, Randy O.; Jennings, Jack W.

    2016-01-01

    BackgroundA novel coaxial biopsy system powered by a handheld drill has recently been introduced for percutaneous bone biopsy. This technical note describes our initial experience performing fluoroscopy-guided vertebral body biopsies with this system, compares the yield of drill-assisted biopsy specimens with those obtained using a manual technique, and assesses the histologic adequacy of specimens obtained with drill assistance.MethodsMedical records of all single-level, fluoroscopy-guided vertebral body biopsies were reviewed. Procedural complications were documented according to the Society of Interventional Radiology classification. The total length of bone core obtained from drill-assisted biopsies was compared with that of matched manual biopsies. Pathology reports were reviewed to determine the histologic adequacy of specimens obtained with drill assistance.ResultsTwenty eight drill-assisted percutaneous vertebral body biopsies met study inclusion criteria. No acute complications were reported. Of the 86 % (24/28) of patients with clinical follow-up, no delayed complications were reported (median follow-up, 28 weeks; range 5–115 weeks). The median total length of bone core obtained from drill-assisted biopsies was 28 mm (range 8–120 mm). This was longer than that obtained from manual biopsies (median, 20 mm; range 5–45 mm; P = 0.03). Crush artifact was present in 11 % (3/28) of drill-assisted biopsy specimens, which in one case (3.6 %; 1/28) precluded definitive diagnosis.ConclusionsA drill-assisted, coaxial biopsy system can be used to safely obtain vertebral body core specimens under fluoroscopic guidance. The higher bone core yield obtained with drill assistance may be offset by the presence of crush artifact

  20. Fluoroscopy-Guided Percutaneous Vertebral Body Biopsy Using a Novel Drill-Powered Device: Technical Case Series

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, Adam N., E-mail: wallacea@mir.wustl.edu; Pacheco, Rafael A., E-mail: pachecor@mir.wustl.edu; Tomasian, Anderanik, E-mail: tomasiana@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Hsi, Andy C., E-mail: hsia@path.wustl.edu [Washington University School of Medicine, Division of Anatomic Pathology, Department of Pathology & Immunology (United States); Long, Jeremiah, E-mail: longj@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Chang, Randy O., E-mail: changr@wusm.wustl.edu [Washington University School of Medicine (United States); Jennings, Jack W., E-mail: jenningsj@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)

    2016-02-15

    BackgroundA novel coaxial biopsy system powered by a handheld drill has recently been introduced for percutaneous bone biopsy. This technical note describes our initial experience performing fluoroscopy-guided vertebral body biopsies with this system, compares the yield of drill-assisted biopsy specimens with those obtained using a manual technique, and assesses the histologic adequacy of specimens obtained with drill assistance.MethodsMedical records of all single-level, fluoroscopy-guided vertebral body biopsies were reviewed. Procedural complications were documented according to the Society of Interventional Radiology classification. The total length of bone core obtained from drill-assisted biopsies was compared with that of matched manual biopsies. Pathology reports were reviewed to determine the histologic adequacy of specimens obtained with drill assistance.ResultsTwenty eight drill-assisted percutaneous vertebral body biopsies met study inclusion criteria. No acute complications were reported. Of the 86 % (24/28) of patients with clinical follow-up, no delayed complications were reported (median follow-up, 28 weeks; range 5–115 weeks). The median total length of bone core obtained from drill-assisted biopsies was 28 mm (range 8–120 mm). This was longer than that obtained from manual biopsies (median, 20 mm; range 5–45 mm; P = 0.03). Crush artifact was present in 11 % (3/28) of drill-assisted biopsy specimens, which in one case (3.6 %; 1/28) precluded definitive diagnosis.ConclusionsA drill-assisted, coaxial biopsy system can be used to safely obtain vertebral body core specimens under fluoroscopic guidance. The higher bone core yield obtained with drill assistance may be offset by the presence of crush artifact.

  1. The combination of mesenchymal stem cells and a bone scaffold in the treatment of vertebral body defects

    Czech Academy of Sciences Publication Activity Database

    Vaněček, Václav; Klíma, K.; Kohout, A.; Foltán, R.; Jiroušek, Ondřej; Šedý, Jiří; Štulík, J.; Syková, Eva; Jendelová, Pavla

    2013-01-01

    Roč. 22, č. 12 (2013), s. 2777-2786 ISSN 0940-6719 R&D Projects: GA ČR GAP304/10/0320; GA MZd(CZ) NT13477 Institutional support: RVO:68378041 ; RVO:68378297 ; RVO:67985823 Keywords : vertebral body defect * mesenchymal stem cells * hydroxyapatite scaffold Subject RIV: FH - Neurology ; FI - Traumatology, Orthopedics (UTAM-F); FI - Traumatology, Orthopedics (FGU-C) Impact factor: 2.473, year: 2013

  2. 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.

  3. Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic, non-specific low back pain and healthy controls

    OpenAIRE

    Mellor, Fiona E.; Thomas, Peter; Thompson, Paul W.; Breen, Alan C.

    2014-01-01

    Introduction: Identifying biomechanical subgroups in chronic, non-specific low back pain (CNSLBP) populations from inter-vertebral displacements has proven elusive. Quantitative fluoroscopy (QF) has excellent repeatability and provides continuous standardised inter-vertebral kinematic data from fluoroscopic sequences allowing assessment of mid-range motion. The aim of this study was to determine whether proportional continuous IV rotational patterns were different in patients and controls. A ...

  4. Influence of physical activity on vertebral strength during late adolescence.

    Science.gov (United States)

    Junno, Juho-Antti; Paananen, Markus; Karppinen, Jaro; Tammelin, Tuija; Niinimäki, Jaakko; Lammentausta, Eveliina; Niskanen, Markku; Nieminen, Miika T; Järvelin, Marjo-Riitta; Takatalo, Jani; Tervonen, Osmo; Tuukkanen, Juha

    2013-02-01

    Reduced vertebral strength is a clear risk factor for vertebral fractures. Men and women with vertebral fractures often have reduced vertebral size and bone mineral density (BMD). Vertebral strength is controlled by both genetic and developmental factors. Malnutrition and low levels of physical activity are commonly considered to result in reduced bone size during growth. Several studies have also demonstrated the general relationship between BMD and physical activity in the appendicular skeleton. In this study, we wanted to clarify the role of physical activity on vertebral bodies. Vertebral dimensions appear to generally be less pliant than long bones when lifetime changes occur. We wanted to explore the association between physical activity during late adolescence and vertebral strength parameters such as cross-sectional size and BMD. The association between physical activity and vertebral strength was explored by measuring vertebral strength parameters and defining the level of physical activity during adolescence. The study population consisted of 6,928 males and females who, at 15 to 16 and 19 years of age, responded to a mailed questionnaire inquiring about their physical activity. A total of 558 individuals at the mean age of 21 years underwent magnetic resonance imaging (MRI) scans. We measured the dimensions of the fourth lumbar vertebra from the MRI scans of the Northern Finland Birth Cohort 1986 and performed T2* relaxation time mapping, reflective of BMD. Vertebral strength was based on these two parameters. We analyzed the association of physical activity on vertebral strength using the analysis of variance. We observed no association between the level of physical activity during late adolescence and vertebral strength at 21 years. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Heritability of prevalent vertebral fracture and volumetric bone mineral density and geometry at the lumbar spine in three generations of the Framingham study.

    Science.gov (United States)

    Liu, Ching-Ti; Karasik, David; Zhou, Yanhua; Hsu, Yi-Hsiang; Genant, Harry K; Broe, Kerry E; Lang, Thomas F; Samelson, Elizabeth J; Demissie, Serkalem; Bouxsein, Mary L; Cupples, L Adrienne; Kiel, Douglas P

    2012-04-01

    Genetic factors likely contribute to the risk for vertebral fractures; however, there are few studies on the genetic contributions to vertebral fracture (VFrx), vertebral volumetric bone mineral density (vBMD), and geometry. Also, the heritability (h(2)) for VFrx and its genetic correlation with phenotypes contributing to VFrx risk have not been established. This study aims to estimate the h(2) of vertebral fracture, vBMD, and cross-sectional area (CSA) derived from quantitative computed tomography (QCT) scans and to estimate the extent to which they share common genetic association in adults of European ancestry from three generations of Framingham Heart Study (FHS) families. Members of the FHS families were assessed for VFrx by lateral radiographs or QCT lateral scout views at 13 vertebral levels (T(4) to L(4)) using Genant's semiquantitative (SQ) scale (grades 0 to 3). Vertebral fracture was defined as having at least 25% reduction in height of any vertebra. We also analyzed QCT scans at the L(3) level for integral (In.BMD) and trabecular (Tb.BMD) vBMD and CSA. Heritability estimates were calculated, and bivariate genetic correlation analysis was performed, adjusting for various covariates. For VFrx, we analyzed 4099 individuals (148 VFrx cases) including 2082 women and 2017 men from three generations. Estimates of crude and multivariable-adjusted h(2) were 0.43 to 0.69 (p < 1.1 × 10(-2)). A total of 3333 individuals including 1737 men and 1596 women from two generations had VFrx status and QCT-derived vBMD and CSA information. Estimates of crude and multivariable-adjusted h(2) for vBMD and CSA ranged from 0.27 to 0.51. In a bivariate analysis, there was a moderate genetic correlation between VFrx and multivariable-adjusted In.BMD (-0.22) and Tb.BMD (-0.29). Our study suggests vertebral fracture, vertebral vBMD, and CSA in adults of European ancestry are heritable, underscoring the importance of further work to identify the specific variants underlying

  6. Irradiation of Spinal Metastases: Should We Continue to Include One Uninvolved Vertebral Body Above and Below in the Radiation Field?

    Energy Technology Data Exchange (ETDEWEB)

    Klish, Darren S. [Lawrence Cancer Center, Lawrence, KS (United States); Grossman, Patricia; Allen, Pamela K. [Department of Radiation Oncology, M. D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Rhines, Laurence D. [Department of Neurosurgery and (PG, PKA, ELC), M. D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Chang, Eric L., E-mail: echang@mdanderson.org [Department of Radiation Oncology, M. D. Anderson Cancer Center, University of Texas, Houston, TX (United States)

    2011-12-01

    Purpose: Historically, the appropriate target volume to be irradiated for spinal metastases is 1-2 vertebral bodies above and below the level of involvement for three reasons: (1) to avoid missing the correct level in the absence of simulation or (2) to account for the possibility of spread of disease to the adjacent level, and (3) to account for beam penumbra. In this study, we hypothesized that isolated failures occurring in the level adjacent to level treated with stereotactic body radiosurgery (SBRS) were infrequent and that with improved localization techniques with image-guided radiation therapy, treatment of only the involved level of spinal metastases may be more appropriate. Methods and Materials: Patients who had received SBRS treatments to only the involved level of the spine as part of a prospective trial for spinal metastases comprised the study population. Follow-up imaging with spine MRI was performed at 3-month intervals following initial treatment. Failures in the adjacent (V{+-}1, V{+-}2) and distant spine were identified and classified accordingly. Results: Fifty-eight patients met inclusion criteria for this study and harbored 65 distinct spinal metastases. At 18-month median follow-up, seven (10.7%) patients failed simultaneously at adjacent levels V{+-}1 and at multiple sites throughout the spine. Only two (3%) patients experienced isolated, solitary adjacent failures at 9 and 11 months, respectively. Conclusion: Isolated local failures of the unirradiated adjacent vertebral bodies may occur in <5% of patients with isolated spinal metastasis. On the basis of the data, the current practice of irradiating one vertebral body above and below seems unnecessary and could be revised to irradiate only the involved level(s) of the spine metastasis.

  7. Percutaneous full endoscopic lumbar foraminoplasty for adjacent level foraminal stenosis following vertebral intersegmental fusion in an awake and aware patient under local anesthesia: A case report.

    Science.gov (United States)

    Yamashita, Kazuta; Higashino, Kosaku; Sakai, Toshinori; Takata, Yoichiro; Hayashi, Fumio; Tezuka, Fumitake; Morimoto, Masatoshi; Chikawa, Takashi; Nagamachi, Akihiro; Sairyo, Koichi

    2017-01-01

    Percutaneous endoscopic surgery for the lumbar spine has become established in the last decade. It requires only an 8 mm skin incision, causes minimal damage to the paravertebral muscles, and can be performed under local anesthesia. With the advent of improved equipment, in particular the high-speed surgical drill, the indications for percutaneous endoscopic surgery have expanded to include lumbar spinal canal stenosis. Transforaminal percutaneous endoscopic discectomy has been used to treat intervertebral stenosis. However, it has been reported that adjacent level disc degeneration and foraminal stenosis can occur following intervertebral segmental fusion. When this adjacent level pathology becomes symptomatic, additional fusion surgery is often needed. We performed minimally invasive percutaneous full endoscopic lumbar foraminoplasty in an awake and aware 50-year-old woman under local anesthesia. The procedure was successful with no complications. Her radiculopathy, including muscle weakness and leg pain due to impingement of the exiting nerve, improved after the surgery. J. Med. Invest. 64: 291-295, August, 2017.

  8. Effect of 6 months of whole body vibration on lumbar spine bone density in postmenopausal women: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Lai CL

    2013-12-01

    Full Text Available Chung-Liang Lai,1,2 Shiuan-Yu Tseng,1,2 Chung-Nan Chen,3 Wan-Chun Liao,2 Chun-Hou Wang,4 Meng-Chih Lee,1,5,* Pi-Shan Hsu5,* 1Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 3Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 4School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; 5Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan*These authors contributed equally to this workBackground: The issue of osteoporosis-induced fractures has attracted the world's attention. Postmenopausal women are particularly at risk for this type of fracture. The nonmedicinal intervention for postmenopausal women is mainly exercise. Whole body vibration (WBV is a simple and convenient exercise. There have been some studies investigating the effect of WBV on osteoporosis; however, the intervention models and results are different. This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density (BMD of the lumbar spine in postmenopausal women.Methods: This study randomized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial. The WBV group received an intervention of high-frequency (30 Hz and high-magnitude (3.2 g WBV in a natural full-standing posture for 5 minutes, three times per week, at a sports center. Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention.Results: Six months later, the BMD of the WBV group had significantly increased by 2.032% (P=0.047, while that of the control group had decreased by 0.046% (P=0.188. The comparison between the two groups showed that the BMD of the WBV group had increased significantly (P=0.016.Conclusion: This study found

  9. 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.

  10. Apparent diffusion coefficient of vertebral haemangiomas allows differentiation from malignant focal deposits in whole-body diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Winfield, Jessica M.; Blackledge, Matthew D.; Collins, David J.; Tunariu, Nina; Messiou, Christina; Poillucci, Gabriele; Shah, Vallari; Kaiser, Martin F.

    2018-01-01

    The aim of this study was to identify apparent diffusion coefficient (ADC) values for typical haemangiomas in the spine and to compare them with active malignant focal deposits. This was a retrospective single-institution study. Whole-body magnetic resonance imaging (MRI) scans of 106 successive patients with active multiple myeloma, metastatic prostate or breast cancer were analysed. ADC values of typical vertebral haemangiomas and malignant focal deposits were recorded. The ADC of haemangiomas (72 ROIs, median ADC 1,085 x 10 -6 mm 2 s -1 , interquartile range 927-1,295 x 10 -6 mm 2 s -1 ) was significantly higher than the ADC of malignant focal deposits (97 ROIs, median ADC 682 x 10 -6 mm 2 s -1 , interquartile range 583-781 x 10 -6 mm 2 s -1 ) with a p-value < 10 -6 . Receiver operating characteristic (ROC) analysis produced an area under the curve of 0.93. An ADC threshold of 872 x 10 -6 mm 2 s -1 separated haemangiomas from malignant focal deposits with a sensitivity of 84.7 % and specificity of 91.8 %. ADC values of classical vertebral haemangiomas are significantly higher than malignant focal deposits. The high ADC of vertebral haemangiomas allows them to be distinguished visually and quantitatively from active sites of disease, which show restricted diffusion. (orig.)

  11. Split-Volume Treatment Planning of Multiple Consecutive Vertebral Body Metastases for Cyberknife Image-Guided Robotic Radiosurgery

    International Nuclear Information System (INIS)

    Sahgal, Arjun; Chuang, Cynthia; Larson, David; Huang, Kim; Petti, Paula; Weinstein, Phil; Ma Lijun

    2008-01-01

    Cyberknife treatment planning of multiple consecutive vertebral body metastases is challenging due to large target volumes adjacent to critical normal tissues. A split-volume treatment planning technique was developed to improve the treatment plan quality of such lesions. Treatment plans were generated for 1 to 5 consecutive thoracic vertebral bodies (CVBM) prescribing a total dose of 24 Gy in 3 fractions. The planning target volume (PTV) consisted of the entire vertebral body(ies). Treatment plans were generated considering both the de novo clinical scenario (no prior radiation), imposing a dose limit of 8 Gy to 1 cc of spinal cord, and the retreatment scenario (prior radiation) with a dose limit of 3 Gy to 1 cc of spinal cord. The split-volume planning technique was compared with the standard full-volume technique only for targets ranging from 2 to 5 CVBM in length. The primary endpoint was to obtain best PTV coverage by the 24 Gy prescription isodose line. A total of 18 treatment plans were generated (10 standard and 8 split-volume). PTV coverage by the 24-Gy isodose line worsened consistently as the number of CVBM increased for both the de novo and retreatment scenario. Split-volume planning was achieved by introducing a 0.5-cm gap, splitting the standard full-volume PTV into 2 equal length PTVs. In every case, split-volume planning resulted in improved PTV coverage by the 24-Gy isodose line ranging from 4% to 12% for the de novo scenario and, 8% to 17% for the retreatment scenario. We did not observe a significant trend for increased monitor units required, or higher doses to spinal cord or esophagus, with split-volume planning. Split-volume treatment planning significantly improves Cyberknife treatment plan quality for CVBM, as compared to the standard technique. This technique may be of particular importance in clinical situations where stringent spinal cord dose limits are required

  12. 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

  13. Magnetic resonance imaging findings of the lumbar spine in elite horseback riders: correlations with back pain, body mass index, trunk/leg-length coefficient, and riding discipline.

    Science.gov (United States)

    Kraft, Clayton N; Pennekamp, Peter H; Becker, Ute; Young, Mei; Diedrich, Oliver; Lüring, Christian; von Falkenhausen, Makus

    2009-11-01

    Most orthopaedic problems experienced by competitive horseback riders are related to pain in the lower back, hip joint, and hamstring muscles. Riders-especially, show jumpers-are frequently hampered in their performance because of lumbar pain. To date, there has been no research into lumbar disk degeneration in elite competitive riders. Competitive horseback riding accelerates lumbar disk degeneration. Cross-sectional study; Level of evidence, 3. Fifty-eight elite riders (18 men, 40 women; mean age, 32.4 years) and a control group of 30 nonriding volunteers (17 men, 13 women; mean age, 28.7 years) were evaluated for lumbar disk degeneration, cross-sectional area of paraspinal muscles, spondylolysis, and spondylolisthesis, using magnetic resonance imaging (MRI). The prevalence of disk degeneration between the 2 groups was compared, and the relationship was investigated between low back pain (LBP), riding discipline, body mass index (BMI), trunk/leg-length coefficient, and MRI results. Eighty-eight percent of elite riders (n = 51) had a history of LBP, versus 33% of the controls (P back pain. Although riders have a high prevalence of LBP, there is no conclusive MRI evidence to suggest that the cause lies in undue disk degeneration, spondylolysis, spondylolisthesis, or pathologic changes of the paraspinal muscles of the lumbar spine.

  14. Methods to score vertebral deformities in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Lems, W. F.; Jahangier, Z. N.; Raymakers, J. A.; Jacobs, J. W.; Bijlsma, J. W.

    1997-01-01

    The objective was to compare four different scoring methods for vertebral deformities: the semiquantitative Kleerekoper score and three quantitative scores (according to Minne, Melton and Raymakers) in patients with rheumatoid arthritis (RA). Lateral radiographs of the thoracic and lumbar vertebral

  15. 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.

  16. 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.

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

    International Nuclear Information System (INIS)

    Karantanas, A.H.; Zibis, A.H.; Papaliaga, M.; Georgiou, E.; Rousogiannis, S.

    1998-01-01

    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.)

  18. Vertebral bone mineral measurement using dual photon absorptiometry and computed tomography

    International Nuclear Information System (INIS)

    Eriksson, S.; Isberg, B.; Lindgren, U.; Huddinge Univ. Hospital

    1988-01-01

    The lumbar spine of 14 cadavers was studied both by 153 Gd dual photon absorptiometry (DPA) and quantitative computed tomography (QCT) at 96 and 125 kVp. The intact spine and the individual vertebrae were analyzed. After these measurements the ash content of the vertebral body, the posterior elements, and the transverse processes was determined. The fat content of the vertebral body as well as its volume was also measured. With DPA, the bone mineral content (BMC) determined in situ as well as on excised spine specimens correlated highly with the amount of total vertebral ash (r > 0.92, SEE 0.81, SEE 3 ). The so-called corpus density and central density determinations were less accurate. No difference in accuracy was found between measurements when using 3 mm and 4.5 mm step intervals. Variations in the distribution of mineral between the vertebral body and the posterior elements contribute to the error in predicting vertebral body mineral with DPA. QCT gave a smaller error when a cylindric portion of the vertebral body with a 20 diameter was measured compared with one with a 9 mm diameter, when the dual energy technique was used (p 3 ). Single energy QCT was insignificantly less accurate than dual energy QCT. Only small differences were found between vertebrae with high fat density of the vertebral body when single or dual QCT was used. QCT was more accurate than DPA in the prediction of the mineral density of individual vertebral bodies (p < 0.05) but no difference was found when the average values for the lumbar spine were calculated. (orig.)

  19. Morphometry study on pre and post-hatching nerve cell bodies of lumbar spinal ganglia of Gallus domesticus

    Directory of Open Access Journals (Sweden)

    Claudio A. Ferraz de Carvalho

    1983-09-01

    Full Text Available A cytomorphometric study was performed in lumbar spinal ganglia neurons of Gallus domesticus on the 10th and 18th incubation days and 8th, 35th, 61st, and 120th post-hatching days. The absolute volume of nucleus and relative volume of cytoplasm were respectively estimated by the Bach² caryometric method and by point-counting volumetry, carried out in 0.5mm thick araldite sections. The relative volume, the surface-to-volume ratio and the total surface of RER, SER, mitochondria, dense bodies, Golgi complex and the relative volume of hyaloplasm inside and outside the Nissl bodies were estimated from electronmicrographs by the Weibel et al.58 method. The conclusions were: a there was an increase of the cell volume and a decrease of the nucleo-cytoplasmic ratio, particularly between the first two ages; b the relative volumes of RER and SER change inversely with respect to each other: the RER increases before hatching, decreasing progressively afterwards; the changes of relative volume of dense bodies are similar to those of the RER, and the mitochondria show relatively small variations concerning the same parameter; c the relative volume of hyaloplasm inside the Nissl bodies decreases while those outside increases; d the surface-to-volume ratio drops sharply for all organelles from the 10th to the 18th day of incubation; after hatching, a tendency to increase is observed; e the membrane surface-to-cytoplasmic volume ratio decreases for all organelles from the 10th to the 18th day of incubation; after hatching, this ratio increases slightly for mitochondria and Golgi complex, sharply for SER, dropping for dense bodies. The RER values alternate regularly.

  20. Use of vertebral body units to locate the cavoatrial junction for optimum central venous catheter tip positioning.

    Science.gov (United States)

    Song, Y G; Byun, J H; Hwang, S Y; Kim, C W; Shim, S G

    2015-08-01

    Central venous catheter (CVC) placement plays an important role in clinical practice; however, optimal positioning of the CVC tip remains a controversial issue. The objective of this study was to evaluate the use of vertebral body unit (VBUs), to locate the cavoatrial junction (CAJ), for optimal CVC tip placement based on chest radiography (CXR) using the carina as a landmark. 524 patients who underwent coronary computed tomographic angiography (CTA) and CXR were included. The position of the CAJ was identified using VBUs, and the efficacy of VBUs for locating the CAJ with the carina as a landmark was analysed using multiple regression analysis. A VBU was defined as the distance between two adjacent vertebral bodies, including the inter-vertebral disk space. The mean (sd) distance from the carina to the superior CAJ was 54.3 (9.7) mm on CTA; the mean distance in VBUs at the level of the carina was 21.4 (1.7) mm on CTA and 22.6 (2.1) mm on CXR. The mean CAJ position was 2.5 VBUs below the carina on CTA and 2.4 VBUs below on CXR with 95% limits of agreement between -0.6 and +0.3. The position of the CVC tip in relation to the carina can be described using the thoracic spine as an internal ruler, and the position of the CAJ in adults was reliably estimated to be 2.4 VBUs below the carina. KCT0001319. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Volume of Lytic Vertebral Body Metastatic Disease Quantified Using Computed Tomography–Based Image Segmentation Predicts Fracture Risk After Spine Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thibault, Isabelle [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Centre Hospitalier de L' Universite de Québec–Université Laval, Quebec, Quebec (Canada); Whyne, Cari M. [Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Department of Surgery, University of Toronto, Toronto, Ontario (Canada); Zhou, Stephanie; Campbell, Mikki [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Atenafu, Eshetu G. [Department of Biostatistics, University Health Network, University of Toronto, Toronto, Ontario (Canada); Myrehaug, Sten; Soliman, Hany; Lee, Young K. [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Ebrahimi, Hamid [Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Department of Surgery, University of Toronto, Toronto, Ontario (Canada); Yee, Albert J.M. [Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Sahgal, Arjun, E-mail: arjun.sahgal@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2017-01-01

    Purpose: To determine a threshold of vertebral body (VB) osteolytic or osteoblastic tumor involvement that would predict vertebral compression fracture (VCF) risk after stereotactic body radiation therapy (SBRT), using volumetric image-segmentation software. Methods and Materials: A computational semiautomated skeletal metastasis segmentation process refined in our laboratory was applied to the pretreatment planning CT scan of 100 vertebral segments in 55 patients treated with spine SBRT. Each VB was segmented and the percentage of lytic and/or blastic disease by volume determined. Results: The cumulative incidence of VCF at 3 and 12 months was 14.1% and 17.3%, respectively. The median follow-up was 7.3 months (range, 0.6-67.6 months). In all, 56% of segments were determined lytic, 23% blastic, and 21% mixed, according to clinical radiologic determination. Within these 3 clinical cohorts, the segmentation-determined mean percentages of lytic and blastic tumor were 8.9% and 6.0%, 0.2% and 26.9%, and 3.4% and 15.8% by volume, respectively. On the basis of the entire cohort (n=100), a significant association was observed for the osteolytic percentage measures and the occurrence of VCF (P<.001) but not for the osteoblastic measures. The most significant lytic disease threshold was observed at ≥11.6% (odds ratio 37.4, 95% confidence interval 9.4-148.9). On multivariable analysis, ≥11.6% lytic disease (P<.001), baseline VCF (P<.001), and SBRT with ≥20 Gy per fraction (P=.014) were predictive. Conclusions: Pretreatment lytic VB disease volumetric measures, independent of the blastic component, predict for SBRT-induced VCF. Larger-scale trials evaluating our software are planned to validate the results.

  2. 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...

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

    DEFF Research Database (Denmark)

    Masharawi, Y; Kjaer, P; Manniche, C

    2012-01-01

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

  4. [(Modic) signal alterations of vertebral endplates and their correlation to a minimally invasive treatment of lumbar disc herniation using epidural injections].

    Science.gov (United States)

    Liphofer, J P; Theodoridis, T; Becker, G T; Koester, O; Schmid, G

    2006-11-01

    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). 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. 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 nor on the type of 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). 1. Lumbar disc herniation is clearly associated with the prevalence of (Modic) signal alterations. 2. Extensive signal alterations tend to correlate with a negative outcome of an MIT using epidural injections. 3. Such SA in the central portion of the upper CEP correlate significantly with a negative treatment result. 4. The central portion of the upper CEP being extensively affected by (Modic) SA is a negative predictor for the success of a minimally

  5. [Evaluation of the risk of mediastinal or retroperitoneal injuries caused by dorso-lumbar pedicle screws].

    Science.gov (United States)

    Hernigou, P; Germany, W

    1998-09-01

    Within an anatomical and a clinical study, the authors employed computerized tomographic scans to evaluate the risks of anterior surrounding tissues injuries during screw insertion. CT scans of 20 patients suffering from cardiac disease were reviewed retrospectively. Scans through the thoracic and lumbar spine were obtained using 6 mm slice thickness. These examinations were performed with intravenous contrast medium. Measurements of vessel diameters and distance of the soft tissues situated directly anterior to the spine were done. A retrospective study of 61 pedicle screws implanted for spine fractures evaluated the penetration of the anterior vertebral cordex with X rays and CT scans. Computerized tomographic scans of the thoracic and lumbar spine of the 20 patients in the control group confirmed proximity of the posterior mediastinal structures to the anterior vertebral cortex. Many structures of the posterior mediastinum were within five millimeters of the anterior vertebral cortex and thus were at risk: aorta, azygos vein, vena cava, parietal pleura and lungs. The theoretical risk of unrecognized screw penetrations evaluated on geometric shape of the anterior vertebral body is as high as 21 per cent when screw position is only seen with an antero posterior and a lateral X Ray. In the other group, computerized tomographic scans showed that 30 per cent of the implanted screws were outside the boundaries of the anterior thoracic spine. Two orthogonal incidences do not enable determination of whether the extremity of the screw is slightly outside the anterior cortex of the vertebral body. However the geometric shape of the anterior vertebral body enables peroperative definition of a safety zone on two orthogonal incidences. Even if a breach of a few millimeters of the anterior cortical boundaries of the vertebral body may not initially damage the adjacent soft-tissue structures, chronic irritation may result in late damages of these structures. The use of

  6. Computed tomography of thoracic and lumbar spine fractures that have been treated with Harrington instrumentation

    International Nuclear Information System (INIS)

    Golimbu, C.; Firooznia, H.; Rafii, M.; Engler, G.; Delman, A.

    1984-01-01

    Twenty patients with fractures of the thoracic and lumbar spine underwent computed tomography (CT) following Harrington distraction instrumentation and a spinal fusion. CT was done to search for a cause of persistent cord or nerve root compression in those patients who failed to improve and completely recover their partial neurologic deficit (14 cases). The most common abnormality was the presence of residual bone fragments originating in the burst fracture of a vertebral body displaced posteriorly, into the spinal canal. In patients with complications in the late recovery period, CT found exuberant callus indenting the canal or lack of fusion of the bone grafts placed in the anterolateral aspect of the vertebral bodies. This experience indicates that CT is the modality of choice for spinal canal evaluation in those patients who fail to have an optimal clinical course following fractures of the thoracic and lumbar spine treated with Harrington rods

  7. 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.

  8. (Modic) signal alterations of vertebral endplates and their correlation to a minimally invasive treatment of lumbar disc herniation using epidural injections

    International Nuclear Information System (INIS)

    Liphofer, J.P.; Becker, G.T.; Koester, O.; Theodoridis, T.; Schmid, G.

    2006-01-01

    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.)

  9. Age-predicted values for lumbar spine, proximal femur, and whole-body bone mineral density: results from a population of normal children aged 3 to 18 years

    Energy Technology Data Exchange (ETDEWEB)

    Webber, C.E. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Radiology, Hamilton, Ontario (Canada)]. E-mail: webber@hhsc.ca; Beaumont, L.F. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); Morrison, J. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); Sala, A. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada); Univ. of Milan-Bicocca, Monza (Italy); Barr, R.D. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada)

    2007-02-15

    We measured areal bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur and for the total body in 179 subjects (91 girls and 88 boys) with no known disorders that might affect calcium metabolism. Results are also reported for lumbar spine bone mineral content (BMC) and for the derived variable, bone mineral apparent density (BMAD). Expected-for-age values for each variable were derived for boys and girls by using an expression that represented the sum of a steady increase due to growth plus a rapid increase associated with puberty. Normal ranges were derived by assuming that at least 95% of children would be included within 1.96 population standard deviations (SD) of the expected-for-age value. The normal range for lumbar spine BMD derived from our population of children was compared with previously published normal ranges based on results obtained from different bone densitometers in diverse geographic locations. The extent of agreement between the various normal ranges indicates that the derived expressions can be used for reporting routine spine, femur, and whole-body BMD measurements in children and adolescents. The greatest difference in expected-for-age values among the various studies was that arising from intermanufacturer variability. The application of published conversion factors derived from DXA measurements in adults did not account fully for these differences, especially in younger children. (author)

  10. Age-predicted values for lumbar spine, proximal femur, and whole-body bone mineral density: results from a population of normal children aged 3 to 18 years

    International Nuclear Information System (INIS)

    Webber, C.E.; Beaumont, L.F.; Morrison, J.; Sala, A.; Barr, R.D.

    2007-01-01

    We measured areal bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur and for the total body in 179 subjects (91 girls and 88 boys) with no known disorders that might affect calcium metabolism. Results are also reported for lumbar spine bone mineral content (BMC) and for the derived variable, bone mineral apparent density (BMAD). Expected-for-age values for each variable were derived for boys and girls by using an expression that represented the sum of a steady increase due to growth plus a rapid increase associated with puberty. Normal ranges were derived by assuming that at least 95% of children would be included within 1.96 population standard deviations (SD) of the expected-for-age value. The normal range for lumbar spine BMD derived from our population of children was compared with previously published normal ranges based on results obtained from different bone densitometers in diverse geographic locations. The extent of agreement between the various normal ranges indicates that the derived expressions can be used for reporting routine spine, femur, and whole-body BMD measurements in children and adolescents. The greatest difference in expected-for-age values among the various studies was that arising from intermanufacturer variability. The application of published conversion factors derived from DXA measurements in adults did not account fully for these differences, especially in younger children. (author)

  11. Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis

    International Nuclear Information System (INIS)

    Guckenberger, Matthias; Mantel, Frederick; Gerszten, Peter C; Flickinger, John C; Sahgal, Arjun; Létourneau, Daniel; Grills, Inga S; Jawad, Maha; Fahim, Daniel K; Shin, John H; Winey, Brian; Sheehan, Jason; Kersh, Ron

    2014-01-01

    To evaluate patient selection criteria, methodology, safety and clinical outcomes of stereotactic body radiotherapy (SBRT) for treatment of vertebral metastases. Eight centers from the United States (n = 5), Canada (n = 2) and Germany (n = 1) participated in the retrospective study and analyzed 301 patients with 387 vertebral metastases. No patient had been exposed to prior radiation at the treatment site. All patients were treated with linac-based SBRT using cone-beam CT image-guidance and online correction of set-up errors in six degrees of freedom. 387 spinal metastases were treated and the median follow-up was 11.8 months. The median number of consecutive vertebrae treated in a single volume was one (range, 1-6), and the median total dose was 24 Gy (range 8-60 Gy) in 3 fractions (range 1-20). The median EQD2 10 was 38 Gy (range 12-81 Gy). Median overall survival (OS) was 19.5 months and local tumor control (LC) at two years was 83.9%. On multivariate analysis for OS, male sex (p < 0.001; HR = 0.44), performance status <90 (p < 0.001; HR = 0.46), presence of visceral metastases (p = 0.007; HR = 0.50), uncontrolled systemic disease (p = 0.007; HR = 0.45), >1 vertebra treated with SBRT (p = 0.04; HR = 0.62) were correlated with worse outcomes. For LC, an interval between primary diagnosis of cancer and SBRT of ≤30 months (p = 0.01; HR = 0.27) and histology of primary disease (NSCLC, renal cell cancer, melanoma, other) (p = 0.01; HR = 0.21) were correlated with worse LC. Vertebral compression fractures progressed and developed de novo in 4.1% and 3.6%, respectively. Other adverse events were rare and no radiation induced myelopathy reported. This multi-institutional cohort study reports high rates of efficacy with spine SBRT. At this time the optimal fractionation within high dose practice is unknown

  12. Body Position Influences Which Neural Structures Are Recruited by Lumbar Transcutaneous Spinal Cord Stimulation.

    Directory of Open Access Journals (Sweden)

    Simon M Danner

    Full Text Available Transcutaneous stimulation of the human lumbosacral spinal cord is used to evoke spinal reflexes and to neuromodulate altered sensorimotor function following spinal cord injury. Both applications require the reliable stimulation of afferent posterior root fibers. Yet under certain circumstances, efferent anterior root fibers can be co-activated. We hypothesized that body position influences the preferential stimulation of sensory or motor fibers. Stimulus-triggered responses to transcutaneous spinal cord stimulation were recorded using surface-electromyography from quadriceps, hamstrings, tibialis anterior, and triceps surae muscles in 10 individuals with intact nervous systems in the supine, standing and prone positions. Single and paired (30-ms inter-stimulus intervals biphasic stimulation pulses were applied through surface electrodes placed on the skin between the T11 and T12 inter-spinous processes referenced to electrodes on the abdomen. The paired stimulation was applied to evaluate the origin of the evoked electromyographic response; trans-synaptic responses would be suppressed whereas direct efferent responses would almost retain their amplitude. We found that responses to the second stimulus were decreased to 14%±5% of the amplitude of the response to the initial pulse in the supine position across muscles, to 30%±5% in the standing, and to only 80%±5% in the prone position. Response thresholds were lowest during standing and highest in the prone position and response amplitudes were largest in the supine and smallest in the prone position. The responses obtained in the supine and standing positions likely resulted from selective stimulation of sensory fibers while concomitant motor-fiber stimulation occurred in the prone position. We assume that changes of root-fiber paths within the generated electric field when in the prone position increase the stimulation thresholds of posterior above those of anterior root fibers. Thus, we

  13. Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis : A CT-Based Study

    NARCIS (Netherlands)

    Brink, Rob C.; Schlösser, Tom P C; Colo, Dino; Vincken, Koen L.; van Stralen, Marijn; Hui, Steve C N; Chu, Winnie C W; Cheng, Jack C Y; Castelein, RM

    2017-01-01

    Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and

  14. Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages

    OpenAIRE

    Choi, Youn-Kyung; Kim, Jinmi; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Kim, Yong-Il

    2016-01-01

    This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies ...

  15. Congenital lumbar vertebrae agenesis in a lamb.

    Science.gov (United States)

    Farajli Abbasi, Mohammad; Shojaei, Bahador; Azari, Omid

    2017-01-01

    Congenital agenesis of lumbar vertebrae was diagnosed in a day-old female lamb based on radiology and clinical examinations. There was no neurological deficit in hindlimb and forelimb associated with standing disability. Radiography of the abdominal region revealed absence of lumbar vertebrae. Necropsy confirmed clinical and radiographic results. No other anomaly or agenesis was seen macroscopically in the abdominal and thoracic regions as well as vertebral column. Partial absence of vertebral column has been reported in human and different animal species, as an independent occurrence or associated with other organs anomalies. The latter has been designated as caudal regression syndrome. Vertebral agenesis may arise from irregularity in the differentiation of somites to the sclerotome or sclerotome to the vertebral primordium. Most of the previously reported cases of agenesis were related to the lumbosacral region, lonely or along with other visceral absences. This case was the first report of congenital agenesis of lumbar vertebrae in a lamb.

  16. Theoretical analysis of alendronate and risedronate effects on canine vertebral remodeling and microdamage

    OpenAIRE

    Wang, Xiang; Erickson, Antonia M.; Allen, Matthew R.; Burr, David B.; Martin, R. Bruce; Hazelwood, Scott J.

    2009-01-01

    Bisphosphonates suppress bone remodeling activity, increase bone volume, and significantly reduce fracture risk in individuals with osteoporosis and other metabolic bone diseases. The objectives of the current study were to develop a mathematical model that simulates control and 1 year experimental results following bisphosphonate treatment (alendronate or risedronate) in the canine fourth lumbar vertebral body, validate the model by comparing simulation predictions to 3 year experimental res...

  17. SURGICAL TREATMENT OF VERTEBRAL FRACTURES ASSOCIATED WITH LOW MINERAL BONE DENSITY

    Directory of Open Access Journals (Sweden)

    V. V. Rerikh

    2010-01-01

    Full Text Available Surgical treatment of 177 patients with monolocal fractures of thoracic and lumbar vertebral bodies was performed using transpedicular fixation (n=17, transpedicular fixation and osteoplasty (n=101, vertebroplasty (n=48 or kyphoplasty (n=ll. Restoration of support ability of the fractured osteoporotic vertebrae within ventral column by means of plasty particularly in combination with internal fixation allows achievement of better clinical outcomes, improvement of the quality of life in patients in the early and late periods after surgery.

  18. Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

    OpenAIRE

    Ashwini Aithal Padur; Naveen Kumar; Swamy Ravindra Shanthakumar; Arijit Bishnu

    2017-01-01

    Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophyt...

  19. [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.

  20. Lumbar CT findings of patients with low back pain

    International Nuclear Information System (INIS)

    Lee, Yong Chul; Kim, Yang Soo; Kim, Kyun Sang

    1986-01-01

    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.

  1. 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.

  2. 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.

  3. Lumbar posterior marginal intra-osseous cartilaginous node

    Energy Technology Data Exchange (ETDEWEB)

    Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

    1986-03-01

    This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed.

  4. Lumbar posterior marginal intra-osseous cartilaginous node

    International Nuclear Information System (INIS)

    Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

    1986-01-01

    This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed. (orig.)

  5. Biomechanical aspects of lumbar spine injuries in athletes: a review.

    Science.gov (United States)

    Alexander, M J

    1985-03-01

    One of the areas of the body which is very often injured by athletes is the lower lack, or the lumbar area of the spine. This problem is of some concern to physical educators, athletic therapists, coaches, athletes, and physicians. The type of injury which occurs in the lumbar spine is dependent on the direction, magnitude, and the point of application of the forces to the spine. This part of the body is susceptible to injury due to the large forces which must be supported, which include the body weight and any external weights, as well as the forces due to very high accelerations of the body parts. Since the lumbar spine is the only connecting column between the upper and lower parts of the body, all the forces must be transmitted via these structures. There are two general techniques of calculating the forces on the lumbar spinal structures, a static approach and a dynamic approach. The static approach may be useful to calculate compression and shear forces on the spine in stationary positions as may be seen in weightlifting. However, the dynamics approach should be used to calculate the effects of the various weights and inertial forces on spinal structures. The most common types of lower back injuries found in athletes were: muscle strains, ligament sprains, lumbar vertebral fractures, disc injuries, and neural arch fractures. The most common serious athletic injury to the lower back was found to be neural arch fractures at the pars interarticularis, or the isthmus between the superior and inferior articular processes. These fractures are known as spondylolysis, or defect in the pars interarticularis of one side of the vertebrae; and spondylolisthesis, a bilateral defect in the pars interarticularis, often accompanied by forward displacement of the vertebral body. The sports in which lower back injuries commonly occurred were also examined, and it was determined that gymnastics, weightlifting and football were the sports in which the lower back is at greatest

  6. Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages.

    Science.gov (United States)

    Choi, Youn-Kyung; Kim, Jinmi; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Kim, Yong-Il

    2016-01-01

    This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5-18 years of age). We performed Pearson's correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level.

  7. Measurement of Trabecular Bone Parameters in Porcine Vertebral Bodies Using Multidetector CT: Evaluation of Reproducibility of 3-Dimensional CT Histomorphometry

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sung Hwan; Goo, Jin Mo [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Moon Kyung Chul [Dept. of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Sang Bu [Dept. of radiology, National Cancer Center, Goyang (Korea, Republic of); Kim, Kwang Gi [Dept. of Biomedical Engineering, Division of Basic and Applied Sciences, National Cancer Center, Goyang (Korea, Republic of)

    2011-05-15

    To evaluate the reproducibility of 3-dimensional histomorphometry for the microarchitecture analysis of trabecular bone parameters using multidetector computed tomography (MDCT). Thirty-six specimens from porcine vertebral bodies were imaged five times with a 64- detector row MDCT system using the same scan protocols. Locations of the specimens were nearly identical through the scans. Three-dimensional structural parameters of trabecular bone were derived from the five data sets using image analyzing software. The features measured by the analysis programs were trabecular bone volume, trabecular bone volume/tissue volume, trabecular thickness, trabecular separation, trabecular number, trabecular bone pattern factor, structural model index. The structural trabecular parameters showed excellent reproducibility through repeated scanning. Intraclass correlation coefficients of all seven structural parameters were in the range of 0.998 to 1.000. Coefficients of variation of the six structural parameters, excluding structural model index, were not over 1.6%. The measurement of the trabecular structural parameters using multidetector CT and three-dimensional histomophometry analysis program was validated and showed excellent reproducibility. This method could be used as a noninvasive and easily available test in a clinical setting.

  8. HEMATOPOIETIC PROGENITOR CELL CONTENT OF VERTEBRAL BODY MARROW USED FOR COMBINED SOLID ORGAN AND BONE MARROW TRANSPLANTATION

    Science.gov (United States)

    Rybka, Witold B.; Fontes, Paulo A.; Rao, Abdul S.; Winkelstein, Alan; Ricordi, Camillo; Ball, Edward D.; Starzl, Thomas E.

    2010-01-01

    While cadaveric vertebral bodies (VB) have long been proposed as a suitable source of bone marrow (BM) for transplantation (BMT), they have rarely been used for this purpose. We have infused VB BM immediately following whole organ (WO) transplantation to augment donor cell chimerism. We quantified the hematopoietic progenitor cell (HPC) content of VB BM as well as BM obtained from the iliac crests (IC) of normal allogeneic donors (ALLO) and from patients with malignancy undergoing autologous marrow harvest (AUTO). Patients undergoing WOIBM transplantation also had AUTO BM harvested in the event that subsequent lymphohematopoietic reconstitution was required. Twenty-four VB BM, 24 IC BM-ALLO, 31 IC AUTO, and 24 IC WO-AUTO were harvested. VB BM was tested 12 to 72 hr after procurement and infused after completion ofWO grafting. IC BM was tested and then used or cryopreserved immediately. HPC were quantified by clonal assay measuring CFU-GM, BFU-E, and CFU-GEMM, and by flow cytometry for CD34+ progenitor cells. On an average, 9 VB were processed during each harvest, and despite an extended processing time the number of viable nucleated cells obtained was significantly higher than that from IC. Furthermore, by HPC content, VB BM was equivalent to IC BM, which is routinely used for BMT. We conclude that VB BM is a clinically valuable source of BM for allogeneic transplantation. PMID:7701582

  9. Congenital lumbar spinal stenosis: a prospective, control-matched, cohort radiographic analysis.

    Science.gov (United States)

    Singh, Kern; Samartzis, Dino; Vaccaro, Alexander R; Nassr, Ahmad; Andersson, Gunnar B; Yoon, S Tim; Phillips, Frank M; Goldberg, Edward J; An, Howard S

    2005-01-01

    Degenerative lumbar spinal stenosis manifests primarily after the sixth decade of life as a result of facet hypertrophy and degenerative disc disease. Congenital stenosis, on the other hand, presents earlier in age with similar clinical findings but with multilevel involvement and fewer degenerative changes. These patients may have subtle anatomic variations of the lumbar spine that may increase the likelihood of thecal sac compression. However, to the authors' knowledge, no quantitative studies have addressed various radiographic parameters of symptomatic, congenitally stenotic individuals to normal subjects. To radiographically quantify and compare the anatomy of the lumbar spine in symptomatic, congenitally stenotic individuals to age- and sex-matched, asymptomatic, nonstenotic controlled individuals. A prospective, control-matched, cohort radiographic analysis. Axial and sagittal magnetic resonance imaging (MRI) and lateral, lumbar, plain radiographs of 20 surgically treated patients who were given a clinical diagnosis of congenital lumbar stenosis by the senior author were randomized with images of 20, asymptomatic age- and sex-matched subjects. MRIs and lateral, lumbar, plain radiographs were independently quantitatively assessed by two individuals. Measurements obtained from the axial MRIs included: midline anterior-posterior (AP) vertebral body diameter, vertebral body width, midline AP canal diameter, canal width, spinal canal cross-sectional area, pedicle length, and pedicle width. From the sagittal MRIs, the following measurements were calculated: AP vertebral body diameter, vertebral body height, and AP canal diameter at the mid-vertebral level. On the lateral, lumbar, plain radiograph (L3 level), the AP diameters of the vertebral body spinal canal were measured. The images of these 40 individuals were then randomized and distributed in a blinded fashion to five separate spine surgeons who graded the presence and severity of congenital stenosis

  10. [Lumbar spondylosis].

    Science.gov (United States)

    Seichi, Atsushi

    2014-10-01

    Lumbar spondylosis is a chronic, noninflammatory disease caused by degeneration of lumbar disc and/or facet joints. The etiology of lumbar spondylosis is multifactorial. Patients with lumbar spondylosis complain of a broad variety of symptoms including discomfort in the low back lesion, whereas some of them have radiating leg pain or neurologenic intermittent claudication (lumbar spinal stenosis). The majority of patients with spondylosis and stenosis of the lumbosacral spine can be treated nonsurgically. Nonsteroidal anti-inflammatory drugs and COX-2 inhibitors are helpful in controlling symptoms. Prostaglandin, epidural injection, and transforaminal injection are also helpful for leg pain and intermittent claudication. Operative therapy for spinal stenosis or spondylolisthesis is reserved for patients who are totally incapacitated by their condition.

  11. Risk factor analysis for predicting vertebral body re-collapse after posterior instrumented fusion in thoracolumbar burst fracture.

    Science.gov (United States)

    Jang, Hae-Dong; Bang, Chungwon; Lee, Jae Chul; Soh, Jae-Wan; Choi, Sung-Woo; Cho, Hyeung-Kyu; Shin, Byung-Joon

    2018-02-01

    In the posterior instrumented fusion surgery for thoracolumbar (T-L) burst fracture, early postoperative re-collapse of well-reduced vertebral body fracture could induce critical complications such as correction loss, posttraumatic kyphosis, and metal failure, often leading to revision surgery. Furthermore, re-collapse is quite difficult to predict because of the variety of risk factors, and no widely accepted accurate prediction systems exist. Although load-sharing classification has been known to help to decide the need for additional anterior column support, this radiographic scoring system has several critical limitations. (1) To evaluate risk factors and predictors for postoperative re-collapse in T-L burst fractures. (2) Through the decision-making model, we aimed to predict re-collapse and prevent unnecessary additional anterior spinal surgery. Retrospective comparative study. Two-hundred and eight (104 men and 104 women) consecutive patients with T-L burst fracture who underwent posterior instrumented fusion were reviewed retrospectively. Burst fractures caused by high-energy trauma (fall from a height and motor vehicle accident) with a minimum 1-year follow-up were included. The average age at the time of surgery was 45.9 years (range, 15-79). With respect to the involved spinal level, 95 cases (45.6%) involved L1, 51 involved T12, 54 involved L2, and 8 involved T11. Mean fixation segments were 3.5 (range, 2-5). Pedicle screw instrumentation including fractured vertebra had been performed in 129 patients (62.3%). Clinical data using self-report measures (visual analog scale score), radiographic measurements (plain radiograph, computed tomography, and magnetic resonance image), and functional measures using the Oswestry Disability Index were evaluated. Body height loss of fractured vertebra, body wedge angle, and Cobb angle were measured in serial plain radiographs. We assigned patients to the re-collapse group if their body height loss progressed greater

  12. Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report.

    Science.gov (United States)

    Koakutsu, Tomoaki; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin; Itoi, Eiji

    2012-03-01

    Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.

  13. 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

    muscles. Results: In general the von Mises stress was larger by 30 %, and even higher when looking at the von Mises stress distribution in the superio-anterior and central part of the vertebral body and in the pedicles. Conclusion: The application of spine muscles to a finite element model showed markedly...... larger von Mises stress responses in the central and anterior part of the vertebral body, which can be tolerated in the young and healthy spine, but it would increase the risk of compression fractures in the elderly, osteoporotic spine.......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...

  14. Tophaceous gout causing lumbar stenosis: A case report.

    Science.gov (United States)

    Lu, Huigen; Sheng, Jianming; Dai, Jiaping; Hu, Xuqi

    2017-08-01

    Gout in the spine is very rare. The clinical symptoms of the spinal gout are various and lack of specificity. The authors report a case of spinal gout causing lumbar stenosis. We never find such wide-invasive spinal gouty lesion in the published studies. A 68-year-old male had low back pain radiating to bilateral lower limbs, accompanying with intermittent claudication that lasted for 3 months and aggravated 5 days ago. Spinal gout, lumbar stenosis. The patient underwent L2-L4 laminectomy, L2/3 L3/4 an d L4/5 discectomy and transforaminal lumbar interbody fusion with pedicle screw fixation. Dual-energy computed tomography detected extensive tophaceous deposits in L1/2 L2/3 L3/4 and L4/5 lumbar discs as well as the posterior column, especially L2-L3 and L4-L5 facet joints. During the surgery, we found a mass of chalky white material at the posterior column of L3 to L5 vertebral bodies, which also involved the intervertebral discs. Pathological examination confirmed the diagnosis of spinal gout. Although spinal gout is thought to be rare, the diagnosis should be considered if the patient had severe back pain and a history of gout. Dual-energy computed tomography is highly recommended for these patients.

  15. Radiotherapy for vertebral metastases. Analysis of symptoms and clinical effects by MR imaging

    International Nuclear Information System (INIS)

    Sugiyama, Akira

    1994-01-01

    Fifty patients with 63 symptomatic vertebral metastasis (18 sites: pain only, 28 sites: radiculopathy with pain, 17 sites: myelopathy) were treated by radiotherapy. Primary lesions were located in the lung (9 cases), breast (9), colorectal area (9), prostate (7) and so on. We correlated the radiologic findings, symptoms and clinical effects with metastatic features which were classified into 4 types by MR imaging: non-deformity, expanding, vertebral collapse, and destructive mass. Each type of metastasis was accompanied with or without epidural tumor. Osteolytic metastases were apt to create features of deformity (expanding type: 18 vertebrae, vertebral collapse type: 17, destructive mass type: 9). The features of osteoblastic metastases were no deformity (18 vertebrae) and expanding type (2). The symptom of pain only occurred most frequently in the lumbosacral spine. The vertebral body deformity of symptomatic sites was relatively slight (non-deformity type: 6 sites, expanding type: 6, vertebral collapse type: 6), and epidural tumors were seen at only 2 sites. The effect of radiotherapy was excellent (complete pain relief: 64.7%, partial pain relief: 29.4%). Radiculopathy occurred most frequently in the lumber spine. Vertebral body deformity was noted in most symptomatic sites (expanding type: 9 sites, vertebral collapse type: 10, destructive mass type: 2). Complete relief was obtained in 6 sites (22.2%), partial relief in 18 (63.0%). Myelopathy occurred most often in the thoracic spine, followed by the lumbar spine. The vertebral body deformity was severe (expanding: 3 cases, vertebral collapse type: 3, destructive mass type: 6). Epidural tumors were also present in all but one case. Six of 13 patients treated with radiation alone improved. These 6 patients had non-deformity or expanding types with epidural tumor. No improvement was seen in the vertebral collapse type with epidural tumor or destructive mass type. (author)

  16. On the use of volumetric-modulated arc therapy for single-fraction thoracic vertebral metastases stereotactic body radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, Damodar, E-mail: damodar.pokhrel@uky.edu; Sood, Sumit; McClinton, Christopher; Shen, Xinglei; Badkul, Rajeev; Jiang, Hongyu; Mallory, Matthew; Mitchell, Mellissa; Wang, Fen; Lominska, Christopher

    2017-04-01

    To retrospectively evaluate quality, efficiency, and delivery accuracy of volumetric-modulated arc therapy (VMAT) plans for single-fraction treatment of thoracic vertebral metastases using image-guided stereotactic body radiosurgery (SBRS) after RTOG 0631 dosimetric compliance criteria. After obtaining credentialing for MD Anderson spine phantom irradiation validation, 10 previously treated patients with thoracic vertebral metastases with noncoplanar hybrid arcs using 1 to 2 3D-conformal partial arcs plus 7 to 9 intensity-modulated radiation therapy beams were retrospectively re-optimized with VMAT using 3 full coplanar arcs. Tumors were located between T2 and T12. Contrast-enhanced T1/T2-weighted magnetic resonance images were coregistered with planning computed tomography and planning target volumes (PTV) were between 14.4 and 230.1 cc (median = 38.0 cc). Prescription dose was 16 Gy in 1 fraction with 6 MV beams at Novalis-TX linear accelerator consisting of micro multileaf collimators. Each plan was assessed for target coverage using conformality index, the conformation number, the ratio of the volume receiving 50% of the prescription dose over PTV, R50%, homogeneity index (HI), and PTV-1600 coverage per RTOG 0631 requirements. Organs-at-risk doses were evaluated for maximum doses to spinal cord (D{sub 0.03} {sub cc}, D{sub 0.35} {sub cc}), partial spinal cord (D{sub 10%}), esophagus (D{sub 0.03} {sub cc} and D{sub 5} {sub cc}), heart (D{sub 0.03} {sub cc} and D{sub 15} {sub cc}), and lung (V{sub 5}, V{sub 10}, and maximum dose to 1000 cc of lung). Dose delivery efficiency and accuracy of each VMAT-SBRS plan were assessed using quality assurance (QA) plan on MapCHECK device. Total beam-on time was recorded during QA procedure, and a clinical gamma index (2%/2 mm and 3%/3 mm) was used to compare agreement between planned and measured doses. All 10 VMAT-SBRS plans met RTOG 0631 dosimetric requirements for PTV coverage. The plans demonstrated highly conformal and

  17. Morphometric X-ray Absorptiometry: Reference Data for Vertebral Dimensions in a Population-based Sample of Young Danish Men

    International Nuclear Information System (INIS)

    Wulff, R.; Koch Holst, A.; Nielsen, T.L.; Andersen, M.; Hagen, C.; Brixen, K.

    2004-01-01

    Purpose: To determine reference values for vertebral heights in healthy young Danish males using morphometric X-ray absorptiometry (MXA). Material and Methods: A population-based study group of 487 males aged between 20 and 30 years (mean 25 years) from the county of Funen, Denmark, were recruited. Using a Hologic QDR 4500 (dual energy X-ray absorptiometry) DXA-scanner, MXA scans covering the vertebrae from T4 to L4 were acquired for each subject. Anterior (Ha), middle (Hm), and posterior (Hp) heights of the thoracic (T4-T12) and lumbar (L1-L4) vertebral bodies were measured. Moreover, wedge, mid-wedge, crush I, and crush II ratios were calculated. Results: No correlation between vertebral dimensions and crush indices on the one hand and age or weight on the other were found. Body height, however, correlated significantly with the cumulated vertebral heights. Reference data for vertebral dimensions, wedge, mid-wedge, crush I, and crush II are tabulated. Conclusion: The anterior, middle, and posterior heights of the vertebral bodies of T4 to L4 can be measured reproducible with MXA. In young men, the cumulative vertebral heights correlated with body height but not with age. Moreover, the wedge and crush indices were unrelated of both age and height

  18. Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism.

    Science.gov (United States)

    Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia

    2015-02-01

    Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.

  19. 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

  20. 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.

  1. 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.

  2. Lumbar vertebra chordoma | Erlank | SA Journal of Radiology

    African Journals Online (AJOL)

    Abstract. Spinal chordomas in the lumbar region are rare and can easily be overlooked in the differential diagnosis of vertebral column tumours. South African Journal of Radiology Vol. 10 (3) 2006: pp. 37-38 ...

  3. Correlations between the cross-sectional area and moment arm length of the erector spinae muscle and the thickness of the psoas major muscle as measured by MRI and the body mass index in lumbar degenerative kyphosis patients

    International Nuclear Information System (INIS)

    Lee, Hyun; Lee, Sang Jin; Lee, Sang Ho

    2006-01-01

    Lumbar degenerative kyphosis (LDK) is a subgroup of the flatback syndrome, which is a condition caused by spinal degeneration. LDK is reported to be the most frequent cause of lumbar spine deformity in the farming districts of the 'oriental' countries. We investigated the relationship between the cross-sectional area (CSA) and the moment arm length (MAL) of the erector spinae muscle and the thickness of the psoas major muscle (PT) and the body mass index (BMI) by performing statistical analysis, and we tried to show the crucial role of these variables for diagnosing LDK. From July 2004 to April 2005, we retrospectively reviewed 17 LDK patients who had undergone anterior lumbar interbody fusion (ALIF) with posterior stabilization. We measured both the CSA and MAL on the transverse cross-sectional MR image of the trunk at the fourth to fifth vertebrae (L4/5). The MAL was defined as the anterior-posterior distance between the center of the erector spinae muscle and that of the vertebral body. A comparative study was undertaken between the LDK group and the matched (according to age and gender) control group with regard to the CSA, MAL, PT and BMI. The 17 LDK patients were all females [age: 62.5 ± 4.93 years, height: 157 ± 6.19 cm, weight: 55.59 ± 4.7 kg, and BMI: 22.58 ± 2.08 kg/m 2 ]. The control group patients were all female [age: 63.6 ± 2.27 years, height: 156 ± 5.05 cm, weight: 59.65 ± 7.39 kg and BMI: 24.38 ± 2.94 kg/m 2 ]. Spearman's rho indicated a positive association between the CSA and BMI (rho = 0.49, ρ = 0.046), between the MAL and BMI (rho = 0.808, ρ = 0.000) and between the CSA and PT (rho = 0.566, ρ = 0.018) in the LDK patients. In terms of the CSA versus MAL, there was a positive association in both groups (rho = 0.67, ρ = 0.000, MAL = 0.023CSA + 5.454 in the LDK group; rho = 0.564, ρ 0.018, MAL = 0.02CSA + 5.832 in the control group with using linear regression analysis). Independent t-tests revealed that both groups had statistically

  4. Ochronosis of the lumbar vertebral column

    International Nuclear Information System (INIS)

    Bewermeyer, H.; Assheuer, J.; Janson, R.

    1992-01-01

    The clinical picture of ochronosis is not one that could be correlated with a set of typical X-ray features. In the detection of the associated changes to the articular cartilages NMR imaging provides more reliable information than the remaining radiological techniques, which means that the range of uses for this method deserves to be broadened to include related disorders. (orig.) [de

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

    International Nuclear Information System (INIS)

    Jagt-Willems, H.C. van der; Munster, B.C. van; Leeflang, M.; Beuerle, E.; Tulner, C.R.; Lems, W.F.

    2014-01-01

    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

  7. 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

  8. Incidental abdominopelvic findings on expanded field-of-view lumbar spinal MRI: frequency, clinical importance, and concordance in interpretation by neuroimaging and body imaging radiologists

    International Nuclear Information System (INIS)

    Maxwell, A.W.P.; Keating, D.P.; Nickerson, J.P.

    2015-01-01

    Aim: To characterize the frequency of identification, clinical importance, and concordance in interpretation of incidental abdominopelvic findings identified on routine lumbar spinal MRI using supplemental expanded field-of-view (FOV) coronal imaging. Materials and methods: All lumbar spinal MRI reports over a 12-month period were retrospectively reviewed for the presence of incidental abdominopelvic findings identified using expanded FOV coronal imaging. Medical records were used to identify those findings that received follow-up, which were then categorized according to final diagnosis and classified as “indeterminate,” “likely clinically unimportant,” and “likely clinically important”. All cases that received follow-up were blindly and independently re-reviewed by a neuroimaging radiologist and body-imaging radiologist, and reviewer performances were compared to assess for agreement with regard to lesion significance, need for follow-up, and other parameters. Results: In total, 2067 reports were reviewed: 687 (33.2%) featured one or more incidental abdominopelvic findings, and 102 (4.9%) findings received further evaluation. Of these, 11 (10.9%) were classified as “indeterminate,” 50 (49%) as “likely clinically unimportant,” and 41 (40.1%) were classified as “likely clinically important.” Excellent agreement was observed between the reviewing radiologists for all evaluated parameters. Conclusion: The addition of an expanded FOV coronal sequence to the standard lumbar spinal MRI protocol was associated with the identification of a large number of incidental abdominopelvic findings, the minority of which represent likely clinically important findings. Most incidental findings were confidently dismissed by a neuroimaging radiologist as likely clinically unimportant without utilization of additional clinical or radiographic resources. - Highlights: • Expanded field-of-view (FOV) MRI improves detection of important incidental findings.

  9. Comparación entre la respuesta de la actividad muscular lumbar en plataforma vibratoria y en ejercicio clásico de squat isométrico en 30º y 60º. (A comparison of the lumbar muscle activity responsein 30º and 60º isometric squat between whole-body vibration and a classic exercise.

    Directory of Open Access Journals (Sweden)

    Alejandro Santos-Lozano

    2012-01-01

    Full Text Available Whole-body vibration (WBV has improved as a variety of exercises, so it is necessary know muscles responses to the vibration stimulus.The aim of this work was to study and to compare the change in muscle activation in the lumbar area and lower body between the whole-body vibration exercise and classic strength exercises in isometric squat.23 subjects were exposed to six different loads in one of each exercise mode: vibration or classic strength. Both exercises were performed at 30º and 60º semi-squat position. Muscle activity of the lower body and lumbar area was measured using surface electromyography activity (EMG.The results showed that the response of lumbar area in WBV was lower than in the classic strength exercise at the same value of lower body sEMG. Lumbar sEMG was highest for the classic exercise. Moreover, during 30º squat sEMG was higher than during 60ºsquat.ResumenEl aumento del uso de la plataforma vibratoria como forma de realizar ejercicio conlleva la necesidad de conocer las respuestas musculares al estímulo de la misma.El objetivo de este trabajo ha sido estudiar y comparar la respuesta de la activación muscular de la zona lumbar y del tren inferior en el trabajo de plataforma vibratoria con el trabajo clásico de fuerza en un squat isométrico.23 sujetos fueron sometidos a 6 condiciones de vibración y a 6 de un trabajo clásico de pesas. Se analizó la sEMG del tren inferior y de la zona lumbar en un trabajo isométrico de un squat con flexión de 30º y 60º de rodilla.Los resultados muestran que para un mismo valor de sEMG del tren inferior, los valores de sEMG de la zona lumbar son menores en el ejercicio vibratorio. Existiendo en el trabajo de pesas una mayor exigencia en la zona lumbar. Además, con una flexión de 30º la activación muscular es mayor en todas las condiciones. (p

  10. Age-related changes in vertebral and iliac crest 3D bone microstructure-differences and similarities

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Jensen, Michael Vinkel; Niklassen, Andreas Steenholt

    2015-01-01

    Summary Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure...... was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes.Introduction The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between...... the bone microstructure at these skeletal sites.Methods Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19–96 years) and 39 men (23–95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified.Results For both women...

  11. Intrathecal ligaments and nerve root tension: possible sources of lumbar pain during spaceflight.

    Science.gov (United States)

    Kershner, David; Binhammer, Robert

    2004-04-01

    Lumbar intrathecal ligaments have recently been demonstrated to randomly bind dorsal nerve roots to the dura within the lumbar vertebral column. Lengthening of the vertebral column and associated lumbar back pain experienced by astronauts is common in microgravity. This study was designed to investigate the relationship of lumbar intrathecal ligaments in spinal lengthening as a possible mechanism for back pain. A two-part study was designed using 36 vertebral columns from embalmed cadavers. There were 12 vertebral columns studied in mid-sagittal section to demonstrate the possible movement of the spinal cord during lengthening of the vertebral column. The remainder were assessed for the amount of tension placed on a dorsal nerve root by the lumbar intrathecal ligament during lengthening of the vertebral column. The spinal cord moves in a cephalic direction approximately 2.8 mm with 4 cm lengthening of the vertebral column. During lengthening, a loss of thoracic and lordotic curvature was noted with an increase in disk height. Tension was significantly increased on the dorsal nerve roots being tethered by the lumbar intrathecal ligaments in comparison to non-tethered nerve roots during lengthening of the vertebral column. A significant amount of tension is placed on dorsal nerve roots tethered by intrathecal ligaments within the lumbar spine during spinal lengthening. These ligaments randomly bind dorsal nerve roots in the lumbar spine and may be involved in the back pain experienced by astronauts in microgravity.

  12. Prevalence of osteoporosis, vertebral fractures and hypovitaminosis D in postmenopausal women living in a rural environment.

    Science.gov (United States)

    Gómez-de-Tejada Romero, María-Jesús; Navarro Rodríguez, María-del-Carmen; Saavedra Santana, Pedro; Quesada Gómez, José-Manuel; Jódar Gimeno, Esteban; Sosa Henríquez, Manuel

    2014-03-01

    First, to study the difference between two groups of postmenopausal women living in different population centres (rural vs urban) in the prevalence of osteoporosis, fragility fractures and factors which may influence them: hypovitaminosis D, bone mineral density, coexistence of other diseases which predispose to their appearance; secondly, to observe the influence of low socioeconomic status, categorised as poverty. 1229 postmenopausal women were studied, of whom 390 (31.7%), were living in rural areas and 839 (68.3%), in urban areas. Data regarding risk factors related to osteoporosis were obtained, and, among other biochemical measures, 25 hydroxyvitamin D and parathyroid hormone were determined. Bone densitometry was carried out in the lumbar spine and proximal femur, as well as lateral X-rays of the dorsal and lumbar spine. The women who lived in rural areas were older, shorter, heavier and had a higher body mass index than those from urban areas. Among the women from rural areas there was a higher prevalence of poverty, and higher levels of obesity, arterial hypertension and diabetes mellitus were observed, as well as a higher prevalence of densitometric osteoporosis. The rural women had lower values of bone mineral density in the lumbar spine and a higher prevalence of vertebral fractures and hypovitaminosis D. The variables which were associated independently with living in rural areas were poverty, obesity, vertebral fractures, BMD in the lumbar spine and levels of 25 hydroxyvitamin D. In our study, postmenopausal women who live in rural populations have more poverty, lower values of vitamin D, lower BMD in the lumbar spine and a higher prevalence of vertebral fractures and of osteoporosis. The higher prevalence of obesity, arterial hypertension and diabetes mellitus observed in these women may be adjuvant factors, all fostered by their socioeconomic state of poverty. Copyright © 2014. Published by Elsevier Ireland Ltd.

  13. [Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation].

    Science.gov (United States)

    Hu, Hua; Xiong, Chang-Yuan; Han, Guo-Wu

    2012-07-01

    To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 software was established a lumbar pelvic and proximal femur geometric model, then the model was modified with Geomagic 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time,add disc and ligaments. According to the principle of lumbar rotatory manipulation,the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. 1) Under the same condition,the displacement order of lumbar was L1>L2>L3>L5 L5, anterior column > middle column > posterior column. 2) Under the different conditions, the displacement order of lumbar,case 3>case 1>case 4>case 2. 3) Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2 to L5S1 was L1,2>L2,3>L3,4>L4,5>L5S1, as for the same inter-vertebral disc, the order was: second quadrant>third quadrant>first quadrant>fourth quadrant. 4) Under the different conditions,the displacement order of the inter-vertebral disc was L1,2>L2,3>L3,4>L4,5>L5S1, but to same inter-vertebral disc: case 3>case 4>case 1 >case 2. 5) There were apparent displacement and stress concentration in pelvis and hip during the manipulation. 1) The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model; 2) During the process of lumbar rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; 3) During the process of lumbar rotatory manipulation, all the conditions of lumbar pelvic and proximal femur must be

  14. Age-related distribution of vertebral bone-marrow diffusivity

    Energy Technology Data Exchange (ETDEWEB)

    Herrmann, Jochen, E-mail: j.herrmann@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Department of Pediatric Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Krstin, Nina, E-mail: ninakrstin@web.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Schoennagel, Bjoern P., E-mail: b.schoennagel@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Sornsakrin, Marjike, E-mail: m.sornsakrin@uke.de [Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg (Germany); Derlin, Thorsten, E-mail: t.derlin@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Busch, Jasmin D., E-mail: jd.busch@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Petersen, Kay Uwe, E-mail: Kay.Petersen@med.uni-tuebingen.de [Department of Psychiatry, University Clinic Tübingen, Calwerstraße 14 Tübingen 72076 (Germany); Graessner, Joachim, E-mail: joachim.graessner@siemens.com [Siemens AG Healthcare, Lindenplatz 2, 20099 Hamburg (Germany); Adam, Gerhard, E-mail: g.adam@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany); Habermann, Christian R., E-mail: c.habermann@uke.de [Department of Diagnostic and Interventional Radiology, Martinistraße 52, D-20246 Hamburg (Germany)

    2012-12-15

    Purpose: To determine age-related diffusivity changes of the lumbar bone marrow by measurement of apparent diffusion coefficient (ADC) values. Materials and methods: The local ethics committee approved this study and written informed consent was obtained. The study group comprised 88 individuals including 75 healthy volunteers and 13 patients (48 female, 40 male; mean age 36 years, range 0–84 years). The pediatric cases were recruited from patients. Echo-planar diffusion weighted imaging (DWI) was performed with b-values of 50, 400 and 800 s/mm{sup 2}. ADC-values were calculated and measured in the 1st and 2nd vertebral body of the lumbar spine. Correlation between age and ADC-values was analyzed with Spearman's rho test. Results: The ADC values of the vertebral bone marrow of the lumbar spine showed a significant negative correlation with age (rho = −0.398, p = 0.001). The mean ADC values (×10{sup −3} mm{sup 2}/s) in the age groups 0–29 years (mean age 18.0 years, n = 42) and 30–88 years (mean age 51.6 years, n = 46) were 0.54 ± 0.07 and 0.47 ± 0.08, respectively (p < 0.001, T-test). No significant differences were found between children and young adults. Conclusion: Bone marrow ADC values of the lumbar spine show a linear decrease with growing age and thereby reflect the gradual changes of cell composition occurring during marrow conversion.

  15. NONFUSION STABILIZATION IN THE DEGENERATIVE LUMBAR SPINE DISEASES

    Directory of Open Access Journals (Sweden)

    Matjaž Voršič

    2009-04-01

    Conclusions Cosmic is a posterior dynamic nonfusion pedicle screw-rod system for the stabilization of the lumbar vertebral column. It represents the new step in the development of the spinal instrumentation and can efficiently replace the spondylodesis in the treatment of painful degenerative diseases of the lumbar spine.

  16. Direct vertebral body derotation, thoracoplasty, or both: which is better with respect to inclinometer and scoliosis research society-22 scores?

    Science.gov (United States)

    Samdani, Amer F; Hwang, Steven W; Miyanji, Firoz; Lonner, Baron; Marks, Michelle C; Sponseller, Paul D; Newton, Peter O; Cahill, Patrick J; Shufflebarger, Harry L; Betz, Randal R

    2012-06-15

    Prospective, longitudinal cohort (nonrandomized). To compare thoracoplasty (Th), direct vertebral body derotation (DVBD), and Th and DVBD with respect to correction of the rib prominence and Scoliosis Research Society (SRS) self-image scores in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Rib prominence correction is one of the main goals of AIS surgery. Th and DVBD are powerful tools for correction of the rib prominence; however, a paucity of literature exists comparing Th, DVBD, and Th and DVBD. A prospective longitudinal database was queried to identify patients with AIS who underwent a posterior spinal fusion with pedicle screws and 2 years of follow-up. A total of 326 patients were identified and divided into 3 groups: (1) Th alone (N = 47), (2) DVBD alone (N = 196), and (3) both Th and DVBD (N = 83). Patients were subdivided into categories on the basis of their preoperative inclinometer reading: (1) ≤9° (mild), (2) 10 to 15° (moderate), and (3) ≥ 16° (severe). Pre- and postoperative inclinometer readings and SRS self-image scores were compared using analysis of variance. Overall, the groups were similar preoperatively except for the DVBD group having higher percentage of thoracic flexibility. The preoperative rib prominence values were Th = 13.2, DVBD = 14.0, and Th and DVBD = 12.9 (P = 0.27). Taken collectively, the postoperative 2-year inclinometer readings were similar for all 3 groups (Th = 5.2, DVBD = 7.0, Th and DVBD = 5.6; P = 0.66). However, the SRS-22 self-image scores were significantly better for patients having both Th and DVBD (Th = 3.37, DVBD = 3.44, Th and DVBD = 3.76; P self-image scores were highest in the Th and DVBD group. In patients with larger rib prominences, the addition of Th was necessary for optimal rib prominence correction, but there was no difference in SRS-22 self-image scores. Our results suggest that Th alone, DVBD alone, or both Th and DVBD provide equivalent inclinometer results in patients

  17. Fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body metastases: acceptable local control and normal tissue tolerance with 5 fraction approach

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant; Oermann, Eric; Ju, Andrew; Suy, Simeng; Yu, Xia; Rabin, Jennifer [Department of Radiation Medicine, Georgetown University Hospital,, Washington, DC (United States); Kalhorn, Christopher; Nair, Mani N.; Voyadzis, Jean-Marc [Department of Neurosurgery, Georgetown University Hospital,, Washington, DC (United States); Unger, Keith; Collins, Sean P.; Harter, K. W.; Collins, Brian T., E-mail: collinsb@gunet.georgetown.edu [Department of Radiation Medicine, Georgetown University Hospital,, Washington, DC (United States)

    2012-04-26

    This retrospective analysis examines the local control and toxicity of five-fraction fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body (VB) metastases. All patients had favorable performance status (ECOG 0–1), oligometastatic disease, and no prior spine irradiation. A prescribed dose of 30–35 Gy was delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight spine tracking. Suggested maximum spinal cord and esophagus point doses were 30 and 40 Gy, respectively. A median 30 Gy (IQR, 30–35 Gy) dose was delivered to a median prescription isodose line of 70% (IQR, 65–77%) to 20 patients. At 34 months median follow-up (IQR, 25–40 months) for surviving patients, the 1- and 2-year Kaplan–Meier local control estimates were 80 and 73%, respectively. Two of the five local failures were infield in patients who had received irradiation to the gross tumor volume and three were paravertebral failures just outside the PTV in patients with prior corpectomy. No local failures occurred in patients who completed VB radiation alone. The 1- and 2-year Kaplan–Meier overall survival estimates were 80 and 57%, respectively. Most deaths were attributed to metastatic disease; one death was attributed to local recurrence. The mean maximum point doses were 26.4 Gy (SD, 5.1 Gy) to the spinal cord and 29.1 Gy (SD, 8.9 Gy) to the esophagus. Patients receiving maximum esophagus point doses greater than 35 Gy experienced acute dysphagia (Grade I/II). No spinal cord toxicity was documented. Five-fraction fiducial-free CyberKnife SBRT is an acceptable treatment option for newly diagnosed VB metastases with promising local control rates and minimal toxicity despite the close proximity of such tumors to the spinal cord and esophagus. A prospective study aimed at further enhancing local control by targeting the intact VB and escalating the total dose is planned.

  18. Lumbar spinal stenosis

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    Spinal stenosis, which has attracted increasing attention in recent years, represents an important group of clinical and radiologic entities. Recognition and ultimate surgical management of the many abnormalities found in this group require precise preoperative delineation of the morbid anatomy. Conventional axial tomography provided the first accurate picture of the sagittal dimension, but it was limited by poor contrast resolution. Computerized tomography and ultrasound have finally provided the means for accurate measurement of midsagittal diameter and surface area. It is now possible to provide a preoperative assessment of bony and soft-tissue canal compression and to guide surgical decompression by objective anatomic measurements. True spinal stenosis of the lumbar vertebral canal is a form of compression produced by the walls of the vertebral canal. It involves the whole of the vertebral canal by exerting compression at two of its opposite surfaces. There are two types of stenosis: (1) transport stenosis, wherein the clinical manifestations are due to impeded flow of fluid, which is dependent on the available cross-sectional area of the canal surface of the stenotic structure, and (2) compressive stenosis, which includes abnormal compression of opposing surfaces only. According to these definitions, indentation on the spinal canal by disc protrusion or localized tumor is not considered true spinal stenoses. In this chapter the authors discuss only those conditions that produce true canal stenosis

  19. Cross sectional CT morphology of the three lower lumbar vertebrae: with contributions to a more accurate interpretation of AP radiographs of the lumbar spine

    International Nuclear Information System (INIS)

    Schaik, J.P.J. van.

    1984-01-01

    This thesis is concerned with a cross-sectional morphological analysis of certain structures contained in the bony portion of the motion segments between L3 and S1, the vertebral bodies included. Measurements of lengths and angles were based on the use of constant reference points, which permitted comparative studies. Reference points were selected which were sufficiently well defined as to avoid gross errors in measurements. The lateral borders of the vertebral body of L3 are well visualized in AP radiographs, as well as the entire circumference of the pedicles. The bony cortical margins of these structures are more or less orientated in a sagittal direction, and are therefore caught by the X ray beam tangentially over the major part of their length. This tangential projection results in a sharp definition of these margins. Radiographic analysis of wired specimens of lumbar vertebrae showed that the shadow cast by the spinous process in the AP projection corresponds with its posterior portion. (Auth.)

  20. Anatomy of the psoas muscle and lumbar plexus with respect to the surgical approach for lateral transpsoas interbody fusion.

    Science.gov (United States)

    Kepler, Christopher K; Bogner, Eric A; Herzog, Richard J; Huang, Russel C

    2011-04-01

    Lateral transpsoas interbody fusion (LTIF) is a minimally invasive technique that permits interbody fusion utilizing cages placed via a direct lateral retroperitoneal approach. We sought to describe the locations of relevant neurovascular structures based on MRI with respect to this novel surgical approach. We retrospectively reviewed consecutive lumbosacral spine MRI scans in 43 skeletally mature adults. MRI scans were independently reviewed by two readers to identify the location of the psoas muscle, lumbar plexus, femoral nerve, inferior vena cava and right iliac vein. Structures potentially at risk for injury were identified by: a distance from the anterior aspect of the adjacent vertebral bodies of muscle and lumbar plexus is described which allows use of the psoas position as a proxy for lumbar plexus position to identify patients who may be at risk, particularly at the L4-5 level. Further study will establish the clinical relevance of these measurements and the ability of neurovascular structures to be retracted without significant injury.

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

    International Nuclear Information System (INIS)

    Morrison, J.L.; Kaplan, P.A.; Dussault, R.G.; Anderson, M.W.

    2000-01-01

    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.)

  2. 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.)

  3. MR tomography in the assessment of functional stability of posterolateral lumbar fusions

    International Nuclear Information System (INIS)

    Lang, P.; Genant, H.K.; Chafetz, N.; Steiger, P.; Stoller, D.; California Univ., San Francisco

    1987-01-01

    MR tomography was used to assess functional lumbar stability in 30 patients with posterolateral fusions. The vertebral bodies of 9 of the 12 patients with unstable lumbar fusions presented with areas of decreased signal intensity on T 1 - and intermediately weighted images, which increased on T 2 -weighting. The vertebrae of 15 of the 18 patients with stable fusions demonstrated zones of increased signal intensity on T 1 - and intermediately weighted images, which were less intense or invisible on T 2 -weighting. Surgical correlation was available in 11 of the 30 patients studied. Hyperemia and inflammation appear to be responsible for the abnormal signal intensities in the patients with stable fusions, whereas an increase in adipose marrow due to decreased biomechanical stress is thought to account for the atypical signal intensities in the vertebral bodies of the patients with stable fusions. MR tomography seems to be a potential method for evaluating functional lumbar fusion stability. MR tomography may be particularly helpful in those patients with multiple back surgeries and possible instability, recurrent disc herniation, or post-operative fibrosis. MR is recommended in the patient, who appears clinically unstable, whose radiographs and CT, however, do not demonstrate fusion failure. (orig.) [de

  4. 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

  5. Quantification of localized vertebral deformities using a sparse wavelet-based shape model.

    Science.gov (United States)

    Zewail, R; Elsafi, A; Durdle, N

    2008-01-01

    Medical experts often examine hundreds of spine x-ray images to determine existence of various pathologies. Common pathologies of interest are anterior osteophites, disc space narrowing, and wedging. By careful inspection of the outline shapes of the vertebral bodies, experts are able to identify and assess vertebral abnormalities with respect to the pathology under investigation. In this paper, we present a novel method for quantification of vertebral deformation using a sparse shape model. Using wavelets and Independent component analysis (ICA), we construct a sparse shape model that benefits from the approximation power of wavelets and the capability of ICA to capture higher order statistics in wavelet space. The new model is able to capture localized pathology-related shape deformations, hence it allows for quantification of vertebral shape variations. We investigate the capability of the model to predict localized pathology related deformations. Next, using support-vector machines, we demonstrate the diagnostic capabilities of the method through the discrimination of anterior osteophites in lumbar vertebrae. Experiments were conducted using a set of 150 contours from digital x-ray images of lumbar spine. Each vertebra is labeled as normal or abnormal. Results reported in this work focus on anterior osteophites as the pathology of interest.

  6. A case of lumbar pain after intraoperative radiotherapy

    International Nuclear Information System (INIS)

    Shimizu, Wakako; Ogino, Takashi; Murakami, Koji; Nawano, Shigeru; Moriyama, Noriyuki; Ryu, Munemasa; Kawano, Nariaki

    1996-01-01

    We report a case of abnormal magnetic resonance imaging (MRI) findings after intraoperative radiotherapy. A 53-year-old woman with cancer of the papilla of Vater was treated with pancreatoduodenectomy and 20 Gy of intraoperative radiotherapy by electron beam to the tumor bed. Three months later the patient complained of lumbar pain. A change of signal intensity on MRI was detected in the anterior half of the vertebral body within the irradiated field. The signal was of high intensity but was not enhanced by Gd-DTPA on T1-weighted images, was isointense on T2-weighted images and of low intensity with the fat-suppression method. The radiation dose to the lumbar spine and the surrounding soft tissue was calculated to be 16 Gy. Histologic changes in bone after irradiation may include depletion of bone marrow cells and fat degeneration. The MRI findings were compatible with these changes. The radiation dose that can be tolerated by soft tissue is lower than that tolerated by bone. Therefore, late radiation injury of the soft tissue might have been the cause of the patient's lumbar pain. (author)

  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. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    Huwart, Laurent; Foti, Pauline; Andreani, Olivier; Hauger, Olivier; Cervantes, Elodie; Brunner, Philippe; Boileau, Pascal; Amoretti, Nicolas

    2014-01-01

    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

  9. Evaluation of a Novel HA/ZrO2-Based Porous Bioceramic Artificial Vertebral Body Combined with a rhBMP-2/Chitosan Slow-Release Hydrogel.

    Directory of Open Access Journals (Sweden)

    Yihui Shi

    Full Text Available A new HA/ZrO2-based porous bioceramic artificial vertebral body (AVB, carried a recombinant human bone morphogenetic protein-2 (rhBMP-2/chitosan slow-release hydrogel was prepared to repair vertebral bone defect in beagles. An ionic cross-linking was used to prepare the chitosan hydrogel (CS gel as the rhBMP-2 slow-release carrier. The vertebral body defects were implanted with the rhBMP-2-loaded AVB in group A, or a non-drug-loaded AVB in group B, or autologous iliac in group C. The encapsulation rate of rhBMP-2 in rhBMP-2-loaded CS gel was 91.88±1.53%, with a drug load of 39.84±2.34 ng/mg. At 6, 12, 24 weeks postoperatively, radiography showed that the bone calluses gradually increased with time in group A, where the artificial vertebral body had completely fused with host-bone at 24 weeks after surgery. In group C, an apparent bone remodeling was occurred in the early stages, and the graft-bone and host-bone had also fused completely at 24 weeks postoperatively. In group B, fusion occurred less than in groups A and C. At 24 weeks after surgery, micro-computed tomography (Micro-CT revealed that the volume of newly-formed bone in group A was significantly more than in group B (p<0.05. At 24 weeks after surgery, ultra-compressive strengths of the operated segments were 14.03±1.66 MPa in group A, 8.62±1.24 MPa in group B, and 13.78±1.43 MPa in group C. Groups A and C were both significantly higher than group B (p < 0.05. At 24 weeks postoperatively, the hard tissue sections showed that the AVB of group A had tightly fused with host bone, and that pores of the AVB had been filled with abundant nearly mature bone, and that the new bone structured similarly to a trabecular framework, which was similar to that in group C. In contrast, implant fusion of the AVB in group B was not as apparent as group A. In conclusion, the novel HA/ZrO2-based porous bioceramic AVB carried the rhBMP-2-loaded CS gel can promote the repair of bony defect, and induce

  10. Lumbar subtotal corpectomy non-fusion model produced using a novel prosthesis.

    Science.gov (United States)

    Liu, Jiantao; Zhang, Feng; Gao, Zhengchao; Li, Yuhuan; Niu, Binbin; He, Xijing

    2017-11-01

    In this study, we aimed to design a movable artificial lumbar complex (MALC) prosthesis for non-fusion reconstruction after lumbar subtotal corpectomy and to establish an in vitro anterolateral lumbar corpectomy non-fusion model for evaluating the biomechanical stability, preservation of segment movements and influence on adjacent inter-vertebral movements of this prosthesis. Imaging was performed on a total of 26 fresh goat lumbar spine specimens to determine which of the specimens did not meet the requirements (free of deformity and fractures); the residual specimens were randomly divided into an intact group, a fusion group and a non-fusion group. Bone mineral density (BMD) was tested and compared among the three groups. Biomechanical testing was conducted to obtain the range of motion (ROM) in flexion-extension, lateral bending at L2-3, L3-4 and L4-5 and axial rotation at L2-5 in the three groups. Two specimens were excluded due to vertebral fractures. BMD showed no statistical significance among three groups (P > 0.05). The stability of the prosthesis did not differ significantly during flexion, extension, and lateral bending at L2-3, L3-4, and L4-5 and axial torsion at L2-5 between the intact group and the non-fusion group (P > 0.05). Segment movements of the specimens in the non-fusion group revealed significantly decreased L2-3 ROM and significantly increased L3-4 and L4-5 ROM in flexion and lateral bending compared with the fusion group (P inter-vertebral spaces. However, additional studies, including in vivo animal experiments as well as biocompatibility and biomechanical tests of human body specimens are needed.

  11. Kyphoplasty for vertebral augmentation in the elderly with osteoporotic vertebral compression fractures: scenarios and review of recent studies.

    Science.gov (United States)

    Bednar, Timothy; Heyde, Christoph E; Bednar, Grace; Nguyen, David; Volpi, Elena; Przkora, Rene

    2013-11-01

    Vertebral compression fractures caused by osteoporosis are among the most common fractures in the elderly. The treatment focuses on pain control, maintenance of independence, and management of the osteoporosis. Elderly patients often encounter adverse effects to pain medications, do not tolerate bed rest, and are not ideal candidates for invasive spinal reconstructive surgery. Percutaneous vertebral augmentation (vertebroplasty or kyphoplasty) has become popular as a less-invasive alternative. However, studies have questioned the effectiveness of these procedures. The authors conducted a MEDLINE search using relevant search terms including osteoporosis, osteoporotic vertebral compression fracture, elderly, kyphoplasty and vertebroplasty. Two elderly patients presented with a fracture of their third and first lumbar vertebral body, respectively. One patient progressed well with conservative treatment, whereas the other patient was hospitalized secondary to pain after conservative measures failed to offer improvement. The hospitalized patient subsequently opted for a kyphoplasty and was able to resume his normal daily activities after the procedure. Selecting patients on an individual case-by-case basis can optimize the effectiveness and outcomes of a vertebral augmentation. This process includes the documentation of an osteoporotic vertebral compression fracture with the aide of imaging studies, including the acuity of the fracture as well as the correlation with the physical examination findings. Patients who are functional and improving under a conservative regimen are not candidates for kyphoplasty. However, if the conservative management is not successful after 4 to 6 weeks and the patient is at risk to become bedridden, an augmentation should be considered. A kyphoplasty procedure may be preferred over vertebroplasty, given the lower risk profile and better outcomes regarding spinal alignment. Published by Elsevier HS Journals, Inc.

  12. Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction.

    Science.gov (United States)

    Mellor, F E; Thomas, P; Breen, A

    2014-08-01

    Quantitative fluoroscopy is an emerging technology for assessing continuous inter-vertebral motion in the lumbar spine, but information on radiation dose is not yet available. The purposes of this study were to compare the radiation dose from quantitative fluoroscopy of the lumbar spine with lumbar spine radiographs, and identify opportunities for dose reduction in quantitative fluoroscopy. Internationally reported dose area product (DAP) and effective dose data for lumbar spine radiographs were compared with the same for quantitative fluoroscopy and with data from a local hospital for functional radiographs (weight bearing AP, lateral, and/or flexion and extension) ( n  = 27). The effects of procedure time, age, weight, height and body mass index on the fluoroscopy dose were determined by multiple linear regression using SPSS v19 software (IBM Corp., Armonck, NY, USA). The effective dose (and therefore the estimated risk) for quantitative fluoroscopy is 0.561 mSv which is lower than in most published data for lumbar spine radiography. The dose area product (DAP) for sagittal (flexion + extension) quantitative fluoroscopy is 3.94 Gy cm 2 which is lower than local data for two view (flexion and extension) functional radiographs (4.25 Gy cm 2 ), and combined coronal and sagittal dose from quantitative fluoroscopy (6.13 Gy cm 2 ) is lower than for four view functional radiography (7.34 Gy cm 2 ). Conversely DAP for coronal and sagittal quantitative fluoroscopy combined (6.13 Gy cm 2 ) is higher than that published for both lumbar AP or lateral radiographs, with the exception of Nordic countries combined data. Weight, procedure time and age were independently positively associated with total dose, and height (after adjusting for weight) was negatively associated, thus as height increased, the DAP decreased.

  13. Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction

    International Nuclear Information System (INIS)

    Mellor, F.E.; Thomas, P.; Breen, A.

    2014-01-01

    Purpose: Quantitative fluoroscopy is an emerging technology for assessing continuous inter-vertebral motion in the lumbar spine, but information on radiation dose is not yet available. The purposes of this study were to compare the radiation dose from quantitative fluoroscopy of the lumbar spine with lumbar spine radiographs, and identify opportunities for dose reduction in quantitative fluoroscopy. Methods: Internationally reported dose area product (DAP) and effective dose data for lumbar spine radiographs were compared with the same for quantitative fluoroscopy and with data from a local hospital for functional radiographs (weight bearing AP, lateral, and/or flexion and extension) (n = 27). The effects of procedure time, age, weight, height and body mass index on the fluoroscopy dose were determined by multiple linear regression using SPSS v19 software (IBM Corp., Armonck, NY, USA). Results and conclusion: The effective dose (and therefore the estimated risk) for quantitative fluoroscopy is 0.561 mSv which is lower than in most published data for lumbar spine radiography. The dose area product (DAP) for sagittal (flexion + extension) quantitative fluoroscopy is 3.94 Gy cm 2 which is lower than local data for two view (flexion and extension) functional radiographs (4.25 Gy cm 2 ), and combined coronal and sagittal dose from quantitative fluoroscopy (6.13 Gy cm 2 ) is lower than for four view functional radiography (7.34 Gy cm 2 ). Conversely DAP for coronal and sagittal quantitative fluoroscopy combined (6.13 Gy cm 2 ) is higher than that published for both lumbar AP or lateral radiographs, with the exception of Nordic countries combined data. Weight, procedure time and age were independently positively associated with total dose, and height (after adjusting for weight) was negatively associated, thus as height increased, the DAP decreased

  14. Acute vertebral fracture after spinal fusion: a case report illustrating the added value of single-source dual-energy computed tomography to magnetic resonance imaging in a patient with spinal Instrumentation

    International Nuclear Information System (INIS)

    Fuchs, M.; Putzier, M.; Pumberger, M.; Hermann, K.G.; Diekhoff, T.

    2016-01-01

    Magnetic resonance imaging (MRI) is degraded by metal-implant-induced artifacts when used for the diagnostic assessment of vertebral compression fractures in patients with instrumented spinal fusion. Dual-energy computed tomography (DECT) offers a promising supplementary imaging tool in these patients. This case report describes an 85-year-old woman who presented with a suspected acute vertebral fracture after long posterior lumbar interbody fusion. This is the first report of a vertebral fracture that showed bone marrow edema on DECT; however, edema was missed by an MRI STIR sequence owing to metal artifacts. Bone marrow assessment using DECT is less susceptible to metal artifacts than MRI, resulting in improved visualization of vertebral edema in the vicinity of fused vertebral bodies. (orig.)

  15. Bone fractures and lumbar mineral density after renal transplantation. A long-term cross-sectional study.

    Science.gov (United States)

    Jiménez, Sara; Marcén, Roberto; Vaamonde, Carlos; Caballero, Carmen; Fernández-Rodríguez, Ana; Villafruela, Juan José; Galeano, Cristina; Teruel, José Luis; Quereda, Carlos

    2016-02-01

    The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD). One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft function, biochemical mineral metabolism markers and body mass density (DEXA) were measured. Vertebral fractures were assessed by a semiquantitative analysis of lateral spine X-ray exam. At the time of the study, intact parathyroid hormone levels were 127.5 ± 78.4 pg/mL and serum calcidiol 20.4 ± 9.3 ng/mL. DEXA showed osteopenia in 47% and osteoporosis in 23% at lumbar spine, 51% and 14% at femoral neck, and 53% and 8% at trochanter. Eighty-five recipients presented vertebral fractures, 69 mild and 16 moderate/severe fractures. In the multivariate analysis, vertebral fractures were associated with older age (p = 0.010), length of follow-up (p = 0.022) and trochanter T-score (p = 0.038). Twenty-three patients presented peripheral fractures and 19 of them also had vertebral fractures. Patients with peripheral fractures were younger, mostly women and had lower BMD. Vertebral fractures were associated with lower BMD at trochanter. Most fractures were mild and were several times more frequent than in general population. Their clinical significance needs to be determined. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women.

    Science.gov (United States)

    Kim, Kyong-Chol; Shin, Dong-Hyuk; Lee, Sei-Young; Im, Jee-Aee; Lee, Duk-Chul

    2010-11-01

    The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p related to BMD of all sites (p related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.

  17. 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 osteoarthritis entered the regression model, however, greater spine BMD was associated with greater facet joint osteoarthritis (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.

  18. Unicameral bone cyst of a cervical vertebral body and lateral mass with associated pathological fracture in a child. Case report and review of the literature.

    Science.gov (United States)

    Snell, B E; Adesina, A; Wolfla, C E

    2001-10-01

    The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. Magnetic resonance imaging demonstrated mixed signal on both T1- and T2-weighted sequences, with cystic and enhancing solid portions. Magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.

  19. Primary Ewing's sarcoma of the vertebral column

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    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

  20. 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...

  1. Minimally invasive lateral trans-psoas approach for tuberculosis of lumbar spine

    Directory of Open Access Journals (Sweden)

    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.

  2. [Clinical observation of post-extension pulling massage in treating lumbar disc herniation].

    Science.gov (United States)

    Lü, Li-Jiang; Ke, Xue-Ai; Mao, Xu-Dan; Chen, Xiao-Jie; Wu, Fang-Chao; Tong, Hong-Jie

    2010-10-01

    To observe the clinical effect of post-extension pulling massage in treating lumbar disc herniation. From January 2008 to December 2008, 61 patients with lumbar disc herniation, 34 males and 27 females, ranging in age from 17 to 67 years with an average of 42.6 years, were treated with post-extension pulling massage after continued traction for 30 minutes (on alternate days one time, 3 times as a course of treatment). There was bulging type in 9 cases, hernia type in 22, free type in 30. After a course of treatment, the clinical effects were evaluated according to standard of Macnab, the items included pain, lumbar activity, normal work and life of patients. All patients were followed up from 1 to 9 months with an average of 4.6 months. After treatment, the symptoms and signs of patients had obviously improved in above aspects. According to standard of Macnab, 48 cases got excellent result, 10 good, 2 fair, 1 poor. The post-extension pulling massage in treating lumbar disc herniation can obtain satisfactory results, which have localized site of action, small compression for vertebral body and can reduce accidental injury.

  3. PARAMETERS OF NUCLEAR MAGNETIC RESONANCE IN PATIENTS WITH CONGENITAL NARROWING OF THE LUMBAR SPINAL CANAL

    Directory of Open Access Journals (Sweden)

    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.

  4. Lumbar paraspinal muscle transverse area and symmetry in dogs with and without degenerative lumbosacral stenosis.

    Science.gov (United States)

    Henderson, A L; Hecht, S; Millis, D L

    2015-10-01

    To investigate whether dogs with degenerative lumbosacral stenosis have decreased lumbar paraspinal muscle transverse area and symmetry compared with control dogs. Retrospective cross-sectional study comparing muscles in transverse T2-weighted magnetic resonance images for nine dogs with and nine dogs without degenerative -lumbosacral stenosis. Mean transverse area was measured for the lumbar multifidus and sacrocaudalis dorsalis lateralis muscles bilaterally and the L7 vertebral body at the level of the caudal endplate. Transverse areas of both muscle groups relative to L7 and asymmetry indices were compared between study populations using independent t tests. Mean muscle-to-L7 transverse area ratios were significantly smaller in the degenerative lumbosacral stenosis group compared with those in the control group in both lumbar multifidus (0·84 ±0·26 versus 1·09 ±0·25; P=0·027) and sacrocaudalis dorsalis lateralis (0·5 ±0·15 versus 0·68 ±0·12; P=0·005) muscles. Mean asymmetry indices were higher for both muscles in the group with degenerative lumbosacral stenosis than in the control group, but highly variable and the difference was not statistically significant. These findings suggest that dogs with degenerative lumbosacral stenosis have decreased lumbar paraspinal muscle mass that may be a cause or consequence of the -syndrome. Understanding altered paraspinal muscle characteristics may improve understanding of the -pathophysiology and management options for degenerative lumbosacral stenosis. © 2015 British Small Animal Veterinary Association.

  5. The influence of dietary and whole-body nutrient content on the excretion of a vertebrate consumer.

    Directory of Open Access Journals (Sweden)

    Christopher M Dalton

    Full Text Available In many contexts, nutrient excretion by consumers can impact ecosystems by altering the availability of limiting nutrients. Variation in nutrient excretion can be predicted by mass balance models, most of which are premised on two key ideas: (1 consumers maintain fixed whole-body nutrient content (i.e., %N and %P, so-called fixed homeostasis; (2 if dietary nutrients are not matched to whole-body nutrients, excesses of any nutrient are released as excretion to maintain fixed homeostasis. Mass balance models thus predict that consumer excretion should be positively correlated with diet nutrients and negatively correlated with whole-body nutrients. Recent meta-analyses and field studies, however, have often failed to find these expected patterns, potentially because of a confounding influence-flexibility in whole-body nutrient content with diet quality (flexible homeostasis. Here, we explore the impact of flexible homeostasis on nutrient excretion by comparing the N and P excretion of four genetically diverged Trinidadian guppy (Poecilia reticulata populations when reared on diets of variable P content. As predicted by mass balance, P excretion increased on the high-P diet, but, contrary to the notion of fixed homeostasis, guppy whole-body %P also increased on the high-P diet. While there was no overall correlation between excretion nutrients and whole-body nutrients, when the effect of diet on both whole-body and excretion nutrients was included, we detected the expected negative correlation between whole-body N:P and excretion N:P. This last result suggests that mass balance can predict excretion rates within species, but only if dietary effects on whole-body nutrient content are controlled. Flexible homeostasis can obscure patterns predicted by mass balance, creating an imperative to accurately capture an organism's diet quality in predicting its excretion rate.

  6. A clinical case study of long-term injury of the thoracic and lumbar spine

    Directory of Open Access Journals (Sweden)

    Vladimir V Zaretskov

    2016-06-01

    Full Text Available Overestimation of the efficacy of conservative treatment of spine injuries children often leads to unsatisfactory long-term results. The effective correction of post-traumatic spinal column deformities occurs in patients who undergo the operation in the early post-traumatic period. While choosing treatment strategies for children, higher reparative opportunities, which provide early fracture consolidation, including those in faulty positions, should be considered. This study presents a case of surgical treatment for uncomplicated injury of the thoracic and lumbar spine, with long-term compression fragmental fracture of the L1 vertebra body in a 12-year-old child. Due to the long-standing character of the injury right thoraco-frenotomy was conducted with partial L1 vertebral body and resection of the adjacent discs, deformity correction of the thoracic and lumbar spine with a transpedicular system, and ventral spondylodesis with an autograft. This extensive intervention was justified by the peculiarities in the vertebral body damage and the post-traumatic segmental kyphotic deformity that resulted from delayed medical treatment. An anterior approach was chosen to achieve immobilization at the site of the damage before correction using the transpedicular system. Surgical correction of long-term spinal injuries in children, with the use of a combined approach, is usually laborious and traumatic. The prevention of rigid post-traumatic spine deformities with the help of timely diagnostics and appropriate treatment, including surgery, should be a priority to prevent such cases.

  7. Clinical X-ray characteristics of some forms of hematogenous vertebral body osteomyelitis in children and adolescents

    International Nuclear Information System (INIS)

    Sizov, V.A.

    1988-01-01

    Clinico-roentgenological changes in dynamics are studied in 72 children and adolescents with a limited hematogenous vertebrae body osteomyelitis. The clinico-roentgenologic examination lasted from 1 to 15 years. Such a durable examination permitted to trace the development, regularities and remote results of the disease. The increase in vertebrae body height (lengthening) which is considered a pathognomonic sign of tuberculous spondylitis is described for the first time. Unlike tuberculosis, hematogenous spondylitis brings about the body lengthening of both ajacent nonaffected and affected vertebrae in the case of their surface or limited focal injury. 12 refs.; 1 fig

  8. Initial experience with the use of an expandable titanium cage as a vertebral body replacement in patients with tumors of the spinal column: a report of 95 patients.

    Science.gov (United States)

    Viswanathan, Ashwin; Abd-El-Barr, Muhammad M; Doppenberg, Egon; Suki, Dima; Gokaslan, Ziya; Mendel, Ehud; Rao, Ganesh; Rhines, Laurence D

    2012-01-01

    Vertebral body resection to treat spine tumors necessitates reconstruction to maintain spinal stability. The durability of reconstruction may be a challenge in cancer patients as treatment with chemotherapy and/or radiation coupled with poor nutritional status may compromise bone quality. We present a series of patients who underwent implantation of an expandable titanium cage (ETC) for reconstruction after vertebral body resection for primary or metastatic spine tumors. We report the functional outcome, assess the durability of reconstruction, and describe complications associated with this procedure. A retrospective review of patients undergoing placement of ETC after vertebrectomy for spinal tumor at our institution was performed. From September 2001 to August 2006, 95 patients underwent implantation of an ETC for reconstruction of the anterior spinal column following vertebrectomy for tumor (75 one-level, 19 two-level, 1 three-level). All patients underwent spinal stabilization as well. The median survival after surgery was 13.7 months; 23 patients had primary spinal tumors and 72 had metastatic tumors. Numerical pain scores were significantly improved postoperatively indicating a palliative benefit. No new neurological deficits were noted postoperatively, except when intentional neurological sacrifice was performed for oncologic reasons. Median height correction of 14% (range 0-118%) and median improvement in sagittal alignment of 6° (range 0-28°) were demonstrated on immediate postoperative imaging. Three patients experienced hardware related complications, one of which had posterior migration of the ETC. On postoperative imaging, 12 patients demonstrated subsidence of greater than 1 mm, but none required operative revision. Use of an ETC for spinal reconstruction in patients with spinal tumors is safe, decreases pain associated with pathologic fracture, protects neurologic function, and is durable. We found a very low incidence of cage-related construct

  9. Mineralization of the vertebral bodies in Atlantic salmon (Salmo salar L.) is initiated segmentally in the form of hydroxyapatite crystal accretions in the notochord sheath.

    Science.gov (United States)

    Wang, Shou; Kryvi, Harald; Grotmol, Sindre; Wargelius, Anna; Krossøy, Christel; Epple, Mattias; Neues, Frank; Furmanek, Tomasz; Totland, Geir K

    2013-08-01

    We performed a sequential morphological and molecular biological study of the development of the vertebral bodies in Atlantic salmon (Salmo salar L.). Mineralization starts in separate bony elements which fuse to form complete segmental rings within the notochord sheath. The nucleation and growth of hydroxyapatite crystals in both the lamellar type II collagen matrix of the notochord sheath and the lamellar type I collagen matrix derived from the sclerotome, were highly similar. In both matrices the hydroxyapatite crystals nucleate and accrete on the surface of the collagen fibrils rather than inside the fibrils, a process that may be controlled by a template imposed by the collagen fibrils. Apatite crystal growth starts with the formation of small plate-like structures, about 5 nm thick, that gradually grow and aggregate to form extensive multi-branched crystal arborizations, resembling dendritic growth. The hydroxyapatite crystals are always oriented parallel to the long axis of the collagen fibrils, and the lamellar collagen matrices provide oriented support for crystal growth. We demonstrate here for the first time by means of synchroton radiation based on X-ray diffraction that the chordacentra contain hydroxyapatite. We employed quantitative real-time PCR to study the expression of key signalling molecule transcripts expressed in the cellular core of the notochord. The results indicate that the notochord not only produces and maintains the notochord sheath but also expresses factors known to regulate skeletogenesis: sonic hedgehog (shh), indian hedgehog homolog b (ihhb), parathyroid hormone 1 receptor (pth1r) and transforming growth factor beta 1 (tgfb1). In conclusion, our study provides evidence for the process of vertebral body development in teleost fishes, which is initially orchestrated by the notochord. © 2013 Anatomical Society.

  10. CT study of vertebral metastasis: re-realization of the diagnostic role of the vertebral pedicle sign

    International Nuclear Information System (INIS)

    Meng Quanfei; Jiang Bo; Chen Yingming; Zhang Chaohui

    2000-01-01

    Objective: To investigate the essence of the vertebral pedicle sign of vertebral metastasis on plain film, and to explore the useful CT signs for the diagnosis and differential diagnosis of this tumor. Methods: The CT scans of the spine obtained in 48 patients with vertebral metastases, 19 patients with vertebral tuberculosis, and 11 with vertebral myeloma, were analyzed. The CT findings were correlated with the abnormalities seen on plain films in 34 of the 48 patients (66 vertebrae involved) with vertebral metastasis. Results: 66 vertebrae were involved in the group of metastasis. Of the 28 vertebrae whose vertebral body were completely destroyed, 15 were seen bilateral pedicles destruction; Of the 22 vertebrae with lateral destruction of the body, 16 were noticed unilateral pedicle destruction which located posterior to the involved side of the body. Of the 62 micro-metastatic foci, 56 were scattered in the vertebral body. In the 19 para-spinal soft-tissue masses of vertebral tuberculosis, 5 were noticed calcifications and 12 with postcontrast rings enhancement. The rates of vertebral pedicle destruction of vertebral metastasis and myeloma were not statistically different (X 2 = 0.03, P > 0.50). The locations of destruction of vertebral body in vertebral metastasis and myeloma had no statistical difference (X 2 = 3.52, P > 0.10), but they differed from that in tuberculosis (X 2 = 39.32, P < 0.001). The distribution of lesions within the vertebrae of metastasis and tuberculosis was similar, but was quite different from myeloma. Conclusion: The vertebral metastasis initially occurs in the vertebral body. The vertebral pedicle sign on plain film of vertebral metastasis is the outcome of the posterior invasion of the tumor in the vertebral body, which is of no differential significance for vertebral metastasis and myeloma. Para-spinal soft tissue mass, location of destruction of vertebral body, and the distribution of lesions within the vertebrae may help

  11. Case report 351: Aggressive osteoblastoma of the third lumbar vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Frankel, V.H.; Klein, M.J.

    1986-02-01

    In summary, a case is presented of an aggressive osteoblastoma affecting the third lumbar vertebra in a 65-year-old man. Because of the age of the patient, the aggressive, destructive nature of the tumor and the extensive involvement of the vertebral body, metastatic carcinoma as well as several primary malignancies were entertained in the differential diagnosis (e.g. plasmacytoma, chordoma, primary lymphoma of bone). However, the destructive, expanding nature of the lesion, the focal calcification within the area of destroyed bone, the production of new bone with dense sclerosis, raised the possibility of an osteoblastoma, despite the advanced age of the patient. Without the histological material, the type of osteoblastoma (aggressive) could not be diagnosed. (orig./SHA).

  12. Case report 351: Aggressive osteoblastoma of the third lumbar vertebra

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Frankel, V.H.; Klein, M.J.

    1986-01-01

    In summary, a case is presented of an aggressive osteoblastoma affecting the third lumbar vertebra in a 65-year-old man. Because of the age of the patient, the aggressive, destructive nature of the tumor and the extensive involvement of the vertebral body, metastatic carcinoma as well as several primary malignancies were entertained in the differential diagnosis (e.g. plasmacytoma, chordoma, primary lymphoma of bone). However, the destructive, expanding nature of the lesion, the focal calcification within the area of destroyed bone, the production of new bone with dense sclerosis, raised the possibility of an osteoblastoma, despite the advanced age of the patient. Without the histological material, the type of osteoblastoma (aggressive) could not be diagnosed. (orig./SHA)

  13. Preliminary result on trabecular bone score (TBS in lumbar vertebrae with experimentally altered microarchitecture

    Directory of Open Access Journals (Sweden)

    M. Di Stefano

    2013-01-01

    Full Text Available The aim of this preliminary research is to investigate the reliability of a new qualitative parameter, called Trabecular Bone Score (TBS, recently proposed for evaluating the microarchitectural arrangement of cancellous bone in scans carried out by dual energy X-ray absorptiometry (DXA. Vertebral bodies of 15 fresh samples of lumbar spines of adult pig were analysed either in basal conditions and with altered microarchitecture of the cancellous bone obtained by progressive drilling. The examined bony areas do not show changes in bone mineral density (BMD, whereas TBS values decrease with the increasing alteration of the vertebral microtrabecular structure. Our preliminary data seem to confirm the reliability of TBS as a qualitative parameter useful for evaluating the microarchitectural strength in bony areas quantitatively analysed by DXA.

  14. Comparative analysis of morphological and topometric parameters of lumbar spine in normal state and in degenerative-dystrophic changes

    Directory of Open Access Journals (Sweden)

    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.

  15. The extent of environmental and body contamination through aerosols by hydro-surgical debridement in the lumbar spine.

    Science.gov (United States)

    Putzer, David; Lechner, Ricarda; Coraca-Huber, Debora; Mayr, Astrid; Nogler, Michael; Thaler, Martin

    2017-06-01

    Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team. For both test setups, environmental contamination was observed in an area of 6 × 8 m. Both test setups caused contamination of all personnel present during the procedure and of the whole operating theatre. However, the concentration of contamination for the surgical staff and the environment was lower when an additional disposable draping device was used. The study showed that during hydro-surgery debridement, contaminated aerosols spread over the whole surgical room and contaminate the theatre and all personnel.

  16. Diagnosis of Lumbar Foraminal Stenosis using Diffusion Tensor Imaging.

    Science.gov (United States)

    Eguchi, Yawara; Ohtori, Seiji; Suzuki, Munetaka; Oikawa, Yasuhiro; Yamanaka, Hajime; Tamai, Hiroshi; Kobayashi, Tatsuya; Orita, Sumihisa; Yamauchi, Kazuyo; Suzuki, Miyako; Aoki, Yasuchika; Watanabe, Atsuya; Kanamoto, Hirohito; Takahashi, Kazuhisa

    2016-02-01

    Diagnosis of lumbar foraminal stenosis remains difficult. Here, we report on a case in which bilateral lumbar foraminal stenosis was difficult to diagnose, and in which diffusion tensor imaging (DTI) was useful. The patient was a 52-year-old woman with low back pain and pain in both legs that was dominant on the right. Right lumbosacral nerve compression due to a massive uterine myoma was apparent, but the leg pain continued after a myomectomy was performed. No abnormalities were observed during nerve conduction studies. Computed tomography and magnetic resonance imaging indicated bilateral L5 lumbar foraminal stenosis. DTI imaging was done. The extraforaminal values were decreased and tractography was interrupted in the foraminal region. Bilateral L5 vertebral foraminal stenosis was treated by transforaminal lumbar interbody fusion and the pain in both legs disappeared. The case indicates the value of DTI for diagnosing vertebral foraminal stenosis.

  17. Thoracic Vertebral Body Irradiation Contributes to Acute Hematologic Toxicity During Chemoradiation Therapy for Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deek, Matthew P.; Benenati, Brian [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Kim, Sinae [Department of Biostatistics, School of Public Health, Rutgers University, Piscataway, New Jersey (United States); Biometrics Division, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Chen, Ting; Ahmed, Inaya; Zou, Wei [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Aisner, Joseph [Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States); Jabbour, Salma K., E-mail: jabbousk@cinj.rutgers.edu [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (United States)

    2016-01-01

    Purpose: To determine the relationships between radiation doses to the thoracic bone marrow and declines in blood cell counts in non-small cell lung cancer (NSCLC) patients treated with chemoradiation therapy (CRT). Methods and Materials: We included 52 patients with NSCLC treated with definitive concurrent carboplatin–paclitaxel and RT. Dose-volume histogram (DVH) parameters for the thoracic vertebrae (TV), sternum, scapulae, clavicles, and ribs were assessed for associations with changes in blood counts during the course of CRT. Linear and logistic regression analyses were performed to identify associations between hematologic nadirs and DVH parameters. A DVH parameter of Vx was the percentage of the total organ volume exceeding x radiation dose. Results: Grade ≥3 hematologic toxicity including neutropenia developed in 21% (n=11), leukopenia in 42% (n=22), anemia in 6% (n=3), and throbocytopenia in 2% (n=1) of patients. Greater RT dose to the TV was associated with higher risk of grade ≥3 leukopenia across multiple DVH parameters, including TV V{sub 20} (TVV) (odds ratio [OR] 1.06; P=.025), TVV{sub 30} (OR 1.07; P=.013), and mean vertebral dose (MVD) (OR 1.13; P=.026). On multiple regression analysis, TVV{sub 30} (β = −0.004; P=.018) and TVV{sub 20} (β = −0.003; P=.048) were associated with white blood cell nadir. Additional bone marrow sites (scapulae, clavicles, and ribs) did not affect hematologic toxicity. A 20% chance of grade ≥3 leukopenia was associated with a MVD of 13.5 Gy and a TTV{sub 30} of 28%. Cutoff values to avoid grade ≥3 leukopenia were MVD ≤23.9 Gy, TVV{sub 20} ≤56.0%, and TVV{sub 30} ≤52.1%. Conclusions: Hematologic toxicity is associated with greater RT doses to the TV during CRT for NSCLC. Sparing of the TV using advanced radiation techniques may improve tolerance of CRT and result in improved tolerance of concurrent chemotherapy.

  18. Hidroterapia en el embarazo. Dolor lumbar

    OpenAIRE

    Martínez Manzano, Eva S.; Martínez Payá, Jacinto Javier

    2002-01-01

    Con este trabajo hemos estudiado las ventajas que tiene la hidroterapia en el embarazo y la presencia de dolor lumbar, tan frecuente, sobre todo en los últimos meses de gestación. Creemos conveniente hacer referencia a la evolución que sufre la columna vertebral de la cuadrupedia a la bipedestación. Dicho paso contribuye al desarrollo de la inteligencia humana, pero es un importante inconveniente para su columna vertebral, que sigue pagando tributo a la posición erguida, y al conj...

  19. Lumbar Drains Decrease the Risk of Postoperative Cerebrospinal Fluid Leak Following Endonasal Endoscopic Surgery for Suprasellar Meningiomas in Patients With High Body Mass Index.

    Science.gov (United States)

    Cohen, Salomon; Jones, Samuel H; Dhandapani, Sivashanmugam; Negm, Hazem M; Anand, Vijay K; Schwartz, Theodore H

    2018-01-01

    Postoperative cerebrospinal fluid (CSF) leak is a persistent, albeit much less prominent, complication following endonasal endoscopic surgery. The pathology with highest risk is suprasellar meningiomas. A postoperative lumbar drain (LD) is used to decrease the risk of CSF leak but is not universally accepted. To compare the rates of postoperative CSF leak between patients with and without LD who underwent endonasal endoscopic surgical resection of suprasellar meningiomas. A consecutive series of newly diagnosed suprasellar meningiomas was drawn from a prospectively acquired database of endonasal endoscopic surgeries at our institution. An intraoperative, preresection LD was placed and left open at 5 cc/h for ∼48 h. In a subset of patients, the LD could not be placed. Rates of postoperative CSF leak were compared between patients with and without an LD. Twenty-five patients underwent endonasal endoscopic surgical resection of suprasellar meningiomas. An LD could not be placed in 2 patients. There were 2 postoperative CSF leaks (8%), both of which occurred in the patients who did not have an LD (P = .0033). The average body mass index (BMI) of the patients in whom the LD could not be placed was 39.1 kg/m2, compared with 27.6 kg/m2 for those in whom the LD could be placed (P = .009). In the subgroup of obese patients (BMI > 30 kg/m2), LD placement was protective against postoperative CSF leak (P = .022). The inability to place an LD in patients with obesity is a risk factor for postoperative CSF leak. An LD may be useful to prevent postoperative CSF leak, particularly in patients with elevated BMI. Copyright © 2017 by the Congress of Neurological Surgeons

  20. Biomechanical effect of interspinous process distraction height after lumbar fixation surgery: An in vitro model.

    Science.gov (United States)

    Fu, Lin; Ma, Jianxiong; Lu, Bin; Jia, Haobo; Zhao, Jie; Kuang, Mingjie; Feng, Rui; Xu, Liyan; Bai, Haohao; Sun, Lei; Wang, Ying; Ma, Xinlong

    2017-07-01

    Pedicle screw fixation may induce abnormal activity at adjacent segment and accelerate the degeneration of lumbar vertebrae. Dynamic stabilizers could provide an intermediate solution between conservative treatment and fusion surgery. Lumbar vertebral segment cephalad to instrumented fixation was the most common localization of adjacent segment degeneration. The aim of this study is to explore the use of interspinous process devices in the lumbar vertebral segment cephalad to fixation segment in changing the mechanical distribution and limiting abnormal activity of the spine. Eight specimens were tested in the following groups: intact group, instability group (bilateral facetectomy at L3-L4), fixation group (bilateral facetectomy and pedicle screw fixation at L3-L4), and hybrid fixation group (fixation at L3-L4 and simulating interspinous device implantation of 6, 8, 10, 12, 14, 16, and 18 mm at L2-L3). Range of motion, motion of vertebral body, and strain distribution change were recorded. The range of motion in extension with 16- and 18-mm hybrid constructs was significantly lower than intact, instability, and fixation groups. In flexion and lateral bending, the strain values of L4 inferior articular process with 18-mm hybrid construct have a significant difference compared with other groups. In axial rotation, under the condition of a contralateral state, the strain values of L2 superior articular process with 18-mm hybrid construct have a significant difference compared with intact and fixation groups. The strain value of the L4 inferior articular process had negative correlation with height distraction in three dimensions, except extension. A negative correlation between the strain value of the L2 superior articular process and distraction height was found in contralateral bending and contralateral axial rotation. Interspinous process devices above the fixation segment can change the mechanical distribution of the spine and limit activity in some of the

  1. Rapid onset aggressive vertebral haemangioma.

    Science.gov (United States)

    Cheung, Nicholas K; Doorenbosch, Xenia; Christie, John G

    2011-03-01

    Vertebral haemangiomas are generally benign asymptomatic vascular tumours seen commonly in the adult population. Presentations in paediatric populations are extremely rare, which can result in rapid onset of neurological symptoms. We present a highly unusual case of an aggressive paediatric vertebral haemangioma causing significant cord compression. A 13-year-old boy presented with only 2 weeks duration of progressive gait disturbance, truncal ataxia and loss of bladder control. Magnetic resonance imaging (MRI) of the spine revealed a large vascular epidural mass extending between T6 and T8 vertebral bodies. Associated displacement and compression of the spinal cord was present. A highly vascular bony lesion was found during surgery. Histopathology identified this tumour to be a vertebral haemangioma. We present an extremely unusual acute presentation of a paediatric vertebral haemangioma. This study highlights the need for early diagnosis, MRI for investigation and urgent surgical management. © Springer-Verlag 2011

  2. Biomechanical implications of lumbar spinal ligament transection.

    Science.gov (United States)

    Von Forell, Gregory A; Bowden, Anton E

    2014-11-01

    Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.

  3. Anterior cement augmentation of adjacent levels after vertebral body replacement leads to superior stability of the corpectomy cage under cyclic loading-a biomechanical investigation.

    Science.gov (United States)

    Oberkircher, Ludwig; Krüger, Antonio; Hörth, Dominik; Hack, Juliana; Ruchholtz, Steffen; Fleege, Christoph; Rauschmann, Michael; Arabmotlagh, Mohammad

    2018-03-01

    In the operative treatment of osteoporotic vertebral body fractures, a dorsal stabilization in combination with a corpectomy of the fractured vertebral body might be necessary with respect to the fracture morphology, whereby the osteoporotic bone quality may possibly increase the risk of implant failure. To achieve better stability, it is recommended to use cement-augmented screws for dorsal instrumentation. Besides careful end plate preparation, cement augmentation of the adjacent end plates has also been reported to lead to less reduction loss. The aim of the study was to evaluate biomechanically under cyclic loading whether an additional cement augmentation of the adjacent end plates leads to improved stability of the inserted cage. Methodical cadaver study. Fourteen fresh frozen human thoracic spines with proven osteoporosis were used (T2-T7). After removal of the soft tissues, the spine was embedded in Technovit (Kulzer, Germany). Subsequently, a corpectomy of T5 was performed, leaving the dorsal ligamentary structures intact. After randomization with respect to bone quality, two groups were generated: Dorsal instrumentation (cemented pedicle screws, Medtronic, Minneapolis, MN, USA)+cage implantation (CAPRI Corpectomy Cage, K2M, Leesburg, VA, USA) without additional cementation of the adjacent endplates (Group A) and dorsal instrumentation+cage implantation with additional cement augmentation of the adjacent end plates (Group B). The subsequent axial and cyclic loading was performed at a frequency of 1 Hz, starting at 400 N and increasing the load within 200 N after every 500 cycles up to a maximum of 2,200 N. Load failure was determined when the cages sintered macroscopically into the end plates (implant failure) or when the maximum load was reached. One specimen in Group B could not be clamped appropriately into the test bench for axial loading because of a pronounced scoliotic misalignment and had to be excluded. The mean strength for implant

  4. 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.

  5. Structural behavior of human lumbar intervertebral disc under direct shear.

    Science.gov (United States)

    Schmidt, Hendrik; Häussler, Kim; Wilke, Hans-Joachim; Wolfram, Uwe

    2015-03-18

    The intervertebral disc (IVD) is a complex, flexible joint between adjacent vertebral bodies that provides load transmission while permitting movements of the spinal column. Finite element models can be used to help clarify why and how IVDs fail or degenerate. To do so, it is of importance to validate those models against controllable experiments. Due to missing experimental data, shear properties are not used thus far in validating finite element models. This study aimed to investigate the structural shear properties of human lumbar IVDs in posteroanterior (PA) and laterolateral (LL) loading directions. Fourteen lumbar IVDs (median age: 49 years) underwent direct shear in PA and LL loading directions. A custom-build shear device was used in combination with a materials testing machine to load the specimens until failure. Shear stiffness, ultimate shear force and displacement, and work to failure were determined. Each specimen was tested until complete or partial disruption. Median stiffness in PA direction was 490 N/mm and in LL direction 568 N/mm. Median ultimate shear force in the PA direction was 2,877 N and in the LL direction 3,199 N. Work to failure was 12 Nm in the PA and 9 Nm in the LL direction. This study was an experiment to subject IVDs to direct shear. The results could help us to understand the structure and function of IVDs with regard to mechanical spinal stability, and they can be used to validate finite element models of the IVD.

  6. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Ponrartana, Skorn; Fisher, Carissa L.; Aggabao, Patricia C.; Chavez, Thomas A.; Broom, Alexander M.; Wren, Tishya A.L.; Skaggs, David L.; Gilsanz, Vicente

    2016-01-01

    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 2 ; P = 0.0007) and 13.9% (8.22 ± 0.84 vs. 9.55 ± 1.61 cm 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.)

  7. 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.)

  8. Imaging investigation of metabolic and endocrine bone disease of vertebral density

    International Nuclear Information System (INIS)

    Cai Yuezeng; Tian Xiali; Li Jingxue

    2006-01-01

    Objective: To probe vertebral density of metabolic and endocrine bone disease imaging features, characterize the regional distribution of bone trabecular in sandwich spine. Methods: Thirty-six patients who had the bone density abnormality appearance in radiograms were collected in this study. Twelve patients with sandwich spine were performed lumbar CT scan. Thirty-two healthy volunteers as control group were performed lumbar CT scan too. CT values of two groups were measured from different portions of vertebral body, and then were analysed. Twenty two patients were performed dual-energy x-ray absorptiometry (DXA). One patient was performed bone histomorphometry. Results: Abnormal density included decreased and increased density. Decreased density was found in different portions of all patients, which divided into general and regional type. Increased density was obviously in vertebrae, including diffusely increased density and sandwich spine. The mean CT values of superior, middle and inferior portions of sandwich vertebral body were (259.94±18.08), (182.96±34.85), (270.34±19.40) HU. The mean CT values of both superior and inferior portions of sandwich vertebral body were higher than that of control group. The mean CT values of superior and inferior portions of sandwich spine were higher than that of middle portion. The difference of mean CT values between superior and inferior portions had no statistical significance. The difference of CT values among the regions of superior and inferior portions had no statistical significance (F=0.457, 0.462, P>0.05). The difference of CT values among the regions of middle portion had statistical significance(F=4.539, P<0.05). The DXA measurement of sandwich spine showed high, normal and low BMD. Conclusion: The sandwich spine is useful to measure superior and inferior portions of sandwich vertebral body if QCT would be performed. Sandwich spine sign can be used as an imaging index of state evaluation. Increased density in

  9. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M. [AORNA Cardarelli, Neuroradiology Service, Naples (Italy); Pezzullo, M.G. [Seconda Universita degli studi di Napoli - SUN, Radiology Service, Naples (Italy)

    2009-07-15

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  10. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    International Nuclear Information System (INIS)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M.; Pezzullo, M.G.

    2009-01-01

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  11. Neurological complications after 434 MHz microwave hyperthermia of the rat lumbar region including the spinal cord

    NARCIS (Netherlands)

    Franken, N. A.; de Vrind, H. H.; Sminia, P.; Haveman, J.; Troost, D.; Gonzalez Gonzalez, D.

    1992-01-01

    Hyperthermia was applied in the region of the vertebral column from the second to the fifth lumbar vertebra using a ring-shaped 434 MHz microwave radiator. In all experiments temperatures were measured at a 'reference' thermocouple which was placed against the fourth lumbar vertebra. After 60 min of

  12. Assessment of radiological vertebral fractures in HIV-infected patients: clinical implications and predictive factors.

    Science.gov (United States)

    Gazzola, L; Savoldi, A; Bai, F; Magenta, A; Dziubak, M; Pietrogrande, L; Tagliabue, L; Del Sole, A; Bini, T; Marchetti, G; d'Arminio Monforte, A

    2015-10-01

    The aim of this study was to evaluate the clinical impact of including lateral spine X-ray in the screening of bone diseases in HIV-positive patients. A total of 194 HIV-positive patients underwent dual-energy X-ray absorptiometry (DEXA), lateral spine X-ray and bone biochemical analysis. Vertebral fractures were identified using a morphometric analysis of X-rays and classified using the semiquantitative scoring system of Genant et al. For each patient, a spine deformity index (SDI) score was calculated by summing the grades of vertebral deformities. Reductions in vertebral body height of > 25% were considered vertebral fractures, and those Risk factors associated with vertebral fractures were evaluated by univariate and multivariate analysis. Vertebral fractures were detected in 24 patients (12.4%) and vertebral deformities in 17 patients (8.7%); 153 patients (78.9%) did not show any vertebral deformity. Among patients with fractures, only two with SDI > 10 reported lumbar pain; the remaining were asymptomatic. Patients over 50 years old showed a higher prevalence of vertebral fracture [24.4% versus 11.8% in patients 41-50 years old (P = 0.05) and 1.9% in patients ≤ 40 years old (P = 0.04)]. No significant increase in the prevalence according to bone mineral density (BMD) reduction was observed, and 70% of fractures were diagnosed in nonosteoporotic patients. Older age [adjusted odds ratio 1.09; 95% confidence interval (CI) 1.03-1.13; P = 0.001] and steroid use (adjusted odds ratio 3.64; 95% CI 1.29-10.3; P = 0.01) were independently associated with vertebral fracture; no association was found with HIV- or highly active antiretroviral therapy (HAART)-related variables. A prevalence of vertebral fractures of 12.4% was observed in our HIV-positive cohort. Given that two-thirds of fractures occurred in nonosteoporotic patients, spine X-ray may be considered in patients at increased risk, irrespective of BMD; that is, in elderly patients

  13. 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.

  14. 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

  15. [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

  16. TRANSORAL REMOVAL OF SKULL BASE AND C1-C2 VERTEBRAL BODY TUMOURS AND NONTUMOROUS PATHOLOGY IN THE CRANIOCERVICAL JUNCTION ACCOMPANIED BY CRANIOVERTEBRAL INSTABILITY

    Directory of Open Access Journals (Sweden)

    A. N. Shkarubo

    2010-01-01

    Full Text Available 27 patients aged 2,5-61 years with skull base and C1-C2 vertebral body tumours and nontumorous pathology in the craniocervical junction underwent surgery. All patients revealed craniovertebral instability. To perform OSD we used autobone and metallic wire in 1 case, "Ventrofix" - 2; "CCD" - 9, "Vertex" - 15. In 26 cases OSD was followed by transoral tumor removal; in 1 - removal of the skull base chordoma spreading into C1-C2 segments was followed by OSD. In our practice we used original patent instruments, devices and surgical techniques. After the tumor has been removed, the skull defect hermetic closure and plasty were performed using the original patent technique for preventing postoperative CSF leakage as well as different glue compositions. This technique proved to shorten hospitalization period and reduce treatment costs as well as launch an early rehabilitation programme - on the 3d-4th day after operation. Use of new technologies in surgical treatment of skull base tumors invading upper cervical spinal segments accompanied by craniovertebral instability allowed to improve surgical outcome and start up early rehabilitation.

  17. Age-related changes in vertebral and iliac crest 3D bone microstructure--differences and similarities.

    Science.gov (United States)

    Thomsen, J S; Jensen, M V; Niklassen, A S; Ebbesen, E N; Brüel, A

    2015-01-01

    Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes. The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between the bone microstructure at these skeletal sites. Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19-96 years) and 39 men (23-95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified. For both women and men, bone volume per total volume (BV/TV), connectivity density (CD), and trabecular number (Tb.N) decreased significantly, while structure model index (SMI) and trabecular separation (Tb.Sp) increased significantly with age at either skeletal site. Vertebral trabecular thickness (Tb.Th) was independent of age for both women and men, while iliac Tb.Th decreased significantly with age for men, but not for women. In general, the vertebral and iliac age-related changes were similar. The 95th percentile of the Tb.Th distribution increased significantly with age for women but was independent of age for men at the vertebral body, while it was independent of age for either sex at the iliac crest. The Tb.Th probability density functions at the two skeletal sites became significantly more similar with age for women, but not for men. The microstructural parameters at the iliac crest and the vertebral bodies were only moderately correlated from r = 0.38 for SMI in women to r = 0.75 for Tb.Sp in men. Age-related changes in vertebral and iliac bone microstructure were in general similar. The iliac

  18. Vertebral fracture complications following radiation therapy. Report of two cases

    International Nuclear Information System (INIS)

    Tanaka, Hisato; Komine, Mitsunori; Kurokawa, Hiroaki

    2007-01-01

    We observed the outbreak time of a spinal compression fracture following radiation therapy and its natural course. Case 1 was a 88-year-old, woman. NTX 66.9. Underwent cobalt irradiation 54 Gy for esophageal cancer. Three months after irradiation, the first lumbar vertebra was found to de compressed, and low back pain occurred. Vacuum cleft phenomenon in X-P appeared after two weeks, but anterior callus formation appeared in eight weeks, after which the low back pain disappeared. Case 2 was a 77-year-old woman. NTX 86.5. Underwent irradiation 69 Gy for uterine carcinoma. Six months after the irradiation, the fourth/five lumbar vertebra were found to be compressed. Great collapse occurred in X-P after two weeks, but stabilized and did not aggravate thereafter. Low back pain also disappeared. Radiotherapy affects bone cells (osteoblasts, osteoclasts), inhibiting bone remodeling. As a result, deficient elastic resistance occurs. Vertebral bodies are also compressed in such a situation. After that normal callus formation starts from adjacent normal bone cells. The compression fracture observed ranged from three to six months after radiation. Natural course is well. Therefore conservative therapy is recommended. (author)

  19. Lumbar spine intervertebral disc gene delivery: a pilot study in lewis rats.

    Science.gov (United States)

    Damle, Sheela R; Rawlins, Bernard A; Boachie-Adjei, Oheneba; Crystal, Ronald G; Hidaka, Chisa; Cunningham, Matthew E

    2013-02-01

    Basic research toward understanding and treating disc pathology in the spine has utilized numerous animal models, with delivery of small molecules, purified factors, and genes of interest. To date, gene delivery to the rat lumbar spine has only been described utilizing genetically programmed cells in a matrix which has required partial disc excision, and expected limitation of treatment diffusion into the disc. This study was designed to develop and describe a surgical technique for lumbar spine exposure and disc space preparation, and use of a matrix-free method for gene delivery. Naïve or genetically programmed isogeneic bone marrow stromal cells were surgically delivered to adolescent male Lewis rat lumbar discs, and utilizing quantitative biochemical and qualitative immunohistological assessments, the implanted cells were detected 3 days post-procedure. Statistically significant differences were noted for recovery of the β-galactosidase marker gene comparing delivery of naïve or labeled cells (10(5) cells per disc) from the site of implantation, and between delivery of 10(5) or 10(6) labeled cells per disc at the site of implantation and the adjacent vertebral body. Immunohistology confirmed that the β-galactosidase marker was detected in the adjacent vertebra bone in the zone of surgical implantation. The model requires further testing in larger cohorts and with biologically active genes of interest, but the observations from the pilot experiments are very encouraging that this will be a useful comparative model for basic spine research involving gene or cell delivery, or other locally delivered therapies to the intervertebral disc or adjacent vertebral bodies in rats.

  20. Diagnosis of lumbar central spinal stenosis by plain radiography

    International Nuclear Information System (INIS)

    Ilkko, E.

    1989-01-01

    The usefulness of plain radiography in the diagnosis of lumbar central spinal stenosis was studied in 116 patients using computed tomography (CT) as a reference. The most significant signs found in central spinal stenosis were short pedicles, high narrow intervertebral foramina, small interlaminar windows and deep posterior concavity of the vertebral bodies. The sensitivity of plain radiography in the diagnosis of central spinal stenosis as compared to CT was 66%, the specificity was 93% and the accuracy was 86%. The midsagittal and interpedicular diameters were measured from plain radiograms and were compared with corresponding CT diameters. In approximately half of the cases, the sagittal diameters were compatible. The maximum error was 6 mm. On average, the interpedicular distances were measured as too wide. The reliability of CT measurements were established by taking the measurements from the vertebral column of a moose calf, and then comparing these to the real measurements obtained with a calibrated ruler. The maximal differences were 2 mm. (author). 24 refs.; 8 figs.; 3 tabs

  1. Effects of vertebral number variations on carcass traits and genotyping of Vertnin candidate gene in Kazakh sheep

    Directory of Open Access Journals (Sweden)

    Zhifeng Zhang

    2017-09-01

    Full Text Available Objective The vertebral number is associated with body length and carcass traits, which represents an economically important trait in farm animals. The variation of vertebral number has been observed in a few mammalian species. However, the variation of vertebral number and quantitative trait loci in sheep breeds have not been well addressed. Methods In our investigation, the information including gender, age, carcass weight, carcass length and the number of thoracic and lumbar vertebrae from 624 China Kazakh sheep was collected. The effect of vertebral number variation on carcass weight and carcass length was estimated by general linear model. Further, the polymorphic sites of Vertnin (VRTN gene were identified by sequencing, and the association of the genotype and vertebral number variation was analyzed by the one-way analysis of variance model. Results The variation of thoracolumbar vertebrae number in Kazakh sheep (18 to 20 was smaller than that in Texel sheep (17 to 21. The individuals with 19 thoracolumbar vertebrae (T13L6 were dominant in Kazakh sheep (79.2%. The association study showed that the numbers of thoracolumbar vertebrae were positively correlated with the carcass length and carcass weight, statistically significant with carcass length. To investigate the association of thoracolumbar vertebrae number with VRTN gene, we genotyped the VRTN gene. A total of 9 polymorphic sites were detected and only a single nucleotide polymorphism (SNP (rs426367238 was suggested to associate with thoracic vertebral number statistically. Conclusion The variation of thoracolumbar vertebrae number positively associated with the carcass length and carcass weight, especially with the carcass length. VRTN gene polymorphism of the SNP (rs426367238 with significant effect on thoracic vertebral number could be as a candidate marker to further evaluate its role in influence of thoracolumbar vertebral number.

  2. Effects of vertebral number variations on carcass traits and genotyping of Vertnin candidate gene in Kazakh sheep.

    Science.gov (United States)

    Zhang, Zhifeng; Sun, Yawei; Du, Wei; He, Sangang; Liu, Mingjun; Tian, Changyan

    2017-09-01

    The vertebral number is associated with body length and carcass traits, which represents an economically important trait in farm animals. The variation of vertebral number has been observed in a few mammalian species. However, the variation of vertebral number and quantitative trait loci in sheep breeds have not been well addressed. In our investigation, the information including gender, age, carcass weight, carcass length and the number of thoracic and lumbar vertebrae from 624 China Kazakh sheep was collected. The effect of vertebral number variation on carcass weight and carcass length was estimated by general linear model. Further, the polymorphic sites of Vertnin ( VRTN ) gene were identified by sequencing, and the association of the genotype and vertebral number variation was analyzed by the one-way analysis of variance model. The variation of thoracolumbar vertebrae number in Kazakh sheep (18 to 20) was smaller than that in Texel sheep (17 to 21). The individuals with 19 thoracolumbar vertebrae (T13L6) were dominant in Kazakh sheep (79.2%). The association study showed that the numbers of thoracolumbar vertebrae were positively correlated with the carcass length and carcass weight, statistically significant with carcass length. To investigate the association of thoracolumbar vertebrae number with VRTN gene, we genotyped the VRTN gene. A total of 9 polymorphic sites were detected and only a single nucleotide polymorphism (SNP) (rs426367238) was suggested to associate with thoracic vertebral number statistically. The variation of thoracolumbar vertebrae number positively associated with the carcass length and carcass weight, especially with the carcass length. VRTN gene polymorphism of the SNP (rs426367238) with significant effect on thoracic vertebral number could be as a candidate marker to further evaluate its role in influence of thoracolumbar vertebral number.

  3. Quantitative evaluation of vertebral marrow adipose tissue in postmenopausal female using MRI chemical shift-based water–fat separation

    International Nuclear Information System (INIS)

    Li, G.-W.; Xu, Z.; Chen, Q.-W.; Tian, Y.-N.; Wang, X.-Y.; Zhou, L.; Chang, S.-X.

    2014-01-01

    Aim: To investigate the feasibility of assessing vertebral marrow adipose tissue using a magnetic resonance imaging (MRI) chemical shift-based water–fat separation technique at 3 T. Material and methods: A modified Dixon technique was performed to obtain the vertebral marrow fat fraction (FF) in a study of 58 postmenopausal females (age range 49.2–77.4 years), including 24 normal bone density, 19 osteopaenia, and 15 osteoporosis as documented with dual-energy X-ray absorptiometry. The reliability of FF measurements performed by two radiologists independently was evaluated with the intraclass correlation coefficient (ICC). Ten participants were scanned twice to assess the reproducibility of FF measurements. FF values were compared between each vertebral level and between groups. Results: The mean coefficient of variation of FF measurements was 2.1%. According to the ICC, the measurements were reliable (ICC = 0.900 for normal bone density, ICC = 0.937 for osteopaenia and ICC = 0.909 for osteoporosis, p < 0.001 for all). There was an inverse association between mean FF at L1–L4 vertebrae and lumbar spine BMD (r = −0.459, p = 0.006), which remained significant even after controlling for confounders (age, height, and body weight). FF values at different vertebral levels were significantly correlated to each other (r = 0.703–0.921, p < 0.05 for all). There was a general trend toward increased marrow adiposity for more inferior vertebral bodies. Patients with osteopaenia and osteoporosis had a higher marrow fat content compared with normal bone mass after adjusting for confounders, although no significant differences in each vertebral level and average marrow fat content were found between the osteopaenia and osteoporosis groups. Conclusion: Chemical shift-based water–fat separation enables the quantitation of vertebral marrow adiposity with excellent reproducibility, which appears to be a useful method to provide complementary information to osteoporosis

  4. Biomechanical evaluation of a corporectomy in porcine lumbar specimens using flexible polymer belts

    International Nuclear Information System (INIS)

    Beltran-Fernandez, J A; Hernandez-Gomez, L H; Ruiz-Munoz, E; Urriolagoitia-Calderon, G; Urriolagoitia-Sosa, G; Gonzalez-Rebattu, A; RodrIguez-Canizo, R G; Hernandez-Moreno, H

    2009-01-01

    This paper presents the experimental results of a biomechanical evaluation in lumbar porcine specimens (L2-L4), instrumented with flexible polymer belts, under fatigue and tensile loading. The clinical effect called facetary arthrosis is evaluated. An experimental analysis was carried on 3 lumbar porcine specimens. In two of them, polyamide belts are fixed on the interspinous ligament from L2 to L4. Specimens are taken from pigs which are 6 month old. For the present work, the stiffness reduction of the spine and the biomechanical behaviour of the belts in conjunction with the interspinous ligament are evaluated. The purpose is to determine the failure conditions for the elements of the specimen (vertebral disk, supra and intraspinous ligament and vertebral body). Under static loading, which is the base line case, the elements of the specimen failed as a typical healthy structure. While in the fatigue combined with static loading, the element failed in different order. Additionally, the stiffness changed in accordance with the fatigue loading conditions. Because of the simplicity of this alternative technique, a high level of the structural integrity is preserved, as no holes are made on the spinous process in order to insert the fixation screws. Furthermore, there is a cost reduction.

  5. Biomechanical evaluation of a corporectomy in porcine lumbar specimens using flexible polymer belts

    Science.gov (United States)

    Beltrán-Fernández, J. A.; Hernández-Gómez, L. H.; Ruiz-Muñoz, E.; González-Rebattú, A.; Rodríguez-Cañizo, R. G.; Urriolagoitia-Calderón, G.; Urriolagoitia-Sosa, G.; Hernández-Moreno, H.

    2009-08-01

    This paper presents the experimental results of a biomechanical evaluation in lumbar porcine specimens (L2-L4), instrumented with flexible polymer belts, under fatigue and tensile loading. The clinical effect called facetary arthrosis is evaluated. An experimental analysis was carried on 3 lumbar porcine specimens. In two of them, polyamide belts are fixed on the interspinous ligament from L2 to L4. Specimens are taken from pigs which are 6 month old. For the present work, the stiffness reduction of the spine and the biomechanical behaviour of the belts in conjunction with the interspinous ligament are evaluated. The purpose is to determine the failure conditions for the elements of the specimen (vertebral disk, supra and intraspinous ligament and vertebral body). Under static loading, which is the base line case, the elements of the specimen failed as a typical healthy structure. While in the fatigue combined with static loading, the element failed in different order. Additionally, the stiffness changed in accordance with the fatigue loading conditions. Because of the simplicity of this alternative technique, a high level of the structural integrity is preserved, as no holes are made on the spinous process in order to insert the fixation screws. Furthermore, there is a cost reduction.

  6. (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.)

  7. Distribution and length of osteophytes in the lumbar vertebrae and risk of rupture of abdominal aortic aneurysms: a study of dry bones from Chiang Mai, Thailand.

    Science.gov (United States)

    Chanapa, Patcharin; Yoshiyuki, Tohno; Mahakkanukrauh, Pasuk

    2014-09-01

    Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47±2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm.

  8. Vertebral column decancellation in Pott's deformity: use of Surgimap Spine for preoperative surgical planning, retrospective review of 18 patients.

    Science.gov (United States)

    Hu, Wenhao; Zhang, Xuesong; Yu, Jiayi; Hu, Fanqi; Zhang, Hao; Wang, Yan

    2018-01-15

    In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies. The aim of this study was to evaluate the efficacy of Vertebral column decancellation planned preoperatively with the computer software-assistance in the patients with Pott's kyphosis. Between May 2012 and May 2015, 18 patients with Pott's kyphosis underwent the Vertebral column decancellation using Surgimap Spine for preoperative surgical planning. Preoperative and postoperative Konstam's angle, sagittal vertical angle, lumbar lordosis, thoracic kyphosis, pelvic tilt and pelvic incidence were measured. Visual analog scale and American Spinal Injury Association were documented. The Konstam's angles decreased from 88.1° (range, 70-105°) preoperatively to 18.5° (range, 7-31°) (P column decancellation is an effective treatment option for severe Pott's kyphosis. The surgical planning software Surgimap Spine can be a reliable and helpful tool that provides a simplified method to evaluate and analyze the spino-pelvic parameters and simulate the osteotomy procedure. According to individual character, the appropriate surgery strategy should be selected.

  9. Age-related contrast enhancement study of normal bone marrow in lumbar spinal MR imaging

    International Nuclear Information System (INIS)

    Kim, Young A; Ha, Doo Hoe

    1999-01-01

    The purpose of this study was to evaluate the degree of contrast enhancement of normal bone marrow in L-spine relating to aging and to determine the range of contrast enhancement in normal bone marrow. We analyzed a total of 120 patients (20 per decade) who had undergone lumbar spinal MRI and who ranged in age from the 2nd decade to more than the 7th. Bone marrow revealed no abnormal pathology. Sagittal T1-weighted spin echo sequences were obtained before and after gadolinium administration. For each sequence, a region of interest was drawn within the L1 vertebral body from the midsagittal slice. Signal intensity (SI) values of each sequence were ascertained and the percentage increase in SI was calculated. After contrast enhancement, lumbar MRI revealed no statistically significant in the percentage increase in SI of normal bone marrow in relation to aging. Most patients (99%) however showed an SI increase of between 10% and 49%. In only four, none of whom were aged over 40, was this increase above 50%. Lumbar MRI, revealed no statistically significant difference in percentage increase in SI in normal bone marrow relating to aging, but when the increase is above 50% in a patient aged over 40, bone marrow pathology should be further investigated

  10. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures.

    Science.gov (United States)

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

    2017-12-19

    Osteoporotic patients can present with either single or multiple fractures secondary to repeated falls and progressive osteoporosis. Multiple fractures often lead to additional spinal deformity and are a sign of more severe osteoporosis. In the thoracic spine, multiple fractures are associated with the development of gradual thoracic kyphosis but neurologic deficits are uncommon. In the lumbar spine, patients with multiple lumbar fractures have more constant lumbar pain, may have symptoms related to concurrent lumbar stenosis or degenerative scoliosis, and may present with radiculopathy, especially with fractures at L4 and L5. In a review of a series of patients with recurrent multiple lumbar fractures or 'cascading' fractures, it was found that all the patients were female, had severe osteoporosis, often untreated, had a previous history of multiple previous thoracic and lumbar fractures, and all had associated scoliotic spinal deformities ranging from 6 o to 50 o . It was found that if the curve progressed and the greater the degree of curvature, the more frequently subsequent multiple fractures developed, leading to recurrent acute episodes of pain. Forty percent also had additional sacral insufficiency fractures, an unusually high percentage. Biomechanically, the lumbar spine is both more mobile and supports a larger portion of the spinal load compared to the thoracic spine. The existence or worsening of a lumbar spinal deformity from degenerative lumbar scoliosis shifts the mechanical forces more to one side on already weakened osteoporotic lumbar vertebrae and sacrum, leading to an increased incidence of these fractures. Because of the chronic and uneven lower lumbar spinal load with severe vertebral osteoporosis in certain patients with repeat lumbar fractures and worsening degenerative lumbar scoliosis, there may be a rationale to add preventive vertebroplasty at adjacent vertebral endplates when treating acute recurrent lumbar fractures to decrease the

  11. 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.

  12. Reconstruction of Thoracic Spine Using a Personalized 3D-Printed Vertebral Body in Adolescent with T9 Primary Bone Tumor.

    Science.gov (United States)

    Choy, Wen Jie; Mobbs, Ralph J; Wilcox, Ben; Phan, Steven; Phan, Kevin; Sutterlin, Chester E

    2017-09-01

    Neurosurgery and spine surgery have the potential to benefit from the use of 3-dimensional printing (3DP) technology due to complex anatomic considerations and the delicate nature of surrounding structures. We report a procedure that uses a 3D-printed titanium T9 vertebral body implant post T9 vertebrectomy for a primary bone tumor. A 14-year-old female presented with progressive kyphoscoliosis and a pathologic fracture of the T9 vertebra with sagittal and coronal deformity due to a destructive primary bone tumor. Surgical resection and reconstruction was performed in combination with a 3D-printed, patient-specific implant. Custom design features included porous titanium end plates, corrective angulation of the implant to restore sagittal balance, and pedicle screw holes in the 3D implant to assist with insertion of the device. In addition, attachment of the anterior column construct to the posterior pedicle screw construct was possible due to the customized features of the patient-specific implant. An advantage of 3DP is the ability to manufacture patient-specific implants, as in the current case example. Additionally, the use of 3DP has been able to reduce operative time significantly. Surgical procedures can be preplanned using 3DP patient-specific models. Surgeons can train before performing complex procedures, which enhances their presurgical planning in order to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomic fit for the patient, with the potential to improve restoration of anatomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Theoretical effects of fully ductile versus fully brittle behaviors of bone tissue on the strength of the human proximal femur and vertebral body.

    Science.gov (United States)

    Nawathe, Shashank; Yang, Haisheng; Fields, Aaron J; Bouxsein, Mary L; Keaveny, Tony M

    2015-05-01

    The influence of the ductility of bone tissue on whole-bone strength represents a fundamental issue of multi-scale biomechanics. To gain insight, we performed a computational study of 16 human proximal femurs and 12 T9 vertebral bodies, comparing the whole-bone strength for the two hypothetical bounding cases of fully brittle versus fully ductile tissue-level failure behaviors, all other factors, including tissue-level elastic modulus and yield stress, held fixed. For each bone, a finite element model was generated (60-82 μm element size; up to 120 million elements) and was virtually loaded in habitual (stance for femur, compression for vertebra) and non-habitual (sideways fall, only for femur) loading modes. Using a geometrically and materially non-linear model, the tissue was assumed to be either fully brittle or fully ductile. We found that, under habitual loading, changing the tissue behavior from fully ductile to fully brittle reduced whole-bone strength by 38.3±2.4% (mean±SD) and 39.4±1.9% for the femur and vertebra, respectively (p=0.39 for site difference). These reductions were remarkably uniform across bones, but (for the femur) were greater for non-habitual (57.1±4.7%) than habitual loading (pductile cases. These theoretical results suggest that the whole-bone strength of the proximal femur and vertebra can vary substantially between fully brittle and fully ductile tissue-level behaviors, an effect that is relatively insensitive to bone morphology but greater for non-habitual loading. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Too, Chow Wei, E-mail: spyder55@gmail.com; Koch, Guillaume, E-mail: guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juliengarnon@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital, Interventional Radiology Department (France)

    2017-03-15

    Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

  15. Determination of 3D location and rotation of lumbar vertebrae in CT images by symmetry-based auto-registration

    Science.gov (United States)

    Vrtovec, Tomaž; Likar, Boštjan; Pernuš, Franjo

    2007-03-01

    Quantitative measurement of vertebral rotation is important in surgical planning, analysis of surgical results, and monitoring of the progression of spinal deformities. However, many established and newly developed techniques for measuring axial vertebral rotation do not exploit three-dimensional (3D) information, which may result in virtual axial rotation because of the sagittal and coronal rotation of vertebrae. We propose a novel automatic approach to the measurement of the location and rotation of vertebrae in 3D without prior volume reformation, identification of appropriate cross-sections or aid by statistical models. The vertebra under investigation is encompassed by a mask in the form of an elliptical cylinder in 3D, defined by its center of rotation and the rotation angles. We exploit the natural symmetry of the vertebral body, vertebral column and vertebral canal by dividing the vertebral mask by its mid-axial, mid-sagittal and mid-coronal plane, so that the obtained volume pairs contain symmetrical parts of the observed anatomy. Mirror volume pairs are then simultaneously registered to each other by robust rigid auto-registration, using the weighted sum of absolute differences between the intensities of the corresponding volume pairs as the similarity measure. The method was evaluated on 50 lumbar vertebrae from normal and scoliotic computed tomography (CT) spinal scans, showing relatively large capture ranges and distinctive maxima at the correct locations and rotation angles. The proposed method may aid the measurement of the dimensions of vertebral pedicles, foraminae and canal, and may be a valuable tool for clinical evaluation of the spinal deformities in 3D.

  16. Interobserver reproducibility of radiographic evaluation of lumbar spine instability.

    Science.gov (United States)

    Segundo, Saulo de Tarso de Sá Pereira; Valesin, Edgar Santiago; Lenza, Mario; Santos, Durval do Carmo Barros; Rosemberg, Laercio Alberto; Ferretti, Mario

    2016-01-01

    To measure the interobserver reproducibility of the radiographic evaluation of lumbar spine instability. Measurements of the dynamic radiographs of the lumbar spine in lateral view were performed, evaluating the anterior translation and the angulation among the vertebral bodies. The tests were evaluated at workstations of the organization, through the Carestream Health Vue RIS (PACS), version 11.0.12.14 Inc. 2009© system. Agreement in detecting cases of radiographic instability among the observers varied from 88.1 to 94.4%, and the agreement coefficients AC1 were all above 0.8, indicating excellent agreement. The interobserver analysis performed among orthopedic surgeons with different levels of training in dynamic radiographs of the spine obtained high reproducibility and agreement. However, some factors, such as the manual method of measurement and the presence of vertebral osteophytes, might have generated a few less accurate results in this comparative evaluation of measurements. Mensurar a reprodutibilidade interobservadores da avaliação radiográfica da instabilidade da coluna lombar. Foram realizadas mensurações das radiografias dinâmicas de coluna lombar na incidência em perfil, avaliando-se a translação anterior e a angulação entre os corpos vertebrais. Os exames foram avaliados em workstations da própria instituição, por meio do sistema Vue RIS (PACS) da Carestream Health, versão 11.0.12.14 Inc. 2009©. A proporção de concordância em detecção de casos de instabilidade radiográfica entre os observadores variou de 88,1 a 94,4%, e os coeficientes de concordância AC1 estiveram todos acima de 0,8, indicando concordância excelente. A análise interobservadores realizada entre médicos ortopedistas com diferentes níveis de treinamento em radiografias dinâmicas da coluna vertebral obteve elevada reprodutibilidade e concordância. No entanto, alguns fatores, como método manual de aferição e a presença de osteófitos vertebrais, podem

  17. MR imaging of the bone marrow in myeloid leukemia and myelodysplastic syndrome. Comparison of the lumbar spine and femur

    International Nuclear Information System (INIS)

    Tanaka, Osamu; Kobayashi, Yasuyuki; Ichikawa, Tamaki; Matsuura, Katsuhiko; Nagai, Jun; Takagi, Shojiro

    1995-01-01

    MR imaging of the lumber spine and the femur was performed with T1-weighted SE sequence and comparison of the MRI findings of the lumber vertebral body and the femoral marrow was made in 15 patients with acute myeloid leukemia (AML), 5 chronic myelogenous leukemia (CML), and 9 myelodysplastic syndrome (MDS). The MRI appearance of the bone marrow was classified into four patterns: 1) fatty marrow; 2) faint signal; 3) heterogeneous infiltration; and 4) diffuse infiltration. The MRI of the lumber vertebral body showed a diffuse marrow infiltration pattern in over the half of the cases of AML and MDS. On the MRI of the femoral marrow, the signal intensity alteration, a low signal on T1-weighted SE image, began in the proximal femurs almost symmetrically. The abnormal low signal intensity area tended to gradually extend towards the distal portion of the femoral marrow with progression of the disease in the patients with AML and MDS. M2 type of AML tended to be demonstrated as a faint signal pattern, which was significantly different from the other types of AML. In all the cases of CML, a diffuse cellular infiltration pattern was noted with total replacement of the fatty marrow on both lumbar spinal and femoral MRI, and the femoral marrow involvement was more downwardly extended than AML. We concluded that MRI of the femoral marrow was more efficient than that of the lumbar spine in the assessment of myeloid leukemia and MDS. (author)

  18. Predictors of new vertebral endplate signal (Modic) changes in the general population

    DEFF Research Database (Denmark)

    Jensen, Tue Secher; Kjaer, Per; Korsholm, Lars

    2010-01-01

    predictors of new VESC were female gender, disc-related MRI findings (disc degeneration, disc bulges, disc herniation, and other endplate changes) and lifestyle factors [high physical work or leisure activity, high body mass index (BMI), and heavy smoking]. Bivariate and multivariate logistic regressions...... with disc degeneration, bulges or herniations at 40 were the only predictors of new VESC at age 44. Therefore, the development of new VESC at the age of 44 appears to be based on the status and dynamics of the disc, rather than being the result of gender or lifestyle factors such as smoking and physical...... were used to identify predictors of new VESC. New VESC at the age of 44 appeared in 67 of the 344. The majority (84%) of these new signal changes were type 1 VESC and almost half (45%) were only in the endplate and did not extend into the vertebral body. In the multivariate analysis, lumbar disc levels...

  19. Magnetic Resonance Imaging Quantification of Lumbar Spinal Canal Stenosis in Symptomatic Subjects

    Directory of Open Access Journals (Sweden)

    Siddarth Ragupathi

    2017-10-01

    Full Text Available Introduction: Low backache is a common condition to occur in the middle age. It is mainly caused by the degeneration of the intervertebral disc which forms the main support to the vertebral column. Lumbar spinal canal stenosis results in the compression of spinal cord and nerves at the level of lumbar vertebra. Aim: The purpose of this study is to measure the spinal canal dimensions and correlate with the clinical symptoms to establish a radiological criterion based on MRI for diagnosis of lumbar canal stenosis. This study is done to improve the diagnostic accuracy of lumbar spinal canal stenosis. Materials and Methods: Two hundred subjects with complaints of low backache without a traumatic history underwent Magnetic Resonance Imaging (MRI after assessment of pain by two methods: 1. Oswestry Disability Index (ODI scoring and 2. Wong Baker Facial Expression scale. All the images were qualitatively analyzed to obtain the MRI grading for central canal at various levels from L1 to S1 vertebra after making sure that the neural foramina is not involved. Anteroposterior (AP and transverse diameter of spinal canal at intervertebral disc and upper part of vertebral body levels and spinal canal area are measurements that are taken. Descriptive and inferential statistical analysis has been carried out in the present study. Results on continuous measurements are presented on mean±SD (min-max and results on categorical measurements are presented in number (%. Significance is assessed at 5% level of significance. Results: The spinal canal diameter measured along its AP and transverse direction is found to be correlating with the severity of low backache complained by the patient. Comparing the two methods of clinical assessment, ODI scoring was found to be more significant. Conclusion: The spinal canal measurements can be used as a radiologic criterion for diagnosis of acquired lumbar spinal canal stenosis. This will improve the diagnostic accuracy. However

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

    NARCIS (Netherlands)

    van der Jagt-Willems, H.C.; van Munster, B.C.; Leeflang, M.; Beuerle, E.; Tulner, C.R.; Lems, W.F.

    2014-01-01

    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

  1. Normative values for CT-based texture analysis of vertebral bodies in dual X-ray absorptiometry-confirmed, normally mineralized subjects

    International Nuclear Information System (INIS)

    Mannil, Manoj; Eberhard, Matthias; Becker, Anton S.; Alkadhi, Hatem; Guggenberger, Roman; Schoenenberg, Denise; Osterhoff, Georg; Frey, Diana P.; Konukoglu, Ender

    2017-01-01

    To develop age-, gender-, and regional-specific normative values for texture analysis (TA) of spinal computed tomography (CT) in subjects with normal bone mineral density (BMD), as defined by dual X-ray absorptiometry (DXA), and to determine age-, gender-, and regional-specific differences. In this retrospective, IRB-approved study, TA was performed on sagittal CT bone images of the thoracic and lumbar spine using dedicated software (MaZda) in 141 individuals with normal DXA BMD findings. Numbers of female and male subjects were balanced in each of six age decades. Three hundred and five TA features were analyzed in thoracic and lumbar vertebrae using free-hand regions-of-interest. Intraclass correlation (ICC) coefficients were calculated for determining intra- and inter-observer agreement of each feature. Further dimension reduction was performed with correlation analyses. The TA features with an ICC 0.8 with other features were excluded from further analysis for dimension reduction. From the remaining 31 texture features, a significant correlation with age was found for the features mean (r = -0.489, p < 0.001), variance (r = -0.681, p < 0.001), kurtosis (r = 0.273, p < 0.001), and WavEnLL_s4 (r = 0.273, p < 0.001). Significant differences were found between genders for various higher-level texture features (p < 0.001). Regional differences among the thoracic spine, thoracic-lumbar junction, and lumbar spine were found for most TA features (p < 0.021). This study established normative values of TA features on CT images of the spine and showed age-, gender-, and regional-specific differences in individuals with normal BMD as defined by DXA. (orig.)

  2. Normative values for CT-based texture analysis of vertebral bodies in dual X-ray absorptiometry-confirmed, normally mineralized subjects.

    Science.gov (United States)

    Mannil, Manoj; Eberhard, Matthias; Becker, Anton S; Schönenberg, Denise; Osterhoff, Georg; Frey, Diana P; Konukoglu, Ender; Alkadhi, Hatem; Guggenberger, Roman

    2017-11-01

    To develop age-, gender-, and regional-specific normative values for texture analysis (TA) of spinal computed tomography (CT) in subjects with normal bone mineral density (BMD), as defined by dual X-ray absorptiometry (DXA), and to determine age-, gender-, and regional-specific differences. In this retrospective, IRB-approved study, TA was performed on sagittal CT bone images of the thoracic and lumbar spine using dedicated software (MaZda) in 141 individuals with normal DXA BMD findings. Numbers of female and male subjects were balanced in each of six age decades. Three hundred and five TA features were analyzed in thoracic and lumbar vertebrae using free-hand regions-of-interest. Intraclass correlation (ICC) coefficients were calculated for determining intra- and inter-observer agreement of each feature. Further dimension reduction was performed with correlation analyses. The TA features with an ICC  0.8 with other features were excluded from further analysis for dimension reduction. From the remaining 31 texture features, a significant correlation with age was found for the features mean (r = -0.489, p < 0.001), variance (r = -0.681, p < 0.001), kurtosis (r = 0.273, p < 0.001), and WavEnLL_s4 (r = 0.273, p < 0.001). Significant differences were found between genders for various higher-level texture features (p < 0.001). Regional differences among the thoracic spine, thoracic-lumbar junction, and lumbar spine were found for most TA features (p < 0.021). This study established normative values of TA features on CT images of the spine and showed age-, gender-, and regional-specific differences in individuals with normal BMD as defined by DXA.

  3. Normative values for CT-based texture analysis of vertebral bodies in dual X-ray absorptiometry-confirmed, normally mineralized subjects

    Energy Technology Data Exchange (ETDEWEB)

    Mannil, Manoj; Eberhard, Matthias; Becker, Anton S.; Alkadhi, Hatem; Guggenberger, Roman [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Schoenenberg, Denise; Osterhoff, Georg [University Hospital Zurich, Division of Trauma Surgery, Zurich (Switzerland); Frey, Diana P. [University Hospital Zurich, Department of Rheumatology, Zurich (Switzerland); Konukoglu, Ender [Computer Vision Laboratory, Department of Information Technology and Electrical Engineering, Zurich (Switzerland)

    2017-11-15

    To develop age-, gender-, and regional-specific normative values for texture analysis (TA) of spinal computed tomography (CT) in subjects with normal bone mineral density (BMD), as defined by dual X-ray absorptiometry (DXA), and to determine age-, gender-, and regional-specific differences. In this retrospective, IRB-approved study, TA was performed on sagittal CT bone images of the thoracic and lumbar spine using dedicated software (MaZda) in 141 individuals with normal DXA BMD findings. Numbers of female and male subjects were balanced in each of six age decades. Three hundred and five TA features were analyzed in thoracic and lumbar vertebrae using free-hand regions-of-interest. Intraclass correlation (ICC) coefficients were calculated for determining intra- and inter-observer agreement of each feature. Further dimension reduction was performed with correlation analyses. The TA features with an ICC < 0.81 indicating compromised intra- and inter-observer agreement and with Pearson correlation scores r > 0.8 with other features were excluded from further analysis for dimension reduction. From the remaining 31 texture features, a significant correlation with age was found for the features mean (r = -0.489, p < 0.001), variance (r = -0.681, p < 0.001), kurtosis (r = 0.273, p < 0.001), and WavEnLL{sub s}4 (r = 0.273, p < 0.001). Significant differences were found between genders for various higher-level texture features (p < 0.001). Regional differences among the thoracic spine, thoracic-lumbar junction, and lumbar spine were found for most TA features (p < 0.021). This study established normative values of TA features on CT images of the spine and showed age-, gender-, and regional-specific differences in individuals with normal BMD as defined by DXA. (orig.)

  4. Radiographic indices for lumbar developmental spinal stenosis

    Directory of Open Access Journals (Sweden)

    Jason Pui Yin Cheung

    2017-02-01

    Full Text Available Abstract Background Patients with developmental spinal stenosis (DSS are susceptible to developing symptomatic stenosis due to pre-existing narrowed spinal canals. DSS has been previously defined by MRI via the axial anteroposterior (AP bony spinal canal diameter. However, MRI is hardly a cost-efficient tool for screening patients. X-rays are superior due to its availability and cost, but currently, there is no definition of DSS based on plain radiographs. Thus, the aim of this study is to develop radiographic indices for diagnosing DSS. Methods This was a prospective cohort of 148 subjects consisting of patients undergoing surgery for lumbar spinal stenosis (patient group and asymptomatic subjects recruited openly from the general population (control group. Ethics approval was obtained from the local institutional review board. All subjects underwent MRI for diagnosing DSS and radiographs for measuring parameters used for creating the indices. All measurements were performed by two independent investigators, blinded to patient details. Intra- and interobserver reliability analyses were conducted, and only parameters with near perfect intraclass correlation underwent receiver operating characteristic (ROC analysis to determine the cutoff values for diagnosing DSS using radiographs. Results Imaging parameters from a total of 66 subjects from the patient group and 82 asymptomatic subjects in the control group were used for analysis. ROC analysis suggested sagittal vertebral body width to pedicle width ratio (SBW:PW as having the strongest sensitivity and specificity for diagnosing DSS. Cutoff indices for SBW:PW were level-specific: L1 (2.0, L2 (2.0, L3 (2.2, L4 (2.2, L5 (2.5, and S1 (2.8. Conclusions This is the first study to define DSS on plain radiographs based on comparisons between a clinically relevant patient group and a control group. Individuals with DSS can be identified by a simple radiograph using a screening tool allowing for better

  5. Changes in HbA1c levels and body mass index after successful decompression surgery in patients with type 2 diabetes mellitus and lumbar spinal stenosis: results of a 2-year follow-up study.

    Science.gov (United States)

    Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung; Kim, Chi Heon; Kang, Hyun; Kim, Du Hwan

    2017-02-01

    Lumbar spinal stenosis (LSS) can hinder a patient's physical activity, which in turn can impair glucose tolerance and body weight regulation in patients with type 2 diabetes mellitus (DM-2). Therefore, successful lumbar surgery could facilitate glycemic control and body weight regulation. This study aimed to evaluate the effects of postoperative improvement in physical activity on body mass index (BMI) and hemoglobin A 1c (HbA 1c ) level in patients with LSS and DM-2 over a 2-year follow-up period. Prospective longitudinal observational study. Patients with LSS and DM-2. Visual analogue scale (VAS) scores for back pain and leg pain, Oswestry Disability Index (ODI) scores, Japanese Orthopaedic Association (JOA) scores, JOA Back Pain Evaluation Questionnaire (JOABPEQ) sections, BMI, and blood analysis for HbA 1c were carried out. A total of 119 patients were enrolled for analysis of the effect of successful decompression surgery on changes in HbA 1c levels and BMI. The VAS score, ODI score, JOA score, JOABPEQ, BMI, HbA 1c were reassessed at 6 months, 1 year, and 2 years after surgery. Additionally, correlations between changes in HbA 1c and changes in the ODI, JOA, JOABPEQs, and BMI were analyzed. The overall values of HbA1c before and at 6 months, 1 year, and 2 years after the surgery were 7.08±0.94%, 6.58±0.87%, 6.59±0.79%, and 6.59±0.79%, respectively (p-values; 6 months: .024; 1 year: .021; 2 years: .038). In the not well-controlled sugar (non-WCS) group (preoperative HbA 1c >6.5%), the difference between pre- and postoperative HbA 1c was highly statistically significant (p25) patients with DM-2 and LSS. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over.

    Science.gov (United States)

    Armbrecht, Gabriele; Felsenberg, Dieter; Ganswindt, Melanie; Lunt, Mark; Kaptoge, Stephen K; Abendroth, Klaus; Aroso Dias, Antonio; Bhalla, Ashok K; Cannata Andia, Jorge; Dequeker, Jan; Eastell, Richard; Hoszowski, Krzysztof; Lyritis, George; Masaryk, Pavol; van Meurs, Joyce; Miazgowski, Tomasz; Nuti, Ranuccio; Poór, Gyula; Redlund-Johnell, Inga; Reid, David M; Schatz, Helmut; Todd, Christopher J; Woolf, Anthony D; Rivadeneira, Fernando; Javaid, Muhammad K; Cooper, Cyrus; Silman, Alan J; O'Neill, Terence W; Reeve, Jonathan

    2017-07-01

    To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Degenerative Inter-Vertebral Disc Disease (Osteochondrosis Intervertebralis) in Europe: Prevalence, Geographic Variation, and Radiological Correlates in Men and Women Aged 50 and Over

    Science.gov (United States)

    Armbrecht, Gabriele; Felsenberg, Dieter; Ganswindt, Melanie; Lunt, Mark; Kaptoge, Stephen K; Abendroth, Klaus; Aroso Dias, Antonio; Bhalla, Ashok K; Cannata Andia, Jorge; Dequeker, Jan; Eastell, Richard; Hoszowski, Krysztoff; Lyritis, George; Masaryk, Pavol; van Meurs, Joyce; Miazgowski, Tomasz; Nuti, Ranuccio; Poór, Gyula; Redlund-Johnell, Inga; Reid, David M; Schatz, Helmut; Todd, Christopher J; Woolf, Anthony D; Rivadeneira, Fernando; Javaid, Muhammad K; Cooper, Cyrus; Silman, Alan J; O’Neill, Terence W; Reeve, Jonathan

    2017-01-01

    Objectives To assess the prevalence across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal bone mineral density (aBMD) and change in aBMD with time. Methods In the population-based European Prospective Osteoporosis Study 27 age-stratified samples of men and women from across the continent aged 50+ had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results Images from 10,132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Discussion KL Grades 3 and 4 are often used clinically to categorise radiological DDD. Highly variable European prevalences of radiologically-defined DDD Grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes. PMID:28398504

  8. 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

  9. Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus

    Directory of Open Access Journals (Sweden)

    Roberto Sérgio Martins

    2011-08-01

    Full Text Available Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. METHOD: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. RESULTS: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. CONCLUSION: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage.

  10. Imaging of vertebral fracture in osteoporosis

    International Nuclear Information System (INIS)

    Skowronska-Jozwiak, E.; Lewinski, A.; Bieganski, T.

    2008-01-01

    Vertebral collapses are the most frequent fractures in osteoporosis. They are often overlooked, although their presence is a strong risk factor for development of new fractures. Lateral radiographs of the spine are the accepted standard for assessment of fractures. Qualitative (visual), semiquantitative and quantitative (morphometric) techniques are useful in determining the compressive deformities of vertebral bodies. In the present paper, the advantages and the disadvantages of these methods are discussed. The improvement of scan quality allows to use DXA technique to diagnose the fractures, in both - the visual and the morphometric way. The vertebral morphologic assessment also seems to be an important diagnostic tool in pediatric osteoporosis. Application of multidetector CT and especially MR in vertebral imaging of osteoporosis, improves the sensitivity of fracture detection and enables the differentiation of benign from malignant vertebral body collapses. (author)

  11. The effect of intraosseous injection of calcium sulfate on microstructure and biomechanics of osteoporotic lumbar vertebrae in sheep

    Directory of Open Access Journals (Sweden)

    Da LIU

    2014-10-01

    Full Text Available Objective To investigate the effect of calcium sulfate (CS on improvement of microstructure and biomechanical performance of osteoporotic lumbar vertebrae in sheep. Methods Osteoporosis model was reproduced in 8 female sheep by bilateral ovariectomy and methylprednisolone administration. Then the lumbar vertebrae (L1-L4 in each sheep were randomly divided into CS group and blank group (2 vertebrae in each sheep. CS was injected into the vertebral bodies through the pedicle in CS group, and no treatment was given in blank group. All of the animals were sacrificed 3 months later, and vertebrae L1-L4 were harvested. The microstructure and biomechanical performance of vertebral bodies were assessed by micro-CT scanning, histological observation and biomechanical test. Results After ovariectomy and methylprednisolone administration, the mean bone mineral density of the lumbar vertebrae in the sheep was significantly decreased (>25% compared with that before induction (P<0.05, demonstrating a successful reproduction of osteoporosis model. Three months after injection, it was shown that CS was completely degraded without any remnant in the bone tissue. The quality of the bone tissue (trabecular number and tissue mineral density in CS group was significantly better than that in blank group (P<0.05, and the biomechanical performance in CS group was significantly superior to that in blank group (P<0.05. Conclusions  Local injection of CS could significantly improve the microstructure and biomechanical performance of osteoporotic vertebrae, and it may decrease the risk of fracture of patients with osteoporosis. DOI: 10.11855/j.issn.0577-7402.2014.09.02

  12. Lumbar disc herniation in patients with chronic backache.

    Science.gov (United States)

    Ali, Asghar; Khan, Shahbaz Ali; Aurangzeb, Ahsan; Ahmed, Ehtisham; Ali, Gohar; Muhammad, Gul; Mehmood, Shakir

    2013-01-01

    Low back pain with or without lower extremity pain is the most common problem among chronic pain disorders with significant economic, social, and health impact. This study was conducted to determine the frequency of lumbar disc herniation and its different levels, among patients with chronic backache. This cross sectional study was conducted in the department of Neurosurgery, Ayub Medical College Abbottabad from January 2011 to January 2013. All the patients presenting with chronic low backache of either gender above the age 14 years were included in the study. Magnetic resonance imaging (MRI) was done in all the patients included in the study to look for lumbar disc herniation. A total of 477 patients with chronic low backache were included in the study out of which 274 (57.4%) were males. Age of the patients ranged from 19 to 75 (39.92 +/- 12.31) years. Out of 477 patients 38 (7.9%) had significant radiological evidence of disc prolapse at lumbar vertebral levels, with 26 (9.5%) males and 12 (5.9%) females. Among these 38 patients with inter-vertebral disc, 20 (52.6%) of patients had disc herniation at L5-S1, 15 (39.5%) at L4-L5, 2 (5.26%) cases at L3-L4 level and only one case (2.6%) had the involvement of L2-L3 level. No cases of L1-L2 disc prolapse were found. Patients with chronic backache can have inter-vertebral lumbar disc prolapsed disease. Middle age group are more affected by lumbar disc disease especially at the lower lumbar regions.

  13. Closure of the vertebral canal in human embryos and fetuses

    NARCIS (Netherlands)

    Mekonen, Hayelom K.; Hikspoors, Jill P. J. M.; Mommen, Greet; Kruepunga, Nutmethee; Köhler, S. Eleonore; Lamers, Wouter H.

    2017-01-01

    The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10weeks of

  14. Whole-body low-dose computed tomography in multiple myeloma staging: Superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extraskeletal findings compared to radiography with similar radiation exposure.

    Science.gov (United States)

    Lambert, Lukas; Ourednicek, Petr; Meckova, Zuzana; Gavelli, Giampaolo; Straub, Jan; Spicka, Ivan

    2017-04-01

    The primary objective of the present prospective study was to compare the diagnostic performance of conventional radiography (CR) and whole-body low-dose computed tomography (WBLDCT) with a comparable radiation dose reconstructed using hybrid iterative reconstruction technique, in terms of the detection of bone lesions, skeletal fractures, vertebral compressions and extraskeletal findings. The secondary objective was to evaluate lesion attenuation in relation to its size. A total of 74 patients underwent same-day skeletal survey by CR and WBLDCT. In CR and WBLDCT, two readers assessed the number of osteolytic lesions at each region and stage according to the International Myeloma Working Group (IMWG) criteria. A single reader additionally assessed extraskeletal findings and their significance, the number of vertebral compressions and bone fractures. The radiation exposure was 2.7±0.9 mSv for WBLDCT and 2.5±0.9 mSv for CR (P=0.054). CR detected bone involvement in 127 out of 486 regions (26%; Prib fractures compared with CR (188 vs. 47; Pfractures, vertebral compressions and extraskeletal findings, which results in up- or downstaging in 24% patients according to the IMWG criteria. The attenuation of osteolytic lesions can be measured with the avoidance of the partial volume effect.

  15. The analysis of imaging diagnosis and misdiagnosis of vertebral eosinophilic granuloma

    International Nuclear Information System (INIS)

    Liang Weiqiang; Li Sheng

    2007-01-01

    Objective: To analyze the imaging features of vertebral eosinophilic granuloma and the reasons of misdiagnosis, so as to improve the diagnosis accuracy of the disease. Methods: The clinical materials and images findings of 10 patients with vertebral eosinophilic granuloma proved by surgery and histopathology were analyzed retrospectively. Results: Of all the cases, 3 of them were located in cervical vertebra, 5 in thoracic vertebra and 2 in lumbar vertebra. 8 lesions were single and 2 involved the adjacent 2 vertebrae. 4 lesions showed obvious sinking and flattening of the vertebra body, with widening anteroposterior and transverse diameters, 4 cases showed wedge-shaped appearance, 2 cases showed well-defined oval deossification. The appendix of vertebrae in 3 lesions were destroyed with surrounding mass. The intervertebral spaces were normal in 7 cases, slightly widened in 2 cases and slightly narrowed in 1 case. 6 cases showed paravertebra soft tissue swelling or soft tissue mass formation. Conclusion: Though there are some imaging features of vertebral eosinophilic granuloma, close combination with clinical dates and careful analysis of imaging findings can effectively improved the diagnosis accuracy. (authors)

  16. Computed tomography in lumbar canal stenosis

    International Nuclear Information System (INIS)

    Ohta, Shu; Baba, Itsushi; Ishida, Akihisa; Sumida, Tadayuki; Sasaki, Seishu

    1984-01-01

    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. (Namekawa, K)

  17. Varied overstrain injuries of the vertebral column conditioned by evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W

    1983-08-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components.

  18. Varied overstrain injuries of the vertebral column conditioned by evolution

    International Nuclear Information System (INIS)

    Kohlbach, W.

    1983-01-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components. (orig.) [de

  19. Varied overstrain injuries of the vertebral column conditioned by evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W.

    1983-08-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components.

  20. Prognostic Factors for Satisfaction After Decompression Surgery for Lumbar Spinal Stenosis

    DEFF Research Database (Denmark)

    Paulsen, Rune Tendal; Bouknaitir, Jamal Bech; Fruensgaard, Søren

    2018-01-01

    : To present clinical outcome data and identify prognostic factors related to patient satisfaction 1 yr after posterior decompression surgery for lumbar spinal stenosis. METHOD: This multicenter register study included 2562 patients. Patients were treated with various types of posterior decompression. Patients...... with previous spine surgery or concomitant fusion were excluded. Patient satisfaction was analyzed for associations with age, sex, body mass index, smoking status, duration of pain, number of decompressed vertebral levels, comorbidities, and patient-reported outcome measures, which were used to quantify....... CONCLUSION: This study found smoking, long duration of leg pain, and cancerous and neurological disease to be associated with patient dissatisfaction, whereas good walking capacity at baseline was positively associated with satisfaction after 1 yr....

  1. A Radiographic Study on the Associations of Age and Prevalence of Vertebral Fractures with Abdominal Aortic Calcification in Japanese Postmenopausal Women and Men

    Directory of Open Access Journals (Sweden)

    Jun Iwamoto

    2010-01-01

    Full Text Available The purpose of the present study was to determine the associations of age and history of non- and low-traumatic fractures with the severity of abdominal aortic calcification in Japanese postmenopausal women and men. Four hundred and one Japanese persons (24 men and 377 postmenopausal women, mean age: 73.8 years for whom thoracic and lumbar spine radiographs had been obtained to evaluate their posture prior to patient participation in a fall-prevention exercise program were enrolled. The associations of sex, age, history of hip fracture, prevalence of vertebral fracture, and spondylosis grade (the Nathan degree with the severity of abdominal aortic calcification (length of calcification, as evaluated according to the number of vertebral bodies were analyzed. Nine subjects (2.2% had a history of hip fracture, and 221 (55.1% had at least one prevalent vertebral fracture. Two hundred and sixty-seven subjects (66.6% had first-degree spondylosis. Age and the number of prevalent vertebral fractures, but not sex, history of hip fracture, or spondylosis grade, were significantly associated with the severity of abdominal aortic calcification. The present study confirmed that age and the number of vertebral fractures were associated with the severity of abdominal aortic calcification in Japanese postmenopausal women and men.

  2. Weightlifter Lumbar Physiology Health Influence Factor Analysis of Sports Medicine.

    Science.gov (United States)

    Zhang, Xiangyang

    2015-01-01

    Chinese women's weightlifting project has been in the advanced world level, suggests that the Chinese coaches and athletes have many successful experience in the weight lifting training. Little weight lifting belongs to high-risk sports, however, to the lumbar spine injury, some young good athletes often due to lumbar trauma had to retire, and the national investment and athletes toil is regret things. This article from the perspective of sports medicine, weightlifting athletes training situation analysis and put forward Suggestions, aimed at avoiding lumbar injury, guarantee the health of athletes. In this paper, first of all to 50 professional women's weightlifting athletes doing investigation, found that 82% of the athletes suffer from lumbar disease symptoms, the reason is mainly composed of lumbar strain, intensity is too large, motion error caused by three factors. From the Angle of sports medicine and combined with the characteristics of the structure of human body skeleton athletes lumbar structural mechanics analysis, find out the lumbar force's two biggest technical movement, study, and regulate the action standard, so as to minimize lumbar force, for athletes to contribute to the health of the lumbar spine.

  3. MR imaging of tuberculous vertebral osteomyelitis: pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Gouliamos, A.D.; Kehagias, D.T.; Lahanis, S.; Moulopoulou, E.S.; Kalovidouris, A.A.; Trakadas, S.J.; Vlahos, L.j. [Dept. of Radiology, University of Athens (Greece); Athanassopoulou, A.A. [Dept. of Radiology, Asklipiion Hospital, Athens (Greece)

    2001-04-01

    Vertebral osteomyelitis is one of the most common manifestations of tuberculosis. Magnetic resonance imaging is considered the main imaging modality for the diagnosis, the demonstration of the extent of the disease, and follow-up studies. Vertebral destruction involving two consecutive levels with sparing of the intervertebral disc, disc herniation into the vertebral body, epidural involvement, and paraspinal abscess are the most common MRI findings suggestive of tuberculous vertebral osteomyelitis. (orig.)

  4. Vertebral osteoporosis: perfused animal cadaver model for testing new vertebroplastic agents.

    Science.gov (United States)

    Hoell, Thomas; Huschak, Gerald; Beier, Andre; Holzhausen, Hans-Juergen; Meisel, Hans-Joerg; Emmrich, Frank

    2010-12-01

    Experimental study. It was aimed to establish a cadaver model to imitate osteoporotic perfused vertebral bone and to allow for transpedicular transfer of bone cement and various new materials into vertebrae. The model was perfused to simulate vertebroplasty in the presence of transvertebral blood flow. The injection of bone cement into vertebrae bears the risk of irreversible discharge of material into the venous system of the spinal canal. The bovine cadaver model studied allows visual studies of material distribution in a vertebral bone, the potential spill-out of material, and quantification of washout and disintegration phenomena. Thoracic and lumbar vertebrae from 1-year-old calves were cut transversally into 5 mm slices, macerated, and decalcified. The softened bone slices were compressed between 2 transparent plastic discs. A standard vertebroplasty cannula (outer diameter 3.5 mm, inner diameter 2.5 mm) was inserted into the vertebral body via the pedicle to transfer the different vertebroplasty materials. Arterial blood flow was simulated by means of liquid irrigation via 2 needles in the ventral part of the vertebral body slice. Metal powder was mixed with the solution to indicate the blood flow in the bone. The model was evaluated with the vertebroplasty cement polymethylmethacrylate. The model permitted visualization of the insertion and distribution of vertebroplasty materials. Liquid bone cement was effused into the spinal canal as in the clinical situation. Higher modulus cement acted in the same way as in clinical vertebroplasty. Rigid vertebroplasty agents led to trabecular fractures and stable mechanical interactions with the bone and eventually moved dorsal bone fragments into the spinal canal. Sedimentation of the metal powder indicated regions of perfusion. The model simulated the clinical behavior of liquid and higher modulus vertebroplasty agents in the presence of blood flow. It enabled safe ex vivo testing of the mechanical and physical

  5. 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.

  6. 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.

  7. Local differences in mineral content in vertebral trabecular bone measured by dual-energy computed tomography

    International Nuclear Information System (INIS)

    Nepper-Rasmussen, J.; Mosekilde, L.; Aarhus Univ.

    1989-01-01

    Twelve lumbar vertebral bodies from cadavers were examined with dual-energy CT, to measure the calcium content in a big central region of interest (ROI). In each of five vertebrae the calcium content was also measured in six small ROI. After completed scanning, six small cylinders were drilled out from each vertebra, and the ash-density of each cylinder was measured. The dual-energy CT measurements correlated well with the ash-density. Both ash-density and dual-energy CT showed a significantly higher mineral content in the posterior part of the vertebrae than in the anterior part, and this difference might be responsible for problems encountered with the reproducibility of dual-energy CT. (orig.)

  8. 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...

  9. Automatic segmentation of lumbar vertebrae in CT images

    Science.gov (United States)

    Kulkarni, Amruta; Raina, Akshita; Sharifi Sarabi, Mona; Ahn, Christine S.; Babayan, Diana; Gaonkar, Bilwaj; Macyszyn, Luke; Raghavendra, Cauligi

    2017-03-01

    Lower back pain is one of the most prevalent disorders in the developed/developing world. However, its etiology is poorly understood and treatment is often determined subjectively. In order to quantitatively study the emergence and evolution of back pain, it is necessary to develop consistently measurable markers for pathology. Imaging based measures offer one solution to this problem. The development of imaging based on quantitative biomarkers for the lower back necessitates automated techniques to acquire this data. While the problem of segmenting lumbar vertebrae has been addressed repeatedly in literature, the associated problem of computing relevant biomarkers on the basis of the segmentation has not been addressed thoroughly. In this paper, we propose a Random-Forest based approach that learns to segment vertebral bodies in CT images followed by a biomarker evaluation framework that extracts vertebral heights and widths from the segmentations obtained. Our dataset consists of 15 CT sagittal scans obtained from General Electric Healthcare. Our main approach is divided into three parts: the first stage is image pre-processing which is used to correct for variations in illumination across all the images followed by preparing the foreground and background objects from images; the next stage is Machine Learning using Random-Forests, which distinguishes the interest-point vectors between foreground or background; and the last step is image post-processing, which is crucial to refine the results of classifier. The Dice coefficient was used as a statistical validation metric to evaluate the performance of our segmentations with an average value of 0.725 for our dataset.

  10. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis

    Science.gov (United States)

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

    2017-01-01

    Abstract 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

  11. 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

  12. Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures.

    Science.gov (United States)

    Geith, Tobias; Schmidt, Gerwin; Biffar, Andreas; Dietrich, Olaf; Dürr, Hans Roland; Reiser, Maximilian; Baur-Melnyk, Andrea

    2012-11-01

    The objective of our study was to compare the diagnostic value of qualitative diffusion-weighted imaging (DWI), quantitative DWI, and chemical-shift imaging in a single prospective cohort of patients with acute osteoporotic and malignant vertebral fractures. The study group was composed of patients with 26 osteoporotic vertebral fractures (18 women, eight men; mean age, 69 years; age range, 31 years 6 months to 86 years 2 months) and 20 malignant vertebral fractures (nine women, 11 men; mean age, 63.4 years; age range, 24 years 8 months to 86 years 4 months). T1-weighted, STIR, and T2-weighted sequences were acquired at 1.5 T. A DW reverse fast imaging with steady-state free precession (PSIF) sequence at different delta values was evaluated qualitatively. A DW echo-planar imaging (EPI) sequence and a DW single-shot turbo spin-echo (TSE) sequence at different b values were evaluated qualitatively and quantitatively using the apparent diffusion coefficient. Opposed-phase sequences were used to assess signal intensity qualitatively. The signal loss between in- and opposed-phase images was determined quantitatively. Two-tailed Fisher exact test, Mann-Whitney test, and receiver operating characteristic analysis were performed. Sensitivities, specificities, and accuracies were determined. Qualitative DW-PSIF imaging (delta = 3 ms) showed the best performance for distinguishing between benign and malignant fractures (sensitivity, 100%; specificity, 88.5%; accuracy, 93.5%). Qualitative DW-EPI (b = 50 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.50]) and DW single-shot TSE imaging (b = 100 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.18]; b = 400 s/mm(2) [p = 0.18]; b = 600 s/mm(2) [p = 0.39]) did not indicate significant differences between benign and malignant fractures. DW-EPI using a b value of 500 s/mm(2) (p = 0.01) indicated significant differences between benign and malignant vertebral fractures. Quantitative DW-EPI (p = 0.09) and qualitative opposed-phase imaging (p = 0

  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. Chondroblastoma of the Lumbar Vertebra Associated with Cauda Equina Compression

    Directory of Open Access Journals (Sweden)

    Ewe-Juan Yeap

    2013-12-01

    Full Text Available Chondroblastoma is a benign tumour, most often affecting the epiphyses of long tubular bones such as the proximal end of the humerus, femur, and tibia, as well as the distal end of the femur. Vertebral involvement is extremely rare. We report a case of chondroblastoma of the second lumbar vertebra associated with cauda equina compression. Complete excision is necessary to relieve the compression and ensure surgical clearance.

  15. Preliminary clinical research of vertebral body stenting combined with absorbable bone cements for osteoporotic vertebral compression fractures%椎体支架联合可吸收骨水泥治疗骨质疏松性椎体压缩骨折的临床疗效

    Institute of Scientific and Technical Information of China (English)

    贾崇哲; 贾璞; 陈浩; 包利; 冯飞; 刘青山; 杨阳; 唐海

    2016-01-01

    目的 分析经皮椎体后凸成形术(PKP)中运用椎体支架联合可吸收骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果. 方法 前瞻性研究2014年1月-2016年1月应用椎体支架联合可吸收骨水泥治疗OVCF患者.比较术前、术后3d、3、6个月视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体高度恢复情况、椎体后凸Cobb角的变化及其并发症.结果 共纳入15例患者,其中男8例,女7例;年龄51~83岁,平均68.6岁,均完成6个月随访.所有患者均顺利完成手术,无术中、术后并发症发生.VAS评分由术前(7.67±0.62)分改善至术后3d的(2.60 ±0.63)分,术后3个月的(2.00 ±0.65)分,术后6个月的(1.26±0.80)分;ODI由术前(55.62±6.14)%改善至术后3d的(30.84±2.70)%,术后3个月的(21.88±2.42)%,术后6个月的(17.07±2.82)%.术后3d、3个月、6个月与术前比较,VAS评分和ODI显著降低(P均<0.05).椎体前缘高度由术前(2.50 ±0.48) cm恢复为术后3d的(2.59 ±0.49)cm,术后6个月的(2.60±0.50)cm.椎体中部高度由术前(2.27 ±0.38)cm恢复为术后3d的(2.33±0.38) cm,术后6个月的(2.35±0.38) cm.椎体后缘高度由术前(3.09±0.48)cm恢复为术后3d的(3.14±0.46)cm,术后6个月的(3.18±0.50) cm.术后椎体前缘、中部高度较术前均有所恢复(P<0.05),且高度在3d、6个月时丢失不明显(P>0.05);术后椎体后缘高度较术前恢复不明显(P>0.05).Cobb角术前为(8.93±6.58).,恢复为术后3d的(8.03±6.02)°,术后3个月的(8.06±6.08).,术后6个月的(7.93±6.09).,术后Cobb角较术前有所改善(P均<0.05),且随访期间Cobb角变化不明显(P>0.05). 结论 PKP术中椎体支架联合可吸收骨水泥治疗OVCF可改善和维持椎体前缘、中部高度及Cobb角,早期随访效果满意.%Objective To observe the clinical effect and safety of using vertebral body stenting combined with absorbable bone cements during percutaneous kyphoplasty (PKP) for osteoporotic

  16. 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.

  17. Assessment of lumbar spinal canal stenosis by magnetic resonance phlebography

    International Nuclear Information System (INIS)

    Manaka, Masakazu; Komagata, Masashi; Endo, Kenji; Imakiire, Atsuhiro

    2003-01-01

    There is evidence to suggest that cauda equina intermittent claudication is caused by local circulatory disturbances in the cauda equina as well as compression of the cauda equina. We evaluated the role of magnetic resonance phlebography (MRP) in identifying circulatory disturbances of the vertebral venous system in patients with lumbar spinal canal stenosis. Extensive filling defects of the anterior internal vertebral venous plexus were evident in patients with lumbar spinal canal stenosis (n=53), whereas only milder abnormalities were noted in patients with other lumber diseases (n=16) and none in normal subjects (n=13). The extent of the defect on MRP correlated with the time at which intermittent claudication appeared. In patients with lumber spinal canal stenosis, extensive defects of the internal vertebral venous plexus on MRP were noted in the neutral spine position, but the defect diminished with anterior flexion of the spine. This phenomenon correlated closely with the time at which intermittent claudication appeared. Our results highlight the importance of MRP for assessing the underlying mechanism of cauda equina intermittent claudication in patients with lumbar spinal canal stenosis and suggest that congestive venous ischemia is involved in the development of intermittent claudication in these patients. (author)

  18. CT diagnosis in the evaluation of vertebral trauma

    International Nuclear Information System (INIS)

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

    1984-01-01

    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. (author)

  19. Assessment of the bone mineral density in the lumbar vertebrae of newborns by quantitative computed tomography

    International Nuclear Information System (INIS)

    Braillon, P.M.; Lapillonne, A.; Ho, P.S.; Bouvier, R.; Bochu, M.; Salle, B.L.

    1996-01-01

    Objective. To assess the true mineral density (BMD, in g/cm 3 ) of the lumbar spine in newborns. Design and patients. A post-mortem analysis of five infants with gestational ages ranging from 35 to 40 weeks, and birth weights from 2765 to 3200 g, was conducted using dual-energy quantitative computed tomography (QCT; Siemens Somatom DR). A 2 or 4 mm thick slice was obtained for each lumbar vertebra from L1 to L4. The density measured in these vertebrae was corrected by reference to a solid phantom (Osteo-CT) measured simultaneously. A three-dimensional image of the spine (Elscint CT Twin), as well as a photomicrograph of histological preparation from L2 vertebra, were also obtained in another term baby for comparison with the CT results. Results and conclusions. In the range of values studied, the vertebral densities were not dependent on birth weight. BMD values measured in L2, L3 and L4 were not significantly different, but were 10% lower than in L1 in four of five infants. The spatial resolution of the QCT protocol used (0.4 mm) did not permit the differentiation of trabecular and cortical bone, and the vertebral bodies appeared very homogeneous and dense, with a mean density value of 210±30 mg Ca/cm 3 , which is 2.5 times higher than the mean maximum value found in young normal adults. These preliminary results highlight the potential of QCT in neonatology. Special protocols will, however, need to be developed for in vivo measurements in this particular paediatric field. (orig.). With 4 figs., 2 tabs

  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. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  1. Physiological Background of Differences in Quantitative Diffusion-Weighted Magnetic Resonance Imaging Between Acute Malignant and Benign Vertebral Body Fractures: Correlation of Apparent Diffusion Coefficient With Quantitative Perfusion Magnetic Resonance Imaging Using the 2-Compartment Exchange Model.

    Science.gov (United States)

    Geith, Tobias; Biffar, Andreas; Schmidt, Gerwin; Sourbron, Steven; Dietrich, Olaf; Reiser, Maximilian; Baur-Melnyk, Andrea

    2015-01-01

    To test the hypothesis that apparent diffusion coefficient (ADC) in vertebral bone marrow of benign and malignant fractures is related to the volume of the interstitial space, determined with dynamic contrast-enhanced (DCE) magnetic resonance imaging. Patients with acute benign (n = 24) and malignant (n = 19) vertebral body fractures were examined at 1.5 T. A diffusion-weighted single-shot turbo-spin-echo sequence (b = 100 to 600 s/mm) and DCE turbo-FLASH sequence were evaluated. Regions of interest were manually selected for each fracture. Apparent diffusion coefficient was determined with a monoexponential decay model. The DCE magnetic resonance imaging concentration-time curves were analyzed using a 2-compartment tracer-kinetic model. Apparent diffusion coefficient showed a significant positive correlation with interstitial volume in the whole study population (Pearson r = 0.66, P correlation between ADC and the permeability-surface area product could be observed when analyzing the whole study population (Spearman rs = 0.40, P = 0.008), but not when separately examining the subgroups. Plasma flow showed a significant correlation with ADC in benign fractures (Pearson r = 0.23, P = 0.03). Plasma volume did not show significant correlations with ADC. The results support the hypothesis that the ADC of a lesion is inversely correlated to its cellularity. This explains previous observations that ADC is reduced in more malignant lesions.

  2. Lumbar dorsal ramus syndrome.

    Science.gov (United States)

    Bogduk, N

    1980-11-15

    Low back pain, referred pain in the lower limbs, and spasm of the back, gluteal, and hamstring muscles are clinical features which can be induced in normal volunteers by stimulating structures which are innervated by the lumbar dorsal rami. Conversely, they can be relieved in certain patients by selective interruption of conduction along dorsal rami. These facts permit the definition of a lumbar dorsal ramus syndrome, which can be distinguished from the intervertebral disc syndrome and other forms of low back pain. The distinguishing feature is that, in lumbar dorsal ramus syndrome, all the clinical features are exclusively mediated by dorsal rami and do not arise from nerve-root compression. The pathophysiology, pathology, and treatment of this syndrome are described. Recognition of this syndrome, and its treatment with relatively minor procedures, can obviate the need for major surgery which might otherwise be undertaken.

  3. 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

    persistent in both flexion and extension views and much more exaggerated in extension. 4. In herniated disk group, anterior epidural space above the lesion was normal but widened at the vertebral body level just below the lesion.

  4. High signal in bone marrow at diffusion-weighted imaging with body background suppression (DWIBS) in healthy children

    Energy Technology Data Exchange (ETDEWEB)

    Ording Mueller, Lil-Sofie; Avenarius, Derk [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Olsen, Oeystein E. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom)

    2011-02-15

    In our experience, diffusion-weighted imaging with body background suppression (DWIBS) is hard to interpret in children who commonly have foci of restricted diffusion in their skeletons unrelated to pathology, sometimes in an asymmetrical pattern. This raises serious concern about the accuracy of DWIBS in cancer staging in children. To describe the signal distribution at DWIBS in the normal developing lumbar spine and pelvic skeleton. Forty-two healthy children underwent an MR DWIBS sequence of the abdomen and pelvis. An axial short-tau inversion-recovery (STIR) echo-planar imaging (EPI) pulse sequence was used. Two radiologists did a primary review of the images and based on these preliminary observations, separate scoring systems for the lumbar spine, pelvis and proximal femoral epiphyses/femoral heads were devised. Visual evaluation of the images was then performed by the two radiologists in consensus. The scoring was repeated separately 2 months later by a third radiologist. Restricted diffusion was defined as areas of high signal compared to the background. Coronal maximum intensity projection (MIP) reformats were used to assess the vertebral bodies. For the pelvis, the extension of high signal for each bone was given a score of 0 to 4. Cohen's Kappa interobserver agreement coefficients of signal distribution and asymmetry were calculated. All children had areas of high signal, both within the lumbar vertebral bodies and within the pelvic skeleton. Three patterns of signal distribution were seen in the lumbar spine, but no specific pattern was seen in the pelvis. There was a tendency toward a reduction of relative area of high signal within each bone with age, but also a widespread interindividual variation. Restricted diffusion is a normal finding in the pelvic skeleton and lumbar spine in children with an asymmetrical distribution seen in 48% of normal children in this study. DWIBS should be used with caution for cancer staging in children as this could

  5. High signal in bone marrow at diffusion-weighted imaging with body background suppression (DWIBS) in healthy children

    International Nuclear Information System (INIS)

    Ording Mueller, Lil-Sofie; Avenarius, Derk; Olsen, Oeystein E.

    2011-01-01

    In our experience, diffusion-weighted imaging with body background suppression (DWIBS) is hard to interpret in children who commonly have foci of restricted diffusion in their skeletons unrelated to pathology, sometimes in an asymmetrical pattern. This raises serious concern about the accuracy of DWIBS in cancer staging in children. To describe the signal distribution at DWIBS in the normal developing lumbar spine and pelvic skeleton. Forty-two healthy children underwent an MR DWIBS sequence of the abdomen and pelvis. An axial short-tau inversion-recovery (STIR) echo-planar imaging (EPI) pulse sequence was used. Two radiologists did a primary review of the images and based on these preliminary observations, separate scoring systems for the lumbar spine, pelvis and proximal femoral epiphyses/femoral heads were devised. Visual evaluation of the images was then performed by the two radiologists in consensus. The scoring was repeated separately 2 months later by a third radiologist. Restricted diffusion was defined as areas of high signal compared to the background. Coronal maximum intensity projection (MIP) reformats were used to assess the vertebral bodies. For the pelvis, the extension of high signal for each bone was given a score of 0 to 4. Cohen's Kappa interobserver agreement coefficients of signal distribution and asymmetry were calculated. All children had areas of high signal, both within the lumbar vertebral bodies and within the pelvic skeleton. Three patterns of signal distribution were seen in the lumbar spine, but no specific pattern was seen in the pelvis. There was a tendency toward a reduction of relative area of high signal within each bone with age, but also a widespread interindividual variation. Restricted diffusion is a normal finding in the pelvic skeleton and lumbar spine in children with an asymmetrical distribution seen in 48% of normal children in this study. DWIBS should be used with caution for cancer staging in children as this could lead

  6. Imaging the vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Davies, John R.; Weissberg, Peter L. [Addenbrooke' s Hospital and University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Gillard, Jonathan H. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospitald, University Department of Radiology, Cambridge (United Kingdom)

    2005-07-01

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  7. Imaging the vertebral artery

    International Nuclear Information System (INIS)

    Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M.; Davies, John R.; Weissberg, Peter L.; Gillard, Jonathan H.

    2005-01-01

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  8. Mechanical Loading during Growth Is Associated with Plane-specific Differences in Vertebral Geometry: A Cross-sectional Analysis Comparing Artistic Gymnasts vs. Non-gymnasts

    Science.gov (United States)

    Dowthwaite, Jodi N.; Rosenbaum, Paula F.; Scerpella, Tamara A.

    2011-01-01

    Lumbar spine geometry, density and indices of bone strength were assessed relative to menarche status, using artistic gymnastics exposure during growth as a model of mechanical loading. Paired posteroanterior (PA) and supine lateral (LAT) DXA scans of L3 for 114 females (60 ex/gymnasts and 54 non-gymnasts) yielded output for comparison of paired (PALAT) versus standard PA and LAT outcomes. BMC, areal BMD, vertebral body dimensions, bone mineral apparent density (BMAD), axial compressive strength (IBS) and a fracture risk index were evaluated, modeling vertebral body geometry as an ellipsoid cylinder. Two-factor ANCOVA tested statistical effects of gymnastic exposure, menarche status and their interaction, adjusting for age and height as appropriate. Compared to non-gymnasts, ex/gymnasts exhibited greater PABMD, PABMC, PAWIDTH, PA CROSS-SECTIONAL AREA (CSA), PAVOLUME, LATBMD, LATBMAD, PALATCSA and PALATIBS (p<0.05). Non-gymnasts exhibited greater LATDEPTH/PAWIDTH, LATBMC/PABMC, LATVHEIGHT, LATAREA and Fracture Risk Index. Using ellipsoid vertebral geometric models, no significant differences were detected for PA or PALAT BMAD. In contrast, cuboid model results (Carter 1992) suggested erroneous ex/gymnast PABMAD advantages, resulting from invalid assumptions of proportional variation in linear skeletal dimensions. Gymnastic exposure was associated with shorter, wider vertebral bodies, yielding greater axial compressive strength and lower fracture risk, despite no BMAD advantage. Our results suggest the importance of plane-specific vertebral geometric adaptation to mechanical loading during growth. Paired scan output provides a more accurate assessment of this adaptation than PA or LAT plane scans alone. PMID:21839871

  9. A study on clinical findings about vertebral disease diagnosed with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham-Gyum [Ansan College, Seoul (Korea, Republic of)

    2006-09-15

    In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%.

  10. A study on clinical findings about vertebral disease diagnosed with MRI

    International Nuclear Information System (INIS)

    Kim, Ham-Gyum

    2006-01-01

    In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

  11. Quantification of bone mineral density at 3rd lumbar vertebra by dual photon absorptiometry in healthy subjects

    International Nuclear Information System (INIS)

    Fukunaga, Masao; Otsuka, Nobuaki; Ono, Shimato

    1987-01-01

    Bone mineral density (BMD), by dual photon absorptiometry (DPA), at the 3rd lumbar vertebra (L 3 ) was measured in healthy subjects (37 males and 49 females). BMD values on 1 slice of vertebral body (L 3 ), employed as a routine, showed good correlation to the mean BMD values, calculated from multiple slices of whole L 3 . BMD values, by DPA, at L 3 were better correlation to concentrations of bone mineral equivalent material, by quantitative computed tomography, at the trabecular bone of L 3 than to BMD values, by single photon absorptiometry, at distal radius (predominantly cortical bone). Furthermore, by this DPA technique, bone diminution at L 3 with aging was shown in both sexes. These data suggest that measurements of BMD by DPA is greatly useful for evaluating the spinal bone mineral content. (author)

  12. Lumbar spinal stenosis

    DEFF Research Database (Denmark)

    Lønne, Greger; Fritzell, Peter; Hägg, Olle

    2018-01-01

    BACKGROUND: Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains con...

  13. Relationship Between BMD and Prevalent Vertebral Fractures in Indian Women Older Than 50 Yr.

    Science.gov (United States)

    Gupta, Yashdeep; Marwaha, Raman K; Kukreja, Subhash; Bhadra, Kuntal; Narang, Archana; Mani, Kalaivani; Mithal, Ambrish; Tandon, Nikhil

    2016-01-01

    The purpose of the study was to study the relationship of morphometric vertebral fractures with bone mineral density (BMD) in Indian women older than 50 yr. Four hundred fifteen healthy Indian women older than 50 yr (mean age: 62.8 yr) underwent lateral X-rays of the lumbar and thoracic spine. Genant's semiquantitative method was used to diagnose and classify morphometric vertebral fractures. BMD was measured by DXA at lumbar spine and total hip. Recruited subjects underwent anthropometric, biochemical, and hormonal evaluation. Vertebral fractures were present in 17.1% (95% confidence interval: 13.5, 20.8) subjects. Prevalence of osteoporosis based on BMD was 35.7%. By adding those with prevalent fractures, the number of women requiring therapy for osteoporosis would increase to 46.5%. The BMD measured at femur neck, total hip, and lumbar spine (L1eL4) was not found to be lower in women with vertebral fractures as compared with those without fractures. BMD was not found to be lower in women with vertebral fractures as compared with those without fractures. Significant number of additional subjects with BMD in the normal or osteopenic range become eligible for osteoporosis treatment when presence of vertebral fracture is used as an independent indication for such treatment. Copyright © 2016 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  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. Diabetes Mellitus, a New Risk Factor for Lumbar Spinal Stenosis: A Case–Control Study

    Directory of Open Access Journals (Sweden)

    Leila Asadian

    2016-01-01

    Full Text Available Objectives This study aimed to determine the prevalence of diabetes mellitus in patients with spinal stenosis and lumbar vertebral disk degeneration, and the correlation of diabetes with these diseases. Study Design This is a cross-sectional study. Methods This case–control study was performed during 2012–2014 with 110 patients suffering from lumbar spinal stenosis and 110 patients with lumbar disk herniation, who were diagnosed using clinical and radiological evidences. Additionally, 110 participants who were referred to the clinic and did not show clinical signs of degenerative diseases of the lumbar spine entered the study as a control group. Demographic data and medical histories of the patients were collected using checklists. Results A total of 50 patients (15.2% were diagnosed with diabetes, which comprised 32 (29.1% in the stenosis group, 7 (6.4% in the lumbar disk herniation group, and 11 (10% in the control group. The prevalence of diabetes in women with spinal stenosis and women with lumbar disk herniation was 35.9% and 10.3%, respectively, whereas prevalence of diabetes in women was 10.9% in the control group. This difference was statistically significant in the spinal stenosis group in comparison with the controls ( P < 0.0001. Conversely, no significant difference was found in men. Conclusions There is an association between diabetes and lumbar spinal stenosis. Diabetes mellitus may be a predisposing factor for the development of lumbar spinal stenosis.

  16. Evaluating Intensity Modulated Proton Therapy Relative to Passive Scattering Proton Therapy for Increased Vertebral Column Sparing in Craniospinal Irradiation in Growing Pediatric Patients

    International Nuclear Information System (INIS)

    Giantsoudi, Drosoula; Seco, Joao; Eaton, Bree R.; Simeone, F. Joseph; Kooy, Hanne; Yock, Torunn I.; Tarbell, Nancy J.; DeLaney, Thomas F.; Adams, Judith; Paganetti, Harald; MacDonald, Shannon M.

    2017-01-01

    Purpose: At present, proton craniospinal irradiation (CSI) for growing children is delivered to the whole vertebral body (WVB) to avoid asymmetric growth. We aimed to demonstrate the feasibility and potential clinical benefit of delivering vertebral body sparing (VBS) versus WVB CSI with passively scattered (PS) and intensity modulated proton therapy (IMPT) in growing children treated for medulloblastoma. Methods and Materials: Five plans were generated for medulloblastoma patients, who had been previously treated with CSI PS proton radiation therapy: (1) single posteroanterior (PA) PS field covering the WVB (PS-PA-WVB); (2) single PA PS field that included only the thecal sac in the target volume (PS-PA-VBS); (3) single PA IMPT field covering the WVB (IMPT-PA-WVB); (4) single PA IMPT field, target volume including thecal sac only (IMPT-PA-VBS); and (5) 2 posterior-oblique (−35°, +35°) IMPT fields, with the target volume including the thecal sac only (IMPT2F-VBS). For all cases, 23.4 Gy (relative biologic effectiveness [RBE]) was prescribed to 95% of the spinal canal. The dose, linear energy transfer, and variable-RBE-weighted dose distributions were calculated for all plans using the tool for particle simulation, version 2, Monte Carlo system. Results: IMPT VBS techniques efficiently spared the anterior vertebral bodies (AVBs), even when accounting for potential higher variable RBE predicted by linear energy transfer distributions. Assuming an RBE of 1.1, the V10 Gy(RBE) decreased from 100% for the WVB techniques to 59.5% to 76.8% for the cervical, 29.9% to 34.6% for the thoracic, and 20.6% to 25.1% for the lumbar AVBs, and the V20 Gy(RBE) decreased from 99.0% to 17.8% to 20.0% for the cervical, 7.2% to 7.6% for the thoracic, and 4.0% to 4.6% for the lumbar AVBs when IMPT VBS techniques were applied. The corresponding percentages for the PS VBS technique were higher. Conclusions: Advanced proton techniques can sufficiently reduce the dose to the vertebral

  17. Evaluating Intensity Modulated Proton Therapy Relative to Passive Scattering Proton Therapy for Increased Vertebral Column Sparing in Craniospinal Irradiation in Growing Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Giantsoudi, Drosoula, E-mail: dgiantsoudi@mgh.harvard.edu; Seco, Joao; Eaton, Bree R.; Simeone, F. Joseph; Kooy, Hanne; Yock, Torunn I.; Tarbell, Nancy J.; DeLaney, Thomas F.; Adams, Judith; Paganetti, Harald; MacDonald, Shannon M.

    2017-05-01

    Purpose: At present, proton craniospinal irradiation (CSI) for growing children is delivered to the whole vertebral body (WVB) to avoid asymmetric growth. We aimed to demonstrate the feasibility and potential clinical benefit of delivering vertebral body sparing (VBS) versus WVB CSI with passively scattered (PS) and intensity modulated proton therapy (IMPT) in growing children treated for medulloblastoma. Methods and Materials: Five plans were generated for medulloblastoma patients, who had been previously treated with CSI PS proton radiation therapy: (1) single posteroanterior (PA) PS field covering the WVB (PS-PA-WVB); (2) single PA PS field that included only the thecal sac in the target volume (PS-PA-VBS); (3) single PA IMPT field covering the WVB (IMPT-PA-WVB); (4) single PA IMPT field, target volume including thecal sac only (IMPT-PA-VBS); and (5) 2 posterior-oblique (−35°, +35°) IMPT fields, with the target volume including the thecal sac only (IMPT2F-VBS). For all cases, 23.4 Gy (relative biologic effectiveness [RBE]) was prescribed to 95% of the spinal canal. The dose, linear energy transfer, and variable-RBE-weighted dose distributions were calculated for all plans using the tool for particle simulation, version 2, Monte Carlo system. Results: IMPT VBS techniques efficiently spared the anterior vertebral bodies (AVBs), even when accounting for potential higher variable RBE predicted by linear energy transfer distributions. Assuming an RBE of 1.1, the V10 Gy(RBE) decreased from 100% for the WVB techniques to 59.5% to 76.8% for the cervical, 29.9% to 34.6% for the thoracic, and 20.6% to 25.1% for the lumbar AVBs, and the V20 Gy(RBE) decreased from 99.0% to 17.8% to 20.0% for the cervical, 7.2% to 7.6% for the thoracic, and 4.0% to 4.6% for the lumbar AVBs when IMPT VBS techniques were applied. The corresponding percentages for the PS VBS technique were higher. Conclusions: Advanced proton techniques can sufficiently reduce the dose to the vertebral

  18. Lumbar facet and interfacet shape variation during growth in children from the general population: a three-year follow-up MRI study

    DEFF Research Database (Denmark)

    Masharawi, Youssef M; Kjaer, Per; Bendix, Tom

    2009-01-01

    and orientation is seen in children independent of gender both at t0 and t1. Lumbar facets have widened significantly only in boys from t0 to t1 (up to 30.8%). Girls at t1 manifest greater superior interfacet width relatively to the superior vertebral body width than boys at L2-L4. No significant difference......: The growth of the lumbar facet and interfacet area in children from the general population has rarely been discussed in the literature. This is an important caveat considering the important role these structures play in the development of spinal anomalies. MATERIALS AND METHODS: All lumbar (L1-S1) facet...... and interfacet widths and transverse orientations were measured twice by the same investigator (Y.M.) from T2-weighted MRIs of 100 healthy children (51 boys and 49 girls) from the general population at the mean age of 12 to 13 years (t0) and after 3 years at the mean age of 15 to 16 years (t1) using the i...

  19. Endplates Changes Related to Age and Vertebral Segment

    Directory of Open Access Journals (Sweden)

    Carlos Fernando P. S. Herrero

    2014-01-01

    Full Text Available Endplate separations are defined as the presence of a space between the hyaline cartilage and the cortical bone of the adjacent vertebral body. This study evaluates endplate separations from the vertebral body and intervertebral discs and verifies if endplate separation is related to age and the spinal level. Groups were formed based on age (20–40 and 41–85 years old and the vertebral segment (T7-T8 and L4-L5 segments. Histological analysis included assessment of the length of the vertebral endplates, the number and dimensions of the separations, and orientation of the collagen fibers, in the mid-sagittal slice. Two indexes were created: the separation index (number of separations/vertebral length and separation extension index (sum of all separations/vertebral length. The results of the study demonstrated a direct relationship between the density of separations in the endplate and two variables: age and spinal level.

  20. Vertebral morphometry by dual-energy X-ray absorptiometry

    International Nuclear Information System (INIS)

    Boyanov, M.

    2002-01-01

    Vertebral fractures are a key feature of overt osteoporosis. Different X-ray morphometric techniques have been developed for quantification of changes in vertebral body shape. In recent years, a new method was implemented based on dual-energy X-ray absorptiometry. Morphometric X-ray absorptiometry, MXA, is a source of lower radiation and there is no image distortion. Several aspects of its application are under heavy discussion: image quality, accuracy and precision, reference databases, age changes in vertebral shape. The differential diagnosis of vertebral fracture/deformity is difficult. MXA has prove its value in large epidemiological studies on prevalence of vertebral deformities, as well in assessing the effects of different diseases and medications on vertebral body architecture. MXA is a promising method for future research and clinical work. (author)

  1. Recurrent primary lumbar vertebra chondrosarcoma: Marginal resection and Iodine-125 seed therapy

    Directory of Open Access Journals (Sweden)

    Chunpeng Ren

    2014-01-01

    Full Text Available Chondrosarcomas are uncommon in the spinal column. En bloc excisions with wide margins are of critical importance but not always feasible in spine. We report the outcome in a case of recurrent lumbar vertebral chondrosarcoma treated with marginal resection and iodine-125 seeds placed in the resected tumor bed.

  2. Assisted techniques for vertebral cementoplasty: Why should we do it?

    International Nuclear Information System (INIS)

    Muto, M.; Marcia, S.; Guarnieri, G.; Pereira, V.

    2015-01-01

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications

  3. Assisted techniques for vertebral cementoplasty: Why should we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Muto, M., E-mail: mutomar@tiscali.it [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Marcia, S. [Section of Radiology—Santissima Trinità Hospital, Cagliari (Italy); Guarnieri, G. [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Pereira, V. [Unit of Interventional Neuroradiology–HUG, Geneva (Switzerland)

    2015-05-15

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications.

  4. Lumbar Facet Tropism: A Comprehensive Review.

    Science.gov (United States)

    Alonso, Fernando; Kirkpatrick, Christina M; Jeong, William; Fisahn, Christian; Usman, Sameera; Rustagi, Tarush; Loukas, Marios; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-06-01

    Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine. We performed a literature review of the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism. Facet tropism is most commonly found at L4-L5 vertebral segments and there is some evidence that this condition may lead to facet degenerative spondylolisthesis, intervertebral disc disease, and other degenerative conditions. Long-term analyses of patients are necessary to elucidate relationships between associated findings and facet tropism. In addition, a universally agreed definition that is more precise should be developed for future investigative studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

    2015-03-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  6. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    International Nuclear Information System (INIS)

    Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

    2015-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  7. QUANTITATIVE SIZE ASSESSMENT OF THE LUMBAR SPINAL CANAL BY COMPUTED TOMOGRAPHY

    Directory of Open Access Journals (Sweden)

    M. Midia Z. Miabi

    2007-08-01

    Full Text Available By determining normal ranges of spinal canal diameters we can make early diagnosis in persons who have lower diameters of spinal canal. These persons are predisposed to spinal canal stenosis that is a major cause of spinal radiculopathies. In different studies performed in several countries, minimum and maximum ranges of spinal canal diameters were different for each population. In this study, we tried to determine the mean values of normal spinal canal diameters and areas in Tabriz and its suburb. 39 healthy, young to mid-age cases were selected. Our study was focused on L3-L4 and L4-L5. The following parameters were measured: the area of cross-section of the vertebral body, the area of cross-section of the dural sac, interarticular diameter, interligamentous diameter, antero-posterior diameter of the lumbar canal, inter-pedicular diameter, and the area of cross-section of the vertebral canal. A correlation between the parameters studied and the height of subjects was significant for interligamentous diameter (for L3/L4 and L4/L5 and interarticular diameter (only at L3/L4, cross-section area of the vertebrae (both L3 and L4, cross-section area of vertebral canal (only at L5 level, area of dural sac (at L3/L4 and L4. It was suggested that these diameters and areas should be interpreted as a unction of height of the subject. Most of diameters studied had smaller means than those in previous studies. This can be attributed to differences between populations and it can be interpreted as predisposition to spinal canal stenosis in our population.

  8. Kyphoplasty for severe osteoporotic vertebral compression fractures

    International Nuclear Information System (INIS)

    Bao Zhaohua; Wang Genlin; Yang Huilin; Meng Bin; Chen Kangwu; Jiang Weimin

    2010-01-01

    Objective: To evaluate the clininal efficacy of kyphoplasty for severe osteoporotic vertebral compression fractures. Methods: Forty-five patients with severe osteoporotic compressive fractures were treated by kyphoplasty from Jan 2005 to Jan 2009. The compressive rate of the fractured vertebral bodies was more than 75%. According to the morphology of the vertebral compression fracture bodies the unilateral or bilateral balloon kyphoplasty were selected. The anterior vertebral height was measured on a standing lateral radiograph at pre-operative, post-operative (one day after operation) and final follow-up time. A visual analog scale(VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain status and functional activity. Results: The mean follow-up was for 21.7 months (in range from 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from preoperative (18.7 ± 3.1)% to postoperative (51.4 ± 2.3)%, the follow-up period (50.2 ± 2.7)%. There was a significant improvement between preoperative and postoperative values (P 0.05). The VAS was 8.1 ± 1.4 at preoperative, 2.6 ± 0.9 at postoperative, 2.1 ± 0.5 at final follow-up time; and the ODI was preoperative 91.1 ± 2.3, postoperative 30.7 ± 7.1, follow-up period 26.1 ± 5.1. There was statistically significant improvement in the VAS and ODI in the post-operative assessment compared with the pre-operative assessment (P 0.05). Asymptomatic cement leakage occurred in three cases. New vertebral fracture occurred in one case. Conclusion: The study suggests that balloon kyphoplasty is a safe and effective procedure in the treatment of severe osteoporotic vertebral compression fractures. (authors)

  9. 'Fingerprints' of vertebral trauma - a unifying concept based on mechanisms

    International Nuclear Information System (INIS)

    Daffner, R.H.; Deeb, Z.L.; Rothfus, W.E.

    1986-01-01

    Vertebral fractures, like fractures in the peripheral skeleton, occur in predictable and reproducible patterns that are related to the kind of force applied to the affected bone. The same force applied to the cervical, thoracic, or lumbar column will result in injuries which appear quite similar. A review of 621 injuries to the vertebral column revealed that there are basically four mechanisms of injury: flexion, extension, shearing, and torque (rotation). These injuries may occur by themselves or in combination with one another. The severity and extent of damage produced by any mechanism is dependent upon the incident force, the position of the patient at the time of injury, and the velocity of the patient. Thus, there is a pattern of recognizable signs which span the spectrum from mild soft tissue damage to severe skeletal and ligamentous disruption. These patterns are termed the 'fingerprints' of the injury, and this presentation illustrates the four basic types of vertebral injury producing those 'fingerprints'. (orig.)

  10. The top 100 classic papers in lumbar spine surgery.

    Science.gov (United States)

    Steinberger, Jeremy; Skovrlj, Branko; Caridi, John M; Cho, Samuel K

    2015-05-15

    Bibliometric review of the literature. To analyze and quantify the most frequently cited papers in lumbar spine surgery and to measure their impact on the entire lumbar spine literature. Lumbar spine surgery is a dynamic and complex field. Basic science and clinical research remain paramount in understanding and advancing the field. While new literature is published at increasing rates, few studies make long-lasting impacts. The Thomson Reuters Web of Knowledge was searched for citations of all papers relevant to lumbar spine surgery. The number of citations, authorship, year of publication, journal of publication, country of publication, and institution were recorded for each paper. The most cited paper was found to be the classic paper from 1990 by Boden et al that described magnetic resonance imaging findings in individuals without back pain, sciatica, and neurogenic claudication showing that spinal stenosis and herniated discs can be incidentally found when scanning patients. The second most cited study similarly showed that asymptomatic patients who underwent lumbar spine magnetic resonance imaging frequently had lumbar pathology. The third most cited paper was the 2000 publication of Fairbank and Pynsent reviewing the Oswestry Disability Index, the outcome-measure questionnaire most commonly used to evaluate low back pain. The majority of the papers originate in the United States (n=58), and most were published in Spine (n=63). Most papers were published in the 1990s (n=49), and the 3 most common topics were low back pain, biomechanics, and disc degeneration. This report identifies the top 100 papers in lumbar spine surgery and acknowledges those individuals who have contributed the most to the advancement of the study of the lumbar spine and the body of knowledge used to guide evidence-based clinical decision making in lumbar spine surgery today. 3.

  11. Automatic vertebral identification using surface-based registration

    Science.gov (United States)

    Herring, Jeannette L.; Dawant, Benoit M.

    2000-06-01

    This work introduces an enhancement to currently existing methods of intra-operative vertebral registration by allowing the portion of the spinal column surface that correctly matches a set of physical vertebral points to be automatically selected from several possible choices. Automatic selection is made possible by the shape variations that exist among