JPH3 Repeat Expansions Cause a Progressive Akinetic-Rigid Syndrome with Severe Dementia and Putaminal Rim in a Five-Generation African-American Family

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Schneider, Susanne A.; Marshall, Kate E.; Xiao, Jianfeng; LeDoux, Mark S.

2012-01-01

We report the clinical, neuropsychological, genetic and radiological features of a large five-generation African-American kindred from the southern United States presenting with a progressive akinetic-rigid syndrome and severe dementia, but clinically insignificant chorea, due to mutations in JPH3. Overt disease onset was in the mid-twenties to late thirties with cognitive decline, REM sleep disturbance or psychiatric features, followed by development of a levodopa-unresponsive akinetic-rigid motor syndrome. Dystonia and myoclonus were present in some subjects. A bedridden, non-verbal severely akinetic-rigid state developed within 10 to 15 years after onset. CTG repeat expansions ranged from 47 to 53. Imaging revealed generalized cerebral atrophy with severe striatal involvement and putaminal rim hyperintensity. Analysis of our kindred indicates that JPH3 mutations should be considered in the differential diagnosis of early-onset dementia and hypokinetic-rigid syndromes in individuals of African descent. Moreover, chorea may not be overtly manifest at presentation or during significant parts of the disease course. PMID:22447335

A role for thrombospondin-1 deficits in astrocyte-mediated spine and synaptic pathology in Down's syndrome.

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Octavio Garcia

2010-12-01

Full Text Available Down's syndrome (DS is the most common genetic cause of mental retardation. Reduced number and aberrant architecture of dendritic spines are common features of DS neuropathology. However, the mechanisms involved in DS spine alterations are not known. In addition to a relevant role in synapse formation and maintenance, astrocytes can regulate spine dynamics by releasing soluble factors or by physical contact with neurons. We have previously shown impaired mitochondrial function in DS astrocytes leading to metabolic alterations in protein processing and secretion. In this study, we investigated whether deficits in astrocyte function contribute to DS spine pathology.Using a human astrocyte/rat hippocampal neuron coculture, we found that DS astrocytes are directly involved in the development of spine malformations and reduced synaptic density. We also show that thrombospondin 1 (TSP-1, an astrocyte-secreted protein, possesses a potent modulatory effect on spine number and morphology, and that both DS brains and DS astrocytes exhibit marked deficits in TSP-1 protein expression. Depletion of TSP-1 from normal astrocytes resulted in dramatic changes in spine morphology, while restoration of TSP-1 levels prevented DS astrocyte-mediated spine and synaptic alterations. Astrocyte cultures derived from TSP-1 KO mice exhibited similar deficits to support spine formation and structure than DS astrocytes.These results indicate that human astrocytes promote spine and synapse formation, identify astrocyte dysfunction as a significant factor of spine and synaptic pathology in the DS brain, and provide a mechanistic rationale for the exploration of TSP-1-based therapies to treat spine and synaptic pathology in DS and other neurological conditions.

Gorham syndrome of the thorax and cervical spine: CT and MRI findings

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Chung, C.; Yu, J.S.; Resnick, D.; Vaughan, L.M.; Haghighi, P.

1997-01-01

Gorham syndrome is a rare disorder that is characterized by local osseous invasion and surrounding soft tissues by an angiomatous mass, eventually causing lysis of the affected bone. To date, only four cases have reported the MR imaging appearance of this disease and the findings have been variable. We present a case involving the cervical and thoracic spine and part of the osseous hemithorax with attention to the MR findings. (orig.). With 4 figs

Thoracic spine pain

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Aleksey Ivanovich Isaikin

2013-01-01

Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

Bertolotti's syndrome revisited. Transitional vertebrae of the lumbar spine.

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Elster, A D

1989-12-01

Bertolotti's syndrome refers to the association of back pain with lumbosacral transitional vertebrae. Such vertebrae were observed in 140 of 2,000 adults with back pain over a 4-year period of study. Each patient had radiographic evaluation of the lumbar spine by plain films as well as a sectional imaging modality (magnetic resonance [MR] or computed tomography [CT]). The overall incidence of structural pathology (eg, spinal stenosis and disc protrusion) detected by CT or MR was not apparently higher in patients with transitional vertebrae, but the distribution of these lesions was significantly different. Disc bulge or herniation, when it occurred, was nearly nine times more common at the interspace immediately above the transitional vertebra than at any other level. Spinal stenosis and nerve root canal stenosis were more common at or near the interspace above the transitional vertebra than at any other level. Degenerative change at the articulation between the transverse process of the transitional vertebra and the pelvis was an uncommon occurrence; when seen there was no significant correlation with the reported side of pain. It is postulated that hypermobility and altered stresses become concentrated in the spine at the level immediately above a lumbar transitional vertebra. Accelerated disc and facet joint degeneration at this level may then result.

Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome

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Zheyu Xu

2017-05-01

Full Text Available We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS. The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM. We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.

Investigation of suspected Guillain-Barre syndrome in childhood: what is the role for gadolinium enhanced magnetic resonance imaging of the spine?

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Smith, Nicholas; Pereira, John; Grattan-Smith, Padraic

2014-10-01

To review the role of gadolinium-enhanced magnetic resonance imaging of the spine in the diagnosis of paediatric Guillain-Barre syndrome and compare it with nerve conduction studies and cerebrospinal fluid analysis. A retrospective review of investigations undertaken in children admitted to our institution with acute Guillain-Barre syndrome over a 10-year period was performed. Seven of eight children (88%) displayed post-gadolinium nerve root enhancement consistent with Guillain-Barre syndrome. This compared with supportive nerve conduction studies in 21/24 children (88%) and cerebrospinal fluid protein analysis consistent with the diagnosis in 16/20 children (80%). Nerve conduction studies are the recognised 'gold standard' technique for confirming a clinical diagnosis of Guillain-Barre syndrome. In this study, a high positive rate was demonstrated. While more experience is necessary, this study and the literature support gadolinium enhanced magnetic resonance imaging of the spine as a valuable, although not necessarily superior, investigation in the diagnosis of Guillain-Barre syndrome. It may be of particular benefit when specialist neurophysiology expertise is unavailable. © 2010 The Authors. Journal compilation © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

INFORMATIVE VALUE OF FRACTAL PORTRAIT OF PATIENTS WITH NEUROLOGICAL SYNDROMES OF OSTEOCHONDROSIS OF THE CERVICAL SPINE

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D. V. Vakulenko

2013-05-01

Full Text Available Patients with neurological syndromes of degenerative disc disease of the cervical spine are characterized by decrease of the fractal dimension of electrocardiosignals compared to healthy. This indicates about a low level of energy, immune status, biorhythms harmonization of different organs and systems, psycho-emotional and physiological activity of the body of patients

The therapeutic effect of memantine through the stimulation of synapse formation and dendritic spine maturation in autism and fragile X syndrome.

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Hongen Wei

Full Text Available Although the pathogenic mechanisms that underlie autism are not well understood, there is evidence showing that metabotropic and ionotropic glutamate receptors are hyper-stimulated and the GABAergic system is hypo-stimulated in autism. Memantine is an uncompetitive antagonist of NMDA receptors and is widely prescribed for treatment of Alzheimer's disease treatment. Recently, it has been shown to improve language function, social behavior, and self-stimulatory behaviors of some autistic subjects. However the mechanism by which memantine exerts its effect remains to be elucidated. In this study, we used cultured cerebellar granule cells (CGCs from Fmr1 knockout (KO mice, a mouse model for fragile X syndrome (FXS and syndromic autism, to examine the effects of memantine on dendritic spine development and synapse formation. Our results show that the maturation of dendritic spines is delayed in Fmr1-KO CGCs. We also detected reduced excitatory synapse formation in Fmr1-KO CGCs. Memantine treatment of Fmr1-KO CGCs promoted cell adhesion properties. Memantine also stimulated the development of mushroom-shaped mature dendritic spines and restored dendritic spine to normal levels in Fmr1-KO CGCs. Furthermore, we demonstrated that memantine treatment promoted synapse formation and restored the excitatory synapses to a normal range in Fmr1-KO CGCs. These findings suggest that memantine may exert its therapeutic capacity through a stimulatory effect on dendritic spine maturation and excitatory synapse formation, as well as promoting adhesion of CGCs.

Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine

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Olow-Nordenram, M.A.K.; Raadberg, C.T.

1984-01-01

Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or serverity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo-nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage. (orig.)

Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine

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Olow-Nordenram, M.A.K.; Raadberg, C.T.

1984-01-01

Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or serverity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo-nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage.

Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis

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Fuchs-Winkelmann Susanne

2010-06-01

Full Text Available Abstract Background Shoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine (T has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion (ROM between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott's sign correlates with ultrasound topometric measurements. Methods Two sex- and age-matched groups (2 × n = 39 underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand (DASH score (obtained by means of a self-assessment questionnaire and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott's sign. Results On examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups (p = 0.66. With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group (p = 0.01. An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant (T5-8: p = 0.03; T9-12: p = 0.02. The study group had an average Constant score of 35.1 points and the control group, 85.5 (p Conclusion The mobility of the thoracic spine should

RSA in Spine: A Review.

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Humadi, Ali; Dawood, Sulaf; Halldin, Klas; Freeman, Brian

2017-12-01

Systematic review of literature. This systematic review was conducted to investigate the accuracy of radiostereometric analysis (RSA), its assessment of spinal motion and disorders, and to investigate the limitations of this technique in spine assessment. Systematic review in all current literature to invesigate the role of RSA in spine. The results of this review concluded that RSA is a very powerful tool to detect small changes between 2 rigid bodies such as a vertebral segment. The technique is described for animal and human studies for cervical and lumbar spine and can be used to analyze range of motion, inducible displacement, and fusion of segments. However, there are a few disadvantages with the technique; RSA percutaneous procedure needs to be performed to implant the markers (and cannot be used preoperatively), one needs a specific knowledge to handle data and interpret the results, and is relatively time consuming and expensive. RSA should be looked at as a very powerful research instrument and there are many questions suitable for RSA studies.

Modern approaches to diagnostics of combined degenerative hip and spine pathology

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V. V. Khominets

2014-01-01

Full Text Available The results of standard radiographs of 90 patients with hip-spine syndrome associated with one unilateral or bilateral III stage hip osteoarthhrosis were analyzed with the aim to improve the diagnostics of pathological changes in the "hip joint-pelvis- spine" complex. 12 parameters of sagittal spinal-pelvic balance and 3 parameters of frontal one were studied and the degenerative changes in spinal motional segments were evaluated. The statistical processing of obtained data was made. It was stated that the most frequent variant of sagittal spinal-pelvic profile is hyperlordosic one, followed by formation of degenerative changes especially in dorsal regions of spine (р=0,076.The strategy of patient examination with hip-spine syndrome was established from clinical and radiographic positions.

MRI of cervical spine injuries complicating ankylosing spondylitis

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Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

2008-09-15

The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

Comparison of the load-sharing characteristics between pedicle-based dynamic and rigid rod devices

International Nuclear Information System (INIS)

Ahn, Yoon-Ho; Chen, W-M; Lee, Kwon-Yong; Park, Kyung-Woo; Lee, Sung-Jae

2008-01-01

Recently, numerous types of posterior dynamic stabilization (PDS) devices have been introduced as an alternative to the fusion devices for the surgical treatment of degenerative lumbar spine. It is hypothesized that the use of 'compliant' materials such as Nitinol (Ni-Ti alloy, elastic modulus = 75 GPa) or polyether-etherketone (PEEK, elastic modulus = 3.2 GPa) in PDS can restore stability of the lumbar spine without adverse stress-shielding effects that have often been found with 'rigid' fusion devices made of 'rigid' Ti alloys (elastic modulus = 114 GPa). Previous studies have shown that suitably designed PDS devices made of more compliant material may be able to help retain kinematic behavior of the normal spine with optimal load sharing between the anterior and posterior spinal elements. However, only a few studies on their biomechanical efficacies are available. In this study, we conducted a finite-element (FE) study to investigate changes in load-sharing characteristics of PDS devices. The implanted models were constructed after modifying the previously validated intact model of L3-4 spine. Posterior lumbar fusion with three different types of pedicle screw systems was simulated: a conventional rigid fixation system (Ti6Al4V, Φ = 6.0 mm) and two kinds of PDS devices (one with Nitinol rod with a three-coiled turn manner, Φ = 4.0 mm; the other with PEEK rod with a uniform cylindrical shape, Φ = 6.0 mm). To simulate the load on the lumbar spine in a neutral posture, an axial compressive load (400 N) was applied. Subsequently, the changes in load-sharing characteristics and stresses were investigated. When the compressive load was applied on the implanted models (Nitinol rod, PEEK rod, Ti-alloy rod), the predicted axial compressive loads transmitted through the devices were 141.8 N, 109.8 N and 266.8 N, respectively. Axial forces across the PDS devices (Nitinol rod, PEEK rod) and rigid system (Ti-alloy rod) with facet joints were predicted to take over 41%, 33

Management of rigid post-traumatic kyphosis.

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Wu, S S; Hwa, S Y; Lin, L C; Pai, W M; Chen, P Q; Au, M K

1996-10-01

Rigid post-traumatic kyphosis after fracture of the thoracolumbar and lumbar spine represents a failure of initial management of the injury. Kyphosis moves the center of gravity anterior. The kyphosis and instability may result in pain, deformity, and increased neurologic deficits. Management for symptomatic post-traumatic kyphosis always has presented a challenge to orthopedic surgeons. To evaluate the surgical results of one stage posterior correction for rigid symptomatic post-traumatic kyphosis of the thoracolumbar and lumbar spine. The management for post-traumatic kyphosis remains controversial. Anterior, posterior, or combined anterior and posterior procedures have been advocated by different authors and show various degrees of success. One vertebra immediately above and below the level of the deformity was instrumented posteriorly by a transpedicular system (internal fixator AO). Posterior decompression was performed by excision of the spinal process and bilateral laminectomy. With the deformed vertebra through the pedicle, the vertebral body carefully is removed around the pedicle level, approximating a wedge shape. The extent to which the deformed vertebral body should be removed is determined by the attempted correction. Correction of the deformity is achieved by manipulation of the operating table and compression of the adjacent Schanz screws above and below the lesion. Thirteen patients with post-traumatic kyphosis with symptoms of fatigue and pain caused by slow progression of kyphotic deformities received posterior decompression, correction, and stabilization as a definitive treatment. The precorrection kyphosis ranged from 30-60 degrees, with a mean of 40 degrees +/- 10.8 degrees. After correction, kyphosis was reduced to an average of 1.5 degrees +/- 3.8 degrees, with a range from -5 degrees to 5 degrees. The average angle of correction was 38.8 degrees +/- 10.4 degrees, with a range from 25 degrees to 60 degrees. Significant difference was found

Physical rehabilitation of patients with lumbar spine dorsopathy at the hospital stage of treatment

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Максим Валериевич Манин

2015-07-01

Full Text Available The aim of the work is an ascertainment of efficiency of the use of an offered way of the complex treatment of the lumbar spine dorsopathies at the hospital stage of treatment as the more effective one comparing to the standard method of the therapeutic physical training for patients with the lumbar spine dorsopathies. The object of research is the lumbar spine dorsopathies. The subject of research is the dynamics of the painful and musculo-tonic syndromes, mobility, degrees of the functional blocking of spine.Methods of research: questioning and interrogation, functional assays of the spine mobility, manual examination. 30 persons with lumbar spine dorsopathies with neurological manifestations took part in the research. 15 patients who underwent extended method of therapeutic physical training (TPT including the way of the complex treatment of the lumbar spine dopsopathies formed the main group. 15 persons who underwent the TPT by the standard method formed the control group. Results, received in testing the dynamics of indicators of the spine mobility blocking, painful, musculo-tonic syndrome at the end of physical rehabilitation reliably demonstrate the more significant increase of results in the main group comparing to the control one. It happened first of all due to the use of traction exercises, positions and traction massage that form the complex treatment of the lumbar spine dorsopathies.An offered way of the complex treatment of the lumbar spine dorsopathies had the more effective impact on an increase of the spine mobility, decrease of the painful syndrome comparing to the standard complex of physical rehabilitation. It gives the reasons to recommend this way for introduction into practice as the mean of special TPT at the hospital stage of treatment. 

Dynamic impact testing of hedgehog spines using a dual-arm crash pendulum.

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Swift, Nathan B; Hsiung, Bor-Kai; Kennedy, Emily B; Tan, Kwek-Tze

2016-08-01

Hedgehog spines are a potential model for impact resistant structures and material. While previous studies have examined static mechanical properties of individual spines, actual collision tests on spines analogous to those observed in the wild have not previously been investigated. In this study, samples of roughly 130 keratin spines were mounted vertically in thin substrates to mimic the natural spine layout on hedgehogs. A weighted crash pendulum was employed to induce and measure the effects of repeated collisions against samples, with the aim to evaluate the influence of various parameters including humidity effect, impact energy, and substrate hardness. Results reveal that softer samples-due to humidity conditioning and/or substrate material used-exhibit greater durability over multiple impacts, while the more rigid samples exhibit greater energy absorption performance at the expense of durability. This trend is exaggerated during high-energy collisions. Comparison of the results to baseline tests with industry standard impact absorbing foam, wherein the spines exhibit similar energy absorption, verifies the dynamic impact absorption capabilities of hedgehog spines and their candidacy as a structural model for engineered impact technology. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cervical spine injury in the elderly: imaging features

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Ehara, S. [Dept. of Radiology, Iwate Medical University School of Medicine, Morioka (Japan); Shimamura, Tadashi [Dept. of Orthopedic Surgery, Iwate Medical University School of Medicine, Morioka (Japan)

2001-01-01

An increase in the elderly population has resulted in an increased incidence of cervical spine injury in this group. No specific type of cervical spine trauma is seen in the elderly, although dens fractures are reported to be common. Hyperextension injuries due to falling and the resultant central cord syndrome in the mid and lower cervical segments due to decreased elasticity as a result of spondylosis may be also characteristic. The imaging features of cervical spine injury are often modified by associated spondylosis deformans, DISH and other systemic disorders. The value of MR imaging in such cases is emphasized. (orig.)

Surgical treatment of gross posttraumatic deformations in thoracic spine

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Aleksei E. Shul’ga

2017-10-01

Full Text Available Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients’ ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra.

Utilization of manual therapy to the lumbar spine in conjunction with traditional conservative care for individuals with bilateral lower extremity complex regional pain syndrome: A case series.

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Walston, Zachary; Hernandez, Luis; Yake, Dale

2018-06-06

Conservative therapies for complex regional pain syndrome (CRPS) have traditionally focused on exercise and desensitization techniques targeted at the involved extremity. The primary purpose of this case series is to report on the potential benefit of utilizing manual therapy to the lumbar spine in conjunction with traditional conservative care when treating patients with lower extremity CRPS. Two patients with the diagnosis of lower extremity CRPS were treated with manual therapy to the lumbar spine in conjunction with education, exercise, desensitization, and soft tissue techniques for the extremity. Patient 1 received 13 sessions over 6 weeks resulting in a 34-point improvement in oswestry disability index (ODI) and 35-point improvement in lower extremity functional scale (LEFS). Patient 2 received 21 sessions over 12 weeks resulting in a 28-point improvement in ODI and a 41-point improvement in LEFS. Both patients exhibited reductions in pain and clinically meaningful improvements in function. Manual therapies when applied to the lumbar spine in these patients as part of a comprehensive treatment plan resulted in improved spinal mobility, decreased pain, and reduction is distal referred symptoms. Although one cannot infer a cause and effect relationship from a case series, this report identifies meaningful clinical outcomes potentially associated with manual physical therapy to the lumbar spine for two patients with complex regional pain syndrome type 1.

The pattern of skeletal anomalies in the cervical spine, hands and feet in patients with Saethre-Chotzen syndrome and Muenke-type mutation

International Nuclear Information System (INIS)

Trusen, Andreas; Beissert, Matthias; Darge, Kassa; Collmann, Hartmut

2003-01-01

Saethre-Chotzen syndrome (SCS) and Muenke-type mutation (MTM) are complex syndromes with craniosynostosis and skeletal anomalies including syndactyly, carpal and tarsal fusions, and cervical spine abnormalities. In this study, we analysed radiographs of the cervical spine, hands and feet of a large patient population with genetically proven SCS and MTM. The aim was to describe the pattern of skeletal anomalies and to determine whether specific features are present that could help differentiate between the two entities. Radiographs of 43 patients (23 males, 20 females) with SCS (n=35) or MTM (n=8) were evaluated. The median age was 8 years (range 1 month-36 years). All radiographs were reviewed by two radiologists. In the hands and feet, a variety of anomalies such as brachyphalangy, clinodactyly, partial syndactyly, partial carpal or tarsal fusion, and cone-shaped epiphyses were noted. Duplicated distal phalanx of the hallux (n=12/35) and triangular deformity of the epiphysis of the distal phalanx of the hallux (n=10/35) were detected in SCS only; calcaneo-cuboid fusion (n=2/35) was detected in MTM only. In the cervical spine, fusion of vertebral bodies and/or the posterior elements occurred only in patients with SCS. Pathognomonic signs for SCS are the triangular shape of the epiphysis and duplicated distal phalanx of the hallux. Calcaneo-cuboid fusion was detected in MTM only. These signs may be helpful in the differentiation of SCS from MTM. (orig.)

δ-Catenin Regulates Spine Architecture via Cadherin and PDZ-dependent Interactions*

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Yuan, Li; Seong, Eunju; Beuscher, James L.; Arikkath, Jyothi

2015-01-01

The ability of neurons to maintain spine architecture and modulate it in response to synaptic activity is a crucial component of the cellular machinery that underlies information storage in pyramidal neurons of the hippocampus. Here we show a critical role for δ-catenin, a component of the cadherin-catenin cell adhesion complex, in regulating spine head width and length in pyramidal neurons of the hippocampus. The loss of Ctnnd2, the gene encoding δ-catenin, has been associated with the intellectual disability observed in the cri du chat syndrome, suggesting that the functional roles of δ-catenin are vital for neuronal integrity and higher order functions. We demonstrate that loss of δ-catenin in a mouse model or knockdown of δ-catenin in pyramidal neurons compromises spine head width and length, without altering spine dynamics. This is accompanied by a reduction in the levels of synaptic N-cadherin. The ability of δ-catenin to modulate spine architecture is critically dependent on its ability to interact with cadherin and PDZ domain-containing proteins. We propose that loss of δ-catenin during development perturbs synaptic architecture leading to developmental aberrations in neural circuit formation that contribute to the learning disabilities in a mouse model and humans with cri du chat syndrome. PMID:25724647

A new mutation of the fukutin gene causing late-onset limb girdle muscular dystrophy

DEFF Research Database (Denmark)

Riisager, Maria; Duno, M; Hansen, Flemming Juul

2013-01-01

to aberrations of FKTN is rare, with only eight reported cases of limb girdle phenotype (LGMD2M). We describe the mildest affected patient outside Japan with genetically confirmed LGMD2M and onset of symptoms at age 14. She was brought to medical attention at age 12, not because of muscle weakness, but due...... to episodes of tachycardia caused by Wolff-Parkinson-White syndrome. On examination, she had rigid spine syndrome, a typical limb girdle dystrophy pattern of muscle weakness, cardiomyopathy, and serum CK levels >2000 IU/L (normal G; p.Y306C mutation in the FKTN gene was found. The case confirms FKTN mutations...... as a cause of LGMD2M without mental retardation and expands the phenotypic spectrum for LGMD2M to include cardiomyopathy and rigid spine syndrome in the mildest affected non-Japanese patient reported so far....

Dendritic spine pathology in autism: lessons learned from mouse models

Institute of Scientific and Technical Information of China (English)

Qiangge Zhang; Dingxi Zhou; Guoping Feng

2016-01-01

Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders that affect up to 1.5% of population in the world. Recent large scale genomic studies show that genetic causes of ASD are very heterogeneous. Gene ontology, pathway analysis and animal model studies have revealed several potential converging mechanisms including postsynaptic dysfunction of excitatory synapses. In this review, we focus on the structural and functional specializations of dendritic spines, and describe their defects in ASD. We use Fragile X syndrome, Rett syndrome and Phe-lan-McDermid syndrome, three of the most studied neurodevelopmental disorders with autism features, as examples to demonstrate the significant contribution made by mouse models towards the understanding of monogenic ASD. We envision that the development and application of new technologies to study the function of dendritic spines in valid animal models will eventually lead to innovative treatments for ASD.

Rigidity in routines and the development of resistance to change in individuals with Prader-Willi syndrome.

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Haig, E L; Woodcock, K A

2017-05-01

Individuals with Prader-Willi syndrome (PWS) commonly show debilitating resistance to change, which has been linked to cognitive deficits in task switching. Anecdotal reports suggest that exposure to flexibility in routines during development may be beneficial for limiting subsequent resistance to change in people with PWS, which is consistent with a beneficial role of such exposure on the development of task switching, highlighted in typical children. Here, we aim to investigate the development of resistance to change in individuals with PWS and hypothesise that exposure to increased rigidity in routines will be associated with increased subsequent resistance to change. An author-compiled informant report interview and two previously validated questionnaires were administered to the caregivers of 10 individuals with PWS (5-23 years). The interview examined rigidity in routines and resistance to change across life stages defined by easily distinguishable events (before school, during primary school, during secondary school, after school, currently), using open-ended and structured yes/no and 5-point Likert questions. Open-ended data were coded using an author-compiled system. Responses from two additional informants and data from the questionnaires were used to assess inter-informant reliability and concurrent validity of the structured questions. The validity of the interview was supported by acceptable inter-rater reliability of the open-ended coding system and inter-informant reliability, internal consistency and concurrent validity of structured questions. Descriptive analyses of ratings of behaviour change showed a pattern of increasing resistance to change over the life course for the four oldest individuals, who had all been exposed to substantial rigidity in routines before and during primary school. Furthermore, only one individual - currently in primary school - was exposed to very little rigidity in routines before and during primary school, and he had

Rare causes of scoliosis and spine deformity: experience and particular features

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Pliarchopoulou Fani M

2007-10-01

Full Text Available Abstract Background Spine deformity can be idiopathic (more than 80% of cases, neuromuscular, congenital or neurofibromatosis-related. However, there are many disorders that may also be involved. We present our experience treating patients with scoliosis or other spine deformities related to rare clinical entities. Methods A retrospective study of the records of a school-screening study in North-West Greece was performed, covering a 10-year period (1992–2002. The records were searched for patients with deformities related to rare disorders. These patients were reviewed as regards to characteristics of underlying disorder and spine deformity, treatment and results, complications, intraoperative and anaesthesiologic difficulties particular to each case. Results In 13 cases, the spine deformity presented in relation to rare disorders. The underlying disorder was rare neurological disease in 2 cases (Rett syndrome, progressive hemidystonia, muscular disorders (facioscapulohumeral muscular dystrophy, arthrogryposis in 2 patients, osteogenesis imperfecta in 2 cases, Marfan syndrome, osteopetrosis tarda, spondyloepiphyseal dysplasia congenita, cleidocranial dysplasia and Noonan syndrome in 1 case each. In 2 cases scoliosis was related to other congenital anomalies (phocomelia, blindness. Nine of these patients were surgically treated. Surgery was avoided in 3 patients. Conclusion This study illustrates the fact that different disorders are related with curves with different characteristics, different accompanying problems and possible complications. Investigation and understanding of the underlying pathology is an essential part of the clinical evaluation and preoperative work-up, as clinical experience at any specific center is limited.

Polyetheretherketone (PEEK) rods: short-term results in lumbar spine degenerative disease.

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Colangeli, S; Barbanti Brodàno, G; Gasbarrini, A; Bandiera, S; Mesfin, A; Griffoni, C; Boriani, S

2015-06-01

Pedicle screw and rod instrumentation has become the preferred technique for performing stabilization and fusion in the surgical treatment of lumbar spine degenerative disease. Rigid fixation leads to high fusion rates but may also contribute to stress shielding and adjacent segment degeneration. Thus, the use of semirigid rods made of polyetheretherketone (PEEK) has been proposed. Although the PEEK rods biomechanical properties, such as anterior load sharing properties, have been shown, there are few clinical studies evaluating their application in the lumbar spine surgical treatment. This study examined a retrospective cohort of patients who underwent posterior lumbar fusion for degenerative disease using PEEK rods, in order to evaluate the clinical and radiological outcomes and the incidence of complications.

δ-Catenin Regulates Spine Architecture via Cadherin and PDZ-dependent Interactions.

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Yuan, Li; Seong, Eunju; Beuscher, James L; Arikkath, Jyothi

2015-04-24

The ability of neurons to maintain spine architecture and modulate it in response to synaptic activity is a crucial component of the cellular machinery that underlies information storage in pyramidal neurons of the hippocampus. Here we show a critical role for δ-catenin, a component of the cadherin-catenin cell adhesion complex, in regulating spine head width and length in pyramidal neurons of the hippocampus. The loss of Ctnnd2, the gene encoding δ-catenin, has been associated with the intellectual disability observed in the cri du chat syndrome, suggesting that the functional roles of δ-catenin are vital for neuronal integrity and higher order functions. We demonstrate that loss of δ-catenin in a mouse model or knockdown of δ-catenin in pyramidal neurons compromises spine head width and length, without altering spine dynamics. This is accompanied by a reduction in the levels of synaptic N-cadherin. The ability of δ-catenin to modulate spine architecture is critically dependent on its ability to interact with cadherin and PDZ domain-containing proteins. We propose that loss of δ-catenin during development perturbs synaptic architecture leading to developmental aberrations in neural circuit formation that contribute to the learning disabilities in a mouse model and humans with cri du chat syndrome. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

Examination of Cervical Spine Histological Sections - A Technical Note

DEFF Research Database (Denmark)

Uhrenholt, Lars; Ullerup, Rita; Vesterby, Annie

2006-01-01

Detailed knowledge of the cervical spine facet joints morphology and anatomy is increasingly important since improved understanding of clinical syndromes, such as whiplash injuries, and therapeutic interventions is based on this knowledge. So far systematic examination of the age-related morphology...... of these joints has not yet been performed, nor has any generally accepted histological classification system for degenerative changes in the cervical spine facet joints been proposed. In the case of whiplash injuries the presented histological method has particular relevance since it allows detailed description...

Alterations to dendritic spine morphology, but not dendrite patterning, of cortical projection neurons in Tc1 and Ts1Rhr mouse models of Down syndrome.

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Matilda A Haas

Full Text Available Down Syndrome (DS is a highly prevalent developmental disorder, affecting 1/700 births. Intellectual disability, which affects learning and memory, is present in all cases and is reflected by below average IQ. We sought to determine whether defective morphology and connectivity in neurons of the cerebral cortex may underlie the cognitive deficits that have been described in two mouse models of DS, the Tc1 and Ts1Rhr mouse lines. We utilised in utero electroporation to label a cohort of future upper layer projection neurons in the cerebral cortex of developing mouse embryos with GFP, and then examined neuronal positioning and morphology in early adulthood, which revealed no alterations in cortical layer position or morphology in either Tc1 or Ts1Rhr mouse cortex. The number of dendrites, as well as dendrite length and branching was normal in both DS models, compared with wildtype controls. The sites of projection neuron synaptic inputs, dendritic spines, were analysed in Tc1 and Ts1Rhr cortex at three weeks and three months after birth, and significant changes in spine morphology were observed in both mouse lines. Ts1Rhr mice had significantly fewer thin spines at three weeks of age. At three months of age Tc1 mice had significantly fewer mushroom spines--the morphology associated with established synaptic inputs and learning and memory. The decrease in mushroom spines was accompanied by a significant increase in the number of stubby spines. This data suggests that dendritic spine abnormalities may be a more important contributor to cognitive deficits in DS models, rather than overall neuronal architecture defects.

[Combined surgical and physical treatment in traumatic painful syndromes of the cervical spine].

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Stachowski, B; Kaczmarek, J; Nosek, A; Kocur, L

1976-01-01

Clinical observations suggest the need for changing therapeutic management to a more active one in cases of cervical spine injury with damage to the spinal cord and nerve roots or brachial plexus. In 248 patients with these injuries treated initially conservatively the incidence of cervicobrachial pain was analysed. Neuralgic pains were present in 31.5% of cases, causalgic pains in 2.4% and sympathalgic pains in 2%. Conservative treatment conducted in these patients (89 cases) during many months after trauma had no effect on return of mobility. Long-term application of physioterapy prevented only temporarily the development of trophic changes and only partially relieved pains. Only surgical decompression of the spinal cord or spinal nerves with stabilization of damaged vertebrae caused disappearance of painful syndromes and improvement in the motor activity of the extremities. These observations show that early surgical intervention for decompression of the spinal cord, roots or brachial plexus should be advocated in these cases.

Vertebral Column Resection for Rigid Spinal Deformity.

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Saifi, Comron; Laratta, Joseph L; Petridis, Petros; Shillingford, Jamal N; Lehman, Ronald A; Lenke, Lawrence G

2017-05-01

Broad narrative review. To review the evolution, operative technique, outcomes, and complications associated with posterior vertebral column resection. A literature review of posterior vertebral column resection was performed. The authors' surgical technique is outlined in detail. The authors' experience and the literature regarding vertebral column resection are discussed at length. Treatment of severe, rigid coronal and/or sagittal malalignment with posterior vertebral column resection results in approximately 50-70% correction depending on the type of deformity. Surgical site infection rates range from 2.9% to 9.7%. Transient and permanent neurologic injury rates range from 0% to 13.8% and 0% to 6.3%, respectively. Although there are significant variations in EBL throughout the literature, it can be minimized by utilizing tranexamic acid intraoperatively. The ability to correct a rigid deformity in the spine relies on osteotomies. Each osteotomy is associated with a particular magnitude of correction at a single level. Posterior vertebral column resection is the most powerful posterior osteotomy method providing a successful correction of fixed complex deformities. Despite meticulous surgical technique and precision, this robust osteotomy technique can be associated with significant morbidity even in the most experienced hands.

A simulation study of spine biofidelity in the hybrid-III 6-year-old ATD.

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Wu, Jun; Cao, Libo; Reed, Matthew P; Hu, Jingwen

2013-01-01

Because of the lack of pediatric biomechanical data, Hybrid-III (HIII) child anthropomorphic test devices (ATDs) are essentially scaled from the mid-size male ATD based on the geometric considerations. These ATDs inherit a rigid thoracic spine from the adult HIII ATDs, which has been criticized as unrealistic. Therefore, the objective of this study was to explore possible design modifications for improving the spine biofidelity of the HIII 6-year-old ATD. A previously developed and validated HIII 6-year-old MADYMO ATD model was used as the baseline model to investigate the effects of design modifications on the spine biofidelity of the current ATD. Several sets of child volunteer and cadaver test data were considered as the design targets, including child volunteer low-speed crash test data, pediatric cadaver cervical spine tensile test data, and child cadaver crash test data. ATD design modifications include adding an additional joint to the thoracic spine region and changing the joint characteristics at the cervical and lumbar spine regions. Optimization techniques were used to match simulation results to each set of test results. The results indicate that the translational characteristics of the cervical and lumbar spine in the current child ATD need to be reduced to achieve realistic spine flexibility. Adding an additional joint at the thoracic spine region with degree of freedom in both flexion/extension and tension would significantly improve the ATD biofidelity in terms of predicting the overall spine curvature and head excursion in frontal crashes. Future ATD spine modification should focus on reducing the neck and lumbar tension stiffness and adding additional flexibility both in flexion/extension and tension at the thoracic spine region. The child ATD model developed in this study can be used as an important tool to improve child ATD biofidelity and child restraint system design in motor vehicle crashes.

Multi-stage 3D-2D registration for correction of anatomical deformation in image-guided spine surgery

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Ketcha, M. D.; De Silva, T.; Uneri, A.; Jacobson, M. W.; Goerres, J.; Kleinszig, G.; Vogt, S.; Wolinsky, J.-P.; Siewerdsen, J. H.

2017-06-01

A multi-stage image-based 3D-2D registration method is presented that maps annotations in a 3D image (e.g. point labels annotating individual vertebrae in preoperative CT) to an intraoperative radiograph in which the patient has undergone non-rigid anatomical deformation due to changes in patient positioning or due to the intervention itself. The proposed method (termed msLevelCheck) extends a previous rigid registration solution (LevelCheck) to provide an accurate mapping of vertebral labels in the presence of spinal deformation. The method employs a multi-stage series of rigid 3D-2D registrations performed on sets of automatically determined and increasingly localized sub-images, with the final stage achieving a rigid mapping for each label to yield a locally rigid yet globally deformable solution. The method was evaluated first in a phantom study in which a CT image of the spine was acquired followed by a series of 7 mobile radiographs with increasing degree of deformation applied. Second, the method was validated using a clinical data set of patients exhibiting strong spinal deformation during thoracolumbar spine surgery. Registration accuracy was assessed using projection distance error (PDE) and failure rate (PDE  >  20 mm—i.e. label registered outside vertebra). The msLevelCheck method was able to register all vertebrae accurately for all cases of deformation in the phantom study, improving the maximum PDE of the rigid method from 22.4 mm to 3.9 mm. The clinical study demonstrated the feasibility of the approach in real patient data by accurately registering all vertebral labels in each case, eliminating all instances of failure encountered in the conventional rigid method. The multi-stage approach demonstrated accurate mapping of vertebral labels in the presence of strong spinal deformation. The msLevelCheck method maintains other advantageous aspects of the original LevelCheck method (e.g. compatibility with standard clinical workflow, large

An analysis of patient positioning during stereotactic lung radiotherapy performed without rigid external immobilization.

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Dahele, Max; Verbakel, Wilko; Cuijpers, Johan; Slotman, Ben; Senan, Suresh

2012-07-01

Intra-fraction patient motion is incompletely understood and the optimum amount of support or immobilization during stereotactic body radiotherapy (SBRT) is unclear. Rigid immobilization is often advocated, but motion still occurs. In contrast, we deliver the vast majority of SBRT using simple supporting devices, simultaneously emphasizing comfort, frequent position checks and progressive reduction in treatment times. We report spine stability during lung SBRT. Patients lie on a thin mattress with arms supported above their head and below-knee support. Stereoscopic spine X-rays before and after fraction delivery identified motion in three translational and three rotational directions. Images from 109 fractions in 30 patients resulted in 327 translational and 327 rotational pre- and post-fraction comparisons. Mean RapidArc® delivery time for variable fraction dose was 4.2 min (SD=1.4). 92% and 97% of translational and rotational differences were ≤1 mm and ≤1° in any direction and 98% of translational differences were ≤1.5mm. Mean vertical, longitudinal and lateral motion was 0mm (SD=0.4), 0mm (0.6) and 0mm (0.6). 84% and 94% of the 109 fractions were delivered with ≤1 and ≤1.5mm translation in all three directions and 93% with ≤1° of rotation. Two patients accounted for 10/17 fractions with >1mm translational motion. Based on pre and post-fraction X-ray imaging during fast lung SBRT, simple support devices can result in spine stability that is comparable to that reported with rigid external immobilization. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Dural ectasia and conventional radiography in the Marfan lumbosacral spine

International Nuclear Information System (INIS)

Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

2001-01-01

Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

Robust MR spine detection using hierarchical learning and local articulated model.

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Zhan, Yiqiang; Maneesh, Dewan; Harder, Martin; Zhou, Xiang Sean

2012-01-01

A clinically acceptable auto-spine detection system, i.e., localization and labeling of vertebrae and inter-vertebral discs, is required to have high robustness, in particular to severe diseases (e.g., scoliosis) and imaging artifacts (e.g. metal artifacts in MR). Our method aims to achieve this goal with two novel components. First, instead of treating vertebrae/discs as either repetitive components or completely independent entities, we emulate a radiologist and use a hierarchial strategy to learn detectors dedicated to anchor (distinctive) vertebrae, bundle (non-distinctive) vertebrae and inter-vertebral discs, respectively. At run-time, anchor vertebrae are detected concurrently to provide redundant and distributed appearance cues robust to local imaging artifacts. Bundle vertebrae detectors provide candidates of vertebrae with subtle appearance differences, whose labels are mutually determined by anchor vertebrae to gain additional robustness. Disc locations are derived from a cloud of responses from disc detectors, which is robust to sporadic voxel-level errors. Second, owing to the non-rigidness of spine anatomies, we employ a local articulated model to effectively model the spatial relations across vertebrae and discs. The local articulated model fuses appearance cues from different detectors in a way that is robust to abnormal spine geometry resulting from severe diseases. Our method is validated by 300 MR spine scout scans and exhibits robust performance, especially to cases with severe diseases and imaging artifacts.

Does Semi-Rigid Instrumentation Using Both Flexion and Extension Dampening Spacers Truly Provide an Intermediate Level of Stabilization?

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Dilip Sengupta

2013-01-01

Full Text Available Conventional posterior dynamic stabilization devices demonstrated a tendency towards highly rigid stabilization approximating that of titanium rods in flexion. In extension, they excessively offload the index segment, making the device as the sole load-bearing structure, with concerns of device failure. The goal of this study was to compare the kinematics and intradiscal pressure of monosegmental stabilization utilizing a new device that incorporates both a flexion and extension dampening spacer to that of rigid internal fixation and a conventional posterior dynamic stabilization device. The hypothesis was the new device would minimize the overloading of adjacent levels compared to rigid and conventional devices which can only bend but not stretch. The biomechanics were compared following injury in a human cadaveric lumbosacral spine under simulated physiological loading conditions. The stabilization with the new posterior dynamic stabilization device significantly reduced motion uniformly in all loading directions, but less so than rigid fixation. The evaluation of adjacent level motion and pressure showed some benefit of the new device when compared to rigid fixation. Posterior dynamic stabilization designs which both bend and stretch showed improved kinematic and load-sharing properties when compared to rigid fixation and when indirectly compared to existing conventional devices without a bumper.

Surgical management of cervical spine instability in Rheumatoid Arthritis patients

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Pedro Miguel Marques

2015-01-01

Full Text Available Aim: Cross-sectional study that aims to evaluate the results of cervical spine surgeries due to rheumatoid arthritis (RA instability, between January of 2000 and of 2012 in a main Portuguese centre Methods: Patients followed on Rheumatology submitted to cervical spine fusion due to atlantoaxial (AAI, sub-axial (SAI or cranio-cervical (CCI instabilities between 2000-2012 were included. Information about the surgical procedure and associated complications was gathered and imagiologic and clinical indexes before and after surgery (as anterior and posterior atlanto-axial interval and Ranawat index were evaluated and compared using adequate statistics. Results: Forty-five patients with RA were included: 25 with AAI, 13 with CCI and 7 with SAI. Ten AAI and 4 CCI patients were submitted to wiring stabilization techniques; 15 AAI and 9 CCI patients to rigid ones; and in all patients with SAI an anterior cervical arthrodesis was chosen. There is a significant increase in PADI and a decrease in AADI in the postoperative evaluation (p

Examination of Cervical Spine Histological Sections - A Technical Note

DEFF Research Database (Denmark)

Uhrenholt, Lars; Ullerup, Rita; Vesterby, Annie

2006-01-01

Detailed knowledge of the cervical spine facet joints morphology and anatomy is increasingly important since improved understanding of clinical syndromes, such as whiplash injuries, and therapeutic interventions is based on this knowledge. So far systematic examination of the age-related morphology...... of these joints has not yet been performed, nor has any generally accepted histological classification system for degenerative changes in the cervical spine facet joints been proposed. In the case of whiplash injuries the presented histological method has particular relevance since it allows detailed description...... of the anatomy and pathoanatomical status of the osteo-cartilagenous structures, including the facet joints from where a major portion of chronic whiplash patients experience their pain symptoms....

Stabilization of dendritic spine clusters and hyperactive Ras-MAPK signaling predict enhanced motor learning in an autistic savant mouse model

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Ryan Thomas Ash

2014-03-01

Full Text Available That both prominent behavioral inflexibility and exceptional learning abilities are seen occasionally in autistic patients is a mystery. We hypothesize that these altered patterns of learning and memory can arise from a pathological imbalance between the stability and plasticity of internal neural representations. We evaluated this hypothesis in the mouse model of MECP2 duplication syndrome, which demonstrates enhanced motor learning, stereotyped behaviors, and social avoidance. Learning-associated structural plasticity was measured in the motor cortex of MECP2 duplication mice by 2-photon imaging (Fig. 1A. An increased stabilization rate of learning-associated dendritic spines was observed in mutants, and this correlated with rotarod performance. Analysis of the spatial distribution of stabilized spines revealed that the mutant’s increased spine stabilization was due to a specific increase in the stability of spines jointly formed in ~9-micron clusters. Clustered spine stabilization but not isolated spine stabilization predicted enhanced motor performance in MECP2 duplication mice (Fig. 1B. Biochemical assays of Ras-MAPK and mTOR pathway activation demonstrated profound hyperphosphorylation of MAPK in the motor cortex of MECP2 duplication mice with motor training (Fig. 1C. Taken together these data suggest that a pathological bias towards hyperstability of learning-associated dendritic spine clusters driven by hyperactive Ras-MAPK signaling could contribute to neurobehavioral phenotypes in this form of syndromic autism.

A chronic alcoholic man with high fever, neck rigidity and loss of consciousness: remember the Austrian syndrome a commonly unrecognised invasive pneumococcus triad.

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Georgiadou, Sarah P; Manoulakas, Efstratios; Makaritsis, Konstantinos P; Dalekos, George N

2018-05-30

Austrian syndrome is a rare medical condition characterised by the triad of pneumonia, meningitis and endocarditis due to Streptococcus pneumoniae Native aortic valve insufficiency is the most common cause of cardiac failure in these patients, requiring valve replacement. We report a 52-year-old chronic alcoholic man who presented with fever, neck rigidity and loss of c onsciousness. Lumbar puncture revealed central nervous system infection while chest X-ray showed pneumonia. Blood and cerebrospinal fluid cultures revealed S. pneumonia Transoesophageal echocardiography revealed aortic endocarditis with severe valve insufficiency. The patient underwent aortic valve replacement and was finally discharged after completion of 6 weeks intravenous antibiotic treatment. Nowadays, Austrian syndrome is seen infrequently in the antibiotic era. However, clinicians should be aware of this syndrome as its early recognition and prompt combined medical and surgical treatment could reduce morbidity and mortality due to this potentially catastrophic clinical entity. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Diseases of the spine, spinal cord, and extremities

International Nuclear Information System (INIS)

Tanaka, H.

1983-01-01

This paper covers the following topics: acupuncture needle in the spinal canal of the neck; thoracic tuberculous spondylitis: cold abscess; comminuted fracture of the fifth cervical vertebra; lumbar spondylolysis; lumbar spondylosis; ossification of the posterior longitudinal ligament; disk herniation of the cervical spine: narrowing of the root tunnel; ankylosing spondylitis: narrowing of the root tunnel; ossification of the ligamentum flavum; narrow spinal canal syndrome; syringomyelia; epidural neurinoma of the cervical spine; neurofibromatosis; spinal arteriovenous malformation; atrophy of the thoracic spinal cord; osteomyelitis tuberculosa of the rib; osteomyelitis tuberculosa of the left femur; chronic osteomyelitis of the left humerus; malignant giant cell tumor of the left femur; rheumatoid arthritis of the left hip joint; arthrosis deformans of the left hip joint; and enchondroma of the left index finger: Proximal Phalanx

Rigidity, Chaos and Integration: Hemispheric Interaction and Individual Differences in Metaphor Comprehension

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Miriam eFaust

2014-07-01

Full Text Available Neurotypical individuals cope flexibly with the full range of semantic relations expressed in human language, including metaphoric relations. This impressive semantic ability may be associated with distinct and flexible patterns of hemispheric interaction, including higher right hemisphere (RH involvement for processing novel metaphors. However, this ability may be impaired in specific clinical conditions, such as Asperger syndrome and schizophrenia. The impaired semantic processing is accompanied by different patterns of hemispheric interaction during semantic processing, showing either reduced (in Asperger or excessive (in schizophrenia RH involvement. This paper interprets these individual differences using the terms Rigidity, Chaos and Integration, which describe patterns of semantic memory network states that either lead to semantic well-being or are disruptive of it. We argue that these semantic network states lie on a rigidity-chaos semantic continuum. We define these terms via network science terminology and provide network, cognitive and neural evidence to support our claim. This continuum includes LH hyper-rigid semantic memory state on one end (e.g., in persons with Asperger syndrome, and RH chaotic and over-flexible semantic memory state on the other end (e.g., in persons with schizophrenia. In between these two extremes lie different states of semantic memory structure which are related to individual differences in semantic creativity. We suggest that efficient semantic processing is achieved by semantic integration, a balance between semantic rigidity and semantic chaos. Such integration is achieved via intra-hemispheric communication. However, impairments to this well-balanced and integrated pattern of hemispheric interaction, e.g., when one hemisphere dominates the other, may lead to either semantic rigidity or semantic chaos, moving away from semantic integration and thus impairing the processing of metaphoric language.

Facet joint syndrome

International Nuclear Information System (INIS)

Zigrai, M.; Zakovic, J.; Brezinova, M.; Pavlovicova, M.

2002-01-01

It is the purpose of the study to demonstrate the clinical relevance of degenerative changes in the facet joint of patients with low back pain irradiating to the lower extremities, and discuss some problems relating to diagnosis and different diagnosis. 119 patients presenting the listed bellow syndromes are covered by the study: scoliosis, polytopic pain vertebral syndrome, paresis and history of trauma. all patients undergo comprehensive neurological examination with special attention focused on the spine: CT and plain x-rays are taken of the lumbosacral segment to assess the condition of the facet joints. The neurological examination demonstrates in all cases pain syndrome in the lumbar spine referred to one or both lower extremities. In 56% it is a matter of persisting pain, and in 44% - recurrent. More than half of the patients complain of sacroiliac (SI) dislocation and palpatory pain. Unilateral or bilateral degenerative changes are documented by imaging studies in all patients, including: subchondral thickening, osteopathy narrowing the lateral or central part of the spinal canal with ensuing nerve root compression. The lumbosacral zygoapophyseal joints are source of pseudoradicular pain. A correlation between clinical picture and GT changes is noted in all patients with facet joint syndrome. CT is an indispensable method in diagnosing facet joint syndrome. (authors)

EXAMINATION RESULTS OF CHILDREN WITH CERVICAL SYNDROME

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N. H. Bakhteeva

2010-01-01

Full Text Available By the example of examination of 80 children aged from 4 to 18 with cervical syndrome it is indicated, that the diagnosed abnormalities of hemodynamics in vertebrobasilar basin in patients of all age groups are connected both with bone and vascular pathology of the cervical part of the spine. The pathology has functional or congenital character. Early detection of discicirculatory vascular injuries in the cervical part of the spine in children with cervical syndrome will allow to define the therapeutic management of patients and to prolong juvenile osteochondrosis clinical behaviour.

Post-mortem MRI of the foetal spine and spinal cord

International Nuclear Information System (INIS)

Widjaja, E.; Whitby, E.H.; Cohen, M.; Paley, M.N.J.; Griffiths, P.D.

2006-01-01

Aims: To compare the findings of post-mortem magnetic resonance imaging (MRI) of the foetal spine with autopsy with a view to using post-mortem MRI as an alternative or adjunct to autopsy, particularly in foetal and neonatal cases. Materials and Methods: The brains and spines of 41 foetuses, with a gestational age range of 14-41 weeks, underwent post-mortem MRI before autopsy. Post-mortem MRI of the brain consisted of T2-weighted sequences in three orthogonal planes and MRI of the spine consisted of T2-weighted sequence in the sagittal and axial planes in all cases and coronal planes in selected cases. Results: Thirty of 41 (78%) foetal spines were found to be normal at autopsy and on post-mortem MRI. Eleven of 41 (22%) foetal spines were abnormal: eight foetuses had myelomeningocoeles and Chiari 2 deformities, one foetus had limited dorsal myeloschisis, one foetus had caudal regression syndrome, and one had diastematomyelia. The post-mortem MRI findings concurred with the autopsy findings in 10/11 of the abnormal cases, the disagreement being the case of diastematomyelia that was shown on post-mortem MRI but was not diagnosed at autopsy. Conclusions: In this series, post-mortem MRI findings agreed with the autopsy findings in 40/41(98%) cases and in one case the post-mortem MRI demonstrated an abnormality not demonstrated at autopsy

Genetics Home Reference: Andersen-Tawil syndrome

Science.gov (United States)

... abnormal side-to-side curvature of the spine ( scoliosis ). The signs and symptoms of Andersen-Tawil syndrome ... Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic ... from the Nemours Foundation: Arrhythmias Merck Manual Consumer Version: Long QT Syndrome and Torsades de ...

Airway management in Escobar syndrome: A formidable challenge

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Shaji Mathew

2013-01-01

Full Text Available Escobar syndrome is a rare autosomal recessive disorder characterized by flexion joint and digit contractures, skin webbing, cleft palate, deformity of spine and cervical spine fusion. Associated difficult airway is mainly due to micrognathia, retrognathia, webbing of neck and limitation of the mouth opening and neck extension. We report a case of a 1 year old child with Escobar syndrome posted for bilateral hamstrings to quadriceps transfer. The child had adequate mouth opening with no evidence of cervical spine fusion, yet we faced difficulty in intubation which was ultimately overcome by securing a proseal laryngeal mask airway (PLMA and then by intubating with an endotracheal tube railroaded over a paediatric fibreoptic bronchoscope passed through the lumen of a PLMA.

Posterior Rigid Instrumentation of C7: Surgical Considerations and Biomechanics at the Cervicothoracic Junction. A Review of the Literature.

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Bayoumi, Ahmed B; Efe, Ibrahim E; Berk, Selim; Kasper, Ekkehard M; Toktas, Zafer Orkun; Konya, Deniz

2018-03-01

The cervicothoracic junction is a challenging anatomic transition in spine surgery. It is commonly affected by different types of diseases that may significantly impair stability in this region. The seventh cervical vertebra (C7) is an atypical cervical vertebra with unique anatomic features compared to subaxial cervical spine (C3 to C6). C7 has relatively broader laminae, larger pedicles, smaller lateral masses, and a long nonbifid spinous process. These features allow a variety of surgical methods for performing posterior rigid instrumentation in the form of different types of screws, such as lateral mass screws, pedicle screws, transfacet screws, and intralaminar screws. Many biomechanical studies on cadavers have evaluated and compared different types of implants at C7. We reviewed PubMed/Medline by using specific combinations of keywords to summarize previously published articles that examined C7 posterior rigid instrumentation thoroughly in an experimental fashion on patients or cadavers with additional descriptive radiologic parameters for evaluation of the optimum surgical technique for each type. A total of 44 articles were reported, including 22 articles that discussed anatomic considerations (entry points, sagittal and axial trajectories, and features of screws) and another 22 articles that discussed the relevant biomechanical testing at this transitional region if C7 was directly involved in terms of receiving posterior rigid implants. C7 can accommodate different types of screws, which can provide additional benefits and risks based on availability of bony purchase, awareness of surgical technique, biomechanics, and anatomic considerations. Copyright © 2017 Elsevier Inc. All rights reserved.

Cervical Spine pain as a presenting complaint in metastatic pancreatic cancer: a case report.

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Rosenberg, Emily; Buchtel, Lindsey

2016-01-01

A 48 year-old female presented to her primary care physician with a two-month history of neck pain with negative cervical spine x-rays. During that office visit, the patient was noted to be tachycardic with EKG revealing ST depressions, which led to hospital admission. Acute coronary syndrome was ruled out, however, persistent neck pain warranted inpatient MRI of the cervical spine, which revealed a cervical spine lesion. Extensive investigation and biopsy ultimately confirmed stage IV pancreatic adenocarcinoma with metastases to the bone, liver, and likely lung. In the literature, the findings of a primary metastatic site being bone is rare with only a few case reports showing vertebral or sternal metastasis as the first clinical manifestation of pancreatic cancer. The uniqueness of this case lies in the only presenting complaint being cervical spine pain in the setting of extensive metastases to the liver, bone, and likely lung.

Whole-body muscle MRI to detect myopathies in non-extrapyramidal bent spine syndrome

International Nuclear Information System (INIS)

Ohana, Mickael; Durand, Marie-Christine; Marty, Catherine; Lazareth, Jean-Philippe; Maisonobe, Thierry; Mompoint, Dominique; Carlier, Robert-Yves

2014-01-01

Bent spine syndrome (BSS), defined as an abnormal forward flexion of the trunk resolving in supine position, is usually related to parkinsonism, but can also be encountered in myopathies. This study evaluates whole-body muscle MRI (WB-mMRI) as a tool for detecting underlying myopathy in non-extrapyramidal BSS. Forty-three patients (90 % women; 53-86 years old) with a non-extrapyramidal BSS were prospectively included. All underwent a 1.5-T WB-mMRI and a nerve conduction study. Muscle biopsy was performed if a myopathy could not be eliminated based on clinical examination and all tests. Systematic MRI interpretation focused on peripheral and axial muscle injury; spinal posture and incidental findings were also reported. WB-mMRI was completed for all patients, with 13 muscle biopsies ultimately needed and myopathy revealed as the final etiological diagnosis in five cases (12 %). All biopsy-proven myopathies were detected by the WB-mMRI. Relevant incidental MRI findings were made in seven patients. This study supports WB-mMRI as a sensitive and feasible tool for detecting myopathy in BSS patients. Associated with electroneuromyography, it can better indicate when a muscle biopsy is needed and guide it when required. Rigorous radiological interpretation is mandatory, so as not to miss incidental findings of clinical consequence. (orig.)

Whole-body muscle MRI to detect myopathies in non-extrapyramidal bent spine syndrome

Energy Technology Data Exchange (ETDEWEB)

Ohana, Mickael [Nouvel Hopital Civil - Hopitaux Universitaires de Strasbourg, Service de Radiologie B, Strasbourg (France); Durand, Marie-Christine [AP-HP - Hopital Raymond Poincare, Service de Neurologie, Garches (France); Marty, Catherine; Lazareth, Jean-Philippe [AP-HP - Hopital Raymond Poincare, Service de Rhumatologie, Garches (France); Maisonobe, Thierry [APH-HP - Hopital de la Pitie-Salpetriere, Service de Neuropathologie, Paris (France); Mompoint, Dominique; Carlier, Robert-Yves [AP-HP - Hopital Raymond Poincare, Service de Radiologie, Garches (France)

2014-08-15

Bent spine syndrome (BSS), defined as an abnormal forward flexion of the trunk resolving in supine position, is usually related to parkinsonism, but can also be encountered in myopathies. This study evaluates whole-body muscle MRI (WB-mMRI) as a tool for detecting underlying myopathy in non-extrapyramidal BSS. Forty-three patients (90 % women; 53-86 years old) with a non-extrapyramidal BSS were prospectively included. All underwent a 1.5-T WB-mMRI and a nerve conduction study. Muscle biopsy was performed if a myopathy could not be eliminated based on clinical examination and all tests. Systematic MRI interpretation focused on peripheral and axial muscle injury; spinal posture and incidental findings were also reported. WB-mMRI was completed for all patients, with 13 muscle biopsies ultimately needed and myopathy revealed as the final etiological diagnosis in five cases (12 %). All biopsy-proven myopathies were detected by the WB-mMRI. Relevant incidental MRI findings were made in seven patients. This study supports WB-mMRI as a sensitive and feasible tool for detecting myopathy in BSS patients. Associated with electroneuromyography, it can better indicate when a muscle biopsy is needed and guide it when required. Rigorous radiological interpretation is mandatory, so as not to miss incidental findings of clinical consequence. (orig.)

Biomechanics of Posterior Dynamic Fusion Systems in the Lumbar Spine: Implications for Stabilization With Improved Arthrodesis.

Science.gov (United States)

Yu, Alexander K; Siegfried, Catherine M; Chew, Brandon; Hobbs, Joseph; Sabersky, Abraham; Jho, Diana J; Cook, Daniel J; Bellotte, Jonathan Brad; Whiting, Donald M; Cheng, Boyle C

2016-08-01

A comparative biomechanical human cadaveric spine study of a dynamic fusion rod and a traditional titanium rod. The purpose of this study was to measure and compare the biomechanical metrics associated with a dynamic fusion device, Isobar TTL Evolution, and a rigid rod. Dynamic fusion rods may enhance arthrodesis compared with a rigid rod. Wolff's law implies that bone remodeling and growth may be enhanced through anterior column loading (AL). This is important for dynamic fusion rods because their purpose is to increase AL. Six fresh-frozen lumbar cadaveric specimens were used. Each untreated specimen (Intact) underwent biomechanical testing. Next, each specimen had a unilateral transforaminal lumbar interbody fusion performed at L3-L4 using a cage with an integrated load cell. Pedicle screws were also placed at this time. Subsequently, the Isobar was implanted and tested, and finally, a rigid rod replaced the Isobar in the same pedicle screw arrangement. In terms of range of motion, the Isobar performed comparably to the rigid rod and there was no statistical difference found between Isobar and rigid rod. There was a significant difference between the intact and rigid rod and also between intact and Isobar conditions in flexion extension. For interpedicular displacement, there was a significant increase in flexion extension (P=0.017) for the Isobar compared with the rigid rod. Isobar showed increased AL under axial compression compared with the rigid rod (P=0.024). Isobar provided comparable stabilization to a rigid rod when using range of motion as the metric, however, AL was increased because of the greater interpedicular displacement of dynamic rod compared with a rigid rod. By increasing interpedicular displacement and AL, it potentially brings clinical benefit to procedures relying on arthrodesis.

Minimally invasive surgical treatment options for patients with degenerative lumbar spine disease

International Nuclear Information System (INIS)

Durny, P.

2014-01-01

The most common cause of reduced activity in working people is degenerative disc disease and spondylosis of lumbar spine. The variety of clinical findings such as segmental lumbago or severe form of mixed radicular compression syndromes can be occurred. Neurosurgical intervention is indicated in case of failure of conservative treatment and graphical findings correlating with a clinical picture. Large decompressive surgical procedures can destabilize segments previously affected. Recommendations from recent years suggested the functional reconstruction of damaged parts of the vertebrae, intervertebral discs and joints. Continuously improving surgical procedures and instrumentations, intended for operative treatment of lumbar spine degenerative diseases is primarily an effort to improve the properties of implants while minimizing tissue damage during the approach to the target structure. To protect functions of active spine stabilizer and paraspinal muscles is an important factor for the final outcome of the operation. Depend on the nature and extent of the disease the approaches to the spine can be an anterior, lateral and posterior as open surgery or minimally invasive procedures. (author)

The spine problem: Finding a function for dendritic spines

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Sarah eMalanowski

2014-09-01

Full Text Available Why do neurons have dendritic spines? This question— the heart of what Yuste calls the spine problem— presupposes that why-questions of this sort have scientific answers: that empirical findings can favor or count against claims about why neurons have spines. Here we show how such questions can receive empirical answers. We construe such why-questions as questions about how spines make a difference to the behavior of some mechanism that we take to be significant. Why-questions are driven fundamentally by the effort to understand how some item, such as the dendritic spine, is situated in the causal structure of the world (the causal nexus. They ask for a filter on that busy world that allows us to see a part’s individual contribution to a mechanism, independent of everything else going on. So understood, answers to why-questions can be assessed by testing the claims these answers make about the causal structure of a mechanism. We distinguish four ways of making a difference to a mechanism (necessary, modulatory, component, background condition, and we sketch their evidential requirements. One consequence of our analysis is that there are many spine problems and that any given spine problem might have many acceptable answers.

[Semiotics of the Currarino syndrome].

Science.gov (United States)

Pankevych, T L; Lóniushkin, O I; Sitkovskyĭ, M B; Kaplan, V M; Iurchenko, M I; Cherniienko, Iu L

1993-01-01

The main criteria for diagnosis of the Currarino syndrome have been defined. Roentgenologic investigation of the lumbar-sacral spine in direct projection is indicated to all the patients with anorectal developmental defects, in particular with congenital anorectal stenosis. In detection of a specific defect of the terminal vertebrae, the performance of computed tomography of the pelvic bottom and nuclear magnetic resonance tomography of the lumbar-sacral spine is necessary. This permits to assess the nature of a presacral tumour and degree of dysplasia of the external and sphincter. Timely diagnosis of the Currarino syndrome in children with the anorectal developmental defects permits to avoid severe septic and functional complications in surgical intervention.

CT imaging techniques for describing motions of the cervicothoracic junction and cervical spine during flexion, extension, and cervical traction.

Science.gov (United States)

Simon, Scott; Davis, Martin; Odhner, Dewey; Udupa, Jayaram; Winkelstein, Beth

2006-01-01

Computerized tomographic study of human cadavers undergoing traction and flexion-extension bending. To investigate the feasibility of using computerized tomography techniques to quantify relative vertebral motions of the cervical spine and cervicothoracic junction (CTJ), and to define normative CTJ kinematics. Despite developing an understanding of the mechanical behavior of the cervical spine, little remains known about the cervicothoracic junction. The CTJ is more difficult to image than other cervical regions given the anatomic features of the surrounding bones obstructing CTJ visualization. As such, limited data have been reported describing the responses of the CTJ for motions and loading in the sagittal plane, confounding the clinical assessment of its injuries and surgical treatments used at this region. Helical CT images of the cervical spine and CTJ were acquired incrementally during each of flexion, extension, and cervical traction. Vertebral surfaces were reconstructed using the specialized image analysis software, 3DVIEWNIX. A mathematical description of relative vertebral motions was derived by computing rigid transformations. Euler angles and translations were calculated. Regional spine stiffness was defined for traction. The CTJ was found to be much stiffer (779 N/mm) than the cervical spine (317 N/mm) in tension. In flexion-extension bending, the CTJ was similar to the lower cervical spine. The CTJ demonstrated significantly less coupled motion than the cervical spine. The CTJ, as a transition region between the cervical and thoracic spines, has unique kinematic characteristics. This application of kinematic CT methods is useful for quantifying unreported normative ranges of motion for the CTJ, difficult by other conventional radiologic means.

[Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome].

Science.gov (United States)

Gil Martín, A R; Carreras Aja, M; Arrieta Ardieta, I; Labayen Azparren, I

2014-01-01

Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Lumbar spine chordoma

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M.A. Hatem, M.B.Ch.B, MRes, LMCC

2014-01-01

Full Text Available Chordoma is a rare tumor arising from notochord remnants in the spine. It is slow-growing, which makes it difficult to diagnose and difficult to follow up after treatment. Typically, it occurs in the base of the skull and sacrococcygeal spine; it rarely occurs in other parts of the spine. CT-guided biopsy of a suspicious mass enabled diagnosis of lumbar spine chordoma.

Vitamin B1-deficient mice show impairment of hippocampus-dependent memory formation and loss of hippocampal neurons and dendritic spines: potential microendophenotypes of Wernicke-Korsakoff syndrome.

Science.gov (United States)

Inaba, Hiroyoshi; Kishimoto, Takuya; Oishi, Satoru; Nagata, Kan; Hasegawa, Shunsuke; Watanabe, Tamae; Kida, Satoshi

2016-12-01

Patients with severe Wernicke-Korsakoff syndrome (WKS) associated with vitamin B1 (thiamine) deficiency (TD) show enduring impairment of memory formation. The mechanisms of memory impairment induced by TD remain unknown. Here, we show that hippocampal degeneration is a potential microendophenotype (an endophenotype of brain disease at the cellular and synaptic levels) of WKS in pyrithiamine-induced thiamine deficiency (PTD) mice, a rodent model of WKS. PTD mice show deficits in the hippocampus-dependent memory formation, although they show normal hippocampus-independent memory. Similarly with WKS, impairments in memory formation did not recover even at 6 months after treatment with PTD. Importantly, PTD mice exhibit a decrease in neurons in the CA1, CA3, and dentate gyrus (DG) regions of the hippocampus and reduced density of wide dendritic spines in the DG. Our findings suggest that TD induces hippocampal degeneration, including the loss of neurons and spines, thereby leading to enduring impairment of hippocampus-dependent memory formation.

Vitamin B1-deficient mice show impairment of hippocampus-dependent memory formation and loss of hippocampal neurons and dendritic spines: potential microendophenotypes of Wernicke–Korsakoff syndrome

Science.gov (United States)

Inaba, Hiroyoshi; Kishimoto, Takuya; Oishi, Satoru; Nagata, Kan; Hasegawa, Shunsuke; Watanabe, Tamae; Kida, Satoshi

2016-01-01

Patients with severe Wernicke–Korsakoff syndrome (WKS) associated with vitamin B1 (thiamine) deficiency (TD) show enduring impairment of memory formation. The mechanisms of memory impairment induced by TD remain unknown. Here, we show that hippocampal degeneration is a potential microendophenotype (an endophenotype of brain disease at the cellular and synaptic levels) of WKS in pyrithiamine-induced thiamine deficiency (PTD) mice, a rodent model of WKS. PTD mice show deficits in the hippocampus-dependent memory formation, although they show normal hippocampus-independent memory. Similarly with WKS, impairments in memory formation did not recover even at 6 months after treatment with PTD. Importantly, PTD mice exhibit a decrease in neurons in the CA1, CA3, and dentate gyrus (DG) regions of the hippocampus and reduced density of wide dendritic spines in the DG. Our findings suggest that TD induces hippocampal degeneration, including the loss of neurons and spines, thereby leading to enduring impairment of hippocampus-dependent memory formation. PMID:27576603

Spatial and Working Memory Is Linked to Spine Density and Mushroom Spines.

Directory of Open Access Journals (Sweden)

Rasha Refaat Mahmmoud

Full Text Available Changes in synaptic structure and efficacy including dendritic spine number and morphology have been shown to underlie neuronal activity and size. Moreover, the shapes of individual dendritic spines were proposed to correlate with their capacity for structural change. Spine numbers and morphology were reported to parallel memory formation in the rat using a water maze but, so far, there is no information on spine counts or shape in the radial arm maze (RAM, a frequently used paradigm for the evaluation of complex memory formation in the rodent.24 male Sprague-Dawley rats were divided into three groups, 8 were trained, 8 remained untrained in the RAM and 8 rats served as cage controls. Dendritic spine numbers and individual spine forms were counted in CA1, CA3 areas and dentate gyrus of hippocampus using a DIL dye method with subsequent quantification by the Neuronstudio software and the image J program.Working memory errors (WME and latency in the RAM were decreased along the training period indicating that animals performed the task. Total spine density was significantly increased following training in the RAM as compared to untrained rats and cage controls. The number of mushroom spines was significantly increased in the trained as compared to untrained and cage controls. Negative significant correlations between spine density and WME were observed in CA1 basal dendrites and in CA3 apical and basal dendrites. In addition, there was a significant negative correlation between spine density and latency in CA3 basal dendrites.The study shows that spine numbers are significantly increased in the trained group, an observation that may suggest the use of this method representing a morphological parameter for memory formation studies in the RAM. Herein, correlations between WME and latency in the RAM and spine density revealed a link between spine numbers and performance in the RAM.

Spatial and Working Memory Is Linked to Spine Density and Mushroom Spines.

Science.gov (United States)

Mahmmoud, Rasha Refaat; Sase, Sunetra; Aher, Yogesh D; Sase, Ajinkya; Gröger, Marion; Mokhtar, Maher; Höger, Harald; Lubec, Gert

2015-01-01

Changes in synaptic structure and efficacy including dendritic spine number and morphology have been shown to underlie neuronal activity and size. Moreover, the shapes of individual dendritic spines were proposed to correlate with their capacity for structural change. Spine numbers and morphology were reported to parallel memory formation in the rat using a water maze but, so far, there is no information on spine counts or shape in the radial arm maze (RAM), a frequently used paradigm for the evaluation of complex memory formation in the rodent. 24 male Sprague-Dawley rats were divided into three groups, 8 were trained, 8 remained untrained in the RAM and 8 rats served as cage controls. Dendritic spine numbers and individual spine forms were counted in CA1, CA3 areas and dentate gyrus of hippocampus using a DIL dye method with subsequent quantification by the Neuronstudio software and the image J program. Working memory errors (WME) and latency in the RAM were decreased along the training period indicating that animals performed the task. Total spine density was significantly increased following training in the RAM as compared to untrained rats and cage controls. The number of mushroom spines was significantly increased in the trained as compared to untrained and cage controls. Negative significant correlations between spine density and WME were observed in CA1 basal dendrites and in CA3 apical and basal dendrites. In addition, there was a significant negative correlation between spine density and latency in CA3 basal dendrites. The study shows that spine numbers are significantly increased in the trained group, an observation that may suggest the use of this method representing a morphological parameter for memory formation studies in the RAM. Herein, correlations between WME and latency in the RAM and spine density revealed a link between spine numbers and performance in the RAM.

Polyetheretherketone (PEEK) Rods in Lumbar Spine Degenerative Disease: A Case Series.

Science.gov (United States)

Ormond, D Ryan; Albert, Ladislau; Das, Kaushik

2016-08-01

Retrospective case series. The purpose of our study was to retrospectively review the results of posterior lumbar fusion using polyetheretherketone (PEEK) rods. Pedicle screw and rod instrumentation has become the preferred technique for performing stabilization and fusion in the lumbar spine for degenerative disease. Rigid fixation with titanium rods leads to high fusion rates, but may also contribute to stress shielding and adjacent segment degeneration (ASD). Thus, some have advocated using semirigid rods made of PEEK. Although the biomechanical properties of PEEK rods have shown improved stress-shielding characteristics and anterior load-sharing properties, there are very few clinical studies evaluating their application in the lumbar spine. We evaluated a retrospective cohort of 42 patients who underwent posterior lumbar fusion from 2007 to 2009 for the treatment of lumbar spine degenerative disease using PEEK rods. Reoperation rate was the primary outcome evaluated. Fusion rate was also evaluated. Eight of the 42 patients with PEEK rods required reoperation. Reasons for reoperation mainly included ASD (5/8) and nonunion with cage migration (3/8). Radiographically, documented fusion rate was 86%. Mean follow-up was 31.4 months. No statistical differences were found in fusion rates or reoperation between age above 55 years and younger than 55 years (P=1.00), male and female (P=0.110), single or multilevel fusion (P=0.67), and fusion with and without an interbody graft (P=0.69). Smokers showed a trend towards increased risk of reoperation for ASD or instrumentation failure (P=0.056). PEEK rods demonstrate a similar fusion and reoperation rate in comparison to other instrumentation modalities in the treatment of degenerative lumbar spine disease.

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)

CDK10 Mutations in Humans and Mice Cause Severe Growth Retardation, Spine Malformations, and Developmental Delays

NARCIS (Netherlands)

Windpassinger, Christian; Piard, Juliette; Bonnard, Carine; Alfadhel, Majid; Lim, Shuhui; Bisteau, Xavier; Blouin, Stéphane; Ali, Nur'Ain B; Ng, Alvin Yu Jin; Lu, Hao; Tohari, Sumanty; Talib, S Zakiah A; van Hul, Noémi; Caldez, Matias J; Van Maldergem, Lionel; Yigit, Gökhan; Kayserili, Hülya; Youssef, Sameh A; Coppola, Vincenzo; de Bruin, Alain; Tessarollo, Lino; Choi, Hyungwon; Rupp, Verena; Roetzer, Katharina; Roschger, Paul; Klaushofer, Klaus; Altmüller, Janine; Roy, Sudipto; Venkatesh, Byrappa; Ganger, Rudolf; Grill, Franz; Ben Chehida, Farid; Wollnik, Bernd; Altunoglu, Umut; Al Kaissi, Ali; Reversade, Bruno; Kaldis, Philipp

2017-01-01

In five separate families, we identified nine individuals affected by a previously unidentified syndrome characterized by growth retardation, spine malformation, facial dysmorphisms, and developmental delays. Using homozygosity mapping, array CGH, and exome sequencing, we uncovered bi-allelic

A classification of growth friendly spine implants.

Science.gov (United States)

Skaggs, David L; Akbarnia, Behrooz A; Flynn, John M; Myung, Karen S; Sponseller, Paul D; Vitale, Michael G

2014-01-01

Various types of spinal implants have been used with the objective of minimizing spinal deformities while maximizing the spine and thoracic growth in a growing child with a spinal deformity. The aim of this study was to describe a classification system of growth friendly spinal implants to allow researchers and clinicians to have a common language and facilitate comparative studies. Growth friendly spinal implant systems fall into 3 categories based upon the forces of correction the implants exert on the spine, which are as follows: Distraction-based systems correct spinal deformities by mechanically applying a distractive force across a deformed segment with anchors at the top and bottom of the implants, which commonly attach to the spine, rib, and/or the pelvis. The present examples of distraction-based implants are spine-based or rib-based growing rods, vertical expandable titanium rib prosthesis, and remotely expandable devices. Compression-based systems correct spinal deformities with a compressive force applied to the convexity of the curve causing convex growth inhibition. This compressive force may be generated both mechanically at the time of implantation, as well as over time resulting from longitudinal growth of vertebral endplates hindered by the spinal implants. Examples of compression-based systems are vertebral staples and tethers. Guided growth systems correct spinal deformity by anchoring multiple vertebrae (usually including the apical vertebrae) to rods with mechanical forces including translation at the time of the initial implant. The majority of the anchors are not rigidly attached to the rods, thus permitting longitudinal growth over time as the anchors slide over the rods. Examples of guided growth systems include the Luque trolley and Shilla. Each system has its benefits and shortcomings. Knowledge of the fundamental principles upon which these systems are based may aid the clinician to choose an appropriate treatment for patients. Having a

Understanding geological processes: Visualization of rigid and non-rigid transformations

Science.gov (United States)

Shipley, T. F.; Atit, K.; Manduca, C. A.; Ormand, C. J.; Resnick, I.; Tikoff, B.

2012-12-01

Visualizations are used in the geological sciences to support reasoning about structures and events. Research in cognitive sciences offers insights into the range of skills of different users, and ultimately how visualizations might support different users. To understand the range of skills needed to reason about earth processes we have developed a program of research that is grounded in the geosciences' careful description of the spatial and spatiotemporal patterns associated with earth processes. In particular, we are pursuing a research program that identifies specific spatial skills and investigates whether and how they are related to each other. For this study, we focus on a specific question: Is there an important distinction in the geosciences between rigid and non-rigid deformation? To study a general spatial thinking skill we employed displays with non-geological objects that had been altered by rigid change (rotation), and two types of non-rigid change ("brittle" (or discontinuous) and "ductile" (or continuous) deformation). Disciplinary scientists (geosciences and chemistry faculty), and novices (non-science faculty and undergraduate psychology students) answered questions that required them to visualize the appearance of the object before the change. In one study, geologists and chemists were found to be superior to non-science faculty in reasoning about rigid rotations (e.g., what an object would look like from a different perspective). Geologists were superior to chemists in reasoning about brittle deformations (e.g., what an object looked like before it was broken - here the object was a word cut into many fragments displaced in different directions). This finding is consistent with two hypotheses: 1) Experts are good at visualizing the types of changes required for their domain; and 2) Visualization of rigid and non-rigid changes are not the same skill. An additional important finding is that there was a broad range of skill in both rigid and non-rigid

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.

EXPERIENCE OF SURGICAL TREATMENT OF INJURIES OF MIDDLE AND LOWER CERVICAL SPINE WHILE DIVING

Directory of Open Access Journals (Sweden)

I. P. Ardashev

2012-01-01

Full Text Available Objective - to analyze the long-term results of surgical treatment of patients with injuries of middle- and lower cervical spine in diving. Materials and methods. An analysis of surgical treatment of 27 patients and assessment of the long-term results of 20 patients in a period of 6 months to 6 years were performed with analysis of clinical, neurological, radiographic data and mortality. Results. Mostly the C5 vertebra was damaged - in 17 patients (63%. Compression fractures of vertebral bodies met in 6 (22%, compression-comminuted fractures - in 16 (59% patients, dislocations - in 5 (19%. All patients had neurological disorders. All observations noted rigid stabilization of the spine with an implant made of porous nickel-titanium, the presence of bone-metal block at the level of the damaged vertebral body Mortality in the postoperative period was 26%. In the long-term period the initial neurological symptoms were observed in 7 (30% patients, 13 (48% patients had marked regression of neurological symptoms. Full functional maladjustment was observed in 6 patients with no motor function below the damaged segment, originally belonging to groups A and B on the classification of H.L. Frankel. Moderate and mild degree of functional adaptation disorders were present in 5 and 4 patients respectively. In the remaining patients we did not reveal a functional maladjustment. Range of motion in the cervical spine in all patients was considered as good. Conclusions. Anterior decompressive-stabilizing surgeries on the spine with an implant made of porous nickel-titanium and metal plate CSLP allows reliably stabilization of the injured spine and the rehabilitation of this severe category of patients.

Heterogeneity in cervical spine assessment in paediatric trauma: A survey of physicians' knowledge and application at a paediatric major trauma centre.

Science.gov (United States)

Buckland, Aaron J; Bressan, Silvia; Jowett, Helen; Johnson, Michael B; Teague, Warwick J

2016-10-01

Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. A cross-sectional survey of physicians actively engaged in trauma care within a paediatric trauma centre was undertaken. Participation was voluntary and responses de-idenitified. The survey comprised 20 questions regarding initial assessment, imaging, immobilisation and perioperative management. Physicians' responses were compared with available current evidence. Sixty-seven physicians (28% registrars, 17% fellows and 55.2% consultants) participated. Physicians rated altered mental state, intoxication and distracting injury as the most important contraindications to cervical spine clearance in children. Fifty-four per cent considered adequate plain imaging to be 3-view cervical spine radiographs (anterior-posterior, lateral and odontoid), whereas 30% considered CT the most sensitive modality for detecting unstable cervical spine injuries. Physicians' responses reflected marked heterogeneity regarding semi-rigid cervical collars and what constitutes cervical spine 'clearance'. Greater consensus existed for perioperative precautions in this setting. Physicians actively engaged in paediatric trauma care demonstrate marked heterogeneity in their knowledge and application of cervical spine assessment. This is compounded by a lack of paediatric-specific evidence and definitions, involvement of multiple specialties and staff turnover within busy departments. A validated decision-making tool for cervical spine assessment will represent an important advance in paediatric trauma. © 2016 Australasian

SpineData

DEFF Research Database (Denmark)

Kent, Peter; Kongsted, Alice; Jensen, Tue Secher

2015-01-01

Background: Large-scale clinical registries are increasingly recognized as important resources for quality assurance and research to inform clinical decision-making and health policy. We established a clinical registry (SpineData) in a conservative care setting where more than 10,000 new cases...... of spinal pain are assessed each year. This paper describes the SpineData registry, summarizes the characteristics of its clinical population and data, and signals the availability of these data as a resource for collaborative research projects. Methods: The SpineData registry is an Internet-based system...... that captures patient data electronically at the point of clinical contact. The setting is the government-funded Medical Department of the Spine Centre of Southern Denmark, Hospital Lillebaelt, where patients receive a multidisciplinary assessment of their chronic spinal pain. Results: Started in 2011...

Rigid multibody system dynamics with uncertain rigid bodies

Energy Technology Data Exchange (ETDEWEB)

Batou, A., E-mail: anas.batou@univ-paris-est.fr; Soize, C., E-mail: christian.soize@univ-paris-est.fr [Universite Paris-Est, Laboratoire Modelisation et Simulation Multi Echelle, MSME UMR 8208 CNRS (France)

2012-03-15

This paper is devoted to the construction of a probabilistic model of uncertain rigid bodies for multibody system dynamics. We first construct a stochastic model of an uncertain rigid body by replacing the mass, the center of mass, and the tensor of inertia by random variables. The prior probability distributions of the stochastic model are constructed using the maximum entropy principle under the constraints defined by the available information. The generators of independent realizations corresponding to the prior probability distribution of these random quantities are further developed. Then several uncertain rigid bodies can be linked to each other in order to calculate the random response of a multibody dynamical system. An application is proposed to illustrate the theoretical development.

Conspicuous carotenoid-based pelvic spine ornament in three-spined stickleback populations—occurrence and inheritance

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CR Amundsen

2015-04-01

Full Text Available Reports on reddish carotenoid-based ornaments in female three-spined sticklebacks (Gasterosteus aculeatus are few, despite the large interest in the species’ behaviour, ornamentation, morphology and evolution. We sampled sticklebacks from 17 sites in north-western Europe in this first extensive study on the occurrence of carotenoid-based female pelvic spines and throat ornaments. The field results showed that females, and males, with reddish spines were found in all 17 populations. Specimens of both sexes with conspicuous red spines were found in several of the sites. The pelvic spines of males were more intensely red compared to the females’ spines, and large specimens were more red than small ones. Fish infected with the tapeworm (Schistocephalus solidus had drabber spines than uninfected fish. Both sexes had red spines both during and after the spawning period, but the intensity of the red colour was more exaggerated during the spawning period. As opposed to pelvic spines, no sign of red colour at the throat was observed in any female from any of the 17 populations. A rearing experiment was carried out to estimate a potential genetic component of the pelvic spine ornament by artificial crossing and rearing of 15 family groups during a 12 months period. The results indicated that the genetic component of the red colour at the spines was low or close to zero. Although reddish pelvic spines seem common in populations of stickleback, the potential adaptive function of the reddish pelvic spines remains largely unexplained.

Dural ectasia and conventional radiography in the Marfan lumbosacral spine

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Ahn, N U [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Johns Hopkins Outpatient Center, Dept. of Orthopaedic Surgery, Baltimore, MD (United States); Nallamshetty, L; Ahn, U M; Buchowski, J M; Kebaish, K M; Sponseller, P D [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Rose, P S [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (United States); Garrett, E S [Dept. of Oncology, Division of Biostatistics, Johns Hopkins University School of Medicine, Baltimore (United States)

2001-06-01

Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P<0.03); scalloping values at the L1 and L5 levels (P<0.05); sagittal diameters of the vertebral canal at L5-S1 (P<0.03); transverse process to width ratios at L2 (P<0.03). Criteria were developed for diagnosis of dural ectasia in Marfan patients. These included presence of one of the following: interpediculate distance at L4 >38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

OSTEOSYNTHESIS OF THE SPINE AT PATHOLOGICAL FRACTURES AGAINST THE BACKGROUND OF EXTENSIVE METASTATIC SPREAD IN COMBINATION WITH RADIO- AND CHEMOTHERAPY

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R. M. Tikhilov

2010-01-01

Full Text Available The results of the stabilizing spine osteosynthesis in 82 patients with extensive metastatic spread are presented. Patients have been distributed to 3 groups: in I group the extended osteosynthesis of a spine without application cement vertebroplasty was carried out, in II group the extended spine osteosynthesis was performed, but with performance vertebroplasty through cannulated screws, in III group the limited osteosynthesis with cement vertebroplasty through cannulas screws was applied. Results of treatment were estimated considering spine support ability, elimination of a painful syndrome (scale of pain McAfee, 1989 and neurologic dysfunctions (scale ASIA/IMSOP, 1992, improvement of quality of a life (scale SF-36. The received positive results of treatment allow to conclude that tactics of treatment has been chosen correctly.

Imaging the Traumatized Spine'Clearing The Cervical Spine'

International Nuclear Information System (INIS)

Monu, U.V.J.

2015-01-01

Failure to recognize and diagnose injury to the cervical spine on plain radiographs can lead to severe and devastating consequences to the patient in particular and to the radiologist financially and otherwise. CT examination of the cervical spine aids and significantly improves diagnoses in many instances. it is neither economically feasible nor desirable to obtain CT on all patients. Meticulous attention to detail and zero tolerance for deviations from the usual radiographic landmarks will help select cases that should obtain additional imaging in form of CT or MRI scans. Faced with a task of clearing a cervical spine, a number of options are available. The first discriminator is whether or not the patient can be cleared clinically. If that is not possible, radiographic evaluation is needed. Strict adherence to a minimum three view plain radiograph for C-spine series must be maintained. Deviation from established norms for cervical spine radiographs should trigger a CT for additional evaluation

Tooth agenesis and craniofacial morphology in pre-orthodontic children with and without morphological deviations in the upper cervical spine

DEFF Research Database (Denmark)

Jasemi, Ashkan; Sonnesen, Liselotte

2016-01-01

AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis...... in the two groups together. METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with (19 children, mean age 11.9) and without (107 children, mean age 11.4) upper spine morphological deviations. Visual assessment of upper spine morphology...... and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms. RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations (2.2 ± 1.6 vs...

A systematic review of the need for MRI for the clearance of cervical spine injury in obtunded blunt trauma patients after normal cervical spine CT

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Iyore AO James

2014-01-01

Full Text Available Clearance of cervical spine injury (CSI in the obtunded or comatose blunt trauma patient remains controversial. In patients with unreliable physical examination and no evidence of CSI on computed tomography (CT, magnetic resonance imaging of the cervical spine (CS-MRI is the typical follow-up study. There is a growing body of evidence suggesting that CS-MRI is unnecessary with negative findings on a multi-detector CT (MDCT scan. This review article systematically analyzes current literature to address the controversies surrounding clearance of CSI in obtunded blunt trauma patients. A literature search through MEDLINE database was conducted using all databases on the National Center for Biotechnology Information (NCBI website (www.ncbi.nlm.nih.gov for keywords: "cervical spine injury," "obtunded," and "MRI." The search was limited to studies published within the last 10 years and with populations of patients older than 18 years old. Eleven studies were included in the analysis yielding data on 1535 patients. CS-MRI detected abnormalities in 256 patients (16.6%. The abnormalities reported on CS-MRI resulted in prolonged rigid c-collar immobilization in 74 patients (4.9%. Eleven patients (0.7% had unstable injury detected on CS-MRI alone that required surgical intervention. In the obtunded blunt trauma patient with unreliable clinical examination and a normal CT scan, there is still a role for CS-MRI in detecting clinically significant injuries when MRI resources are available. However, when a reliable clinical exam reveals intact gross motor function, CS-MRI may be unnecessary.

Spine deformities in patients with Ehlers-Danlos syndrome, type IV - late results of surgical treatment

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Tesiorowski Maciej

2010-11-01

Full Text Available Abstract Background Spinal deformities in Ehlers-Danlos syndrome are usually progressive and may require operative treatment. There is limited number of studies describing late results of surgery in this disease. Methods This is a retrospective study of the records of 11 patients with Ehlers-Danlos syndrome type IV, treated surgically between 1990 and 2007. All patients underwent surgical treatment for spinal deformity. Duration of operation, type of instrumentation, intraoperative blood loss, complications and number of additional surgeries were noted. Radiographic measurement was performed on standing AP and lateral radiographs acquired before surgery, just after and at final follow up. Results The mean follow up period was 5.5 ± 2.9 years (range 1-10 years. The mean preoperative thoracic and lumbar curve were 109.5 ± 19.9° (range 83° - 142° and 75.6 ± 26.7° (range 40° - 108° respectively. Posterior spine fusion alone was performed on 6 patients and combined anterior and posterior fusion (one- or two stage on 5 cases. Posterior segmental spinal instrumentation was applied with use of hooks, screws and wires. The mean postoperative thoracic and lumbar curve improved to 79.3 ± 16.1° (range 56° - 105° and 58.5 ± 27.7° (range 10° - 95° respectively, with a slight loss of correction during follow up. The average thoracic and lumbar correction was 26.4 ± 14.9% (range 5.3 - 50.4% and 26.3 ± 21.2% (range 7.9 - 75%. Postoperatively, the mean kyphosis was 79.5 ± 40.3° (range 21° -170°, and lordosis was 50.8 ± 18.6° (range 20° -79°. Hyperkyphosis increased during follow up while lordosis remained stable. Mean Th12-L2 angle was -3.5 ±9.9° (range -19° - 15° postoperatively and did not change significantly during follow up. Conclusions Huge spinal deformities in patients with Ehlers-Danlos syndrome require complex and extensive surgery. There is a big risk of sagittal imbalance in this group.

Cervical bracing practices after degenerative cervical surgery: a survey of cervical spine research society members.

Science.gov (United States)

Lunardini, David J; Krag, Martin H; Mauser, Nathan S; Lee, Joon Y; Donaldson, William H; Kang, James D

2018-05-21

Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures. The overall bracing rate was 67%. This included 8.4% who used a hard collar in each scenario. Twenty-two percent of surgeons never used a hard collar, while 34% never used a soft collar, and 3.6% (3 respondents) did not use a brace in any surgical scenario. Bracing frequency for specific surgical scenarios varied from 39% after foraminotomy to 88% after multi-level corpectomy with anterior & posterior fixation. After one, two and three level anterior cervical discectomy & fusion (ACDF), bracing rates were 58%, 65% and 76% for an average of 3.3, 4.3 and 5.3 weeks, respectively. After single level corpectomy, 77% braced for an average of 6.2 weeks. After laminectomy and fusion, 72% braced for an average of 5.4 weeks. Significant variation persists among surgeons on the type and length of post-operative brace usage after cervical spine surgeries. Overall rates of bracing have not changed significantly with time. Given the lack evidence in the literature to support bracing, reconsidering use of a brace after certain surgeries may be warranted. Copyright © 2018. Published by Elsevier Inc.

Thoracic spine x-ray

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Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

Astrocyte-secreted thrombospondin-1 modulates synapse and spine defects in the fragile X mouse model.

Science.gov (United States)

Cheng, Connie; Lau, Sally K M; Doering, Laurie C

2016-08-02

Astrocytes are key participants in various aspects of brain development and function, many of which are executed via secreted proteins. Defects in astrocyte signaling are implicated in neurodevelopmental disorders characterized by abnormal neural circuitry such as Fragile X syndrome (FXS). In animal models of FXS, the loss in expression of the Fragile X mental retardation 1 protein (FMRP) from astrocytes is associated with delayed dendrite maturation and improper synapse formation; however, the effect of astrocyte-derived factors on the development of neurons is not known. Thrombospondin-1 (TSP-1) is an important astrocyte-secreted protein that is involved in the regulation of spine development and synaptogenesis. In this study, we found that cultured astrocytes isolated from an Fmr1 knockout (Fmr1 KO) mouse model of FXS displayed a significant decrease in TSP-1 protein expression compared to the wildtype (WT) astrocytes. Correspondingly, Fmr1 KO hippocampal neurons exhibited morphological deficits in dendritic spines and alterations in excitatory synapse formation following long-term culture. All spine and synaptic abnormalities were prevented in the presence of either astrocyte-conditioned media or a feeder layer derived from FMRP-expressing astrocytes, or following the application of exogenous TSP-1. Importantly, this work demonstrates the integral role of astrocyte-secreted signals in the establishment of neuronal communication and identifies soluble TSP-1 as a potential therapeutic target for Fragile X syndrome.

[Spondylarthrosis of the cervical spine. Therapy].

Science.gov (United States)

Radl, R; Leixner, G; Stihsen, C; Windhager, R

2013-09-01

Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied.

Hampered long-term depression and thin spine loss in the nucleus accumbens of ethanol-dependent rats.

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Spiga, Saturnino; Talani, Giuseppe; Mulas, Giovanna; Licheri, Valentina; Fois, Giulia R; Muggironi, Giulia; Masala, Nicola; Cannizzaro, Carla; Biggio, Giovanni; Sanna, Enrico; Diana, Marco

2014-09-02

Alcoholism involves long-term cognitive deficits, including memory impairment, resulting in substantial cost to society. Neuronal refinement and stabilization are hypothesized to confer resilience to poor decision making and addictive-like behaviors, such as excessive ethanol drinking and dependence. Accordingly, structural abnormalities are likely to contribute to synaptic dysfunctions that occur from suddenly ceasing the use of alcohol after chronic ingestion. Here we show that ethanol-dependent rats display a loss of dendritic spines in medium spiny neurons of the nucleus accumbens (Nacc) shell, accompanied by a reduction of tyrosine hydroxylase immunostaining and postsynaptic density 95-positive elements. Further analysis indicates that "long thin" but not "mushroom" spines are selectively affected. In addition, patch-clamp experiments from Nacc slices reveal that long-term depression (LTD) formation is hampered, with parallel changes in field potential recordings and reductions in NMDA-mediated synaptic currents. These changes are restricted to the withdrawal phase of ethanol dependence, suggesting their relevance in the genesis of signs and/or symptoms affecting ethanol withdrawal and thus the whole addictive cycle. Overall, these results highlight the key role of dynamic alterations in dendritic spines and their presynaptic afferents in the evolution of alcohol dependence. Furthermore, they suggest that the selective loss of long thin spines together with a reduced NMDA receptor function may affect learning. Disruption of this LTD could contribute to the rigid emotional and motivational state observed in alcohol dependence.

Diagnostic imaging of Klippel-Feil syndrome: conventional radiography, CT and MR imaging. Case report; Bildgebende Diagnostik des Klippel-Feil-Syndroms: Konventionelle Roentgenaufnahmen, CT und MRT. Fallbericht

Energy Technology Data Exchange (ETDEWEB)

Jochens, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schubeus, P. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Steinkamp, H.J. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Menzhausen, L. [Abt. fuer Psychiatrie, Urban Krankenhaus, Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

1993-12-31

In two patients with Klippel-Feil syndrome, type II radiographic findings of the malformation are shown in the cervical spine and the craniocervical junction. Conventional X-rays of the cervical spine in the AP and lateral view and conventional tomography as well as CT of the cervical spine were obtained in both patients. One of the two patients additionally underwent MR imaging. Findings of the different imaging modalities are compared with each other. (orig.) [Deutsch] Anhand von zwei Patienten mit Klippel-Feil-Syndrom Typ II werden typische radiologische Befunde des Missbildungssyndroms im Bereich der Halswirbelsaeule und des kraniozervikalen Ueberganges dargestellt. Neben den konventionellen HWS-Roentgenaufnahmen und den konventionellen Schichtaufnahmen, wurden bei beiden Patienten ein CT der HWS und bei einem Patienten zusaetzlich ein MRT durchgefuehrt. Die Ergebnisse und Befunde der verschiedenen Untersuchungsverfahren werden einander gegenuebergestellt. (orig.)

Spondylocarpotarsal synostosis syndrome (not rare but infrequently recognised syndrome)

International Nuclear Information System (INIS)

Marik, I.; Kaissi, A.; Ghachem, M.; Chehida, F.; Safi, H.; Masel, J.; Kozlowsk, K.

2006-01-01

Spondylocarpotarsal synostosis syndrome - a rarely recognised entity - is characterised by malsegmentation of the spine and carpal/tarsal fusions. The main reason for the rarity of its diagnosis is that radiographs of the hands and feet are not routinely performed in children with scoliosis and/or kyphoscoliosis, and fusion of the carpal/tarsal bones may not be evident in preschool children. We report four patients with spondylocarpotarsal synostosis syndrome; the diagnosis in three of these was not made until radiographs of the hands were performed. The amount of scoliosis was much less evident in two of these patients (sibs) than in the others. (author)

Surgical treatment of double thoracic adolescent idiopathic scoliosis with a rigid proximal thoracic curve.

Science.gov (United States)

Sudo, Hideki; Abe, Yuichiro; Abumi, Kuniyoshi; Iwasaki, Norimasa; Ito, Manabu

2016-02-01

There is limited consensus on the optimal surgical strategy for double thoracic adolescent idiopathic scoliosis (AIS). Recent studies have reported that pedicle screw constructs to maximize scoliosis correction cause further thoracic spine lordosis. The objective of this study was to apply a new surgical technique for double thoracic AIS with rigid proximal thoracic (PT) curves and assess its clinical outcomes. Twenty one consecutive patients with Lenke 2 AIS and a rigid PT curve (Cobb angle ≥30º on side-bending radiographs, flexibility ≤30 %) treated with the simultaneous double-rod rotation technique (SDRRT) were included. In this technique, a temporary rod is placed at the concave side of the PT curve. Then, distraction force is applied to correct the PT curve, which reforms a sigmoid double thoracic curve into an approximate single thoracic curve. As a result, the PT curve is typically converted from an apex left to an apex right curve before applying the correction rod for PT and main thoracic curve. All patients were followed for at least 2 years (average 2.7 years). The average main thoracic and PT Cobb angle correction rate at the final follow-up was 74.7 and 58.0 %, respectively. The average preoperative T5-T12 thoracic kyphosis was 9.3°, which improved significantly to 19.0° (p corrected using SDRRT for Lenke 2 AIS with a rigid PT curve.

SPINET: A Parallel Computing Approach to Spine Simulations

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Peter G. Kropf

1996-01-01

Full Text Available Research in scientitic programming enables us to realize more and more complex applications, and on the other hand, application-driven demands on computing methods and power are continuously growing. Therefore, interdisciplinary approaches become more widely used. The interdisciplinary SPINET project presented in this article applies modern scientific computing tools to biomechanical simulations: parallel computing and symbolic and modern functional programming. The target application is the human spine. Simulations of the spine help us to investigate and better understand the mechanisms of back pain and spinal injury. Two approaches have been used: the first uses the finite element method for high-performance simulations of static biomechanical models, and the second generates a simulation developmenttool for experimenting with different dynamic models. A finite element program for static analysis has been parallelized for the MUSIC machine. To solve the sparse system of linear equations, a conjugate gradient solver (iterative method and a frontal solver (direct method have been implemented. The preprocessor required for the frontal solver is written in the modern functional programming language SML, the solver itself in C, thus exploiting the characteristic advantages of both functional and imperative programming. The speedup analysis of both solvers show very satisfactory results for this irregular problem. A mixed symbolic-numeric environment for rigid body system simulations is presented. It automatically generates C code from a problem specification expressed by the Lagrange formalism using Maple.

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

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.)

Breast Carcinoma Associated with Poland's Syndrome: One Case Report and Literatures Review

Institute of Scientific and Technical Information of China (English)

Xin Wang; Liansheng Ning

2008-01-01

@@ Introduction Poland's syndrome is a rare congenital anomaly,characterized by abnormalities of the chest wall,breast,spine and upper limb.The incidence of this syndrome has been estimated to be 1:30000.The pathogenesis is still uncleart[1].

Distinctive skeletal dysplasia in Cockayne syndrome

International Nuclear Information System (INIS)

Silengo, M.C.; Franceschini, P.; Bianco, R.; Biagioli, M.; Pastorin, L.; Vista, N.; Baldassar, A.; Benso, L.

1986-01-01

Cockayne syndrom is a well-known autosomal recessive form of dwarfism with senile-like appearance. Skeletal changes such as flattening of vertebral bodies, ivory epiphyses and thickening of cranial vault, have been observed in some patients with this condition. We describe here a 5.5-year-old girl with the typical clinical signs of Cockayne syndrome and a distinctive form of bone dysplasia with major involvment of the spine. (orig.)

Distinctive skeletal dysplasia in Cockayne syndrome

Energy Technology Data Exchange (ETDEWEB)

Silengo, M.C.; Franceschini, P.; Bianco, R.; Biagioli, M.; Pastorin, L.; Vista, N.; Baldassar, A.; Benso, L.

1986-03-01

Cockayne syndrome is a well-known autosomal recessive form of dwarfism with senile-like appearance. Skeletal changes such as flattening of vertebral bodies, ivory epiphyses and thickening of cranial vault, have been observed in some patients with this condition. We describe here a 5.5-year-old girl with the typical clinical signs of Cockayne syndrome and a distinctive form of bone dysplasia with major involvement of the spine.

Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome). Case report.

Science.gov (United States)

Fini, G; Belli, E; Mici, E; Virciglio, P; Moricca, L M; D'Itri, L; Leonardi, A; Malavenda, M S; Krizzuk, D; Merola, R; Maturo, A; Pasta, V

2013-01-01

Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome (NBCCS) comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies, calcifications of the falx cerebri etc. The diagnosis is made according to clinical criteria (Kimonis Criteria) and genetic ones. We studied one family where father and then his sun resulted affected by each syndrome. Gorlin-Goltz syndrome is a rare disease diagnosed according to clinical criteria sometimes difficult to integrate. The family case we presented shows how you can get diagnosis even in older age and after numerous surgeries. Patients should be given special attention and therefore should be monitorized and need multidisciplinary treatments continued in time, even a trivial change of signs and symptoms may be an important indicator of a precipitating event which puts the patient's life under threat.

Nevoid basal cell carcinoma syndrome; Naevoid Basalzellkarzinom-Syndrom

Energy Technology Data Exchange (ETDEWEB)

Grgic, A.; Heinrich, M.; Heckmann, M.; Kramann, B. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Aliani, S. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Kinder- und Jugendmedizin; Dill-Mueller, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Hautklinik und Poliklinik; Uder, M. [Erlange-Nuernberg Univ. (Germany). Inst. fuer Diagnostische Radiologie

2005-07-01

Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an autosomal-dominant disorder characterized by multiple basal cell carcinomas, jaw cysts, palmar/plantar pits, calcification of the falx cerebri, and spine and rib anomalies. The combination of clinical, imaging, and histological findings is helpful in identifying NBCCS patients. Imaging plays a crucial role in evaluation of these patients. We present a wide variety of clinical and radiological findings characteristic of this disease. (orig.)

Multiple pterygium syndrome: Challenge for anesthesiologist

Directory of Open Access Journals (Sweden)

P Sethi

2016-01-01

Full Text Available Multiple pterygium syndrome (MPS is a very rare autosomal recessive disorder characterized by flexion of joint and digit contractures, skin webbing, cleft palate, deformity of the spine, and cervical spine fusion. Difficult airway is associated mainly due to micrognathia, retrognathia, webbing of the neck, and limitation of the mouth opening and neck extension. We are reporting a case of a 5-year-old female diagnosed with MPS and exhibiting a bilateral club foot and congenital vertical talus. The patient was posted for manipulation and above the knee casting under general anesthesia.

Laron syndrome abnormalities: spinal stenosis, os odontoideum, degenerative changes of the atlanto-odontoid joint, and small oropharynx.

Science.gov (United States)

Kornreich, Liora; Horev, Gadi; Schwarz, Michael; Karmazyn, Boaz; Laron, Zvi

2002-04-01

Patients with Laron syndrome have an inborn growth hormone resistance. We investigated abnormalities in the upper airways and cervical spine in patients with Laron syndrome. We prospectively examined 11 patients (one child aged 9 years and 10 adults aged 36-68 years), 10 of whom underwent MR imaging of the spine or head; nine, radiography of the cervical spine; and four, CT of C1-C2. The width of the spinal canal was evaluated visually and quantitatively and compared with reference values. The smallest diameter of the oropharynx and the thickness of the palate were measured and compared with reference values. Nine age-matched female patients referred for MR imaging for unrelated reasons served as control subjects. Cervical spinal stenosis was present in seven of the adult patients, within a confidence interval of 95%. Anomaly of the dens compatible with os odontoideum was present in three patients, causing focal myelomalacia in two. The atlanto-odontoid joint showed osteoarthritic changes in six of the adult patients. The mediolateral diameter of the oropharynx was significantly smaller in the patients with Laron syndrome than in the control subjects (P Laron syndrome develop significant narrowing of the cervical spinal canal and early degenerative changes of the atlanto-odontoid joint. Laron syndrome is associated with os odontoideum causing myelomalacia. The dimensions of the oropharynx are small. Patients may be prone to neurologic morbidity and sleep disturbances. Routine MR imaging of the cervical spine is recommended in these patients.

Thyroid storm following anterior cervical spine surgery for tuberculosis of cervical spine

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Sanjiv Huzurbazar

2014-01-01

Full Text Available Objective: The primary objective was to report this rare case and discuss the probable mechanism of thyroid storm following anterior cervical spine surgery for Kochs cervical spine.

No publication bias in industry funded clinical trials of degenerative diseases of the spine.

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Son, Colin; Tavakoli, Samon; Bartanusz, Viktor

2016-03-01

Industry sponsorship of clinical research of degenerative diseases of the spine has been associated with excessive positive published results as compared to research carried out without industry funding. We sought the rates of publication of clinical trials of degenerative diseases of the spine based on funding source as a possible explanation for this phenomenon. We reviewed all clinical trials registered at clinicaltrials.gov relating to degenerative diseases of the spine as categorized under six medical subject heading terms (spinal stenosis, spondylolisthesis, spondylolysis, spondylosis, failed back surgery syndrome, intervertebral disc degeneration) and with statuses of completed or terminated. These collected studies were categorized as having, or not having, industry funding. Published results for these studies were then sought within the clinicaltrials.gov database itself, PubMed and Google Scholar. One hundred sixty-one clinical trials met these criteria. One hundred nineteen of these trials had industry funding and 42 did not. Of those with industry funding, 45 (37.8%) had identifiable results. Of those without industry funding, 17 (40.5%) had identifiable results. There was no difference in the rates of publication of results from clinical trials of degenerative diseases of the spine no matter the funding source. Copyright © 2015 Elsevier Ltd. All rights reserved.

Diagnostic imaging of Klippel-Feil syndrome: conventional radiography, CT and MR imaging. Case report

International Nuclear Information System (INIS)

Jochens, R.; Schubeus, P.; Steinkamp, H.J.; Menzhausen, L.; Felix, R.

1993-01-01

In two patients with Klippel-Feil syndrome, type II radiographic findings of the malformation are shown in the cervical spine and the craniocervical junction. Conventional X-rays of the cervical spine in the AP and lateral view and conventional tomography as well as CT of the cervical spine were obtained in both patients. One of the two patients additionally underwent MR imaging. Findings of the different imaging modalities are compared with each other. (orig.) [de

Disparities in Rates of Spine Surgery for Degenerative Spine Disease Between HIV Infected and Uninfected Veterans

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King, Joseph T.; Gordon, Adam J.; Perkal, Melissa F.; Crystal, Stephen; Rosenthal, Ronnie A.; Rodriguez-Barradas, Maria C.; Butt, Adeel A.; Gibert, Cynthia L.; Rimland, David; Simberkoff, Michael S.; Justice, Amy C.

2011-01-01

Study Design Retrospective analysis of nationwide Veterans Health Administration (VA) clinical and administrative data. Objective Examine the association between HIV infection and the rate of spine surgery for degenerative spine disease. Summary of Background Data Combination anti-retroviral therapy (cART) has prolonged survival in patients with HIV/AIDS, increasing the prevalence of chronic conditions such as degenerative spine disease that may require spine surgery. Methods We studied all HIV infected patients under care in the VA from 1996–2008 (n=40,038) and uninfected comparator patients (n=79,039) matched on age, gender, race, year, and geographic region. The primary outcome was spine surgery for degenerative spine disease defined by ICD-9 procedure and diagnosis codes. We used a multivariate Poisson regression to model spine surgery rates by HIV infection status, adjusting for factors that might affect suitability for surgery (demographics, year, comorbidities, body mass index, cART, and laboratory values). Results Two-hundred twenty eight HIV infected and 784 uninfected patients underwent spine surgery for degenerative spine disease during 700,731 patient-years of follow-up (1.44 surgeries per 1,000 patient-years). The most common procedures were spinal decompression (50%), and decompression and fusion (33%); the most common surgical sites were the lumbosacral (50%), and cervical (40%) spine. Adjusted rates of surgery were lower for HIV infected patients (0.86 per 1,000 patient-years of follow-up) than for uninfected patients (1.41 per 1,000 patient-years; IRR 0.61, 95% CI: 0.51, 0.74, Pdegenerative spine disease. Possible explanations include disease prevalence, emphasis on treatment of non-spine HIV-related symptoms, surgical referral patterns, impact of HIV on surgery risk-benefit ratio, patient preferences, and surgeon bias. PMID:21697770

COXA-VERTEBRAL SYNDROME AND ITS SIGNIFICANCE IN HIP ARTHROPLASTY (REVIEW

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A. O. Denisov

2012-01-01

Full Text Available Lumbosacral spine and hip joints is a complex physiological functions of the co-operation of a large number of anatomical structures. Lesions of the links in the system can mutually afflict each other. Combined pathology of the hip and lumbosacral spine is called hip-spine syndrome, or coxa-vertebral syndrome. Symptoms of the joint and spine are very similar and only a careful examination and clinical examination may find the differences. As the disease progresses the hip increases the restriction of movement, there is a contracture of the limbs in a vicious position, which leads to an increase in tilt of the pelvis, increased lumbar lordosis and to functional shortening of limbs on the affected side. This gives rise to functional impairment, and then strain the joints of his spine and disease - osteochondrosis and scoliosis. After the successful operation of total hip replacement is often progressive clinical lesions of vertebral segment, which is manifested pain and is often offset by the results of arthroplasty as the restoration of movement in the hip joint, and the change in length limb after arthroplasty leads to rupture formed a functional stereotype change in the mobility of the lumbar spine, pelvis regression bias that causes the dynamic compression spinal nerve root. Depending on the duration of the existence, severity and nature of changes in the pelvic girdle is suitable correction of equipment replacement surgery, including, for example, in some cases, deliberate shortening or lengthening the preservation of the lower extremity, offset change, etc.

Research articles published by Korean spine surgeons: Scientific progress and the increase in spine surgery.

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Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun Jib; Kawaguchi, Yoshiharu

2017-02-01

There has been a marked increase in spine surgery in the 21st century, but there are no reports providing quantitative and qualitative analyses of research by Korean spine surgeons. The study goal was to assess the status of Korean spinal surgery and research. The number of spine surgeries was obtained from the Korean National Health Insurance Service. Research articles published by Korean spine surgeons were reviewed by using the Medline/PubMed online database. The number of spine surgeries in Korea increased markedly from 92,390 in 2004 to 164,291 in 2013. During the 2000-2014 period, 1982 articles were published by Korean spine surgeons. The annual number of articles increased from 20 articles in 2000 to 293 articles in 2014. There was a positive correlation between the annual spine surgery and article numbers (particles with Oxford levels of evidence 1, 2, and 3. The mean five-year impact factor (IF) for article quality was 1.79. There was no positive correlation between the annual IF and article numbers. Most articles (65.9%) were authored by neurosurgical spine surgeons. But spinal deformity-related topics were dominant among articles authored by orthopedics. The results show a clear quantitative increase in Korean spinal surgery and research over the last 15years. The lack of a correlation between annual IF and published article numbers indicate that Korean spine surgeons should endeavor to increase research value. Copyright © 2016 Elsevier Ltd. All rights reserved.

The two-body problem of a pseudo-rigid body and a rigid sphere

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Kristiansen, Kristian Uldall; Vereshchagin, M.; Gózdziewski, K.

2012-01-01

n this paper we consider the two-body problem of a spherical pseudo-rigid body and a rigid sphere. Due to the rotational and "re-labelling" symmetries, the system is shown to possess conservation of angular momentum and circulation. We follow a reduction procedure similar to that undertaken...... in the study of the two-body problem of a rigid body and a sphere so that the computed reduced non-canonical Hamiltonian takes a similar form. We then consider relative equilibria and show that the notions of locally central and planar equilibria coincide. Finally, we show that Riemann's theorem on pseudo......-rigid bodies has an extension to this system for planar relative equilibria....

A prospective study of spine fractures diagnosed by total spine computed tomography in high energy trauma patients

International Nuclear Information System (INIS)

Takami, Masanari; Nohda, Kazuhiro; Sakanaka, Junya; Nakamura, Masamichi; Yoshida, Munehito

2011-01-01

Since it is known to be impossible to identify spinal fractures in high-energy trauma patients the primary trauma evaluation, we have been performing total spine computed tomography (CT) in high-energy trauma cases. We investigated the spinal fractures that it was possible to detect by total spine CT in 179 cases and evaluated the usefulness of total spine CT prospectively. There were 54 (30.2%) spinal fractures among the 179 cases. Six (37.5%) of the 16 cervical spine fractures that were not detected on plain X-ray films were identified by total spine CT. Six (14.0%) of 43 thoracolumbar spine fractures were considered difficult to diagnose based on the clinical findings if total spine CT had not been performed. We therefore concluded that total spine CT is very useful and should be performed during the primary trauma evaluation in high-energy trauma cases. (author)

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

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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.

Motion in the unstable thoracolumbar spine when spine boarding a prone patient

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Conrad, Bryan P.; Marchese, Diana L.; Rechtine, Glenn R.; Horodyski, MaryBeth

2012-01-01

Introduction Previous research has found that the log roll (LR) technique produces significant motion in the spinal column while transferring a supine patient onto a spine board. The purpose of this project was to determine whether log rolling a patient with an unstable spine from prone to supine with a pulling motion provides better thoracolumbar immobilization compared to log rolling with a push technique. Methods A global instability was surgically created at the L1 level in five cadavers. Two spine-boarding protocols were tested (LR Push and LR Pull). Both techniques entailed performing a 180° LR rotation of the prone patient from the ground to the supine position on the spine board. An electromagnetic tracking device registered motion between the T12 and L2 vertebral segments. Six motion parameters were tracked. Repeated-measures statistical analysis was performed to evaluate angular and translational motion. Results Less motion was produced during the LR Push compared to the LR Pull for all six motion parameters. The difference was statistically significant for three of the six parameters (flexion–extension, axial translation, and anterior–posterior (A–P) translation). Conclusions Both the LR Push and LR Pull generated significant motion in the thoracolumbar spine during the prone to supine LR. The LR Push technique produced statistically less motion than the LR Pull, and should be considered when a prone patient with a suspected thoracolumbar injury needs to be transferred to a long spine board. More research is needed to identify techniques to further reduce the motion in the unstable spine during prone to supine LR. PMID:22330191

[Cervical spine trauma].

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Yilmaz, U; Hellen, P

2016-08-01

In the emergency department 65 % of spinal injuries and 2-5 % of blunt force injuries involve the cervical spine. Of these injuries approximately 50 % involve C5 and/or C6 and 30 % involve C2. Older patients tend to have higher spinal injuries and younger patients tend to have lower injuries. The anatomical and development-related characteristics of the pediatric spine as well as degenerative and comorbid pathological changes of the spine in the elderly can make the radiological evaluation of spinal injuries difficult with respect to possible trauma sequelae in young and old patients. Two different North American studies have investigated clinical criteria to rule out cervical spine injuries with sufficient certainty and without using imaging. Imaging of cervical trauma should be performed when injuries cannot be clinically excluded according to evidence-based criteria. Degenerative changes and anatomical differences have to be taken into account in the evaluation of imaging of elderly and pediatric patients.

βIII Spectrin Is Necessary for Formation of the Constricted Neck of Dendritic Spines and Regulation of Synaptic Activity in Neurons.

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Efimova, Nadia; Korobova, Farida; Stankewich, Michael C; Moberly, Andrew H; Stolz, Donna B; Wang, Junling; Kashina, Anna; Ma, Minghong; Svitkina, Tatyana

2017-07-05

Dendritic spines are postsynaptic structures in neurons often having a mushroom-like shape. Physiological significance and cytoskeletal mechanisms that maintain this shape are poorly understood. The spectrin-based membrane skeleton maintains the biconcave shape of erythrocytes, but whether spectrins also determine the shape of nonerythroid cells is less clear. We show that βIII spectrin in hippocampal and cortical neurons from rodent embryos of both sexes is distributed throughout the somatodendritic compartment but is particularly enriched in the neck and base of dendritic spines and largely absent from spine heads. Electron microscopy revealed that βIII spectrin forms a detergent-resistant cytoskeletal network at these sites. Knockdown of βIII spectrin results in a significant decrease in the density of dendritic spines. Surprisingly, the density of presynaptic terminals is not affected by βIII spectrin knockdown. However, instead of making normal spiny synapses, the presynaptic structures in βIII spectrin-depleted neurons make shaft synapses that exhibit increased amplitudes of miniature EPSCs indicative of excessive postsynaptic excitation. Thus, βIII spectrin is necessary for formation of the constricted shape of the spine neck, which in turn controls communication between the synapse and the parent dendrite to prevent excessive excitation. Notably, mutations of SPTNB2 encoding βIII spectrin are associated with neurodegenerative syndromes, spinocerebellar ataxia Type 5, and spectrin-associated autosomal recessive cerebellar ataxia Type 1, but molecular mechanisms linking βIII spectrin functions to neuronal pathologies remain unresolved. Our data suggest that spinocerebellar ataxia Type 5 and spectrin-associated autosomal recessive cerebellar ataxia Type 1 pathology likely arises from poorly controlled synaptic activity that leads to excitotoxicity and neurodegeneration. SIGNIFICANCE STATEMENT Dendritic spines are small protrusions from neuronal

Overload pain but root differentiation discomfort in the lumbar spine

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Joanna Siminska

2017-06-01

Full Text Available Lumbar pain syndromes of the spine can also be referred to as the pain of the cross. These ailments have now become epidemics of our time. In literature, these pain are referred to as localized ailments that are located in the lumbar, lumbosacral, and cross-iliac areas. Cross pains are a very general term because there are a multitude of factors that cause lumbar disc herniation. This problem poses great diagnostic difficulties. [4]. The nature of these ailments is often difficult to pinpoint by the patient, but it can be the pain that describes patients from blunt, piercing, biting, baking, to those that are termed cold feeling. Keep in mind that the location of the lumbar pain symptoms varies. Patients report pain that is located throughout the lumbar-sacral area or only on one side of the spine, or occurs only in the area of the hip joints. These complaints often radiate along the lower limb. They are often the result of a lack of proper spine prevention: they contribute to this poor body posture, improper sleep positioning, as well as lack of coping skills, as well as a bad diet. In daily life, it is important to remember to do your daily activities in the correct position as well as to use prevention to avoid pain in the lumbar area.

Regional interdependence and manual therapy directed at the thoracic spine.

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McDevitt, Amy; Young, Jodi; Mintken, Paul; Cleland, Josh

2015-07-01

Thoracic spine manipulation is commonly used by physical therapists for the management of patients with upper quarter pain syndromes. The theoretical construct for using thoracic manipulation for upper quarter conditions is a mainstay of a regional interdependence (RI) approach. The RI concept is likely much more complex and is perhaps driven by a neurophysiological response including those related to peripheral, spinal cord and supraspinal mechanisms. Recent evidence suggests that thoracic spine manipulation results in neurophysiological changes, which may lead to improved pain and outcomes in individuals with musculoskeletal disorders. The intent of this narrative review is to describe the research supporting the RI concept and its application to the treatment of individuals with neck and/or shoulder pain. Treatment utilizing both thrust and non-thrust thoracic manipulation has been shown to result in improvements in pain, range of motion and disability in patients with upper quarter conditions. Research has yet to determine optimal dosage, techniques or patient populations to which the RI approach should be applied; however, emerging evidence supporting a neurophysiological effect for thoracic spine manipulation may negate the need to fully answer this question. Certainly, there is a need for further research examining both the clinical efficacy and effectiveness of manual therapy interventions utilized in the RI model as well as the neurophysiological effects resulting from this intervention.

Clinical significance of gas myelography and CT gas myelography of the thoracic spine and the lumbar spine

International Nuclear Information System (INIS)

Yoshinaga, Haruhiko

1984-01-01

Basic and clinical applications relating to air myelography of the cervical spine have already been studied and extensively been used as an adjuvant diagnostic method for diseases of the spine and the spinal cord. However, hardly any application and clinical evaluation have been made concerning gas myelography of the thoracic spine and the lumbar spine. The author examined X-ray findings of 183 cases with diseases of the thoracic spine and the lumbar spine, including contral cases. Gas X-ray photography included simple profile, forehead tomography, sagittal plane, and CT section. Morphological characteristics of normal X-ray pictures of the throacic spine and the lumbar spine were explained from 54 control cases, and all the diameters of the subarachnoidal space from the anterior to the posterior part were measured. X-ray findings were examined on pathological cases, namely 22 cases with diseases of the throacic spine and 107 cases with diseases of the lumbar spine, and as a result these were useful for pathological elucidation of spinal cord tumors, spinal carries, yellow ligament ossification, lumbar spinal canal stenosis, hernia of intervertebral disc, etc. Also, CT gas myelography was excellent in stereoobservation of the spine and the spinal cord in spinal cord tumors, yellow ligament ossification, and spinal canal stenosis. On the other hand, it is not suitable for the diagnoses of intraspinal vascular abnormality, adhesive arachinitis, and running abnormality of the cauda equina nerve and radicle. Gas myelography of the thoracic spine and the lambar spine, is very useful in clinics when experienced techniques are used in photographic conditions, and diagnoses are made, well understanding the characteristics of gas pictures. Thus, its application has been opened to selection of an operative technique, determination of operative ranges, etc. (J.P.N.)

Clinical significance of gas myelography and CT gas myelography of the thoracic spine and the lumbar spine

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Yoshinaga, Haruhiko (Tokyo Medical Coll. (Japan))

1984-05-01

Basic and clinical applications relating to air myelography of the cervical spine have already been studied and extensively been used as an adjuvant diagnostic method for diseases of the spine and the spinal cord. However, hardly any application and clinical evaluation have been made concerning gas myelography of the thoracic spine and the lumbar spine. The author examined X-ray findings of 183 cases with diseases of the thoracic spine and the lumbar spine, including contral cases. Gas X-ray photography included simple profile, forehead tomography, sagittal plane, and CT section. Morphological characteristics of normal X-ray pictures of the throacic spine and the lumbar spine were explained from 54 control cases, and all the diameters of the subarachnoidal space from the anterior to the posterior part were measured. X-ray findings were examined on pathological cases, namely 22 cases with diseases of the throacic spine and 107 cases with diseases of the lumbar spine, and as a result these were useful for pathological elucidation of spinal cord tumors, spinal carries, yellow ligament ossification, lumbar spinal canal stenosis, hernia of intervertebral disc, etc. Also, CT gas myelography was excellent in stereo observation of the spine and the spinal cord in spinal cord tumors, yellow ligament ossification, and spinal canal stenosis. On the other hand, it is not suitable for the diagnoses of intraspinal vascular abnormality, adhesive arachinitis, and running abnormality of the cauda equina nerve and radicle. Gas myelography of the thoracic spine and the lambar spine, is very useful in clinics when experienced techniques are used in photographic conditions, and diagnoses are made, well understanding the characteristics of gas pictures. Thus, its application has been opened to selection of an operative technique, determination of operative ranges, etc.

Rigid Body Sampling and Individual Time Stepping for Rigid-Fluid Coupling of Fluid Simulation

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Xiaokun Wang

2017-01-01

Full Text Available In this paper, we propose an efficient and simple rigid-fluid coupling scheme with scientific programming algorithms for particle-based fluid simulation and three-dimensional visualization. Our approach samples the surface of rigid bodies with boundary particles that interact with fluids. It contains two procedures, that is, surface sampling and sampling relaxation, which insures uniform distribution of particles with less iterations. Furthermore, we present a rigid-fluid coupling scheme integrating individual time stepping to rigid-fluid coupling, which gains an obvious speedup compared to previous method. The experimental results demonstrate the effectiveness of our approach.

Rigidly foldable origami gadgets and tessellations

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Evans, Thomas A.; Lang, Robert J.; Magleby, Spencer P.; Howell, Larry L.

2015-01-01

Rigidly foldable origami allows for motion where all deflection occurs at the crease lines and facilitates the application of origami in materials other than paper. In this paper, we use a recently discovered method for determining rigid foldability to identify existing flat-foldable rigidly foldable tessellations, which are also categorized. We introduce rigidly foldable origami gadgets which may be used to modify existing tessellations or to create new tessellations. Several modified and new rigidly foldable tessellations are presented. PMID:26473037

Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury

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Nobuhiro Tanaka

2018-01-01

Full Text Available Traumatic cervical syndrome comprises the various symptoms that occur as a result of external force such as that of a traffic accident. In 1995, the Quebec Task Force on whiplash-associated disorders (WAD formulated the Quebec classification, with accompanying clinical practice guidelines. These guidelines were in accordance with the stated clinical isolated or combined symptoms of the syndrome: neck pain, headaches, dizziness, numbness of head or face, eye pain, vision loss, double vision, tinnitus, hearing loss, nausea, and numbness and/or weakness of extremities. In recent years, cerebrospinal fluid hypovolemia or fibromyalgia has been recognized as a major notable cause of a variety of symptoms, although many clinical questions remain regarding the pathology of this syndrome. Therefore, its diagnosis and treatment should be conducted extremely carefully. While the Quebec classification and its guidelines are very useful for the normalization and standardization of symptoms of traumatic cervical syndrome, in the future, we would like to see the emergence of new guidelines that better address the diversity of this disease.

Rigid Occipitocervical Instrumented Fusion for Atlantoaxial Instability in an 18-Month-Old Toddler With Brachytelephalangic Chondrodysplasia Punctata: A Case Report.

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Oba, Hiroki; Takahashi, Jun; Takano, Kyoko; Inaba, Yuji; Motobayashi, Mitsuo; Nishimura, Gen; Kuraishi, Shugo; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Uehara, Masashi; Kosho, Tomoki; Kato, Hiroyuki; Uno, Koki

2017-12-01

Case report. We report here on an 18-month-old boy with brachytelephalangic chondrodysplasia punctata (BCDP), whose atlantoaxial instability was successfully managed with occipitocervical instrumented fusion (OCF) using screw and rod instrumentations. Recently, there have been a number of reports on BCDP with early onset of cervical myelopathy. Surgical OCF is a vital intervention to salvage affected individuals from the life-threatening morbidity. Despite recent advancement of instrumentation techniques, however, rigid OCF is technically demanding in very young children with small and fragile osseous elements. To our best knowledge, this is the first report on application of the instrumentation technique to a toddler patient with BCDP. A 16-month-old boy with BCDP presented with tetraplegia and swallow obstacle. Hypoplasia of the odontoid process and atlantoaxial instability were present in lateral radiographs. T2-weighted magnetic resonance (MR) images revealed a high signal region in the spinal cord at the C1-2 and C7-T1 levels. Cervical computed tomography (CT) showed that the pedicles and lateral masses in the cervical spine were small and immature, but the laminae were comparatively thick. One week before surgery, the patient was fitted with a Halo-body jacket. We performed plate-rod placement with occipital cortical screws and C2/C3 interlaminar screws, and added an autogenous bone graft using the right 8 and 9 ribs. Rigid fixation of the occipito-cervical spine was completed successfully without major complications. Postoperative halo-body jacket immobilization was continued for 3 months, after which Aspen collar was fitted. CT confirmed occipitocervical bone fusion at 6 months after surgery. Mild clinical improvements in motor power of the affected muscles and swallowing were witnessed at 1 year postoperatively. Rigid fixation using screw, rod, and occipital plate instrumentation was successful in an 18-month-old toddler with BCDP and atlantoaxial

Urofacial syndrome: A subset of neurogenic bladder dysfunction syndromes?

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K N Stamatiou

2010-01-01

Full Text Available The urofacial syndrome is probably a subset of neurogenic bladder dysfunction syndromes characterized by detrusor-sphincter discoordination along with a characteristic inversion of facial expression with laughing. This characteristic facial expression can facilitate early detection of this disorder, which leads to poor bladder emptying with high residual urine, hydro-nephrosis with vesico-ureteral reflux and potentially renal failure if left untreated. The etiology of the urofacial syndrome is unknown. In our case, a 12-year-old boy of Middle-Eastern origin presented to the Outpatient Department of our hospital with left pyelonephritis, hydronephrosis and bladder dilatation. Voiding cystourethrography performed 15 days later revealed left vesicoureteral reflux. Cystoscopy revealed bladder trabeculation however an anatomic urethral obstruction was not noticed. Both, neurological examination and radiography of the lumbosacral spine were normal. Urodynamic evaluation revealed the typical findings of detrusor-sphincter discoordination.

Outlines and Outcomes of Instrumented Posterior Fusion in the Pediatric Cervical Spine: A Review Article

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Kaveh Haddadi

2016-01-01

Full Text Available Context The most common source of cervical spine arthrodesis in the pediatric populace is the instability related to congenital or traumatic damage. Surgery of cervical spine can be challenging given slighter anatomical constructions, fewer hardened bone, and upcoming growth potential and growth. Evidence Acquisition Trainings in adult patients recommended that consuming screw constructs results in enhanced consequences with inferior amounts of instrumentation catastrophe. But, the pediatric literature is inadequate for minor retrospective series. Authors reviewed the existing pediatric cervical spine arthrodesis literature. They studied 184 abstracts from January 1976 to December 2014. An entire of 883 patients in 82 articles were involved in the evaluation. Patients were characterized as taking either posterior cervical fusion with wiring or posterior cervical fusion with screws or occipitocervical fusion. Results The etiologies faced most frequently were inherited abnormalities (54% shadowed by trauma (28%, Down syndrome (8%, and infectious, oncological, iatrogenic, or mixed causes (10%. The mean duration of follow-up was 32.5 months. Conclusions The consequences of this training are restricted by deviations in construct policy, usage of orthoses, follow-up period and fresher adjuvant produces stimulating fusions. But, a literature review recommend that instrumentation of the cervical spine in children may be harmless and more effective than using screw concepts rather than wiring methods.

Dendritic Spine Instability in a Mouse Model of CDKL5 Disorder Is Rescued by Insulin-like Growth Factor 1.

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Della Sala, Grazia; Putignano, Elena; Chelini, Gabriele; Melani, Riccardo; Calcagno, Eleonora; Michele Ratto, Gian; Amendola, Elena; Gross, Cornelius T; Giustetto, Maurizio; Pizzorusso, Tommaso

2016-08-15

CDKL5 (cyclin-dependent kinase-like 5) is mutated in many severe neurodevelopmental disorders, including atypical Rett syndrome. CDKL5 was shown to interact with synaptic proteins, but an in vivo analysis of the role of CDKL5 in dendritic spine dynamics and synaptic molecular organization is still lacking. In vivo two-photon microscopy of the somatosensory cortex of Cdkl5(-/y) mice was applied to monitor structural dynamics of dendritic spines. Synaptic function and plasticity were measured using electrophysiological recordings of excitatory postsynaptic currents and long-term potentiation in brain slices and assessing the expression of synaptic postsynaptic density protein 95 (PSD-95). Finally, we studied the impact of insulin-like growth factor 1 (IGF-1) treatment on CDKL5 null mice to restore the synaptic deficits. Adult mutant mice showed a significant reduction in spine density and PSD-95-positive synaptic puncta, a reduction of persistent spines, and impaired long-term potentiation. In juvenile mutants, short-term spine elimination, but not formation, was dramatically increased. Exogenous administration of IGF-1 rescued defective rpS6 phosphorylation, spine density, and PSD-95 expression. Endogenous cortical IGF-1 levels were unaffected by CDKL5 deletion. These data demonstrate that dendritic spine stabilization is strongly regulated by CDKL5. Moreover, our data suggest that IGF-1 treatment could be a promising candidate for clinical trials in CDKL5 patients. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Transfer vibration through spine

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Benyovszky, Adam

2012-01-01

Transfer Vibration through Spine Abstract In the bachelor project we deal with the topic of Transfer Vibration through Spine. The problem of TVS is trying to be solved by the critical review method. We analyse some diagnostic methods and methods of treatment based on this principle. Close attention is paid to the method of Transfer Vibration through Spine that is being currently solved by The Research Institute of Thermomechanics in The Czech Academy of Sciences in cooperation with Faculty of...

Micromechanics of Sea Urchin spines.

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Naomi Tsafnat

Full Text Available The endoskeletal structure of the Sea Urchin, Centrostephanus rodgersii, has numerous long spines whose known functions include locomotion, sensing, and protection against predators. These spines have a remarkable internal microstructure and are made of single-crystal calcite. A finite-element model of the spine's unique porous structure, based on micro-computed tomography (microCT and incorporating anisotropic material properties, was developed to study its response to mechanical loading. Simulations show that high stress concentrations occur at certain points in the spine's architecture; brittle cracking would likely initiate in these regions. These analyses demonstrate that the organization of single-crystal calcite in the unique, intricate morphology of the sea urchin spine results in a strong, stiff and lightweight structure that enhances its strength despite the brittleness of its constituent material.

Prevalence and causes of back pain syndromes in children

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A.A. Smirnova

2014-01-01

Full Text Available We present a review of literature devoted to epidemiology, and the nosological and syndromal structure of back pain in children. The data of our own study of school-aged children with back pain are presented. The structure of back pain syndromes in 105 children has been analyzed using the medical aid appealability data. The results of a comprehensive clinical and instrumental study demonstrated that the children mostly had lumbosacral pain (52.4% of cases; neck pain was observed in 29.5% of cases; while thoracic pain syndromes were observed in 18.1% of cases. Congenital defect of the connective tissue was diagnosed in 16.19% of children; congenital abnormalities of the spine, in 15.2%; scoliosis (idiopathic and secondary, in 8.6%; and Scheuermann-Mau's disease, in 5.71%. The conclusion has been made about the high prevalence of back pain in schoolchildren. Muscular tonic syndromes were prevailing in the clinical structure in children; radicular syndromes were less frequent. Musculoskeletal disorders were the main causes of back pain. Congenital defect of the connective tissue was often observed, which was revealed as functional instability of the vertebral motor segment, spondylolisthesis due to weak ligaments, and disc protrusions. Congenital abnormalities of the spine, scoliosis, and Scheuermann-Mau' disease were observed less often. 

Anesthetic management of a child with Down’s Syndrome having atlanto axial instability

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Basant Bhattarai

2009-01-01

Full Text Available Down's syndrome is the most commonly encountered congenital anomaly in medical practice. These patients are of special concern to medical practice because of their associated problems with regard to respiratory, cardiovascular and other systemic problems. As these patients present for repeated surgeries like dental extraction, facial reconstruction and fixation of cervical spine, these patients pose challenges to the anesthesiologist because of their unique set of problems, namely atlantoaxial instability, small trachea, congenital heart disease and repeated chest infections due to lowered immunity. Their reactivity to inhalational anesthetics and atropine is variable. Here we present an interesting case report of a child with Down's syndrome who presented with atlantoaxial instability for MRI of cervical spine under general anesthesia. KeyWords:atlanto axial instability, down’s syndrome, trisomy 21

Tuberculosis of the cervical spine

African Journals Online (AJOL)

Tuberculosis of the cervical spine is rare, comprising 3 -. 5% of cases of tuberculosis of the spine. Eight patients with tuberculosis of the cervicaJ spine seen during 1989 -. 1992 were reviewed. They all presented with neck pain. The 4 children presented with a kyphotic deformity. In all the children the disease was extensive, ...

NON NEUROLOGICAL OUTCOME COMPARISON OF EARLY AND DELAYED SURGICAL STABILIZATION IN C-SPINE FRACTURES

Directory of Open Access Journals (Sweden)

T. G. B. Mahadewa

2014-01-01

Full Text Available Background: Non neurological outcome postsurgical stabilization in C-spine injury has not been reported. Non neurological outcome i.e. the risk of lung infection (pneumonia, systemic inflammation response syndrome (SIRS, length of postoperative care (LOPOC which can compromise the recovery process and treatment period. This study aims to investigate non neurological outcome comparison after early surgical stabilization (ESS and delayed surgical stabilization (DSS in patients with C-spine fractures. Methods: The author retrospectively reviews 59 of 108 consecutive patients who met the inclusion criteria with C-spine fractures who underwent surgical stabilization at the Sanglah General Hospital, between 2007 and 2010. Consisting of 25 patients underwent ESS and 34 patients were treated by DSS. The last follow up period range was 3-36 months. Non neurological outcome were evaluated and compared; the risk of pneumonia, SIRS and LOPOC. Results: Significant statistically between ESS and DSS in; the risk of pneumonia (ESS: DSS= 1:9 by Chi-square-test (p=0.023; the risk of SIRS (ESS: DSS= 1:11 by Chi-square-test (p=0.008; and the LOPOC (ESS: DSS= 6.84:9.97 by independent t-test (p=0.000. Application of ESS for C-spine fractures could provide early mobilization, prompt treatment and facilitate early rehabilitation thus significantly reduces complications due to prolong immobilization and reduces LOPOC. Conclussion: It can be concluded that the ESS strategy is effective and efficient thus may propose an option of surgical timing in C-spine fractures.

Tile-based rigidization surface parametric design study

Science.gov (United States)

Giner Munoz, Laura; Luntz, Jonathan; Brei, Diann; Kim, Wonhee

2018-03-01

Inflatable technologies have proven useful in consumer goods as well as in more recent applications including civil structures, aerospace, medical, and robotics. However, inflatable technologies are typically lacking in their ability to provide rigid structural support. Particle jamming improves upon this by providing structures which are normally flexible and moldable but become rigid when air is removed. Because these are based on an airtight bladder filled with loose particles, they always occupy the full volume of its rigid state, even when not rigidized. More recent developments in layer jamming have created thin, compact rigidizing surfaces replacing the loose volume of particles with thinly layered surface materials. Work in this area has been applied to several specific applications with positive results but have not generally provided the broader understanding of the rigidization performance as a function of design parameters required for directly adapting layer rigidization technology to other applications. This paper presents a parametric design study of a new layer jamming vacuum rigidization architecture: tile-based vacuum rigidization. This form of rigidization is based on layers of tiles contained within a thin vacuum bladder which can be bent, rolled, or otherwise compactly stowed, but when deployed flat, can be vacuumed and form a large, flat, rigid plate capable of supporting large forces both localized and distributed over the surface. The general architecture and operation detailing rigidization and compliance mechanisms is introduced. To quantitatively characterize the rigidization behavior, prototypes rigidization surfaces are fabricated and an experimental technique is developed based on a 3-point bending test. Performance evaluation metrics are developed to describe the stiffness, load-bearing capacity, and internal slippage of tested prototypes. A set of experimental parametric studies are performed to better understand the impact of

Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck

International Nuclear Information System (INIS)

Juhng, Seon Kwan; Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon

2001-01-01

To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm 2 in the femoral neck, while for controls the corresponding figures were 0.989g/cm 2 and 0.765g/cm 2 . Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures

The usefulness of bone scintigraphy in SAPHO syndrome

Energy Technology Data Exchange (ETDEWEB)

Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

2002-08-01

SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

Behavioural syndromes differ predictably between 12 populations of three-spined stickleback

NARCIS (Netherlands)

Dingemanse, Niels J.; Wright, Jonathan; Kazem, Anahita J. N.; Thomas, Dawn K.; Hickling, Rachael; Dawnay, Nick

2007-01-01

1. Animals often differ in suites of correlated behaviours, comparable with how humans differ in personality. Constraints on the architecture of behaviour have been invoked to explain why such 'behavioural syndromes' exist. From an adaptationist viewpoint, however, behavioural syndromes should

Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies.

Science.gov (United States)

Arana, Estanislao; Martí-Bonmatí, Luis; Dosdá, Rosa; Mollá, Enrique

2002-11-01

Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson chi(2) test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease ( p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms.

Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies

International Nuclear Information System (INIS)

Arana, Estanislao; Marti-Bonmati, Luis; Dosda, Rosa; Molla, Enrique

2002-01-01

Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson χ 2 test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease (p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms. (orig.)

[A case of Isaacs' syndrome associated with dextrocardia].

Science.gov (United States)

Torres, L; Cosentino, C; Vélez, M; Anicama, A

Isaacs syndrome is a disorder of unknown etiology characterized by muscular rigidity, cramps and myokymias. Described by Isaacs in 1961 and called by him as continuous muscular activity syndrome. There are few reports in Latino american countries. A 31 year-old man with sustained muscular contractions in lower limbs and diffuse myokymias since he was eighteen-year old. Dextrocardia was disclosed on clinical examination. We report the case of a patient with Isaacs syndrome and dextrocardia.

Airway obstruction due to tracheomalacia caused by innominate artery compression and a kyphotic cervical spine.

Science.gov (United States)

Liu, Chia-Hsin; Huang, Wen-Sheng; Wang, Hong-Hau; Wu, Chin-Pyng; Chian, Chih-Feng; Perng, Wann-Cherng; Tsai, Chen-Liang

2015-02-01

Tracheomalacia can cause variable degrees of intrathoracic airway obstruction and is an easily overlooked cause of respiratory distress in adults. Here, we report a case of acute respiratory failure in which subglottic stenosis was accidentally identified during endotracheal intubation. Subsequent bronchoscopy and computed tomography of the thorax and neck revealed tracheal compression with tracheomalacia caused by a tortuous innominate artery and a kyphotic cervical spine. The patient underwent rigid bronchoscopy with metal stent implantation, and her symptoms were alleviated. These findings outline the importance of precise diagnosis and interventions for preventing recurrent life-threatening respiratory failure in such cases. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Cauda equina syndrome in patients undergoing manipulation of the lumbar spine

NARCIS (Netherlands)

Haldeman, S.; Rubinstein, S M

1992-01-01

Cauda equina syndrome has been implicated as a potential complication of spinal manipulation. A review of the literature from 1911 to 1989 revealed ten reported cases of cauda equina syndrome in patients undergoing manipulation without anesthesia. This article presents three new cases where a

Traumatic thoracolumbar spine fractures

NARCIS (Netherlands)

J. Siebenga (Jan)

2013-01-01

textabstractTraumatic spinal fractures have the lowest functional outcomes and the lowest rates of return to work after injury of all major organ systems.1 This thesis will cover traumatic thoracolumbar spine fractures and not osteoporotic spine fractures because of the difference in fracture

Rigidity and symmetry

CERN Document Server

Weiss, Asia; Whiteley, Walter

2014-01-01

This book contains recent contributions to the fields of rigidity and symmetry with two primary focuses: to present the mathematically rigorous treatment of rigidity of structures, and to explore the interaction of geometry, algebra, and combinatorics. Overall, the book shows how researchers from diverse backgrounds explore connections among the various discrete structures with symmetry as the unifying theme.  Contributions present recent trends and advances in discrete geometry, particularly in the theory of polytopes. The rapid development of abstract polytope theory has resulted in a rich theory featuring an attractive interplay of methods and tools from discrete geometry, group theory, classical geometry, hyperbolic geometry and topology.  The volume will also be a valuable source as an introduction to the ideas of both combinatorial and geometric rigidity theory and its applications, incorporating the surprising impact of symmetry. It will appeal to students at both the advanced undergraduate and gradu...

Spondylocarpotarsal synostosis syndrome (with a posterior midline unsegmented bar)

Energy Technology Data Exchange (ETDEWEB)

Kaissi, A Al; Ghachem, M Ben; Nassib, N; Chehida, F Ben [Hospital d' Enfants, Service d' orthopedie infantile, Tunis (Tunisia); Kozlowski, K [Department of Medical Imaging, Sydney (Australia)

2005-06-01

Spondylocarpotarsal synostosis syndrome (SSS) is characterised by malsegmentation of the thoracic spine and carpal/tarsal fusions. A unilateral or bilateral unsegmented bar may be present in the thoracic spine. Presenting clinical signs are congenital scoliosis early in life, and shortening of the trunk with scoliosis and/or lordosis in older children. We report a 13-year-old girl with SSS and a midline unsegmented bar running along the spinal processes of T3 to L2 and extending into the posterior vertebral elements. (orig.)

Spondylocarpotarsal synostosis syndrome (with a posterior midline unsegmented bar)

International Nuclear Information System (INIS)

Kaissi, A. Al; Ghachem, M. Ben; Nassib, N.; Chehida, F. Ben; Kozlowski, K.

2005-01-01

Spondylocarpotarsal synostosis syndrome (SSS) is characterised by malsegmentation of the thoracic spine and carpal/tarsal fusions. A unilateral or bilateral unsegmented bar may be present in the thoracic spine. Presenting clinical signs are congenital scoliosis early in life, and shortening of the trunk with scoliosis and/or lordosis in older children. We report a 13-year-old girl with SSS and a midline unsegmented bar running along the spinal processes of T3 to L2 and extending into the posterior vertebral elements. (orig.)

Aquatic antagonists: cutaneous sea urchin spine injury.

Science.gov (United States)

Hsieh, Clifford; Aronson, Erica R; Ruiz de Luzuriaga, Arlene M

2016-11-01

Injuries from sea urchin spines are commonly seen in coastal regions with high levels of participation in water activities. Although these injuries may seem minor, the consequences vary based on the location of the injury. Sea urchin spine injuries may cause arthritis and synovitis from spines in the joints. Nonjoint injuries have been reported, and dermatologic aspects of sea urchin spine injuries rarely have been discussed. We present a case of a patient with sea urchin spines embedded in the thigh who subsequently developed painful skin nodules. Tissue from the site of the injury demonstrated foreign-body type granulomas. Following the removal of the spines and granulomatous tissue, the patient experienced resolution of the nodules and associated pain. Extraction of sea urchin spines can attenuate the pain and decrease the likelihood of granuloma formation, infection, and long-term sequelae.

Progressive Encephalomyelitis with Rigidity and Myoclonus Associated With Anti-GlyR Antibodies and Hodgkin’s Lymphoma: A Case Report

Directory of Open Access Journals (Sweden)

Linda Borellini

2017-08-01

Full Text Available IntroductionA 60-year-old man presented with a 6-month history of low back pain and progressive rigidity of the trunk and lower limbs, followed by pruritus, dysphonia, hyperhydrosis, and urinary retention. Brain and spinal imaging were normal. EMG showed involuntary motor unit hyperactivity. Onconeural, antiglutamic acid decarboxylase (anti-GAD, voltage-gated potassium channel, and dipeptidyl peptidase-like protein 6 (DPPX autoantibodies were negative. CSF was negative. Symptoms were partially responsive to baclofen, gabapentin, and clonazepam, but he eventually developed severe dysphagia. Antiglycine receptor (anti-GlyR antibodies turned out positive on both serum and CSF. A plasmapheresis cycle was completed with good clinical response. A PET scan highlighted an isolated metabolically active axillary lymphnode that turned out to be a classic type Hodgkin lymphoma (HL, in the absence of bone marrow infiltration nor B symptoms. Polychemotherapy with ABVD protocol was completed with good clinical response and at 1-year follow-up the neurological examination is normal.BackgroundProgressive encephalomyelitis with rigidity and myoclonus (PERM is a rare and severe neurological syndrome characterized by muscular rigidity and spasms as well as brain stem and autonomic dysfunction. It can be associated with anti-GAD, GlyR, and DPPX antibodies. All of these autoantibodies may be variably associated with malignant tumors and their response to immunotherapy, as well as to tumor removal, is not easily predictable.ConclusionProgressive encephalomyelitis with rigidity and myoclonus has already been described in association with HL, but this is the first case report of a HL manifesting as anti-GlyR antibodies related PERM. Our report highlights the importance of malignancy screening in autoimmune syndromes of suspected paraneoplastic origin.

Sport injuries of the cervical spine

International Nuclear Information System (INIS)

Bargon, G.

1981-01-01

The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion. (orig.) [de

Sport injuries of the cervical spine

Energy Technology Data Exchange (ETDEWEB)

Bargon, G

1981-03-01

The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion.

Birationally rigid varieties

CERN Document Server

Pukhlikov, Aleksandr

2013-01-01

Birational rigidity is a striking and mysterious phenomenon in higher-dimensional algebraic geometry. It turns out that certain natural families of algebraic varieties (for example, three-dimensional quartics) belong to the same classification type as the projective space but have radically different birational geometric properties. In particular, they admit no non-trivial birational self-maps and cannot be fibred into rational varieties by a rational map. The origins of the theory of birational rigidity are in the work of Max Noether and Fano; however, it was only in 1970 that Iskovskikh and Manin proved birational superrigidity of quartic three-folds. This book gives a systematic exposition of, and a comprehensive introduction to, the theory of birational rigidity, presenting in a uniform way, ideas, techniques, and results that so far could only be found in journal papers. The recent rapid progress in birational geometry and the widening interaction with the neighboring areas generate the growing interest ...

Beyond the spine

DEFF Research Database (Denmark)

Donovan, James; Cassidy, J David; Cancelliere, Carol

2015-01-01

Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from...... highlight recent research in these new areas and discuss how clinical research efforts in musculoskeletal areas beyond the spine can benefit patient care and the future of the chiropractic profession....

Subjective assessment of kinesitherapy as an element of comprehensive rehabilitation process of subjects with lower spine pain

Directory of Open Access Journals (Sweden)

Wioletta Łubkowska

2016-02-01

  Abstract Background. Spinal pain has triggered interest in many fields of medicine, such as orthopedics, neurology, rheumatology, and rehabilitation. Despite ongoing development of surgery techniques, a major role is played by fitness improvement treatments, which need to be promoted. The aim of the research was a subjective assessment of kinesitherapy as an element of comprehensive rehabilitation process of subjects with lower spine pain. Material/Methods. This paper has an empirical character. The research was conducted amongst a randomly selected group of 60 patients of Independent Public Health Care Unit in Choszczno, Poland (rehabilitation at an outpatients’ clinic, aged 20-51. All of them were subjected to a series of 10 kinesitherapy treatments. The research used diagnostic polling method and the following techniques: survey and implicit interview. Results. The research proved that after completion of 10 treatments, the subjects noticed a significant improvement of their health. Kinesitherapy helped return to an active professional life for those who were forced to resign or suspend their work. Subjects reported that 10 kinesitherapy treatments were enough to notice their effectiveness in lumbar spine pain reduction. Kinesitherapy treatments resulted in a reduced usage of painkillers. Conclusions. There is evidence of positive impact of physical exercise on treatment results and beneficial effects in patients with spinal pain. Proper education aimed at changing bad habits and advising how to care for spine may be a powerful way to fight for health.   Keywords: spine, pain syndromes, lumbar spine, kinesitherapy, curative exercises, improving fitness.

Robotic systems in spine surgery.

Science.gov (United States)

Onen, Mehmet Resid; Naderi, Sait

2014-01-01

Surgical robotic systems have been available for almost twenty years. The first surgical robotic systems were designed as supportive systems for laparoscopic approaches in general surgery (the first procedure was a cholecystectomy in 1987). The da Vinci Robotic System is the most common system used for robotic surgery today. This system is widely used in urology, gynecology and other surgical disciplines, and recently there have been initial reports of its use in spine surgery, for transoral access and anterior approaches for lumbar inter-body fusion interventions. SpineAssist, which is widely used in spine surgery, and Renaissance Robotic Systems, which are considered the next generation of robotic systems, are now FDA approved. These robotic systems are designed for use as guidance systems in spine instrumentation, cement augmentations and biopsies. The aim is to increase surgical accuracy while reducing the intra-operative exposure to harmful radiation to the patient and operating team personnel during the intervention. We offer a review of the published literature related to the use of robotic systems in spine surgery and provide information on using robotic systems.

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.

Arteriohepatic Dysplasia (Alagille Syndrome in a Child (Clinical Case

Directory of Open Access Journals (Sweden)

Ye.V. Omelchenko

2015-03-01

Full Text Available The article presents a clinical case of a child with a rare nosology — Alagille syndrome. Among the causes of neonatal cholestasis, Alagille syndrome is ranked second, it occurs with an incidence of 1 per 70,000 of newborns. This syndrome is characterized by an insufficient number or by a small dia­meter of intrahepatic bile ducts, which carry bile from the liver. Alagille syndrome includes a combination of at least three of the five main symptoms: chronic cholestasis, cardiovascular defects, abnormalities of the spine, eye defects, typical craniofacial signs. The only definitive therapy with the formation of liver cirrhosis and without gross defects is liver transplantation.

Elective cesarean delivery in a parturient with Klippel-Feil syndrome.

Science.gov (United States)

Kavanagh, T; Jee, R; Kilpatrick, N; Douglas, J

2013-11-01

Klippel-Feil syndrome is defined by congenital fusion of two or more cervical vertebrae and can be associated with abnormalities in multiple systems. Management poses challenges to the anesthesiologist, particularly in pregnancy. Cervical spine immobility and instability can make the management of the airway fraught with danger and vertebral column distortion may make neuraxial anesthesia unreliable. We present the management of a nulliparous patient with features consistent with Type I Klippel-Feil syndrome undergoing elective cesarean delivery. The patient had a potentially difficult airway and features consistent with an unstable cervical spine and severe thoracic and lumbar scoliosis. A combined spinal-epidural technique was used which initially provided satisfactory anesthesia, but ultimately proved inadequate despite use of the epidural component. Satisfactory anesthesia for surgery was eventually achieved with the addition of an intravenous remifentanil infusion. We review previous case reports discussing anesthetic management of parturients with Klippel-Feil syndrome, and describe the challenges encountered and lessons learned from management of this case. Copyright © 2013 Elsevier Ltd. All rights reserved.

Polymyositis-like syndrome caused by hypothyroidism, presenting as camptocormia.

Science.gov (United States)

Kim, Ji Min; Song, Eun Joo; Seo, Jae Seok; Nam, Eon Jeong; Kang, Young Mo

2009-01-01

Polymyositis-like syndrome characterized by proximal muscle weakness and elevation of muscle enzymes may be a presenting manifestation of hypothyroidism. Camptocormia, which can be caused by myopathy of the paraspinal muscles, is an involuntary truncal flexion of the thoracolumbar spine while standing or walking. Among various neuromuscular disorders, hypothyroidism has not been reported in the literature as a cause of camptocormia. This is the first report of polymyositis-like syndrome with camptocormia caused by hypothyroidism.

Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis

Directory of Open Access Journals (Sweden)

Yesupalan Rajam

2008-06-01

Full Text Available Abstract Background A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries. Methods This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed. Results 28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4% would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied. Conclusion Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.

Benign joint hypermobility syndrome

Directory of Open Access Journals (Sweden)

Iwona Słowińska

2014-11-01

Full Text Available Benign joint hypermobility syndrome (BJHS, commonly known as loose ligament syndrome, is a non-inflammatory rheumatic condition. It is characterised by a greater than normal range of motion of the joints of the limbs and spine. The prevalence of the syndrome in preschool-age children is estimated to be between 2% and 30%, depending on ethnic background (with higher prevalence in Asian and African populations, occurring most often in families with a history of the condition and more frequently in girls. This paper presents a case report of a 12-year-old girl. A broad differential diagnostic approach to recurrent joint inflammation with joint effusion and pain made it possible to establish a diagnosis of benign joint hypermobility syndrome. The child met the Brighton criteria; her Beighton score was 7 out of 9. Patient education aimed at eliminating abnormal joint movement and an appropriate rehabilitation programme play key roles in the treatment of BJHS.

Rigidity of Glasses and Macromolecules

Science.gov (United States)

Thorpe, M. F.

1998-03-01

The simple yet powerful ideas of percolation theory have found their way into many different areas of research. In this talk we show how RIGIDITY PERCOLATION can be studied at a similar level of sophistication, using a powerful new program THE PEBBLE GAME (D. J. Jacobs and M. F. Thorpe, Phys. Rev. E) 53, 3682 (1996). that uses an integer algorithm. This program can analyse the rigidity of two and three dimensional networks containing more than one million bars and joints. We find the total number of floppy modes, and find the critical behavior as the network goes from floppy to rigid as more bars are added. We discuss the relevance of this work to network glasses, and how it relates to experiments that involve the mechanical properties like hardness and elasticity of covalent glassy networks like Ge_xAs_ySe_1-x-y and dicuss recent experiments that suggest that the rigidity transition may be first order (Xingwei Feng, W. J.Bresser and P. Boolchand, Phys. Rev. Lett 78), 4422 (1997).. This approach is also useful in macromolecules and proteins, where detailed information about the rigid domain structure can be obtained.

The FAt Spondyloarthritis Spine Score (FASSS)

DEFF Research Database (Denmark)

Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw

2013-01-01

an important measure of treatment efficacy as well as a surrogate marker for new bone formation. The aim of this study was to develop and validate a new scoring method for fat lesions in the spine, the Fat SpA Spine Score (FASSS), which in contrast to the existing scoring method addresses the localization......Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...

Fatal outcome after insufficient spine fixation for pyogenic thoracic spondylodiscitis: an imperative for 360° fusion of the infected spine

Directory of Open Access Journals (Sweden)

Moore Ernest E

2009-02-01

Full Text Available Abstract Background Pyogenic spondylodiscitis represents a potentially life-threatening condition. Due to the low incidence, evidence-based surgical recommendations in the literature are equivocal, and the treatment modalities remain controversial. Case presentation A 59 year-old patient presented with a history of thoracic spondylodiscitis resistant to antibiotic treatment for 6 weeks, progressive severe back pain, and a new onset of bilateral lower extremity weakness. Clinically, the patient showed a deteriorating spastic paraparesis of her lower extremities. An emergent MRI revealed a kyphotic wedge compression fracture at T7/T8 with significant spinal cord compression, paravertebral and epidural abscess, and signs of myelopathy. The patient underwent surgical debridement with stabilization of the anterior column from T6–T9 using an expandable titanium cage, autologous bone graft, and an anterolateral locking plate. The patient recovered well under adjunctive antibiotic treatment. She presented again to the emergency department 6 months later, secondary to a repeat fall, with acute paraplegia of the lower extremities and radiographic evidence of failure of fixation of the anterior T-spine. She underwent antero-posterior revision fixation with hardware removal, correction of kyphotic malunion, evacuation of a recurrent epidural abscess, decompression of the spinal canal, and 360° fusion from T2–T11. Despite the successful salvage procedure, the patient deteriorated in the postoperative phase, when she developed multiple complications including pneumonia, acute respiratory distress syndrome, bacterial meningitis, abdominal compartment syndrome, followed by septic shock with multiple organ failure and a lethal outcome within two weeks after revision surgery. Conclusion This catastrophic example of a lethal outcome secondary to failure of anterior column fixation for pyogenic thoracic spondylodiscitis underlines the notion that surgical

Anatomy of large animal spines and its comparison to the human spine: a systematic review.

Science.gov (United States)

Sheng, Sun-Ren; Wang, Xiang-Yang; Xu, Hua-Zi; Zhu, Guo-Qing; Zhou, Yi-Fei

2010-01-01

Animal models have been commonly used for in vivo and in vitro spinal research. However, the extent to which animal models resemble the human spine has not been well known. We conducted a systematic review to compare the morphometric features of vertebrae between human and animal species, so as to give some suggestions on how to choose an appropriate animal model in spine research. A literature search of all English language peer-reviewed publications was conducted using PubMed, OVID, Springer and Elsevier (Science Direct) for the years 1980-2008. Two reviewers extracted data on the anatomy of large animal spines from the identified articles. Each anatomical study of animals had to include at least three vertebral levels. The anatomical data from all animal studies were compared with the existing data of the human spine in the literature. Of the papers retrieved, seven were included in the review. The animals in the studies involved baboon, sheep, porcine, calf and deer. Distinct anatomical differences of vertebrae were found between the human and each large animal spine. In cervical region, spines of the baboon and human are more similar as compared to other animals. In thoracic and lumbar regions, the mean pedicle height of all animals was greater than the human pedicles. There was similar mean pedicle width between animal and the human specimens, except in thoracic segments of sheep. The human spinal canal was wider and deeper in the anteroposterior plane than any of the animals. The mean human vertebral body width and depth were greater than that of the animals except in upper thoracic segments of the deer. However, the mean vertebral body height was lower than that of all animals. This paper provides a comprehensive review to compare vertebrae geometries of experimental animal models to the human vertebrae, and will help for choosing animal model in vivo and in vitro spine research. When the animal selected for spine research, the structural similarities and

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.

Rigidity-tuning conductive elastomer

Science.gov (United States)

Shan, Wanliang; Diller, Stuart; Tutcuoglu, Abbas; Majidi, Carmel

2015-06-01

We introduce a conductive propylene-based elastomer (cPBE) that rapidly and reversibly changes its mechanical rigidity when powered with electrical current. The elastomer is rigid in its natural state, with an elastic (Young’s) modulus of 175.5 MPa, and softens when electrically activated. By embedding the cPBE in an electrically insulating sheet of polydimethylsiloxane (PDMS), we create a cPBE-PDMS composite that can reversibly change its tensile modulus between 37 and 1.5 MPa. The rigidity change takes ˜6 s and is initiated when a 100 V voltage drop is applied across the two ends of the cPBE film. This magnitude of change in elastic rigidity is similar to that observed in natural skeletal muscle and catch connective tissue. We characterize the tunable load-bearing capability of the cPBE-PDMS composite with a motorized tensile test and deadweight experiment. Lastly, we demonstrate the ability to control the routing of internal forces by embedding several cPBE-PDMS ‘active tendons’ into a soft robotic pneumatic bending actuator. Selectively activating the artificial tendons controls the neutral axis and direction of bending during inflation.

Rigidity-tuning conductive elastomer

International Nuclear Information System (INIS)

Shan, Wanliang; Diller, Stuart; Tutcuoglu, Abbas; Majidi, Carmel

2015-01-01

We introduce a conductive propylene-based elastomer (cPBE) that rapidly and reversibly changes its mechanical rigidity when powered with electrical current. The elastomer is rigid in its natural state, with an elastic (Young’s) modulus of 175.5 MPa, and softens when electrically activated. By embedding the cPBE in an electrically insulating sheet of polydimethylsiloxane (PDMS), we create a cPBE–PDMS composite that can reversibly change its tensile modulus between 37 and 1.5 MPa. The rigidity change takes ∼6 s and is initiated when a 100 V voltage drop is applied across the two ends of the cPBE film. This magnitude of change in elastic rigidity is similar to that observed in natural skeletal muscle and catch connective tissue. We characterize the tunable load-bearing capability of the cPBE–PDMS composite with a motorized tensile test and deadweight experiment. Lastly, we demonstrate the ability to control the routing of internal forces by embedding several cPBE–PDMS ‘active tendons’ into a soft robotic pneumatic bending actuator. Selectively activating the artificial tendons controls the neutral axis and direction of bending during inflation. (paper)

Robinow syndrome

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Suresh S

2008-01-01

Full Text Available Robinow syndrome is a rare autosomal recessive mesomelic dwarfism with just more than 100 cases reported in the literature so far. The lower extremity is spared with skeletal deformity usually confined to the forearm, hand, and the dorsal spine. Diagnosis is made easily in the early childhood by the typical "fetal facies" appearance, which disappears to a certain extent as the patient grows. The author reports two cases of this entity with vertebral segmentation defects, rib fusion, and typical severe brachymelia and facial features.

Imaging of cervical spine injuries of childhood

Energy Technology Data Exchange (ETDEWEB)

Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

2007-06-15

Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

Gorham's disease of the spine

International Nuclear Information System (INIS)

Livesley, P.J.; Saifuddin, A.; Webb, P.J.; Mitchell, N.; Ramani, P.

1996-01-01

Massive osteolysis is a rare condition and is very uncommon in the spine. The MRI appearance of Gorham's disease of the spine has not previously been reported. We present here a case of this condition with imaging details. (orig.)

On flexible and rigid nouns

DEFF Research Database (Denmark)

Rijkhoff, Jan

2010-01-01

classes. Finally this article wants to claim that the distinction between rigid and flexible noun categories (a) adds a new dimension to current classifications of parts of speech systems, (b) correlates with certain grammatical phenomena (e.g. so-called number discord), and (c) helps to explain the parts......This article argues that in addition to the major flexible lexical categories in Hengeveld’s classification of parts of speech systems (Contentive, Non-Verb, Modifier), there are also flexible word classes within the rigid lexical category Noun (Set Noun, Sort Noun, General Noun). Members...... by the flexible item in the external world. I will then argue that flexible word classes constitute a proper category (i.e. they are not the result of a merger of some rigid word classes) in that members of flexible word categories display the same properties regarding category membership as members of rigid word...

The postoperative spine

International Nuclear Information System (INIS)

Anon.

1985-01-01

The failed back surgery syndrome (FBSS) is one of the most perplexing medical and medicoeconomic problems facing our health system today. In many studies reoperation rates tend to be between 10 and 20%, but as many as 20-45% 3 of patients may have persistent back or radicular pain following what was to have been definitive therapy. The causes for the FBSS are very complex. The Workmen's Compensation system and medicolegal trends toward very high settlements of litigation for injury have provided serious incentive for patients to remain symptomatic. It is difficult to analyze any statistical survey of symptomatic back patients without serious bias from this group of patients. Others suggest that patients with severe psychological problems, drug abuse, and alcoholism are inappropriately selected as surgical candidates. They believe that careful psychological evaluation of patients minimizes FBSS. Even if all extrinsic factors could be eliminated, the problem of failed back surgery would still be a major one. This chapter is based on a review of 300 postoperative lumbar spine multiplanar CT scans performed over a 15-month period. All patients had a complete set of axial images, with sagittal and coronal reformations photographed twice: optimized once for bone definition and once for soft-tissue contrast resolution

X-Ray Exam: Cervical Spine

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... Staying Safe Videos for Educators Search English Español X-Ray Exam: Cervical Spine KidsHealth / For Parents / X-Ray ... MRI): Lumbar Spine Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

CT-3DRA registration for radiosurgery treatments: a comparison among rigid, affine and non rigid approaches

International Nuclear Information System (INIS)

Stancanello, J.; Loeckx, D.; Francescon, P.; Calvedon, C.; Avanzo, M.; Cora, S.; Scalchi, P.; Cerveri, P.; Ferrigno, G.

2004-01-01

This work aims at comparing rigid, affine and Local Non Rigid (LNR) CT-3D Rotational Angiography (CT-3DRA) registrations based on mutual information. 10 cranial and 1 spinal cases have been registered by rigid and affine transformations; while LNR has been applied to the cases where residual deformation must be corrected. An example of CT-3DRA registration without regularization term and an example of LNR using the similarity criterion and the regularization term as well as 3D superposition of the 3DRA before and after the registration without the regularization term are presented. All the registrations performed by rigid transformation converged to an acceptable solution. The results about the robustness test in axial direction are reported. Conclusions: For cranial cases, affine transformation endowed with threshold-segmentation pre-processing can be considered the most favourable solution for almost all registrations; for some cases, LNR provides more accurate results. For the spinal case rigid transformation is the most suitable when immobilizing patient during examinations; in this case the increase of accuracy by using LNR registrations seems to be not significant

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.

Science.gov (United States)

Kobak, Senol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

2013-01-01

Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

Directory of Open Access Journals (Sweden)

Şenol Kobak

2013-01-01

Full Text Available Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

Cervical spine motion in manual versus Jackson table turning methods in a cadaveric global instability model.

Science.gov (United States)

DiPaola, Matthew J; DiPaola, Christian P; Conrad, Bryan P; Horodyski, MaryBeth; Del Rossi, Gianluca; Sawers, Andrew; Bloch, David; Rechtine, Glenn R

2008-06-01

A study of spine biomechanics in a cadaver model. To quantify motion in multiple axes created by transfer methods from stretcher to operating table in the prone position in a cervical global instability model. Patients with an unstable cervical spine remain at high risk for further secondary injury until their spine is adequately surgically stabilized. Previous studies have revealed that collars have significant, but limited benefit in preventing cervical motion when manually transferring patients. The literature proposes multiple methods of patient transfer, although no one method has been universally adopted. To date, no study has effectively evaluated the relationship between spine motion and various patient transfer methods to an operating room table for prone positioning. A global instability was surgically created at C5-6 in 4 fresh cadavers with no history of spine pathology. All cadavers were tested both with and without a rigid cervical collar in the intact and unstable state. Three headrest permutations were evaluated Mayfield (SM USA Inc), Prone View (Dupaco, Oceanside, CA), and Foam Pillow (OSI, Union City, CA). A trained group of medical staff performed each of 2 transfer methods: the "manual" and the "Jackson table" transfer. The manual technique entailed performing a standard rotation of the supine patient on a stretcher to the prone position on the operating room table with in-line manual cervical stabilization. The "Jackson" technique involved sliding the supine patient to the Jackson table (OSI, Union City, CA) with manual in-line cervical stabilization, securing them to the table, then initiating the table's lock and turn mechanism and rotating them into a prone position. An electromagnetic tracking device captured angular motion between the C5 and C6 vertebral segments. Repeated measures statistical analysis was performed to evaluate the following conditions: collar use (2 levels), headrest (3 levels), and turning technique (2 levels). For all

Torsional Rigidity of Minimal Submanifolds

DEFF Research Database (Denmark)

Markvorsen, Steen; Palmer, Vicente

2006-01-01

We prove explicit upper bounds for the torsional rigidity of extrinsic domains of minimal submanifolds $P^m$ in ambient Riemannian manifolds $N^n$ with a pole $p$. The upper bounds are given in terms of the torsional rigidities of corresponding Schwarz symmetrizations of the domains in warped...

Variation in armour of three-spine stickleback

OpenAIRE

Wiig, Elisabeth

2014-01-01

The three-spine stickleback is an adaptable fish with variation in morphology and behaviour, inhabiting saltwater, brackish water and fresh water. It is armoured with 30-35 bone plates along its lateral line. In addition, it is equipped with three spines on its back and two pelvic spine. These features constitute an excellent anti-predator defence system. Yet, there is a strong selection for reduction in armour of three-spine stickleback in freshwater stickleback. In this project, the bone st...

A Septin-Dependent Diffusion Barrier at Dendritic Spine Necks.

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Helge Ewers

Full Text Available Excitatory glutamatergic synapses at dendritic spines exchange and modulate their receptor content via lateral membrane diffusion. Several studies have shown that the thin spine neck impedes the access of membrane and solute molecules to the spine head. However, it is unclear whether the spine neck geometry alone restricts access to dendritic spines or if a physical barrier to the diffusion of molecules exists. Here, we investigated whether a complex of septin cytoskeletal GTPases localized at the base of the spine neck regulates diffusion across the spine neck. We found that, during development, a marker of the septin complex, Septin7 (Sept7, becomes localized to the spine neck where it forms a stable structure underneath the plasma membrane. We show that diffusion of receptors and bulk membrane, but not cytoplasmic proteins, is slower in spines bearing Sept7 at their neck. Finally, when Sept7 expression was suppressed by RNA interference, membrane molecules explored larger membrane areas. Our findings indicate that Sept7 regulates membrane protein access to spines.

Conspicuous and aposematic spines in the animal kingdom

Science.gov (United States)

Inbar, Moshe; Lev-Yadun, Simcha

2005-04-01

Spines serve as a common physical defence mechanism in both the plant and animal kingdoms. Here we argue that as in plants, defensive animal spines are often conspicuous (shape and colour) and should be considered aposematic. Conspicuous spines may evolve as signals or serve as a cue for potential predators. Spine conspicuousness in animals has evolved independently across and within phyla occupying aquatic and terrestrial ecosystems, indicating that this convergent phenomenon is highly adaptive. Still, many spines are cryptic, suggesting that conspicuity is not simply constrained by developmental factors such as differences in the chemical composition of the integument. Aposematism does not preclude the signalling role of conspicuous spines in the sexual arena.

Flexible and rigid cystoscopy in women.

Science.gov (United States)

Gee, Jason R; Waterman, Bradley J; Jarrard, David F; Hedican, Sean P; Bruskewitz, Reginald C; Nakada, Stephen Y

2009-01-01

Previous studies have evaluated the tolerability of rigid versus flexible cystoscopy in men. Similar studies, however, have not been performed in women. We sought to determine whether office-based flexible cystoscopy was better tolerated than rigid cystoscopy in women. Following full IRB approval, women were prospectively randomized in a single-blind manner. Patients were randomized to flexible or rigid cystoscopy and draped in the lithotomy position to maintain blinding of the study. Questionnaires evaluated discomfort before, during, and after cystoscopy. Thirty-six women were randomized to flexible (18) or rigid (18) cystoscopy. Indications were surveillance (16), hematuria (15), recurrent UTIs (2), voiding dysfunction (1), and other (2). All questionnaires were returned by 31/36 women. Using a 10-point visual analog scale (VAS), median discomfort during the procedure for flexible and rigid cystoscopy were 1.4 and 1.8, respectively, in patients perceiving pain. Median recalled pain 1 week later was similar at 0.8 and 1.15, respectively. None of these differences were statistically significant. Flexible and rigid cystoscopy are well tolerated in women. Discomfort during and after the procedure is minimal in both groups. Urologists should perform either procedure in women based on their preference and skill level.

Results of the spine-to-rib-cage distraction in the treatment of early onset scoliosis

Directory of Open Access Journals (Sweden)

Teli Marco

2010-01-01

Full Text Available Background: Growing rod systems have been used in the last 30 years for the treatment of early onset scoliosis (EOS with variable success rates. We report the results of treatment of EOS with a newly developed hybrid rod distraction system applied to the rib cage and spine with a nonfusion technique in a prospective multicenter clinical trial. Materials and Methods: A total of 22 patients affected by progressive EOS resistant to cast and/or brace treatment were enrolled from 2004 to 2005 after informed consent into a trial of surgical treatment with a single spine-to-rib growing rod instrumentation growing spine profiler (GSP. Curves> 60° Cobb in the frontal plane or bending < 50% were addressed with staged anterior annulotomy and fusion and posterior implantation of a GSP rod. Less severe and rigid curves were treated with posterior implantation of GSP only. The elongation of GSP was planned according to spinal growth. Patients were kept in a brace between elongations. Results: A total of 20 patients were available to follow-up with complete data. The mean follow up is 4.1 years. Mean age at time of initial surgery was 5 years (3-8. Nine patients had staged antero-posterior surgeries, 11 posterior only surgeries. Mean spinal growth was 1.9 cm (1.5-2.3 or 0.5 cm per year. Mean coronal Cobb′s angle correction was from 56° to 45°. Major complications affected 40% of patients and included rod failure in 6/20 and crankshaft in 5/20 (all in the anteroposterior surgery group. Conclusion: Treatment of EOS with spine-to-rib growing rod in the present form provides similar correction and complication rates to those published in the series considering traditional single or dual growing rod systems. Based on this, the authors recommend revision of the GSP design and a new clinical trial to test safety and efficacy.

Return to golf after spine surgery.

Science.gov (United States)

Abla, Adib A; Maroon, Joseph C; Lochhead, Richard; Sonntag, Volker K H; Maroon, Adara; Field, Melvin

2011-01-01

no published evidence indicates when patients can resume golfing after spine surgery. The objective of this study is to provide data from surveys sent to spine surgeons. a survey of North American Spine Society members was undertaken querying the suggested timing of return to golf. Of 1000 spine surgeons surveyed, 523 responded (52.3%). The timing of recommended return to golf and the reasons were questioned for college/professional athletes and avid and recreational golfers of both sexes. Responses were tallied for lumbar laminectomy, lumbar microdiscectomy, lumbar fusion, and anterior cervical discectomy with fusion. the most common recommended time for return to golf was 4-8 weeks after lumbar laminectomy and lumbar microdiscectomy, 2-3 months after anterior cervical fusion, and 6 months after lumbar fusion. The results showed a statistically significant increase in the recommended time to resume golf after lumbar fusion than after cervical fusion in all patients (p golf after spine surgery depends on many variables, including the general well-being of patients in terms of pain control and comfort when golfing. This survey serves as a guide that can assist medical practitioners in telling patients the average times recommended by surgeons across North America regarding return to golf after spine surgery.

[Case with difficulty in differentiating between transient neuroleptic malignant syndrome and catatonia after neuroleptic analgesia].

Science.gov (United States)

Yanagawa, Youichi; Miyazaki, Masaki

2010-02-01

An 18-year-old woman was treated with neuroleptic analgesia using fentanyl, morphine, droperidol and haloperidol for general anesthesia and pain control for her knee operation. Postoperatively, she showed emotional unstableness, following dyspnea, tachycardia, fever, hyperhydrosis, muscle rigidity and myoclonus like involuntary movement. She received infusion of 140 mg dantrolene in total under suspicion of having neuroleptic malignant syndrome, but her symptoms improved slightly. After being transferred to our hospital, she exhibited immobility, mutism, rigidity, and catalepsy, and she was suspected of having lethal catatonia. Infusion of diazepam 10 mg resulted in dramatical improvement of her symptoms. Differential diagnosis between neuroleptic malignant syndrome and catatonia is difficult; however, a first line therapy is differential diagnosis. Thus, physician should consider catatonia when treating neuroleptic malignant like syndrome.

The potential impact of various diagnostic strategies in cases of chronic pain syndromes associated with lumbar spine degeneration

Directory of Open Access Journals (Sweden)

Bokov A

2013-04-01

Full Text Available Andrey Bokov, Olga Perlmutter, Alexander Aleynik, Marina Rasteryaeva, Sergey Mlyavykh Scientific Research Institute of Traumatology and Orthopedics, Nizhniy Novgorod, Russian Federation Purpose: To study the possible effects of various diagnostic strategies and the relative contribution of various structures in order to determine the optimal diagnostic strategy in treating patients with noncompressive pain syndromes. Study design: Prospective, nonrandomized cohort study of 83 consecutive patients with noncompressive pain syndromes resistant to repeated courses of conservative treatment. The follow-up period was 18 months. Results: Nucleoplasty was effective in cases of discogenic pain; the consequences related to false positive results of the discography were significant. The most specific criterion was 80% pain relief after facet joint blocks, whereas 50% pain relief and any subjective pain relief were not associated with a significant increase in the success rate. A considerable rate of false negative results was associated with 80% pain relief, whereas 50% pain relief after facet joint blocks showed the optimal ratio of sensitivity and specificity. Facet joint pain was detected in 50.6% of cases (95% confidence interval 44.1%–66.3%, discogenic pain in 16.9% cases (95% confidence interval 9.5%–26.7%, and sacroiliac joint pain in 7.2% cases (95% confidence interval 2.7%–15%. It was impossible to differentiate the main source of pain in 25.3% of cases. Conclusion: It is rational to adjust the diagnostic algorithm to the probability of detecting a particular pain source and, in doing so, reduce the number of invasive diagnostic measures to evaluate a pain source. False positive results of diagnostic measures can negatively affect the overall efficacy of a particular technology; therefore, all reasons for the failure should be studied in order to reach an unbiased conclusion. In choosing diagnostic criteria, not only should the success rate

Analysis of Switched-Rigid Floating Oscillator

Directory of Open Access Journals (Sweden)

Prabhakar R. Marur

2009-01-01

Full Text Available In explicit finite element simulations, a technique called deformable-to-rigid (D2R switching is used routinely to reduce the computation time. Using the D2R option, the deformable parts in the model can be switched to rigid and reverted back to deformable when needed during the analysis. The time of activation of D2R however influences the overall dynamics of the system being analyzed. In this paper, a theoretical basis for the selection of time of rigid switching based on system energy is established. A floating oscillator problem is investigated for this purpose and closed-form analytical expressions are derived for different phases in rigid switching. The analytical expressions are validated by comparing the theoretical results with numerical computations.

Survey of French spine surgeons reveals significant variability in spine trauma practices in 2013.

Science.gov (United States)

Lonjon, G; Grelat, M; Dhenin, A; Dauzac, C; Lonjon, N; Kepler, C K; Vaccaro, A R

2015-02-01

In France, attempts to define common ground during spine surgery meetings have revealed significant variability in clinical practices across different schools of surgery and the two specialities involved in spine surgery, namely, neurosurgery and orthopaedic surgery. To objectively characterise this variability by performing a survey based on a fictitious spine trauma case. Our working hypothesis was that significant variability existed in trauma practices and that this variability was related to a lack of strong scientific evidence in spine trauma care. We performed a cross-sectional survey based on a clinical vignette describing a 31-year-old male with an L1 burst fracture and neurologic symptoms (numbness). Surgeons received the vignette and a 14-item questionnaire on the management of this patient. For each question, surgeons had to choose among five possible answers. Differences in answers across surgeons were assessed using the Index of Qualitative Variability (IQV), in which 0 indicates no variability and 1 maximal variability. Surgeons also received a questionnaire about their demographics and surgical experience. Of 405 invited spine surgeons, 200 responded to the survey. Five questions had an IQV greater than 0.9, seven an IQV between 0.5 and 0.9, and two an IQV lower than 0.5. Variability was greatest about the need for MRI (IQV=0.93), degree of urgency (IQV=0.93), need for fusion (IQV=0.92), need for post-operative bracing (IQV=0.91), and routine removal of instrumentation (IQV=0.94). Variability was lowest for questions about the need for surgery (IQV=0.42) and use of the posterior approach (IQV=0.36). Answers were influenced by surgeon specialty, age, experience level, and type of centre. Clinical practice regarding spine trauma varies widely in France. Little published evidence is available on which to base recommendations that would diminish this variability. Copyright © 2015. Published by Elsevier Masson SAS.

Gitelman's syndrome: a rare presentation mimicking cauda equina syndrome.

LENUS (Irish Health Repository)

Quinlan, C S

2012-02-01

We describe a case of bilateral weakness of the lower limbs, sensory disturbance and intermittent urinary incontinence, secondary to untreated Gitelman\\'s syndrome, in a 42-year-old female who was referred with presumed cauda equina syndrome. On examination, the power of both legs was uniformly reduced, and the perianal and lower-limb sensation was altered. However, MRI of the lumbar spine was normal. Measurements of serum and urinary potassium were low and blood gas analysis revealed metabolic alkalosis. Her symptoms resolved following potassium replacement. We emphasise the importance of measurement of the plasma and urinary levels of electrolytes in the investigation of patients with paralysis of the lower limbs and suggest that they, together with blood gas analysis, allow the exclusion of unusual causes of muscle weakness resulting from metabolic disorders such as metabolic alkalosis.

Torsional rigidity, isospectrality and quantum graphs

International Nuclear Information System (INIS)

Colladay, Don; McDonald, Patrick; Kaganovskiy, Leon

2017-01-01

We study torsional rigidity for graph and quantum graph analogs of well-known pairs of isospectral non-isometric planar domains. We prove that such isospectral pairs are distinguished by torsional rigidity. (paper)

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

Science.gov (United States)

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

2008-03-01

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

Targeting of NF-κB to Dendritic Spines Is Required for Synaptic Signaling and Spine Development.

Science.gov (United States)

Dresselhaus, Erica C; Boersma, Matthew C H; Meffert, Mollie K

2018-04-25

Long-term forms of brain plasticity share a requirement for changes in gene expression induced by neuronal activity. Mechanisms that determine how the distinct and overlapping functions of multiple activity-responsive transcription factors, including nuclear factor κB (NF-κB), give rise to stimulus-appropriate neuronal responses remain unclear. We report that the p65/RelA subunit of NF-κB confers subcellular enrichment at neuronal dendritic spines and engineer a p65 mutant that lacks spine enrichment (p65ΔSE) but retains inherent transcriptional activity equivalent to wild-type p65. Wild-type p65 or p65ΔSE both rescue NF-κB-dependent gene expression in p65-deficient murine hippocampal neurons responding to diffuse (PMA/ionomycin) stimulation. In contrast, neurons lacking spine-enriched NF-κB are selectively impaired in NF-κB-dependent gene expression induced by elevated excitatory synaptic stimulation (bicuculline or glycine). We used the setting of excitatory synaptic activity during development that produces NF-κB-dependent growth of dendritic spines to test physiological function of spine-enriched NF-κB in an activity-dependent response. Expression of wild-type p65, but not p65ΔSE, is capable of rescuing spine density to normal levels in p65-deficient pyramidal neurons. Collectively, these data reveal that spatial localization in dendritic spines contributes unique capacities to the NF-κB transcription factor in synaptic activity-dependent responses. SIGNIFICANCE STATEMENT Extensive research has established a model in which the regulation of neuronal gene expression enables enduring forms of plasticity and learning. However, mechanisms imparting stimulus specificity to gene regulation, ensuring biologically appropriate responses, remain incompletely understood. NF-κB is a potent transcription factor with evolutionarily conserved functions in learning and the growth of excitatory synaptic contacts. Neuronal NF-κB is localized in both synapse and

Effects of unconsciousness during spinal immobilization on tissue-interface pressures: A randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard.

Science.gov (United States)

Hemmes, Baukje; Brink, Peter R G; Poeze, Martijn

2014-11-01

Immobilization of the spine of patients with trauma at risk of spinal damage is usually performed using a rigid long spineboard or vacuum mattress, both during prehospital and in-hospital care. However, disadvantages of these immobilization devices in terms of discomfort and tissue-interface pressures have guided the development of soft-layered long spineboards. We compared tissue-interface pressures between awake and anaesthetized (unconscious) patients during immobilization on a rigid spineboard and a soft-layered long spineboard. In this comparative study, 30 anaesthetized patients were randomized to immobilization on either the rigid spineboard or the soft-layered spineboard for the duration of their elective surgery. Tissue-interface pressures measured using an Xsensor pressure-mapping device were compared with those of 30 healthy volunteers who were immobilized sequentially on the rigid spineboard and the soft-layered spineboard. Redness of the sacrum was also recorded for the anaesthetized patients immediately after the surgery. For both anaesthetized patients and awake volunteers, tissue-interface pressures were significantly lower on the soft-layered spineboard than on the rigid spineboard, both at start and after 15min. On the soft-layered spineboard, tissue interface pressure and peak pressure index (PPI) for the sacrum were significantly lower for anaesthetized patients than for awake volunteers. Peak pressures and PPI on the rigid spineboard were equal for both groups. Tissue-interface pressures did not change significantly over time. Redness of the sacrum was significantly more pronounced on the rigid spineboard than on the soft-layered spineboard. This prospective randomized controlled trial shows that using a soft-layered spineboard compared to a rigid spineboard for spinal immobilization resulted in lower tissue-interface pressures in both awake volunteers and anaesthetized patients. Moreover, tissue-interface pressures on the soft

Differentiating C8–T1 Radiculopathy from Ulnar Neuropathy: A Survey of 24 Spine Surgeons

Science.gov (United States)

Stoker, Geoffrey E.; Kim, Han Jo; Riew, K. Daniel

2013-01-01

Study Design Questionnaire. Objective To evaluate the ability of spine surgeons to distinguish C8–T1 radiculopathies from ulnar neuropathy. Methods Twenty-four self-rated “experienced” cervical spine surgeons completed a questionnaire with the following items. (1) If the ulnar nerve is cut at the elbow, which of the following would be numb: ulnar forearm, small and ring fingers; only the ulnar forearm; only the small and ring fingers; or none of the above? (2) Which of the following muscles are weak with C8–T1 radiculopathies but intact with ulnar neuropathy at the elbow: flexor digiti minimi brevis, flexor pollicis brevis, abductor digiti minimi, abductor pollicis brevis, adductor pollicis, opponens digiti minimi, opponens pollicis, medial lumbricals, lateral lumbricals, dorsal interossei, palmar interossei? Results Fifteen of 24 surgeons (63%) correctly answered the first question—that severing the ulnar nerve results in numbness of the fifth and fourth fingers. None correctly identified all four nonulnar, C8–T1-innervated options in the second question without naming additional muscles. Conclusion The ulnar nerve provides sensation to the fourth and fifth fingers and medial border of the hand. The medial antebrachial cutaneous nerve provides sensation to the medial forearm. The ulnar nerve innervates all intrinsic hand muscles, except the abductor and flexor pollicis brevis, opponens pollicis, and lateral two lumbricals, which are innervated by C8 and T1 via the median nerve. By examining these five muscles, one can clinically differentiate cubital tunnel syndrome from C8–T1 radiculopathies. Although all participants considered themselves to be experienced cervical spine surgeons, this study reveals inadequate knowledge regarding the clinical manifestations of C8–T1 radiculopathies and cubital tunnel syndrome. PMID:24494175

A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

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Egemen Kucuk

2014-04-01

Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

Retropharyngeal cold abscess without Pott's spine | Singh | South ...

African Journals Online (AJOL)

Retropharyngeal cold abscess without Pott's spine. ... pyogenic osteomyelitis, tube‚rculosis of the spine, or external injuries caused by endoscopes ... in an adult woman without tuberculosis of the cervical spine who was managed surgically by ...

Social defeat stress induces depression-like behavior and alters spine morphology in the hippocampus of adolescent male C57BL/6 mice

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Sergio D. Iñiguez

2016-12-01

Hippocampi were then dissected and Western blots were conducted to quantify protein levels for various markers important for synaptic plasticity including protein kinase M zeta (PKMζ, protein kinase C zeta (PKCζ, the dopamine-1 (D1 receptor, tyrosine hydroxylase (TH, and the dopamine transporter (DAT. Furthermore, we examined the presence of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA-receptor subunit GluA2 as well as colocalization with the post-synaptic density 95 (PSD95 protein, within different spine subtypes (filopodia, stubby, long-thin, mushroom using an immunohistochemistry and Golgi-Cox staining technique. The results revealed that social defeat induced a depression-like behavioral profile, as inferred from decreased social interaction levels, increased immobility on the tail suspension test, and decreases in body weight. Whole hippocampal immunoblots revealed decreases in GluA2, with a concomitant increase in DAT and TH levels in the stressed group. Spine morphology analyses further showed that defeated mice displayed a significant decrease in stubby spines, and an increase in long-thin spines within the CA1 stratum radiatum. Further evaluation of GluA2/PSD95 containing-spines demonstrated a decrease of these markers within long-thin and mushroom spine types. Together, these results indicate that juvenile social stress induces GluA2- and dopamine-associated dysregulation in the hippocampus – a neurobiological mechanism potentially underlying the development of mood-related syndromes as a consequence of adolescent bullying.

Kinesiotherapy of Parkinson`s disease and Parkinson`s syndrom

OpenAIRE

Zechovská, Lenka

2013-01-01

Author: Lenka Zechovská Institution: Rehabilitation Clinic, Faculty of Medicine in Hradec Králové Title: Kinesiotherapy of Parkinson's disease and Parkinson's syndrome Supervisor: Mgr. Ivana Vondráková Number of pages: 115 Number of attachments: 8 Year of defence: 2013 Keywords: Parkinson's disease, basal ganglia, tremor, rigidity, hypokinesia Bachelor thesis deals with the problems of Parkinson's disease and Parkinson's syndrome. The theoretical part includes the basal ganglia pathophysiolog...

Rigidity of monodromies for Appell's hypergeometric functions

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Yoshishige Haraoka

2015-01-01

Full Text Available For monodromy representations of holonomic systems, the rigidity can be defined. We examine the rigidity of the monodromy representations for Appell's hypergeometric functions, and get the representations explicitly. The results show how the topology of the singular locus and the spectral types of the local monodromies work for the study of the rigidity.

Chondrosarcoma of the Mobile Spine and Sacrum

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Ryan M. Stuckey

2011-01-01

Full Text Available Chondrosarcoma is a rare malignant tumor of bone. This family of tumors can be primary malignant tumors or a secondary malignant transformation of an underlying benign cartilage tumor. Pain is often the initial presenting complaint when chondrosarcoma involves the spine. In the mobile spine, chondrosarcoma commonly presents within the vertebral body and shows a predilection for the thoracic spine. Due to the resistance of chondrosarcoma to both radiation and chemotherapy, treatment is focused on surgery. With en bloc excision of chondrosarcoma of the mobile spine and sacrum patients can have local recurrence rates as low as 20%.

Accountable disease management of spine pain.

Science.gov (United States)

Smith, Matthew J

2011-09-01

The health care landscape has changed with new legislation addressing the unsustainable rise in costs in the US system. Low-value service lines caring for expensive chronic conditions have been targeted for reform; for better or worse, the treatment of spine pain has been recognized as a representative example. Examining the Patient Protection and Affordable Care Act and existing pilot studies can offer a preview of how chronic care of spine pain will be sustained. Accountable care in an organization capable of collecting, analyzing, and reporting clinical data and operational compliance is forthcoming. Interdisciplinary spine pain centers integrating surgical and medical management, behavioral medicine, physical reconditioning, and societal reintegration represent the model of high-value care for patients with chronic spine pain. Copyright © 2011 Elsevier Inc. All rights reserved.

Imaging the cervical spine following rugby related injury

International Nuclear Information System (INIS)

Beck, J.J.W.

2016-01-01

Rugby Union and Rugby League are popular sports with high participation across the world. The high impact nature of the sport results in a high proportion of injuries. Rugby has an association with cervical spine injury which has potentially catastrophic consequences for the patient. Anecdotal evidence suggests that radiographers find it challenging to visualise the cervicothoracic junction on the lateral supine cervical spine projection in broad shouldered athletes. This paper intends to analyse the risk factors for cervical spine injuries in rugby and discuss the imaging strategy in respect to radiography and CT scanning in high risk patient groups such as rugby players who are suspected of suffering a cervical spine injury. - Highlights: • Rugby as a participation sport represents a risk of cervical spine injury. • Conventional radiography lacks sensitivity in identifying cervical spine injury. • The body habitus of rugby players makes the imaging of the cervicothoracic junction challenging. • CT scanning should replace radiography in the event of serious suspicion of cervical spine injury. • The notion of CT being a high dose modality should be questioned.

Side Effects of Minocycline Treatment in Patients with Fragile X Syndrome and Exploration of Outcome Measures

Science.gov (United States)

Utari, Agustini; Chonchaiya, Weerasak; Rivera, Susan M.; Schneider, Andrea; Hagerman, Randi J.; Faradz, Sultana M. H.; Ethell, Iryna M.; Nguyen, Danh V.

2010-01-01

Minocycline can rescue the dendritic spine and synaptic structural abnormalities in the fragile X knock-out mouse. This is a review and preliminary survey to document side effects and potential outcome measures for minocycline use in the treatment of individuals with fragile X syndrome. We surveyed 50 patients with fragile X syndrome who received…

Comparing the effectiveness of myofascial techniques with massage in persons with upper crossed syndrome (preliminary report

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Łukasik Edyta

2017-06-01

Full Text Available Introduction: Upper crossed syndrome is a postural syndrome, with myofascial and functional imbalance within the shoulder girdle and the cervical spine. The therapy usually includes myofascial techniques or massage. The aim of this work was to indicate which of these forms of therapy is more effective in terms of myofascial release.

Three-dimensional MR myelography of the lumbar spine: comparative case study to X-ray myelography

International Nuclear Information System (INIS)

Eberhardt, K.E.W.; Hollenbach, H.P.; Tomandl, B.; Huk, W.J.

1997-01-01

Conventional myelography was compared with a new type of MR technique using a fat-suppressing 3D fast imaging with steady precession (FISP) sequence for diagnosis of the lumbar root compression syndrome. 80 patients with discogenic disease in the lumbar spine were examined with a 1.0-T whole-body MR system (Siemens Magnetom Impact, Erlangen, Germany). A strongly T2 * -weighted 3D FISP sequence was applied in the sagittal orientation. To obtain fat suppression, a frequency-selective 1-3-3-1 prepulse was applied prior to the imaging sequence. The acquired 3D data set was evaluated using a maximum intensity projection (MIP) program. The measurement time was 7 min, 47 s. Magnetic resonance myelography has significant advantages over conventional myelography, particularly in cases of extreme spinal canal stenosis. Compared with the conventional method, this new MR technique shows comparable sensitivity in the visualization of the spinal nerve roots in the lumbar spine. (orig.). With 5 figs., 2 tabs

Neuroimaging Features of San Luis Valley Syndrome

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Matthew T. Whitehead

2015-01-01

Full Text Available A 14-month-old Hispanic female with a history of double-outlet right ventricle and developmental delay in the setting of recombinant chromosome 8 syndrome was referred for neurologic imaging. Brain MR revealed multiple abnormalities primarily affecting midline structures, including commissural dysgenesis, vermian and brainstem hypoplasia/dysplasia, an interhypothalamic adhesion, and an epidermoid between the frontal lobes that enlarged over time. Spine MR demonstrated hypoplastic C1 and C2 posterior elements, scoliosis, and a borderline low conus medullaris position. Presented herein is the first illustration of neuroimaging findings from a patient with San Luis Valley syndrome.

Multiplanar CT of the spine

International Nuclear Information System (INIS)

Rothman, S.L.G.; Glenn, W.V. Jr.

1986-01-01

This is an illustrated text on computed tomography (CT) of the lumbar spine with an emphasis on the role and value of multiplanar imaging for helping determine diagnoses. The book has adequate discussion of scanning techniques for the different regions, interpretations of various abnormalities, degenerative disk disease, and different diagnoses. There is a 50-page chapter on detailed sectional anatomy of the spine and useful chapters on the postoperative spine and the planning and performing of spinal surgery with CT multiplanar reconstruction. There are comprehensive chapters on spinal tumors and trauma. The final two chapters of the book are devoted to CT image processing using digital networks and CT applications of medical computer graphics

Asperger Syndrome: A Primer for Behavioral Interventionists

Science.gov (United States)

Polirstok, Susan Rovet; Houghteling, Lawrence

2006-01-01

Children and adolescents with Asperger Syndrome are intellectually capable, rigid and often obsessive, adhere to stereotypic routines, demonstrate difficulties with pragmatic language and characteristically lack social skills. While the extent of these behaviors may wax and wane and vary by individual, they are in stark contrast with the high…

Sensitivity of lumbar spine loading to anatomical parameters

DEFF Research Database (Denmark)

Putzer, Michael; Ehrlich, Ingo; Rasmussen, John

2016-01-01

Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the in uence of dened geometrical parameters on lumbar spine loading utilizing ve parametrized musculoskeletal lumbar spine ...... lumbar spine model for a subject-specic approach with respect to bone geometry. Furthermore, degeneration processes could lead to computational problems and it is advised that stiffness properties of discs and ligaments should be individualized....

From Wage Rigidities to Labour Market Rigidities: A Turning-Point in Explaining Equilibrium Unemployment?

OpenAIRE

Marco Guerrazzi; Nicola Meccheri

2009-01-01

This paper offers a critical discussion of the concept of labour market rigidity relevant to explaining unemployment. Starting from Keynes’s own view, we discuss how the concept of labour market flexibility has changed over time, involving nominal or real wage flexibility, contract flexibility or labour market institution flexibility. We also provide a critical assessment of the factors that lead the search framework highlighting labour market rigidities (frictions) to challenge the more wide...

Case Report: Multiple pterygium syndrome with marked pterygia of ...

African Journals Online (AJOL)

What characterizes out patient was the extensive pterygia of the fingers which kept them permanently flexed, while they were very mild in the neck, axillary folds and knee joints. Our patient suffered also from mental retardation although mentality is commonly reported to be normal in this syndrome. MRI of the spine revealed ...

Identifying Floppy and Rigid Regions in Proteins

Science.gov (United States)

Jacobs, D. J.; Thorpe, M. F.; Kuhn, L. A.

1998-03-01

In proteins it is possible to separate hard covalent forces involving bond lengths and bond angles from other weak forces. We model the microstructure of the protein as a generic bar-joint truss framework, where the hard covalent forces and strong hydrogen bonds are regarded as rigid bar constraints. We study the mechanical stability of proteins using FIRST (Floppy Inclusions and Rigid Substructure Topography) based on a recently developed combinatorial constraint counting algorithm (the 3D Pebble Game), which is a generalization of the 2D pebble game (D. J. Jacobs and M. F. Thorpe, ``Generic Rigidity: The Pebble Game'', Phys. Rev. Lett.) 75, 4051-4054 (1995) for the special class of bond-bending networks (D. J. Jacobs, "Generic Rigidity in Three Dimensional Bond-bending Networks", Preprint Aug (1997)). This approach is useful in identifying rigid motifs and flexible linkages in proteins, and thereby determines the essential degrees of freedom. We will show some preliminary results from the FIRST analysis on the myohemerythrin and lyozyme proteins.

Paediatric cervical spine injury but NEXUS negative

OpenAIRE

Maxwell, Melanie J; Jardine, Andrew D

2007-01-01

Cervical spine injuries in paediatric patients following trauma are extremely rare. The National Emergency X‐Radiography Utilization Study (NEXUS) guidelines are a set of clinical criteria used to guide physicians in identifying trauma patients requiring cervical spine imaging. It is validated for use in children. A case of a child who did not fulfil the NEXUS criteria for imaging but was found to have a cervical spine fracture is reported.

Fine structure of synapses on dendritic spines

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Michael eFrotscher

2014-09-01

Full Text Available Camillo Golgi’s Reazione Nera led to the discovery of dendritic spines, small appendages originating from dendritic shafts. With the advent of electron microscopy (EM they were identified as sites of synaptic contact. Later it was found that changes in synaptic strength were associated with changes in the shape of dendritic spines. While live-cell imaging was advantageous in monitoring the time course of such changes in spine structure, EM is still the best method for the simultaneous visualization of all cellular components, including actual synaptic contacts, at high resolution. Immunogold labeling for EM reveals the precise localization of molecules in relation to synaptic structures. Previous EM studies of spines and synapses were performed in tissue subjected to aldehyde fixation and dehydration in ethanol, which is associated with protein denaturation and tissue shrinkage. It has remained an issue to what extent fine structural details are preserved when subjecting the tissue to these procedures. In the present review, we report recent studies on the fine structure of spines and synapses using high-pressure freezing (HPF, which avoids protein denaturation by aldehydes and results in an excellent preservation of ultrastructural detail. In these studies, HPF was used to monitor subtle fine-structural changes in spine shape associated with chemically induced long-term potentiation (cLTP at identified hippocampal mossy fiber synapses. Changes in spine shape result from reorganization of the actin cytoskeleton. We report that cLTP was associated with decreased immunogold labeling for phosphorylated cofilin (p-cofilin, an actin-depolymerizing protein. Phosphorylation of cofilin renders it unable to depolymerize F-actin, which stabilizes the actin cytoskeleton. Decreased levels of p-cofilin, in turn, suggest increased actin turnover, possibly underlying the changes in spine shape associated with cLTP. The findings reviewed here establish HPF as

Degenerative disease of the spine

International Nuclear Information System (INIS)

Czervionke, L.F.; Daniels, D.L.

1991-01-01

With few exceptions, magnetic resonance imaging (MRI) is becoming the modality of choice for the evaluation of degenerative disorders of the entire spine. With the implementation of surface coils and continued refinement and development of new pulse sequences, osseous and soft tissue structures of the spine can now be studied in great detail. The introduction of paramagnetic contrast agents has made it possible to differentiate epidural scar from recurrent disc herniation in the postoperative setting and to discern previously undetected degenerative changes within the intervertebral disc itself. This paper discusses the spectrum of degenerative diseases of the spine, including disc degeneration (intervertebral osteochondrosis), disc herniation, spinal stenosis, spondylosis deformans, and osteoarthritis. A brief description of the MR techniques and strategies used to evaluate these disorders is also

Hippocampal Dendritic Spines Are Segregated Depending on Their Actin Polymerization.

Science.gov (United States)

Domínguez-Iturza, Nuria; Calvo, María; Benoist, Marion; Esteban, José Antonio; Morales, Miguel

2016-01-01

Dendritic spines are mushroom-shaped protrusions of the postsynaptic membrane. Spines receive the majority of glutamatergic synaptic inputs. Their morphology, dynamics, and density have been related to synaptic plasticity and learning. The main determinant of spine shape is filamentous actin. Using FRAP, we have reexamined the actin dynamics of individual spines from pyramidal hippocampal neurons, both in cultures and in hippocampal organotypic slices. Our results indicate that, in cultures, the actin mobile fraction is independently regulated at the individual spine level, and mobile fraction values do not correlate with either age or distance from the soma. The most significant factor regulating actin mobile fraction was the presence of astrocytes in the culture substrate. Spines from neurons growing in the virtual absence of astrocytes have a more stable actin cytoskeleton, while spines from neurons growing in close contact with astrocytes show a more dynamic cytoskeleton. According to their recovery time, spines were distributed into two populations with slower and faster recovery times, while spines from slice cultures were grouped into one population. Finally, employing fast lineal acquisition protocols, we confirmed the existence of loci with high polymerization rates within the spine.

Neuroimaging for spine and spinal cord surgery

Energy Technology Data Exchange (ETDEWEB)

Koyanagi, Izumi [Hokkaido Neurosurgical Memorial Hospital (Japan); Iwasaki, Yoshinobu; Hida, Kazutoshi

2001-01-01

Recent advances in neuroimaging of the spine and spinal cord are described based upon our clinical experiences with spinal disorders. Preoperative neuroradiological examinations, including magnetic resonance (MR) imaging and computerized tomography (CT) with three-dimensional reconstruction (3D-CT), were retrospectively analyzed in patients with cervical spondylosis or ossification of the posterior longitudinal ligament (130 cases), spinal trauma (43 cases) and intramedullary spinal cord tumors (92 cases). CT scan and 3D-CT were useful in elucidating the spine pathology associated with degenerative and traumatic spine diseases. Visualization of the deformity of the spine or fracture-dislocation of the spinal column with 3D-CT helped to determine the correct surgical treatment. MR imaging was most important in the diagnosis of both spine and spinal cord abnormalities. The axial MR images of the spinal cord were essential in understanding the laterality of the spinal cord compression in spinal column disorders and in determining surgical approaches to the intramedullary lesions. Although non-invasive diagnostic modalities such as MR imaging and CT scans are adequate for deciding which surgical treatment to use in the majority of spine and spinal cord disorders, conventional myelography is still needed in the diagnosis of nerve root compression in some cases of cervical spondylosis. (author)

Spine immobilization apparatus

Science.gov (United States)

Lambson, K. H.; Vykukal, H. C. (Inventor)

1981-01-01

The apparatus makes use of a normally flat, flexible bladder filled with beads or micro-balloons that form a rigid mass when the pressure within the bladder is decreased below ambient through the use of a suction pump so that the bladder can be conformed to the torso of the victim and provide the desired restraint. The bladder is strapped to the victim prior to being rigidified by an arrangement of straps which avoid the stomach area. The bladder is adapted to be secured to a rigid support, i.e., a rescue chair, so as to enable removal of a victim after the bladder has been made rigid. A double sealing connector is used to connect the bladder to the suction pump and a control valve is employed to vary the pressure within the bladder so as to soften and harden the bladder as desired.

Safe intubation in Morquio-Brailsford syndrome: A challenge for the anesthesiologist

Directory of Open Access Journals (Sweden)

Souvik Chaudhuri

2013-01-01

Full Text Available Morquio-Brailsford syndrome is a type of mucopolysaccharidoses. It is a rare disease with features of short stature, atlantoaxial instability with risk of cord damage, odontoid hypoplasia, pectus carinatum, spine deformities, hepatomegaly, and restrictive lung disease. Neck movements during intubation are associated with the risk of quadriparesis due to cervical instability. This, along with the distortion of the airway anatomy due to deposition of mucopolysaccharides makes airway management arduous. We present our experience in management of difficult airway in a 3-year-old girl with Morquio-Brailsford syndrome posted for magnetic resonance imaging and computerized tomography scan of a suspected unstable cervical spine. As utmost sagacity during intubation is required, the child was intubated inside operation theatre in the presence of experienced anesthesiologists and then shifted to the peripheral location. Intubation was done with an endotracheal tube railroaded over a pediatric fibreoptic bronchoscope passed through the lumen of a classic laryngeal mask airway, keeping head in neutral position.

Prenatal diagnosis of Caudal Regression Syndrome : a case report

Directory of Open Access Journals (Sweden)

Celikaslan Nurgul

2001-12-01

Full Text Available Abstract Background Caudal regression is a rare syndrome which has a spectrum of congenital malformations ranging from simple anal atresia to absence of sacral, lumbar and possibly lower thoracic vertebrae, to the most severe form which is known as sirenomelia. Maternal diabetes, genetic predisposition and vascular hypoperfusion have been suggested as possible causative factors. Case presentation We report a case of caudal regression syndrome diagnosed in utero at 22 weeks' of gestation. Prenatal ultrasound examination revealed a sudden interruption of the spine and "frog-like" position of lower limbs. Termination of pregnancy and autopsy findings confirmed the diagnosis. Conclusion Prenatal ultrasonographic diagnosis of caudal regression syndrome is possible at 22 weeks' of gestation by ultrasound examination.

The Spine of the Cosmic Web

NARCIS (Netherlands)

Aragón-Calvo, Miguel A.; Platen, Erwin; van de Weijgaert, Rien; Szalay, Alexander S.

2010-01-01

We present the SpineWeb framework for the topological analysis of the Cosmic Web and the identification of its walls, filaments, and cluster nodes. Based on the watershed segmentation of the cosmic density field, the SpineWeb method invokes the local adjacency properties of the boundaries between

The Spine of the Cosmic Web

NARCIS (Netherlands)

Aragón-Calvo, Miguel A.; Platen, Erwin; van de Weijgaert, Rien; Szalay, Alexander S.

We present the SpineWeb framework for the topological analysis of the Cosmic Web and the identification of its walls, filaments, and cluster nodes. Based on the watershed segmentation of the cosmic density field, the SpineWeb method invokes the local adjacency properties of the boundaries between

EphB/syndecan-2 signaling in dendritic spine morphogenesis

DEFF Research Database (Denmark)

Ethell, I M; Irie, F; Kalo, M S

2001-01-01

We previously reported that the cell surface proteoglycan syndecan-2 can induce dendritic spine formation in hippocampal neurons. We demonstrate here that the EphB2 receptor tyrosine kinase phosphorylates syndecan-2 and that this phosphorylation event is crucial for syndecan-2 clustering and spine...... formation. Syndecan-2 is tyrosine phosphorylated and forms a complex with EphB2 in mouse brain. Dominant-negative inhibition of endogenous EphB receptor activities blocks clustering of endogenous syndecan-2 and normal spine formation in cultured hippocampal neurons. This is the first evidence that Eph...... receptors play a physiological role in dendritic spine morphogenesis. Our observations suggest that spine morphogenesis is triggered by the activation of Eph receptors, which causes tyrosine phosphorylation of target molecules, such as syndecan-2, in presumptive spines....

Surgery for failed cervical spine reconstruction.

Science.gov (United States)

Helgeson, Melvin D; Albert, Todd J

2012-03-01

Review article. To review the indications, operative strategy, and complications of revision cervical spine reconstruction. With many surgeons expanding their indications for cervical spine surgery, the number of patients being treated operatively has increased. Unfortunately, the number of patients requiring revision procedures is also increasing, but very little literature exists reviewing changes in the indications or operative planning for revision reconstruction. Narrative and review of the literature. In addition to the well-accepted indications for primary cervical spine surgery (radiculopathy, myelopathy, instability, and tumor), we have used the following indications for revision surgery: pseudarthrosis, adjacent segment degeneration, inadequate decompression, iatrogenic instability, and deformity. Our surgical goal for pseudarthrosis is obviously to obtain a fusion, which can usually be performed with an approach not done previously. Our surgical goals for instability and deformity are more complex, with a focus on decompression of any neurologic compression, correction of deformity, and stability. Revision cervical spine reconstruction is safe and effective if performed for the appropriate indications and with proper planning.

Soft soils reinforced by rigid vertical inclusions

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Iulia-Victoria NEAGOE

2013-12-01

Full Text Available Reinforcement of soft soils by rigid vertical inclusions is an increasingly used technique over the last few years. The system consists of rigid or semi-rigid vertical inclusions and a granular platform for the loads transfer from the structure to the inclusions. This technique aims to reduce the differential settlements both at ground level as below the structure. Reinforcement by rigid inclusions is mainly used for foundation works for large commercial and industrial platforms, storage tanks, wastewater treatment plants, wind farms, bridges, roads, railway embankments. The subject is one of interest as it proves the recently concerns at international level in research and design; however, most studies deal more with the static behavior and less with the dynamic one.

Gorlin Goltz syndrome: A clinicopathological case report

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Shobha C Bijjaragi

2014-01-01

Full Text Available The Gorlin-Goltz syndrome is an infrequent multisystemic disease, which is inherited in an autosomal dominant manner. This shows a high level of penetrance and variable expressiveness, characterized by multiple basal cell nevi or carcinomas, odontogenic keratocysts, palmar and / or plantar pits, calcification of the falx cerebri, and is occasionally associated with internal malignancies. It is fundamental to know the major and minor criteria for the diagnosis and early preventive treatment of this syndrome. Here we report a case of a 30-year-old male with major and minor features of the Gorlin-Goltz syndrome, such as, strabismus, barrel-shaped chest, with drooping shoulders and mild kyphosis, polydactyly, hypertelorism, multiple basal cell carcinomas, calcification of the falx cerebri, C5-C7 bifida spine, and fusion of T1 and T2.

Imaging of spine injuries

International Nuclear Information System (INIS)

Lomoschitz, F. . e-mai: friedrich.lomoschitz@univie.ac.at

2001-01-01

Spinal trauma requires a prompt and detailed diagnosis for estimating the prognosis and installing proper therapy. Conventional radiograms are the first imaging modality in most cases. In the cervical and the lumbar spine, a CT has to be performed in patients with polytrauma and a higher risk of complications or with signs of instability. Especially for imaging the cervicocranium, multiplanar reformations in sagittal and coronal planes are necessary. For fractures of the thoracic spine, MR imaging is superior to CT because of the better detection of associated neurologic complications. (author)

Glucocorticoid-induced osteoporosis in the lumbar spine, forearm, and mandible of nephrotic patients

DEFF Research Database (Denmark)

Olgaard, K; Storm, Tina; van Wowern, N

1992-01-01

/day and tapered down to 20 mg/day for 1 year and DFZ was given in an equipotent dosage. Twenty-three patients completed 6 months of treatment, and 18 patients completed 12 months of treatment. Beside laboratory parameters to ensure the effect of treatment on the nephrotic syndrome, all had measurements......The long-term effects of high dose steroid treatment with either prednisone (PDN) or deflazacort (DFZ) were examined on various parts of the skeleton in 29 patients with nephrotic syndrome. All had normal skeleton at the start of the steroid treatment. At the beginning, PDN was given as 80 mg...... of the bone mineral content (BMC) at 0, 6, and 12 months of treatment. BMC was measured by single photon absorptiometry of both forearms and by dual photon absorptiometry of the mandible, forearms, and lumbar spine. The effect of DFZ was compared to that of PDN due to a potential "calcium sparing" effect...

Wnt-5a/Frizzled9 Receptor Signaling through the Gαo-Gβγ Complex Regulates Dendritic Spine Formation*

Science.gov (United States)

Ramírez, Valerie T.; Ramos-Fernández, Eva; Henríquez, Juan Pablo; Lorenzo, Alfredo; Inestrosa, Nibaldo C.

2016-01-01

Wnt ligands play crucial roles in the development and regulation of synapse structure and function. Specifically, Wnt-5a acts as a secreted growth factor that regulates dendritic spine formation in rodent hippocampal neurons, resulting in postsynaptic development that promotes the clustering of the PSD-95 (postsynaptic density protein 95). Here, we focused on the early events occurring after the interaction between Wnt-5a and its Frizzled receptor at the neuronal cell surface. Additionally, we studied the role of heterotrimeric G proteins in Wnt-5a-dependent synaptic development. We report that FZD9 (Frizzled9), a Wnt receptor related to Williams syndrome, is localized in the postsynaptic region, where it interacts with Wnt-5a. Functionally, FZD9 is required for the Wnt-5a-mediated increase in dendritic spine density. FZD9 forms a precoupled complex with Gαo under basal conditions that dissociates after Wnt-5a stimulation. Accordingly, we found that G protein inhibition abrogates the Wnt-5a-dependent pathway in hippocampal neurons. In particular, the activation of Gαo appears to be a key factor controlling the Wnt-5a-induced dendritic spine density. In addition, we found that Gβγ is required for the Wnt-5a-mediated increase in cytosolic calcium levels and spinogenesis. Our findings reveal that FZD9 and heterotrimeric G proteins regulate Wnt-5a signaling and dendritic spines in cultured hippocampal neurons. PMID:27402827

Vasoplegic syndrome: A challenge to anaesthetic management

Directory of Open Access Journals (Sweden)

Amarjyoti Hazarika

2015-01-01

Full Text Available Perioperative hypotension is a well-recognized and relatively common problem during surgery. Vasoplegic syndrome is one such condition which is characterized by severe persistent hypotension with normal to high cardiac output and low systemic resistance. It is commonly seen in patients undergoing cardiac surgery on cardiopulmonary bypass. However, this syndrome has also been reported in off pump surgeries. Management of intraoperative hypotension may be challenging for an anaesthesiologist, if it does not respond or poorly respond to conventional therapy. We report the management of a hypertensive patient posted for spine surgery in prone position, who developed severe hypotension under anaesthesia refractory to treatment.

Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients

Science.gov (United States)

Murphy, M.; Connolly, P.; O’Byrne, J.

2008-01-01

neurologically deficit at time of injury. Outcome of the injury was related to increasing age, co-morbidity and the severity of neurological deficit. Injuries of the cervical spine are not infrequent occurrence in the elderly and occur with relatively minor trauma. Neck pain in the elderly patients should be thoroughly evaluated to exclude C2 injuries. Most patients can be managed in an orthosis but unstable injuries require rigid external immobilization or surgical stabilization. PMID:18196293

Anesthetic management of a patient with stiff-person syndrome and thymoma: a case report

Institute of Scientific and Technical Information of China (English)

QIN Xiang; WANG Dong-xin; WU Xin-min

2006-01-01

@@ Stiff-person syndrome (SPS, also called stiff-man syndrome) is a rare neurological disease with autoimmune features. It is characterized by fluctuating and progressive muscle rigidity, and episodic spasm that prominently involve axial and limb musculature.1,2 Herein we report a case of anesthetic management of a patient with SPS for thymectomy and review several other cases.

Subacromial impingement in patients with whiplash injury to the cervical spine

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Giddins Grey E

2008-06-01

Full Text Available Abstract Background Impingement syndrome and shoulder pain have been reported to occur in a proportion of patients following whiplash injuries to the neck. In this study we aim to examine these findings to establish the association between subacromial impingement and whiplash injuries to the cervical spine. Methods and results We examined 220 patients who had presented to the senior author for a medico-legal report following a whiplash injury to the neck. All patients were assessed for clinical evidence of subacromial impingement. 56/220 patients (26% had developed shoulder pain following the injury; of these, 11/220 (5% had clinical evidence of impingement syndrome. Only 3/11 patients (27% had the diagnosis made prior to evaluation for their medico-legal report. In the majority, other clinicians had overlooked the diagnosis. The seatbelt shoulder was involved in 83% of cases (p Conclusion After a neck injury a significant proportion of patients present with shoulder pain, some of whom have treatable shoulder pathology such as impingement syndrome. The diagnosis is, however, frequently overlooked and shoulder pain is attributed to pain radiating from the neck resulting in long delays before treatment. It is important that this is appreciated and patients are specifically examined for signs of subacromial impingement after whiplash injuries to the neck. Direct seatbelt trauma to the shoulder is one possible explanation for its aetiology.

Surgical Site Infections in Pediatric Spine Surgery: Comparative Microbiology of Patients with Idiopathic and Nonidiopathic Etiologies of Spine Deformity.

Science.gov (United States)

Maesani, Matthieu; Doit, Catherine; Lorrot, Mathie; Vitoux, Christine; Hilly, Julie; Michelet, Daphné; Vidal, Christophe; Julien-Marsollier, Florence; Ilharreborde, Brice; Mazda, Keyvan; Bonacorsi, Stéphane; Dahmani, Souhayl

2016-01-01

Surgical site infections (SSIs) are a concern in pediatric spine surgery with unusually high rates for a clean surgery and especially for patients with deformity of nonidiopathic etiology. Microbiologic differences between etiologies of spine deformities have been poorly investigated. We reviewed all cases of SSI in spinal surgery between 2007 and 2011. Characteristics of cases and of bacteria according to the etiology of the spine disease were investigated. Of 496 surgeries, we identified 51 SSIs (10.3%) in 49 patients. Staphylococcus aureus was the most frequent pathogen whatever the etiology (n = 31, 61% of infection cases). The second most frequent pathogens vary according to the etiology of the spine deformity. It was Gram-negative bacilli (GNB) in nonidiopathic cases (n = 19, 45% of cases) and anaerobe in idiopathic cases (n = 8, 38% of cases), particularly Gram-positive anaerobic cocci (n = 5, 24% of cases). Infection rate was 6.8% in cases with idiopathic spine disease (n = 21) and 15.9% in cases with nonidiopathic spine disease (n = 30). Nonidiopathic cases were more frequently male with lower weight. American Society of Anesthesiologists score was more often greater than 2, they had more frequently sacral implants and postoperative intensive care unit stay. GNB were significantly associated with a nonidiopathic etiology, low weight, younger age and sacral fusion. SSIs were polymicrobial in 31% of cases with a mean of 1.4 species per infection cases. S. aureus is the first cause of SSI in pediatric spine surgery. However, Gram-positive anaerobic cocci should be taken into account in idiopathic patients and GNB in nonidiopathic patients when considering antibiotic prophylaxis and curative treatment.

Effectiveness of Treatment of Idiopathic Scoliosis by SpineCor Dynamic Bracing with Special Physiotherapy Programme in SpineCor System.

Science.gov (United States)

Rożek, Karina; Potaczek, Tomasz; Zarzycka, Maja; Lipik, Ewa; Jasiewicz, Barbara

2016-10-28

The SpineCor dynamic brace for the treatment of idiopathic scoliosis is designed to maintain the correct position of the spine and a new movement strategy for 20 hours per day. The SpineCor exercise system intensifies and complements the brace treatment. This study evaluated the effectiveness of a comprehensive treatment of idiopathic scoliosis involving the SpineCor system. The study assessed a group of 40 patients (38 girls and 2 boys) with idiopathic scoliosis treated with the SpineCor brace. The average age at beginning of treatment was 13.1 yrs (10-15). Minimum treatment time was 18 months. 28 participants met the SRS criteria. Angles of the curve before and after bracing based on imaging studies were measured at the beginning and end of the treatment, analyzed and compared. Rehabilitation focused on teaching active corrective movement throughout the brace treatment. A control group was formed of 33 patients, including 21 meeting the SRS criteria, who used the SpineCor dynamic brace but did not participate in the associated exercise programme. Among patients from the exercise group who met the SRS criteria, 25% demonstrated reduced curve angles, 35.7% demonstrated curve progression and 39.3% showed stabilization (no change). Among patients meeting the SRS criteria from the control group, a decrease in curve angle was observed in 14.3% of the patients, curve progression in 57.1% and stabilization in 28.6%. 1. The addition of a dedicated physiotherapy programme to SpineCor dynamic bracing improves the chances of obtaining a positive outcome. 2. It is necessary to further analyse the course of the comprehensive treatment, also with regard to other types of braces and kinesiotherapy programmes.

Neuroleptic Malignant Syndrome: A Case Aimed at Raising Clinical Awareness

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Jad Al Danaf

2015-01-01

Full Text Available A 60-year-old man with a history of bipolar disorder on risperidone, bupropion, and escitalopram was admitted for community acquired streptococcal pneumonia. Four days later, he developed persistent hyperthermia, dysautonomia, rigidity, hyporeflexia, and marked elevation of serum creatine phosphokinase. He was diagnosed with neuroleptic malignant syndrome (NMS and improved with dantrolene, bromocriptine, and supportive therapy. This case emphasizes the importance of considering a broad differential diagnosis for fever in the ICU, carefully reviewing the medication list for all patients, and considering NMS in patients with fever and rigidity.

Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy

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Ali J. Electricwala

2016-01-01

Full Text Available Ewing’s Sarcoma (ES is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012. Primary ES of the spine is extremely rare (Yan et al., 2011. It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009. We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES. Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years.

Pott's Spine with Bilateral Psoas Abscesses

OpenAIRE

Masavkar, Sanjeevani; Shanbag, Preeti; Inamdar, Prithi

2012-01-01

A high degree of suspicion and appropriate imaging studies are required for the early diagnosis of Pott's spine. We describe a 4-year-old boy with Pott's disease of the lumbar spine with bilateral psoas abscesses. The child responded to conservative treatment with antituberculous treatment and ultrasonographically guided percutaneous drainage of the abscesses.

Upper spine morphology in hypophosphatemic rickets and healthy controls

DEFF Research Database (Denmark)

Gjørup, Hans; Sonnesen, Liselotte; Beck-Nielsen, Signe S

2014-01-01

BACKGROUND/OBJECTIVES: The aim of this study was to describe upper spine morphology in adult patients with hypophosphatemic rickets (HR) compared with controls to assess differences in spine morphology in terms of severity of skeletal impact and to study associations between spine morphology...

The SAPHO syndrome: defining the radiologic spectrum of diseases comprising the syndrome

International Nuclear Information System (INIS)

Sugimoto, H.; Tamura, K.; Fujii, T.

1998-01-01

The objective of our study was to clarify the radiologic spectrum of disease entities belonging to the SAPHO syndrome (SAPHO being an acronym for synovitis, acne, pustulosis, hyperostosis, and osteitis). A retrospective analysis of radiologic data was undertaken to determine the relationship of the osteoarthritic changes seen in palmoplantar pustulosis (PPP, n = 179), acne (n = 3), psoriasis vulgaris (PsV, n = 355), generalized pustular psoriasis (GPP, n = 25), and chronic recurrent multifocal osteomyelitis (CRMO, n = 4). Osseous changes of PPP, acne, and CRMO overlap each other; 7 PPP, 2 acne, and 3 CRMO patients manifested stenocostoclavicular hyperostosis as well as hyperostosis of the spine, pelvis, and/or femur. These findings were not seen in either PsV or GPP patients. Thirteen PsV and 4 GPP patients had peripheral arthritis and/or symmetrical sacroiliitis, which were not observed in the PPP, acne, and CRMO patients. The PPP, acne, and CRMO patients may be grouped as belonging to the single disease entity, namely SAPHO syndrome. Our findings do not support the inclusion of PsV and GPP in the spectrum of this syndrome. (orig.)

Periscopic Spine Surgery

National Research Council Canada - National Science Library

Cleary, Kevin R

2000-01-01

.... Key research accomplishments for the first year are: ̂Demonstrated the value of intraoperative CT for visualization and verification of the anatomy in complex spine surgeries in the neurosurgery operating room...

Gonadal dose reduction in lumbar spine radiography

International Nuclear Information System (INIS)

Moilanen, A.; Kokko, M.L.; Pitkaenen, M.

1983-01-01

Different ways to minimize the gonadal dose in lumbar spine radiography have been studied. Two hundred and fifty lumbar spine radiographs were reviewed to assess the clinical need for lateral L5/S1 projection. Modern film/screen combinations and gonadal shielding of externally scattered radiation play a major role in the reduction of the genetic dose. The number of exposures should be minimized. Our results show that two projections, anteroposterior (AP) and lateral, appear to be sufficient in routine radiography of the lumbar spine. (orig.)

Rheumatoid arthritis: Radiological changes in the cervical spine

International Nuclear Information System (INIS)

Al-Boukai, Ahmad A.; Al-Arfaj, Abdurahman S.

2003-01-01

Objective was to describe the radiographic cervical spine changes in rheumatoid arthritis patients.Forty-nine patients (37 females and 12 males ) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between June 1998 and December 2000, were studied for their radiographic cervical spine changes . Their mean age at disease onset was 41.4 + 13.4 years (range of 18-73)and mean duration of disease was 9.1+-6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs cervical spine were obtained to study the cervical spine changes. Cervical radiographic changes were found in 34 patients (27 females and 7 males) 10 had subluxation (7 with atlanto-axial subluxation,2 with sub-axial subluxation,and one with lateral subluxation ). No vertical impaction was seen. Erosion of odontoid process was seen in one patient .All were rheumatoid seropositive Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not clinically significant. (author)

The Burden of Clostridium difficile after Cervical Spine Surgery.

Science.gov (United States)

Guzman, Javier Z; Skovrlj, Branko; Rothenberg, Edward S; Lu, Young; McAnany, Steven; Cho, Samuel K; Hecht, Andrew C; Qureshi, Sheeraz A

2016-06-01

Study Design Retrospective database analysis. Objective The purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after cervical spine surgery. Methods A total of 1,602,130 cervical spine surgeries from the Nationwide Inpatient Sample database from 2002 to 2011 were included. Patients were included for study based on International Classification of Diseases Ninth Revision, Clinical Modification procedural codes for cervical spine surgery for degenerative spine diagnoses. Baseline patient characteristics were determined. Multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. Results Incidence of C. difficile infection in postoperative cervical spine surgery hospitalizations is 0.08%, significantly increased since 2002 (p difficile infection were significantly increased in patients with comorbidities such as congestive heart failure, renal failure, and perivascular disease. Circumferential cervical fusion (odds ratio [OR] = 2.93, p difficile infection after degenerative cervical spine surgery. C. difficile infection after cervical spine surgery results in extended length of stay (p costs (p difficile after cervical spine surgery is nearly 8% versus 0.19% otherwise (p difficile to be a significant predictor of inpatient mortality (OR = 3.99, p difficile increases the risk of in-hospital mortality and costs approximately $6,830,695 per year to manage in patients undergoing elective cervical spine surgery. Patients with comorbidities such as renal failure or congestive heart failure have increased probability of developing infection after surgery. Accepted antibiotic guidelines in this population must be followed to decrease the risk of developing postoperative C. difficile colitis.

Dysphagia associated with cervical spine and postural disorders.

Science.gov (United States)

Papadopoulou, Soultana; Exarchakos, Georgios; Beris, Alexander; Ploumis, Avraam

2013-12-01

Difficulties with swallowing may be both persistent and life threatening for the majority of those who experience it irrespective of age, gender, and race. The purpose of this review is to define oropharyngeal dysphagia and describe its relationship to cervical spine disorders and postural disturbances due to either congenital or acquired disorders. The etiology and diagnosis of dysphagia are analyzed, focusing on cervical spine pathology associated with dysphagia as severe cervical spine disorders and postural disturbances largely have been held accountable for deglutition disorders. Scoliosis, kyphosis–lordosis, and osteophytes are the primary focus of this review in an attempt to elucidate the link between cervical spine disorders and dysphagia. It is important for physicians to be knowledgeable about what triggers oropharyngeal dysphagia in cases of cervical spine and postural disorders. Moreover, the optimum treatment for dysphagia, including the use of therapeutic maneuvers during deglutition, neck exercises, and surgical treatment, is discussed.

A direct comparison of spine rotational stiffness and dynamic spine stability during repetitive lifting tasks.

Science.gov (United States)

Graham, Ryan B; Brown, Stephen H M

2012-06-01

Stability of the spinal column is critical to bear loads, allow movement, and at the same time avoid injury and pain. However, there has been a debate in recent years as to how best to define and quantify spine stability, with the outcome being that different methods are used without a clear understanding of how they relate to one another. Therefore, the goal of the present study was to directly compare lumbar spine rotational stiffness, calculated with an EMG-driven biomechanical model, to local dynamic spine stability calculated using Lyapunov analyses of kinematic data, during a series of continuous dynamic lifting challenges. Twelve healthy male subjects performed 30 repetitive lifts under three varying load and three varying rate conditions. With an increase in the load lifted (constant rate) there was a significant increase in mean, maximum, and minimum spine rotational stiffness (pstiffness (pstiffness and a non-significant decrease in local dynamic stability (p>0.05). Weak linear relationships were found for the varying rate conditions (r=-0.02 to -0.27). The results suggest that spine rotational stiffness and local dynamic stability are closely related to one another, as they provided similar information when movement rate was controlled. However, based on the results from the changing lifting rate conditions, it is evident that both models provide unique information and that future research is required to completely understand the relationship between the two models. Using both techniques concurrently may provide the best information regarding the true effects of (in) stability under different loading and movement scenarios, and in comparing healthy and clinical populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Right thoracic curvature in the normal spine

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Masuda Keigo

2011-01-01

Full Text Available Abstract Background Trunk asymmetry and vertebral rotation, at times observed in the normal spine, resemble the characteristics of adolescent idiopathic scoliosis (AIS. Right thoracic curvature has also been reported in the normal spine. If it is determined that the features of right thoracic side curvature in the normal spine are the same as those observed in AIS, these findings might provide a basis for elucidating the etiology of this condition. For this reason, we investigated right thoracic curvature in the normal spine. Methods For normal spinal measurements, 1,200 patients who underwent a posteroanterior chest radiographs were evaluated. These consisted of 400 children (ages 4-9, 400 adolescents (ages 10-19 and 400 adults (ages 20-29, with each group comprised of both genders. The exclusion criteria were obvious chest and spinal diseases. As side curvature is minimal in normal spines and the range at which curvature is measured is difficult to ascertain, first the typical curvature range in scoliosis patients was determined and then the Cobb angle in normal spines was measured using the same range as the scoliosis curve, from T5 to T12. Right thoracic curvature was given a positive value. The curve pattern was organized in each collective three groups: neutral (from -1 degree to 1 degree, right (> +1 degree, and left ( Results In child group, Cobb angle in left was 120, in neutral was 125 and in right was 155. In adolescent group, Cobb angle in left was 70, in neutral was 114 and in right was 216. In adult group, Cobb angle in left was 46, in neutral was 102 and in right was 252. The curvature pattern shifts to the right side in the adolescent group (p Conclusions Based on standing chest radiographic measurements, a right thoracic curvature was observed in normal spines after adolescence.

Spine device clinical trials: design and sponsorship.

Science.gov (United States)

Cher, Daniel J; Capobianco, Robyn A

2015-05-01

Multicenter prospective randomized clinical trials represent the best evidence to support the safety and effectiveness of medical devices. Industry sponsorship of multicenter clinical trials is purported to lead to bias. To determine what proportion of spine device-related trials are industry-sponsored and the effect of industry sponsorship on trial design. Analysis of data from a publicly available clinical trials database. Clinical trials of spine devices registered on ClinicalTrials.gov, a publicly accessible trial database, were evaluated in terms of design, number and location of study centers, and sample size. The relationship between trial design characteristics and study sponsorship was evaluated using logistic regression and general linear models. One thousand six hundred thrity-eight studies were retrieved from ClinicalTrials.gov using the search term "spine." Of the 367 trials that focused on spine surgery, 200 (54.5%) specifically studied devices for spine surgery and 167 (45.5%) focused on other issues related to spine surgery. Compared with nondevice trials, device trials were far more likely to be sponsored by the industry (74% vs. 22.2%, odds ratio (OR) 9.9 [95% confidence interval 6.1-16.3]). Industry-sponsored device trials were more likely multicenter (80% vs. 29%, OR 9.8 [4.8-21.1]) and had approximately four times as many participating study centers (pdevices not sponsored by the industry. Most device-related spine research is industry-sponsored. Multicenter trials are more likely to be industry-sponsored. These findings suggest that previously published studies showing larger effect sizes in industry-sponsored vs. nonindustry-sponsored studies may be biased as a result of failure to take into account the marked differences in design and purpose. Copyright © 2015 Elsevier Inc. All rights reserved.

Cervical Klippel-Feil syndrome predisposing an elderly African man to central cord myelopathy following minor trauma

OpenAIRE

Olufemi Adeleye, A; Olusola Akinyemi, R

2010-01-01

An otherwise-healthy, active 83-year-old Nigerian man developed reversible central cord myelopathy from a mild fall on a level surface. Cervical spine magnetic resonance imaging (MRI) revealed C5, 6, and 7 block vertebrae and marked disc extrusions only at the immediately adjoining upper and lower non-fused segments of the cervical spine. There was no spinal canal stenosis otherwise. We think that the unique presentation of this case of Klippel-Feil syndrome further supports the impression th...

Isolated Cervical Rib Fracture: A Rare Etiology of Thoracic Outlet Syndrome

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Rayees Ahmad Dar

2011-01-01

Full Text Available Isolated fracture of a cervical rib is a very rare entity and usually presents as a painless swelling or as thoracic outlet syndrome. We describe a case of a 45-year-old woman with history of fall two months back. She presented with symptoms of neurogenic thoracic outlet syndrome for one month. Isolated left cervical rib fracture was documented on X-ray cervical spine. Her fractured cervical rib was resected through a supraclavicular approach, and symptoms resolved completely in the postoperative period.

Dendritic spine morphology and dynamics in health and disease

Directory of Open Access Journals (Sweden)

Lee S

2015-06-01

Full Text Available Stacey Lee,1 Huaye Zhang,2 Donna J Webb1,3,4 1Department of Biological Sciences, Vanderbilt University, Nashville, TN, 2Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, 3Department of Cancer Biology, 4Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, TN, USA Abstract: Dendritic spines are actin-rich structures that form the postsynaptic terminals of excitatory synapses in the brain. The development and plasticity of spines are essential for cognitive processes, such as learning and memory, and defects in their density, morphology, and size underlie a number of neurological disorders. In this review, we discuss the contribution and regulation of the actin cytoskeleton in spine formation and plasticity as well as learning and memory. We also highlight the role of key receptors and intracellular signaling pathways in modulating the development and morphology of spines and cognitive function. Moreover, we provide insight into spine/synapse defects associated with several neurological disorders and the molecular mechanisms that underlie these spine defects. Keywords: dendritic spines, synapses, synaptic plasticity, actin cytoskeleton, glutamate receptors, neurological disorders

The Progression of Posterior Cortical Atrophy to Corticobasal Syndrome: Lumping or Splitting Neurodegenerative Diseases?

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Maurizio Giorelli

2014-06-01

Full Text Available Background: Posterior cortical atrophy is a clinical syndrome that is characterized by the progressive loss of visuospatial integration and is associated with neurodegenerative conditions.Case Report: We describe a 60‐year‐old female with simultanagnosia, oculomotor apraxia, and optic ataxia for which she received an initial clinical diagnosis of posterior cortical atrophy. Three years later, she developed Balint's syndrome, Gerstmann's syndrome, left alien hand syndrome, smooth asymmetric (left rigidity, cortical sensory loss, and spontaneous myoclonic jerks of the left arm, which suggested a final diagnosis of corticobasal syndrome.Discussion: This case report indicates that corticobasal syndrome may present with visuospatial deficits.

MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS

Energy Technology Data Exchange (ETDEWEB)

Thurnher, M.M. [Neuroradiology Section, Department of Radiology, University Hospital Vienna (Austria); Post, M.J.D. [Department of Radiology, Neuroradiology Section, University of Miami School of Medicine, Miami, FL (United States); Jinkins, J.R. [Neuroimaging Research, Department of Radiology, Nebraska Medical Center, Omaha, NE (United States)

2000-08-01

Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment. (orig.)

MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS

International Nuclear Information System (INIS)

Thurnher, M.M.; Post, M.J.D.; Jinkins, J.R.

2000-01-01

Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment. (orig.)

Spine micromorphology of normal and hyperhydric Mammillaria gracilis Pfeiff. (Cactaceae) shoots.

Science.gov (United States)

Peharec, P; Posilović, H; Balen, B; Krsnik-Rasol, M

2010-07-01

Artificial conditions of tissue culture affect growth and physiology of crassulacean acid metabolism plants which often results in formation of hyperhydric shoots. In in vitro conditions Mammillaria gracilis Pfeiff. (Cactaceae) growth switches from organized to unorganized way, producing a habituated organogenic callus which simultaneously regenerates morphologically normal as well as altered hyperhydric shoots. In this study, influence of tissue culture conditions on morphology of cactus spines of normal and hyperhydric shoots was investigated. Spines of pot-grown Mammillaria plants and of in vitro regenerated shoots were examined with stereo microscope and scanning electron microscope. The pot-grown plants had 16-17 spines per areole. In vitro grown normal shoots, even though they kept typical shoot morphology, had lower number of spines (11-12) and altered spine morphology. This difference was even more pronounced in spine number (six to seven) and morphology of the hyperhydric shoots. Scanning electron microscopy analysis revealed remarkable differences in micromorphology of spine surface between pot-grown and in vitro grown shoots. Spines of in vitro grown normal shoots showed numerous long trichomes, which were more elongated on spines of the hyperhydric shoots; the corresponding structures on spine surface of pot-grown plants were noticed only as small protrusions. Scanning electron microscopy morphometric studies showed that the spines of pot-grown plants were significantly longer compared to the spines of shoots grown in tissue culture. Moreover, transverse section shape varies from elliptical in pot-grown plants to circular in normal and hyperhydric shoots grown in vitro. Cluster and correspondence analyses performed on the scanning electron microscope obtained results suggest great variability among spines of pot-grown plants. Spines of in vitro grown normal and hyperhydric shoots showed low level of morphological variation among themselves despite the

Turban pin aspiration: new fashion, new syndrome.

Science.gov (United States)

Ilan, Ophir; Eliashar, Ron; Hirshoren, Nir; Hamdan, Kasem; Gross, Menachem

2012-04-01

Turban pin aspiration syndrome is a new clinical entity afflicting young Islamic girls wearing a turban.The goal of this study was to present our experience in diagnosis and treatment of this new entity, define its clinical and epidemiologic features, and shed a new light on the role of fashion in the increased incidence. A retrospective study in a tertiary university hospital. Review of clinical parameters and epidemiologic features of 26 patients diagnosed with turban pin aspiration syndrome admitted to the Hadassah-Hebrew University Hospitals in Jerusalem from 1990 to 2010. All patients were Muslim females with an average age of 16 years. In all cases, the history was positive for accidental aspiration. Most of the pins were located in the trachea (42%). In 20 cases, the pins were extracted by rigid bronchoscopy without major complications. Fluoroscopy-assisted rigid bronchoscopy was used successfully in three cases. In one case, the object was self-ejected by coughing before the bronchoscopy, and two patients were referred to the chest unit for thoracotomy. Clinicians should be aware of this distinct form of foreign body aspiration, its method of diagnosis, and extraction techniques. A cultural investigation showed a difference in the turban-fastening technique of young girls as compared with their mothers. Removal by rigid bronchoscopy is a safe method with a high success rate and should be considered as the preferred extraction method of choice. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Spine Metastases in Lung Cancer

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O.Yu. Stolyarova

2015-10-01

Full Text Available The purpose and the objectives of the study were to determine the incidence of metastatic lesions to various parts of the spine, the assessment of the association with other clinical signs of lung cancer (localization, form, histology, degree of differentiation, staging, nature of extraosseous metastasis, to investigate the effect of these parameters on the survi­val of the patients. Material and methods. The study included 1071 patients with lung cancer aged 24 to 86 years. None of the examined patients has been operated previously for lung cancer, and after arriving at a diagnosis, all patients received radiation therapy, 73 % of them — combined radiochemothe­rapy. Results. Metastasis in the vertebral bodies and vertebral joints occurs in 13 % of patients with lung cancer and in 61 % of patients with bone form of the disease, the ratio of the defeat of thoracic, sacral, lumbar and cervical spine was 6 : 4 : 2 : 1. The development of metastases in the spine is mostly associa­ted with the localization of the tumor in the upper lobe of the lung, the peripheral form of the disease, with non-small cell histologic variants (adenocarcinoma and squamous cell carcinoma. The number of metastases in the spinal column directly correlates with the degree of metastatic involvement of the inguinal lymph nodes, abdominal wall and the liver, has an impact on the invasion of lung tumor into the esophagus and the trachea. The life expectancy of the deceased persons with spine metastases is less than that of other patients with the lung cancer, but the overall survival rate in these groups of patients is not very different. Conclusions. Clinical features of lung cancer with metastases in the spine necessitate the development of medical technology of rational radiochemotherapy in such patients.

Minimally invasive spine surgery: Hurdles to be crossed

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Mahesh Bijjawara

2014-01-01

Full Text Available MISS as a concept is noble and all surgeons need to address and minimize the surgical morbidity for better results. However, we need to be cautions and not fall prey into accepting that minimally invasive spine surgery can be done only when certain metal access systems are used. Minimally invasive spine surgery (MISS has come a long way since the description of endoscopic discectomy in 1997 and minimally invasive TLIF (mTLIF in 2003. Today there is credible evidence (though not level-I that MISS has comparable results to open spine surgery with the advantage of early postoperative recovery and decreased blood loss and infection rates. However, apart from decreasing the muscle trauma and decreasing the muscle dissection during multilevel open spinal instrumentation, there has been little contribution to address the other morbidity parameters like operative time , blood loss , access to decompression and atraumatic neural tissue handling with the existing MISS technologies. Since all these parameters contribute to a greater degree than posterior muscle trauma for the overall surgical morbidity, we as surgeons need to introspect before we accept the concept of minimally invasive spine surgery being reduced to surgeries performed with a few tubular retractors. A spine surgeon needs to constantly improve his skills and techniques so that he can minimize blood loss, minimize traumatic neural tissue handling and minimizing operative time without compromising on the surgical goals. These measures actually contribute far more, to decrease the morbidity than approach related muscle damage alone. Minimally invasine spine surgery , though has come a long way, needs to provide technical solutions to minimize all the morbidity parameters involved in spine surgery, before it can replace most of the open spine surgeries, as in the case of laparoscopic surgery or arthroscopic surgery.

Gorham Syndrome - massive osteolysis of the cervical spine

International Nuclear Information System (INIS)

Gissler, H.M.; Schoenekaes, K.; Panke, J.

2001-01-01

The Gorham syndrome is identifiable only on the basis of a combination of radiological findings and the clinical pathology. The case history until diagnostic verification very often reveals a long phase of successive tentative diagnoses. Therefore, the radiology expert has to consider this rare bone disease when the case history shows an atypical healing process characterised by progressive osteolysis, negative bacteriology, and non-specific histology. Due to the low incidence and the possibility of spontaneous interruptions, debates about suitable approaches for treatment continue to be controversial. If vertebral bodies are involved, surgery should be applied for stabilisation. A radiotherapy may rapidly reduce the pain and induce recalcification. Therapeutic radiation doses should not be lower than 35-45 Gy. (orig./CB) [de

Evaluation and management of 2 ferocactus spines in the orbit.

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Russell, David J; Kim, Tim I; Kubis, Kenneth

2013-01-01

A 49-year-old woman, who had fallen face first in a cactus 1 week earlier, presented with a small, mobile, noninflamed subcutaneous nodule at the rim of her right lateral orbit with no other functional deficits. A CT scan was obtained, which revealed a 4-cm intraorbital tubular-shaped foreign body resembling a large cactus spine. A second preoperative CT scan, obtained for an intraoperative guidance system, demonstrated a second cactus spine, which was initially not seen on the first CT scan. Both spines were removed surgically without complication. The authors discuss factors that can cause diagnosis delay, review the radiographic features of cactus spines, and discuss the often times benign clinical course of retained cactus spine foreign bodies. To the authors' knowledge, this is the first case report of cactus spines in the orbit. Health-care professionals should have a low threshold for imaging in cases of traumatic injuries involving cactus spines.

[Usefullness of intrasacral fixation in an extremely unstable lumbosacral spine].

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Nishiura, Tsukasa; Nishiguchi, Mitsuhisa; Kusaka, Noboru; Takayama, Kazuhiro; Maeda, Yasuhiko; Ogihara, Kotaro; Nakagawa, Minoru

2007-04-01

Intrasacral fixation technique devised by Jackson is said to provide rigid lumbosacral fixation. We treated 3 cases of lumbosacral lesions using this technique in which lumbosacral segment had become extremely unstable during surgical intervention adding to the effect of original lesions. In all cases, surgeries were performed in 2 stages, intrasacral fixation and anterior stabilization. Case 1: A 52-year-old male was diagnosed fungal discitis and spondylitis at L4 and L5. X-ray showed destruction of the vertebral bodies. L2, L3 and sacrum were fixed posteriorly using the intrasacral fixation technique. One week after the first operation, L4 and L5 vertebral bodies were replaced by long fibula grafts through the extraperitoneal approach. Case 2: A 25-year-old female with cauda equina syndrome and abnormal body form diagnosed as having spondyloptosis in which the entire vertebral body of L5 had descended below the endplate of S1. MR imaging revealed marked canal stenosis at the S1 level. In the first surgery, L5 vertebral body was resected through the transperitoneal approach. After 1 week of bed rest, posterior segments of L5 were resected, L4 was affixed to the sacrum and anterior stabilization was achieved with 2 mesh cages and lumbosacral spine was fixed using the intrasacral fixation technique. Case 3: A 64-year-old female was diagnosed as having pyogenic discitis and osteomyelitis at the L5-S1 level. In spite of successful medical treatment for infection, low back pain continued. Radiologically, L5 vertebral body was shown to have collapsed and slipped anteriorly over the sacrum. L3, L4 and sacrum were fixed by intrasacral fixation. One week after the first operation, the L5/S1 disc and the suppurtive vertebral bodies were resected through the extraperitoneal approach and anterior stabilization was performed with iliac bone grafts. At follow-up for a minimum of 6 months, initial fixation was maintained in all 3 cases and bony fusion was obtained. The

Contextual Learning Induces Dendritic Spine Clustering in Retrosplenial Cortex

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Adam C Frank

2014-03-01

Full Text Available Molecular and electrophysiological studies find convergent evidence suggesting that plasticity within a dendritic tree is not randomly dispersed, but rather clustered into functional groups. Further, results from in silico neuronal modeling show that clustered plasticity is able to increase storage capacity 45 times compared to dispersed plasticity. Recent in vivo work utilizing chronic 2-photon microscopy tested the clustering hypothesis and showed that repetitive motor learning is able to induce clustered addition of new dendritic spines on apical dendrites of L5 neurons in primary motor cortex; moreover, clustered spines were found to be more stable than non-clustered spines, suggesting a physiological role for spine clustering. To further test this hypothesis we used in vivo 2-photon imaging in Thy1-YFP-H mice to chronically examine dendritic spine dynamics in retrosplenial cortex (RSC during spatial learning. RSC is a key component of an extended spatial learning and memory circuit that includes hippocampus and entorhinal cortex. Importantly, RSC is known from both lesion and immediate early gene studies to be critically involved in spatial learning and more specifically in contextual fear conditioning. We utilized a modified contextual fear conditioning protocol wherein animals received a mild foot shock each day for five days; this protocol induces gradual increases in context freezing over several days before the animals reach a behavioral plateau. We coupled behavioral training with four separate in vivo imaging sessions, two before training begins, one early in training, and a final session after training is complete. This allowed us to image spine dynamics before training as well as early in learning and after animals had reached behavioral asymptote. We find that this contextual learning protocol induces a statistically significant increase in the formation of clusters of new dendritic spines in trained animals when compared to home

Successful airway management with King Vision device in a child with Morquio syndrome: case report

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Lina Maritza Guerra

2017-09-01

Full Text Available Morquio syndrome also called type IV mucopolysaccharidosis, is a condition produced by lysosomal deposit. Morquio syndrome have several implications in the airway management because is characterized by C1-C2, instability, short height, cervical spine instability, odontoid hypoplasia, and Pectus carinatum, this, in addition to airway anatomy distortion. Case summary: This is a case report of successful airway management with video laryngoscopy of a child whit anticipated difficult airway whit Morquio syndrome. Conclusion: The video laryngoscopes are a good choice for management of anticipated difficult airway in child patients.

Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.

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Itz, Coen J; Willems, Paul C; Zeilstra, Dick J; Huygen, Frank J

2016-01-01

When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. The aim of the guideline is to determine which invasive treatment intervention is preferred for each included pain syndrome when conservative treatment has failed. Diagnostic studies were evaluated using the EBRO criteria, and studies on therapies were evaluated with the Grading of Recommendations Assessment, Development and Evaluation system. For the evaluation of invasive treatment options, the guideline committee decided that the outcome measures of pain, function, and quality of life were most important. The definition, epidemiology, pathophysiological mechanism, diagnostics, and recommendations for invasive therapy for each of the spinal back pain syndromes are reported. The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study. © 2015 World Institute of Pain.

How Do Object Size and Rigidity Affect Reaching and Grasping in Infants with Down Syndrome?

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de Campos, Ana Carolina; Francisco, Kelly Regina; Savelsbergh, Geert J. P.; Rocha, Nelci Adriana Cicuto Ferreira

2011-01-01

Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The purpose of the present study was to investigate the interaction between such an intrinsic factor, Down syndrome, and extrinsic factors, such as different object properties. Seven infants with Down syndrome and seven…

Setting the equation: establishing value in spine care.

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Resnick, Daniel K; Tosteson, Anna N A; Groman, Rachel F; Ghogawala, Zoher

2014-10-15

Topic review. Describe value measurement in spine care and discuss the motivation for, methods for, and limitations of such measurement. Spinal disorders are common and are an important cause of pain and disability. Numerous complementary and competing treatment strategies are used to treat spinal disorders, and the costs of these treatments is substantial and continue to rise despite clear evidence of improved health status as a result of these expenditures. The authors present the economic and legislative imperatives forcing the assessment of value in spine care. The definition of value in health care and methods to measure value specifically in spine care are presented. Limitations to the utility of value judgments and caveats to their use are presented. Examples of value calculations in spine care are presented and critiqued. Methods to improve and broaden the measurement of value across spine care are suggested, and the role of prospective registries in measuring value is discussed. Value can be measured in spine care through the use of appropriate economic measures and patient-reported outcomes measures. Value must be interpreted in light of the perspective of the assessor, the duration of the assessment period, the degree of appropriate risk stratification, and the relative value of treatment alternatives.

Thermostability in rubredoxin and its relationship to mechanical rigidity

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Rader, A. J.

2010-03-01

The source of increased stability in proteins from organisms that thrive in extreme thermal environments is not well understood. Previous experimental and theoretical studies have suggested many different features possibly responsible for such thermostability. Many of these thermostabilizing mechanisms can be accounted for in terms of structural rigidity. Thus a plausible hypothesis accounting for this remarkable stability in thermophilic enzymes states that these enzymes have enhanced conformational rigidity at temperatures below their native, functioning temperature. Experimental evidence exists to both support and contradict this supposition. We computationally investigate the relationship between thermostability and rigidity using rubredoxin as a case study. The mechanical rigidity is calculated using atomic models of homologous rubredoxin structures from the hyperthermophile Pyrococcus furiosus and mesophile Clostridium pasteurianum using the FIRST software. A global increase in structural rigidity (equivalently a decrease in flexibility) corresponds to an increase in thermostability. Locally, rigidity differences (between mesophilic and thermophilic structures) agree with differences in protection factors.

Thermostability in rubredoxin and its relationship to mechanical rigidity

International Nuclear Information System (INIS)

Rader, A J

2010-01-01

The source of increased stability in proteins from organisms that thrive in extreme thermal environments is not well understood. Previous experimental and theoretical studies have suggested many different features possibly responsible for such thermostability. Many of these thermostabilizing mechanisms can be accounted for in terms of structural rigidity. Thus a plausible hypothesis accounting for this remarkable stability in thermophilic enzymes states that these enzymes have enhanced conformational rigidity at temperatures below their native, functioning temperature. Experimental evidence exists to both support and contradict this supposition. We computationally investigate the relationship between thermostability and rigidity using rubredoxin as a case study. The mechanical rigidity is calculated using atomic models of homologous rubredoxin structures from the hyperthermophile Pyrococcus furiosus and mesophile Clostridium pasteurianum using the FIRST software. A global increase in structural rigidity (equivalently a decrease in flexibility) corresponds to an increase in thermostability. Locally, rigidity differences (between mesophilic and thermophilic structures) agree with differences in protection factors

Selectable six-element multicoil array for entire spine imaging

International Nuclear Information System (INIS)

Byrne, J.W.; Bluma-Walter, J.; Prorok, R.J.

1990-01-01

This article introduces a new multicoil array that can provide entire spine imaging in two acquisitions with no need to manually reposition either the coil or the patient. A selectable contoured multicoil array with six elements was used to obtain coverage of the entire spine. The first four elements were used for imaging the upper spine region (cervical/thoracic) during the first acquisition, and the last four elements were used for imaging the lower spine region (thoracic/lumbar) during the second acquisition. The overall coil length was approximately 75 cm

Degenerative disorders of the spine

International Nuclear Information System (INIS)

Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra; Pistoia, Francesca; Spacca, Giorgio

2005-01-01

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

Degenerative disorders of the spine

Energy Technology Data Exchange (ETDEWEB)

Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Pistoia, Francesca; Spacca, Giorgio [S. Salvatore Hospital, Department of Neuroscience, L' Aquila (Italy)

2005-03-01

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

49 CFR 587.18 - Dimensions of fixed rigid barrier.

Science.gov (United States)

2010-10-01

... TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) DEFORMABLE BARRIERS Offset Deformable Barrier § 587.18 Dimensions of fixed rigid barrier. (a) The fixed rigid barrier has a mass of not... 49 Transportation 7 2010-10-01 2010-10-01 false Dimensions of fixed rigid barrier. 587.18 Section...

RIGIDITY, SENSITIVITY AND QUALITY OF ATTACHMENT - THE ROLE OF MATERNAL RIGIDITY IN THE EARLY SOCIOEMOTIONAL DEVELOPMENT OF PREMATURE-INFANTS

NARCIS (Netherlands)

BUTCHER, PR; KALVERBOER, A; MINDERAA, RB; VANDOORMAAL, EF; TENWOLDE, Y

1993-01-01

The associations between a mother's rigidity, her sensitivity in early (3 month) interaction and the quality of her premature infant's attachment at 13 months were investigated. Rigidity as a personality characteristic was not found to be significantly associated with sensitivity or quality of

Improvement in Scoliosis Top View: Evaluation of Vertebrae Localization in Scoliotic Spine-Spine Axial Presentation

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Paweł Główka

2016-11-01

Full Text Available Morphological analysis of the scoliotic spine is based on two-dimensional X-rays: coronal and sagittal. The three-dimensional character of scoliosis has raised the necessity for analyzing scoliosis in three planes. We proposed a new user-friendly method of graphical presentation of the spine in the third plane–the Spine Axial Presentation (SAP. Eighty-five vertebrae of patients with scoliosis were analyzed. Due to different positions during X-rays (standing and computer tomography (CT (supine, the corresponding measurements cannot be directly compared. As a solution, a software creating Digital Reconstructed Radiographs (DRRs from CT scans was developed to replace regular X-rays with DRRs. Based on the measurements performed on DRRs, the coordinates of vertebral bodies central points were defined. Next, the geometrical centers of vertebral bodies were determined on CT scans. The reproducibility of measurements was tested with Intraclass Correlation Coefficient (ICC, using p = 0.05. The intra-observer reproducibility and inter-observer reliability for vertebral body central point’s coordinates (x, y, z were high for results obtained based on DRRs and CT scans, as well as for comparison results obtained based on DRR and CT scans. Based on two standard radiographs, it is possible to localize vertebral bodies in 3D space. The position of vertebral bodies can be present in the Spine Axial Presentation.

Bilateral locked facets in the thoracic spine

NARCIS (Netherlands)

M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

1984-01-01

textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

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.

Short-term combined effects of thoracic spine thrust manipulation and cervical spine nonthrust manipulation in individuals with mechanical neck pain: a randomized clinical trial.

Science.gov (United States)

Masaracchio, Michael; Cleland, Joshua A; Hellman, Madeleine; Hagins, Marshall

2013-03-01

Randomized clinical trial. To investigate the short-term effects of thoracic spine thrust manipulation combined with cervical spine nonthrust manipulation (experimental group) versus cervical spine nonthrust manipulation alone (comparison group) in individuals with mechanical neck pain. Research has demonstrated improved outcomes with both nonthrust manipulation directed at the cervical spine and thrust manipulation directed at the thoracic spine in patients with neck pain. Previous studies have not determined if thoracic spine thrust manipulation may increase benefits beyond those provided by cervical nonthrust manipulation alone. Sixty-four participants with mechanical neck pain were randomized into 1 of 2 groups, an experimental or comparison group. Both groups received 2 treatment sessions of cervical spine nonthrust manipulation and a home exercise program consisting of active range-of-motion exercises, and the experimental group received additional thoracic spine thrust manipulations. Outcome measures were collected at baseline and at a 1-week follow-up, and included the numeric pain rating scale, the Neck Disability Index, and the global rating of change. Participants in the experimental group demonstrated significantly greater improvements (Ppain rating scale and Neck Disability Index at the 1-week follow-up compared to those in the comparison group. In addition, 31 of 33 (94%) participants in the experimental group, compared to 11 of 31 participants (35%) in the comparison group, indicated a global rating of change score of +4 or higher at the 1-week follow-up, with an associated number needed to treat of 2. Individuals with neck pain who received a combination of thoracic spine thrust manipulation and cervical spine nonthrust manipulation plus exercise demonstrated better overall short-term outcomes on the numeric pain rating scale, the Neck Disability Index, and the global rating of change.

Magnetic Resonance Imaging (MRI): Lumbar Spine (For Parents)

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... Staying Safe Videos for Educators Search English Español Magnetic Resonance Imaging (MRI): Lumbar Spine KidsHealth / For Parents / Magnetic Resonance Imaging (MRI): Lumbar Spine What's in this article? ...

Brachial Plexopathy After Cervical Spine Surgery.

Science.gov (United States)

Than, Khoi D; Mummaneni, Praveen V; Smith, Zachary A; Hsu, Wellington K; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Retrospective, multicenter case-series study and literature review. To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. A retrospective case-series study of 12 903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy. A literature review of the US National Library of Medicine and the National Institutes of Health (PubMed) database was conducted to identify articles pertaining to brachial plexopathy following cervical spine surgery. In our total population of 12 903 patients, only 1 suffered from postoperative brachial plexopathy. The overall prevalence rate was thus 0.01%, but the prevalence rate at the site where this complication occurred was 0.07%. Previously reported risk factors for postoperative brachial plexopathy include age, anterior surgical procedures, and a diagnosis of ossification of the posterior longitudinal ligament. The condition can also be due to patient positioning during surgery, which can generally be detected via the use of intraoperative neuromonitoring. Brachial plexopathy following cervical spine surgery is rare and merits further study.

EFFICIENCY METHODS OF PHYSICAL REHABILITATION OF OSTEOCHONDROSIS OF THE LUMBAR SPINE

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Кyreev IV

2017-03-01

Full Text Available Introduction. Osteochondrosis – the most common disease of the spine, which affects more than 70% of the population. Important is the social significance of osteochondrosis, in the structure of diseases of the musculoskeletal system as a whole the average primary disability of adult consequence of osteochondrosis – 1,7 to 10 000. It is important finding the most effective methods of complex treatment, and most importantly rehabilitation and recovery of patients with osteochondrosis. Material & methods. We selected 16 patients with osteochondrosis of the lumbar spine, men aged 29-42 years with disease duration from 2 to 9 years. To determine the effectiveness of the methods of physical rehabilitation of patients with lumbar osteochondrosis outside the period of exacerbation assessed the dynamics of three indicators: vertebral syndrome, extravertebral syndrome, subjective assessment of the general condition of patients by psychological testing. After the examination, the patients divided into two groups of 8 people. Patients of the first group received physical therapy (ultrasound therapy and massage therapy. Pharmacotherapy is not done. Patients of the second group received medications according to the recommendations received after discharge from hospital. Results & discussion. After the rehabilitation treatment severity of vertebral syndrome significantly decreased to 1,1±0,23 points (р < 0,05 in first group and to до 1,0±0,33 points in second group (р < 0,05 with no significant difference between groups of patients. These figures suggest that all patients there was a reduction in pain to a weak pain, but some patients even before its termination. After rehabilitation terms of pain rate in the first group significantly decreased to 1,1±0,03 (p <0,05 points; in the second group, the figure dropped significantly to 1,2±0,08 (p <0, 05 points. In patients who did not receive pharmacotherapy, improvement in psychological testing "HAM

Fifty top-cited spine articles from mainland China: A citation analysis.

Science.gov (United States)

Wu, Yaohong; Zhao, Yachao; Lin, Linghan; Lu, Zhijun; Guo, Zhaoyang; Li, Xiaoming; Chen, Rongchun; Ma, Huasong

2018-02-01

Objective To identify the 50 top-cited spine articles from mainland China and to analyze their main characteristics. Methods Web of Science was used to identify the 50 top-cited spine articles from mainland China in 27 spine-related journals. The title, year of publication, number of citations, journal, anatomic focus, subspecialty, evidence level, city, institution and author were recorded. Results The top 50 articles had 29-122 citations and were published in 11 English-language journals; most (32) were published in the 2000s. The journal Spine had the largest number of articles and The Lancet had the highest impact factor. The lumber spine was the most discussed anatomic area (18). Degenerative spine disease was the most common subspecialty topic (22). Most articles were clinical studies (29); the others were basic research (21). Level IV was the most common evidence level (17). Conclusions This list indicates the most influential articles from mainland China in the global spine research community. Identification of these articles provides insights into the trends in spine care in mainland China and the historical contributions of researchers from mainland China to the international spine research field.

Accuracy of pedicle screw placement in patients with Marfan syndrome.

Science.gov (United States)

Qiao, Jun; Zhu, Feng; Xu, Leilei; Liu, Zhen; Sun, Xu; Qian, Bangping; Jiang, Qing; Zhu, Zezhang; Qiu, Yong

2017-03-21

There is no study concerning safety and accuracy of pedicle screw placement in Marfan syndrome. The objective of this study is to investigate accuracy and safety of pedicle screw placement in scoliosis associated with Marfan syndrome. CT scanning was performed to analyze accuracy of pedicle screw placement. Pedicle perforations were classified as medial, lateral or anterior and categorized to four grades: ≤ 2 mm as Grade 1, 2.1-4.0 mm as Grade 2, 4.1-6.0 mm as Grade 3, ≥6.1 mm as Grade 4. Fully contained screws or with medial wall perforation ≤ 2 mm or with lateral wall perforation ≤ 6 mm and without injury of visceral organs were considered acceptable, otherwise were unacceptable. 976 pedicle screws were placed, 713 screws (73.1%) were fully contained within the cortical boundaries of the pedicle. 924 (94.7%) screws were considered as acceptable, and 52 (5.3%) as unacceptable. The perforation rate was higher using free-hand technique than O-arm navigation technique (30.8% VS. 11.4%, P Marfan syndrome is accuracy and safe. O-arm navigation was an effective modality to ensure the safety and accuracy of screw placement. Special attention should be paid when screws were placed at the lumber spine and the concave side of spine deformity to avoid the higher rate of complications.

Cervical spine injury in child abuse: report of two cases

Energy Technology Data Exchange (ETDEWEB)

Rooks, V.J.; Sisler, C.; Burton, B. [Tripler Army Medical Center, Honolulu, HI (United States). Dept. of Radiology

1998-03-01

Pediatric cervical spine injuries have rarely been reported in the setting of child abuse. We report two cases of unsuspected lower cervical spine fracture-dislocation in twin infant girls who had no physical examination findings to suggest cervical spine injury. Classic radio-graphic findings of child abuse were noted at multiple other sites in the axial and appendicular skeleton. Magnetic resonance (MR) imaging proved to be valuable in both the initial evaluation of the extent of cervical spine injury and in following postoperative changes. The unexpected yet devastating findings in these two cases further substantiate the importance of routine evaluation of the cervical spine in cases of suspected child abuse. (orig.)

Cervical spine injury in child abuse: report of two cases

International Nuclear Information System (INIS)

Rooks, V.J.; Sisler, C.; Burton, B.

1998-01-01

Pediatric cervical spine injuries have rarely been reported in the setting of child abuse. We report two cases of unsuspected lower cervical spine fracture-dislocation in twin infant girls who had no physical examination findings to suggest cervical spine injury. Classic radio-graphic findings of child abuse were noted at multiple other sites in the axial and appendicular skeleton. Magnetic resonance (MR) imaging proved to be valuable in both the initial evaluation of the extent of cervical spine injury and in following postoperative changes. The unexpected yet devastating findings in these two cases further substantiate the importance of routine evaluation of the cervical spine in cases of suspected child abuse. (orig.)

Transitional lumbosacral vertebrae and low back pain: diagnostic pitfalls and management of Bertolotti's syndrome

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Almeida,Daniel Benzecry de; Mattei,Tobias Alécio; Sória,Marília Grando; Prandini,Mirto Nelso; Leal,André Giacomelli; Milano,Jerônimo Buzzeti; Ramina,Ricardo

2009-01-01

OBJECTIVE: Bertolotti's syndrome is a spine disorder characterized by the occurrence of a congenital lumbar transverse mega-apophysis in a transitional vertebral body that usually articulates with the sacrum or the iliac bone. It has been considered a possible cause of low back pain. METHOD: We analyzed the cases of Bertolotti's syndrome that failed clinical treatment and reviewed the literature concerning this subject. RESULTS: Five patients in our series had severe low back pain due to the ...

Anophthalmia-plus syndrome: a clinical report and review of the literature.

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Makhoul, Imad R; Soudack, Michalle; Kochavi, Orna; Guilburd, Joseph N; Maimon, Shimon; Gershoni-Baruch, Ruth

2007-01-01

We describe a term male infant of healthy non-consanguineous parents, born with congenital malformations, including bilateral cleft palate and lip, mild microphthalmia with iris coloboma and glaucoma of the right eye, and blepharophimosis with severe microphthalmia of the left eye. Spine radiograph and MRI showed first sacral hemivertebra with spina bifida, and agenesis of the 2nd, 3rd, 4th, and 5th sacral vertebrae and coccyx. Spine MRI showed caudal tethering of spinal cord at L(3) level, filum terminalis lipoma and a syringomyelia. Brain ultrasound and MRI showed hypoplasia of corpus callosum with mild dilatation of the lateral ventricles. Orbital MRI showed bilateral microphthalmia-distorted small left eyeball with posteriorly located lens, and a split vitreous body in the right eye, suggestive of primary hyperplastic vitreous. The karyotype was normal. Summary of the findings in nine cases (our case and eight published cases) support the notion that anophthalmia-plus syndrome (APS) is a distinct syndrome. Gene locus of APS is yet to be identified. (c) 2006 Wiley-Liss, Inc.

Defensive Medicine in U.S. Spine Neurosurgery.

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Din, Ryan S; Yan, Sandra C; Cote, David J; Acosta, Michael A; Smith, Timothy R

2017-02-01

Observational cross-sectional survey. To compare defensive practices of U.S. spine and nonspine neurosurgeons in the context of state medical liability risk. Defensive medicine is a commonly reported and costly phenomenon in neurosurgery. Although state liability risk is thought to contribute greatly to defensive practice, variation within neurosurgical specialties has not been well explored. A validated, online survey was sent via email to 3344 members of the American Board of Neurological Surgeons. The instrument contained eight question domains: surgeon characteristics, patient characteristics, practice type, insurance type, surgeon liability profile, basic surgeon reimbursement, surgeon perceptions of medical legal environment, and the practice of defensive medicine. The overall response rate was 30.6% (n = 1026), including 499 neurosurgeons performing mainly spine procedures (48.6%). Spine neurosurgeons had a similar average practice duration as nonspine neurosurgeons (16.6 vs 16.9 years, P = 0.64) and comparable lifetime case volume (4767 vs 4,703, P = 0.71). The average annual malpractice premium for spine neurosurgeons was similar to nonspine neurosurgeons ($104,480.52 vs $101,721.76, P = 0.60). On average, spine neurosurgeons had a significantly higher rate of ordering labs, medications, referrals, procedures, and imaging solely for liability concerns compared with nonspine neurosurgeons (89.2% vs 84.6%, P = 0.031). Multivariate analysis revealed that spine neurosurgeons were roughly 3 times more likely to practice defensively compared with nonspine neurosurgeons (odds ratio, OR = 2.9, P = 0.001) when controlling for high-risk procedures (OR = 7.8, P < 0.001), annual malpractice premium (OR = 3.3, P = 0.01), percentage of patients publicly insured (OR = 1.1, P = 0.80), malpractice claims in the last 3 years (OR = 1.13, P = 0.71), and state medical-legal environment (OR = 1.3, P = 0

Spatiotemporal Dynamics of Dendritic Spines in the Living Brain

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Chia-Chien eChen

2014-05-01

Full Text Available Dendritic spines are ubiquitous postsynaptic sites of most excitatory synapses in the mammalian brain, and thus may serve as structural indicators of functional synapses. Recent works have suggested that neuronal coding of memories may be associated with rapid alterations in spine formation and elimination. Technological advances have enabled researchers to study spine dynamics in vivo during development as well as under various physiological and pathological conditions. We believe that better understanding of the spatiotemporal patterns of spine dynamics will help elucidate the principles of experience-dependent circuit modification and information processing in the living brain.

MAGNETIC RESONANCE IMAGING IN FAILED BACK SURGERY SYNDROME

OpenAIRE

SEN, KK; SINGH, AMARJIT

1999-01-01

The failed back surgery syndrome (FBSS) is a severe, long-lasting, disabling and relatively frequent (5-10%) complication of lumbosacral spine surgery. Wrong level surgery, inadequate surgical techniques, vertebral instability, recurrent disc herniation, and lumbosacral fibrosis are the most frequent causes of FBSS. The results after repeated surgery on recurrent disc herniations are comparable to those after the first intervention, whereas repeated surgery for fibrosis gives only 30-35% succ...

49 CFR 572.85 - Lumbar spine flexure.

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine flexure. 572.85 Section 572.85... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.85 Lumbar spine flexure. (a) When subjected to continuously applied force in accordance with paragraph (b...

Cranial irradiation alters dendritic spine density and morphology in the hippocampus.

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Ayanabha Chakraborti

Full Text Available Therapeutic irradiation of the brain is a common treatment modality for brain tumors, but can lead to impairment of cognitive function. Dendritic spines are sites of excitatory synaptic transmission and changes in spine structure and number are thought to represent a morphological correlate of altered brain functions associated with hippocampal dependent learning and memory. To gain some insight into the temporal and sub region specific cellular changes in the hippocampus following brain irradiation, we investigated the effects of 10 Gy cranial irradiation on dendritic spines in young adult mice. One week or 1 month post irradiation, changes in spine density and morphology in dentate gyrus (DG granule and CA1 pyramidal neurons were quantified using Golgi staining. Our results showed that in the DG, there were significant reductions in spine density at both 1 week (11.9% and 1 month (26.9% after irradiation. In contrast, in the basal dendrites of CA1 pyramidal neurons, irradiation resulted in a significant reduction (18.7% in spine density only at 1 week post irradiation. Analysis of spine morphology showed that irradiation led to significant decreases in the proportion of mushroom spines at both time points in the DG as well as CA1 basal dendrites. The proportions of stubby spines were significantly increased in both the areas at 1 month post irradiation. Irradiation did not alter spine density in the CA1 apical dendrites, but there were significant changes in the proportion of thin and mushroom spines at both time points post irradiation. Although the mechanisms involved are not clear, these findings are the first to show that brain irradiation of young adult animals leads to alterations in dendritic spine density and morphology in the hippocampus in a time dependent and region specific manner.

Cracking of open traffic rigid pavement

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Niken Chatarina

2017-01-01

Full Text Available The research is done by observing the growth of real structure cracking in Natar, Lampung, Indonesia compared to C. Niken’s et al research and literature study. The rigid pavement was done with open traffic system. There are two main crack types on Natar rigid pavement: cracks cross the road, and cracks spreads on rigid pavement surface. The observation of cracks was analyzed by analyzing material, casting, curing, loading and shrinkage mechanism. The relationship between these analysis and shrinkage mechanism was studied in concrete micro structure. Open traffic make hydration process occur under vibration; therefore, fresh concrete was compressed and tensioned alternately since beginning. High temperature together with compression, cement dissociation, the growth of Ca2+ at very early age leads abnormal swelling. No prevention from outside water movement leads hydration process occur with limited water which caused spreads fine cracks. Limited water improves shrinkage and plastic phase becomes shorter; therefore, rigid pavement can’t accommodate the abnormal swelling and shrinking alternately and creates the spread of cracks. Discontinuing casting the concrete makes both mix under different condition, the first is shrink and the second is swell and creates weak line on the border; so, the cracks appear as cracks across the road.

Degenerative Changes in the Spine: Is This Arthritis?

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... in my spine. Does this mean I have arthritis? Answers from April Chang-Miller, M.D. Yes. ... spine. Osteoarthritis is the most common form of arthritis. Doctors may also refer to it as degenerative ...

Reversible Rigidity Control Using Low Melting Temperature Alloys

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Shan, Wanliang; Lu, Tong; Majidi, Carmel

2013-03-01

Inspired by nature, materials able to achieve rapid rigidity changes have important applications for human body protection in military and many other areas. This talk presents the fabrication and design of soft-matter technologies that exhibit rapid reversible rigidity control. Fabricated with a masked deposition technique, the soft-matter composite contains liquid-phase and phase-changing metal alloys embedded in a soft and highly stretchable elastomer. The composite material can reversibly change its rigidity by three orders of magnitude and sustain large deformation.

Social defeat stress induces depression-like behavior and alters spine morphology in the hippocampus of adolescent male C57BL/6 mice.

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Iñiguez, Sergio D; Aubry, Antonio; Riggs, Lace M; Alipio, Jason B; Zanca, Roseanna M; Flores-Ramirez, Francisco J; Hernandez, Mirella A; Nieto, Steven J; Musheyev, David; Serrano, Peter A

2016-12-01

Social stress, including bullying during adolescence, is a risk factor for common psychopathologies such as depression. To investigate the neural mechanisms associated with juvenile social stress-induced mood-related endophenotypes, we examined the behavioral, morphological, and biochemical effects of the social defeat stress model of depression on hippocampal dendritic spines within the CA1 stratum radiatum. Adolescent (postnatal day 35) male C57BL/6 mice were subjected to defeat episodes for 10 consecutive days. Twenty-four h later, separate groups of mice were tested on the social interaction and tail suspension tests. Hippocampi were then dissected and Western blots were conducted to quantify protein levels for various markers important for synaptic plasticity including protein kinase M zeta (PKMζ), protein kinase C zeta (PKCζ), the dopamine-1 (D1) receptor, tyrosine hydroxylase (TH), and the dopamine transporter (DAT). Furthermore, we examined the presence of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-receptor subunit GluA2 as well as colocalization with the post-synaptic density 95 (PSD95) protein, within different spine subtypes (filopodia, stubby, long-thin, mushroom) using an immunohistochemistry and Golgi-Cox staining technique. The results revealed that social defeat induced a depression-like behavioral profile, as inferred from decreased social interaction levels, increased immobility on the tail suspension test, and decreases in body weight. Whole hippocampal immunoblots revealed decreases in GluA2, with a concomitant increase in DAT and TH levels in the stressed group. Spine morphology analyses further showed that defeated mice displayed a significant decrease in stubby spines, and an increase in long-thin spines within the CA1 stratum radiatum. Further evaluation of GluA2/PSD95 containing-spines demonstrated a decrease of these markers within long-thin and mushroom spine types. Together, these results indicate that juvenile

Isoflurane reversibly destabilizes hippocampal dendritic spines by an actin-dependent mechanism.

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Jimcy Platholi

Full Text Available General anesthetics produce a reversible coma-like state through modulation of excitatory and inhibitory synaptic transmission. Recent evidence suggests that anesthetic exposure can also lead to sustained cognitive dysfunction. However, the subcellular effects of anesthetics on the structure of established synapses are not known. We investigated effects of the widely used volatile anesthetic isoflurane on the structural stability of hippocampal dendritic spines, a postsynaptic structure critical to excitatory synaptic transmission in learning and memory. Exposure to clinical concentrations of isoflurane induced rapid and non-uniform shrinkage and loss of dendritic spines in mature cultured rat hippocampal neurons. Spine shrinkage was associated with a reduction in spine F-actin concentration. Spine loss was prevented by either jasplakinolide or cytochalasin D, drugs that prevent F-actin disassembly. Isoflurane-induced spine shrinkage and loss were reversible upon isoflurane elimination. Thus, isoflurane destabilizes spine F-actin, resulting in changes to dendritic spine morphology and number. These findings support an actin-based mechanism for isoflurane-induced alterations of synaptic structure in the hippocampus. These reversible alterations in dendritic spine structure have important implications for acute anesthetic effects on excitatory synaptic transmission and synaptic stability in the hippocampus, a locus for anesthetic-induced amnesia, and have important implications for anesthetic effects on synaptic plasticity.

A human neurodevelopmental model for Williams syndrome.

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Chailangkarn, Thanathom; Trujillo, Cleber A; Freitas, Beatriz C; Hrvoj-Mihic, Branka; Herai, Roberto H; Yu, Diana X; Brown, Timothy T; Marchetto, Maria C; Bardy, Cedric; McHenry, Lauren; Stefanacci, Lisa; Järvinen, Anna; Searcy, Yvonne M; DeWitt, Michelle; Wong, Wenny; Lai, Philip; Ard, M Colin; Hanson, Kari L; Romero, Sarah; Jacobs, Bob; Dale, Anders M; Dai, Li; Korenberg, Julie R; Gage, Fred H; Bellugi, Ursula; Halgren, Eric; Semendeferi, Katerina; Muotri, Alysson R

2016-08-18

Williams syndrome is a genetic neurodevelopmental disorder characterized by an uncommon hypersociability and a mosaic of retained and compromised linguistic and cognitive abilities. Nearly all clinically diagnosed individuals with Williams syndrome lack precisely the same set of genes, with breakpoints in chromosome band 7q11.23 (refs 1-5). The contribution of specific genes to the neuroanatomical and functional alterations, leading to behavioural pathologies in humans, remains largely unexplored. Here we investigate neural progenitor cells and cortical neurons derived from Williams syndrome and typically developing induced pluripotent stem cells. Neural progenitor cells in Williams syndrome have an increased doubling time and apoptosis compared with typically developing neural progenitor cells. Using an individual with atypical Williams syndrome, we narrowed this cellular phenotype to a single gene candidate, frizzled 9 (FZD9). At the neuronal stage, layer V/VI cortical neurons derived from Williams syndrome were characterized by longer total dendrites, increased numbers of spines and synapses, aberrant calcium oscillation and altered network connectivity. Morphometric alterations observed in neurons from Williams syndrome were validated after Golgi staining of post-mortem layer V/VI cortical neurons. This model of human induced pluripotent stem cells fills the current knowledge gap in the cellular biology of Williams syndrome and could lead to further insights into the molecular mechanism underlying the disorder and the human social brain.

Brachial Plexopathy After Cervical Spine Surgery

OpenAIRE

Than, Khoi D.; Mummaneni, Praveen V.; Smith, Zachary A.; Hsu, Wellington K.; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

2017-01-01

Study Design: Retrospective, multicenter case-series study and literature review. Objectives: To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. Methods: A retrospective case-series study of 12?903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy....

Tophaceous gout in the cervical spine

Energy Technology Data Exchange (ETDEWEB)

Cabot, Jonathan [Royal Adelaide Hospital, Department of Orthopaedic Surgery, Adelaide, South Australia (Australia); Mosel, Leigh; Kong, Andrew; Hayward, Mike [Flinders Medical Centre, Department of Medical Imaging, Bedford Park, South Australia (Australia)

2005-12-01

Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. (orig.)

Tophaceous gout in the cervical spine

International Nuclear Information System (INIS)

Cabot, Jonathan; Mosel, Leigh; Kong, Andrew; Hayward, Mike

2005-01-01

Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. (orig.)

Determination of Weight Suspension Rigidity in the Transport-Erector Aggregates

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V. A. Zverev

2016-01-01

Full Text Available The aim is to determine weight suspension rigidity in aggregates designed to perform technological transport-erector operations at the miscellaneous launch complexes.We consider the weight suspension comprising the following distinctive structural components: the executive weight-lowering mechanism, polyspast mechanism, rope, traverse, and rods. A created structural dynamic model of suspension allowed us to define weight suspension rigidity. Within the framework of design analysis of a dynamic model we determined the rigidity of its structural units, i.e. traverse, rope, and polyspast.Known analytical relationships were used to calculate the rope rigidity. To determine rigidity of polyspast and traverse have been created special models based on the finite element method. For each model deformation in the specific points under the test load have been defined. Data obtained were used to determine trigidity of traverses and polyspast, and also rigidity of suspension in total. The rigidity models of polispast mechanism and traverse have been developed and calculated using the software complex "Zenit-95".As the research results, the paper presents a dynamic model of the weight suspension of the transport-erector aggregate, the finite element models of the polispast mechanism and traverse, an algorithm for determining the weight suspension rigidity and relevant analytical relationships.Independent calculation of weight suspension rigidity enables us to simplify further dynamic calculation of the aggregate-weight system because it allows attaining a simpler model of the aggregate-weight system that uses the weight suspension model as an element of equivalent rigidity. Despite this simplification the model allows us to determine correctly weight movement parameters and overloads in the aggregate-weight system in the process of technical operations.

Automated curved planar reformation of 3D spine images

International Nuclear Information System (INIS)

Vrtovec, Tomaz; Likar, Bostjan; Pernus, Franjo

2005-01-01

Traditional techniques for visualizing anatomical structures are based on planar cross-sections from volume images, such as images obtained by computed tomography (CT) or magnetic resonance imaging (MRI). However, planar cross-sections taken in the coordinate system of the 3D image often do not provide sufficient or qualitative enough diagnostic information, because planar cross-sections cannot follow curved anatomical structures (e.g. arteries, colon, spine, etc). Therefore, not all of the important details can be shown simultaneously in any planar cross-section. To overcome this problem, reformatted images in the coordinate system of the inspected structure must be created. This operation is usually referred to as curved planar reformation (CPR). In this paper we propose an automated method for CPR of 3D spine images, which is based on the image transformation from the standard image-based to a novel spine-based coordinate system. The axes of the proposed spine-based coordinate system are determined on the curve that represents the vertebral column, and the rotation of the vertebrae around the spine curve, both of which are described by polynomial models. The optimal polynomial parameters are obtained in an image analysis based optimization framework. The proposed method was qualitatively and quantitatively evaluated on five CT spine images. The method performed well on both normal and pathological cases and was consistent with manually obtained ground truth data. The proposed spine-based CPR benefits from reduced structural complexity in favour of improved feature perception of the spine. The reformatted images are diagnostically valuable and enable easier navigation, manipulation and orientation in 3D space. Moreover, reformatted images may prove useful for segmentation and other image analysis tasks

Influence of flock coating on bending rigidity of woven fabrics

Science.gov (United States)

Ozdemir, O.; Kesimci, M. O.

2017-10-01

This work presents the preliminary results of our efforts that focused on the effect of the flock coating on the bending rigidity of woven fabrics. For this objective, a laboratory scale flocking unit is designed and flocked samples of controlled flock density are produced. Bending rigidity of the samples with different flock densities are measured on both flocked and unflocked sides. It is shown that the bending rigidity depends on both flock density and whether the side to be measured is flocked or not. Adhesive layer thickness on the bending rigidity is shown to be dramatic. And at higher basis weights, flock density gets less effective on bending rigidity.

CT should replace three-view radiographs as the initial screening test in patients at high, moderate, and low risk for blunt cervical spine injury: a prospective comparison.

Science.gov (United States)

Bailitz, John; Starr, Frederic; Beecroft, Matthew; Bankoff, Jon; Roberts, Roxanne; Bokhari, Faran; Joseph, Kimberly; Wiley, Dorian; Dennis, Andrew; Gilkey, Susan; Erickson, Paul; Raksin, Patricia; Nagy, Kimberly

2009-06-01

An estimated 10,000 Americans suffer cervical spine injuries each year. More than 800,000 cervical spine radiographs (CSR) are ordered annually. The human and healthcare costs associated with these injuries are enormous especially when diagnosis is delayed. Controversy exists in the literature concerning the diagnostic accuracy of CSR, with reported sensitivity ranging from 32% to 89%. We sought to compare prospectively the sensitivity of cervical CT (CCT) to CSR in the initial diagnosis of blunt cervical spine injury for patients meeting one or more of the NEXUS criteria. The study prospectively compared the diagnostic accuracy of CSR to CCT in consecutive patients evaluated for blunt trauma during 23 months at an urban, public teaching hospital and Level I Trauma Center. Inclusion criteria were adult patient, evaluated for blunt cervical spine injury, meeting one or more of the NEXUS criteria. All patients received both three-view CSR and CCT as part of a standard diagnostic protocol. Each CSR and CCT study was interpreted independently by a different radiology attending who was blinded to the results of the other study. Clinically significant injuries were defined as those requiring one or more of the following interventions: operative procedure, halo application, and/or rigid cervical collar. Of 1,583 consecutive patients evaluated for blunt cervical spine trauma, 78 (4.9%) patients received only CCT or CSR and were excluded from the study. Of the remaining 1,505 patients, 78 (4.9%) had evidence of a radiographic injury by CSR or CCT. Of these 78 patients with radiographic injury, 50 (3.3%) patients had clinically significant injuries. CCT detected all patients with clinically significant injuries (100% sensitive), whereas CSR detected only 18 (36% sensitive). Of the 50 patients, 15 were at high risk, 19 at moderate risk, and 16 at low risk for cervical spine injury according to previously published risk stratification. CSR detected clinically significant

Epidural Hematoma Following Cervical Spine Surgery.

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Schroeder, Gregory D; Hilibrand, Alan S; Arnold, Paul M; Fish, David E; Wang, Jeffrey C; Gum, Jeffrey L; Smith, Zachary A; Hsu, Wellington K; Gokaslan, Ziya L; Isaacs, Robert E; Kanter, Adam S; Mroz, Thomas E; Nassr, Ahmad; Sasso, Rick C; Fehlings, Michael G; Buser, Zorica; Bydon, Mohamad; Cha, Peter I; Chatterjee, Dhananjay; Gee, Erica L; Lord, Elizabeth L; Mayer, Erik N; McBride, Owen J; Nguyen, Emily C; Roe, Allison K; Tortolani, P Justin; Stroh, D Alex; Yanez, Marisa Y; Riew, K Daniel

2017-04-01

A multicentered retrospective case series. To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment ( P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.

The SAPHO syndrome: defining the radiologic spectrum of diseases comprising the syndrome

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Sugimoto, H.; Tamura, K. [Department of Radiology, Jichi Medical School, 3311 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04 (Japan); Fujii, T. [Department of Pathology, Jichi Medical School, 3311 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04 (Japan)

1998-06-02

The objective of our study was to clarify the radiologic spectrum of disease entities belonging to the SAPHO syndrome (SAPHO being an acronym for synovitis, acne, pustulosis, hyperostosis, and osteitis). A retrospective analysis of radiologic data was undertaken to determine the relationship of the osteoarthritic changes seen in palmoplantar pustulosis (PPP, n = 179), acne (n = 3), psoriasis vulgaris (PsV, n = 355), generalized pustular psoriasis (GPP, n = 25), and chronic recurrent multifocal osteomyelitis (CRMO, n = 4). Osseous changes of PPP, acne, and CRMO overlap each other; 7 PPP, 2 acne, and 3 CRMO patients manifested stenocostoclavicular hyperostosis as well as hyperostosis of the spine, pelvis, and/or femur. These findings were not seen in either PsV or GPP patients. Thirteen PsV and 4 GPP patients had peripheral arthritis and/or symmetrical sacroiliitis, which were not observed in the PPP, acne, and CRMO patients. The PPP, acne, and CRMO patients may be grouped as belonging to the single disease entity, namely SAPHO syndrome. Our findings do not support the inclusion of PsV and GPP in the spectrum of this syndrome. (orig.) With 7 figs., 2 tabs., 30 refs.

Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

International Nuclear Information System (INIS)

Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade; Laufer, Ilya

2016-01-01

Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

Energy Technology Data Exchange (ETDEWEB)

Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Taunk, Neil Kanth; Yamada, Yoshiya [Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States); Laufer, Ilya, E-mail: fymoraes@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Neurosurgery, New York, NY (United States)

2016-02-15

Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

An unusual presentation of pediatric osteoblastoma in a patient with Klippel-Trenaunay-Weber syndrome: case report.

Science.gov (United States)

Wallace, Scott A; Ignacio, Romeo C; Klugh, Arnett; Gates, Gregory; Henry, Marion C W

2015-06-01

Osteoblastoma is an uncommon primary bone tumor that usually presents as a painful lesion in a long bone or in the spine. Osteoblastoma has been reported only twice in the literature in conjunction with systemic fibromatosis. The authors report the case of an 8-year-old girl with suspected Klippel-Trenaunay-Weber syndrome, a rare syndrome of systemic fibromatosis, who presented with a painless thoracic rib lesion that was found to be an osteoblastoma.

Brief Report: Should the DSM V Drop Asperger Syndrome?

Science.gov (United States)

Ghaziuddin, Mohammad

2010-01-01

The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However,…

Barriers in the brain : resolving dendritic spine morphology and compartmentalization

NARCIS (Netherlands)

Adrian, Max; Kusters, Remy; Wierenga, Corette J; Storm, Cornelis; Hoogenraad, Casper C; Kapitein, Lukas C

2014-01-01

Dendritic spines are micron-sized protrusions that harbor the majority of excitatory synapses in the central nervous system. The head of the spine is connected to the dendritic shaft by a 50-400 nm thin membrane tube, called the spine neck, which has been hypothesized to confine biochemical and

Lumbar Spine Surgery in Patients with Parkinson Disease.

Science.gov (United States)

Schroeder, Joshua E; Hughes, Alexander; Sama, Andrew; Weinstein, Joseph; Kaplan, Leon; Cammisa, Frank P; Girardi, Federico P

2015-10-21

Parkinson disease is the second most common neurodegenerative condition. The literature on patients with Parkinson disease and spine surgery is limited, but increased complications have been reported. All patients with Parkinson disease undergoing lumbar spine surgery between 2002 and 2012 were identified. Patients' charts, radiographs, and outcome questionnaires were reviewed. Parkinson disease severity was assessed with use of the modified Hoehn and Yahr staging scale. Complications and subsequent surgeries were analyzed. Risk for reoperation was assessed. Ninety-six patients underwent lumbar spine surgery. The mean patient age was 63.0 years. The mean follow-up duration was 30.1 months. The Parkinson disease severity stage was Parkinson disease severity stage of ≥3 (p Parkinson disease is good, with improvement of spine-related pain. A larger prospective study is warranted. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Soft-matter composites with electrically tunable elastic rigidity

International Nuclear Information System (INIS)

Shan, Wanliang; Lu, Tong; Majidi, Carmel

2013-01-01

We use a phase-changing metal alloy to reversibly tune the elastic rigidity of an elastomer composite. The elastomer is embedded with a sheet of low-melting-point Field’s metal and an electric Joule heater composed of a serpentine channel of liquid-phase gallium–indium–tin (Galinstan ® ) alloy. At room temperature, the embedded Field’s metal is solid and the composite remains elastically rigid. Joule heating causes the Field’s metal to melt and allows the surrounding elastomer to freely stretch and bend. Using a tensile testing machine, we measure that the effective elastic modulus of the composite reversibly changes by four orders of magnitude when powered on and off. This dramatic change in rigidity is accurately predicted with a model for an elastic composite. Reversible rigidity control is also accomplished by replacing the Field’s metal with shape memory polymer. In addition to demonstrating electrically tunable rigidity with an elastomer, we also introduce a new technique to rapidly produce soft-matter electronics and multifunctional materials in several minutes with laser-patterned adhesive film and masked deposition of liquid-phase metal alloy. (paper)

Soft-matter composites with electrically tunable elastic rigidity

Science.gov (United States)

Shan, Wanliang; Lu, Tong; Majidi, Carmel

2013-08-01

We use a phase-changing metal alloy to reversibly tune the elastic rigidity of an elastomer composite. The elastomer is embedded with a sheet of low-melting-point Field’s metal and an electric Joule heater composed of a serpentine channel of liquid-phase gallium-indium-tin (Galinstan®) alloy. At room temperature, the embedded Field’s metal is solid and the composite remains elastically rigid. Joule heating causes the Field’s metal to melt and allows the surrounding elastomer to freely stretch and bend. Using a tensile testing machine, we measure that the effective elastic modulus of the composite reversibly changes by four orders of magnitude when powered on and off. This dramatic change in rigidity is accurately predicted with a model for an elastic composite. Reversible rigidity control is also accomplished by replacing the Field’s metal with shape memory polymer. In addition to demonstrating electrically tunable rigidity with an elastomer, we also introduce a new technique to rapidly produce soft-matter electronics and multifunctional materials in several minutes with laser-patterned adhesive film and masked deposition of liquid-phase metal alloy.

Rigid body motion in stereo 3D simulation

International Nuclear Information System (INIS)

Zabunov, Svetoslav

2010-01-01

This paper addresses the difficulties experienced by first-grade students studying rigid body motion at Sofia University. Most quantities describing the rigid body are in relations that the students find hard to visualize and understand. They also lose the notion of cause-result relations between vector quantities, such as the relation between torque and angular momentum. Consequently, the understanding of physical laws and conservation principles in free rigid body motion is hampered. This paper presents the capabilities of a 3D simulation, which aims to clarify these questions to the students, who are taught mechanics in the general physics course. The rigid body motion simulations may be observed at http://ialms.net/sim/, and are intended to complement traditional learning practices, not replace them, as the author shares the opinion that no simulation may fully resemble reality.

Spinal involvement in Camptodactyly Arthropathy Coxa-vara Pericarditis (CACP) syndrome in two Yemeni sisters

NARCIS (Netherlands)

Emad, Yasser; Ragab, Yasser; Ibrahim, Osama; Khalifa, Maher; Dawood, Ahmed; Rasker, Johannes J.

2017-01-01

Aim of the work The objective of this clinical report is to describe the detailed magnetic resonance imaging (MRI) findings of the spine, knee and hip joints in two young sisters with Camptodactyly Arthropathy Coxa-vara Pericarditis (CACP) syndrome. Cases report In two young sisters, both had normal

SAPHO: syndrome or concept? Imaging findings

Energy Technology Data Exchange (ETDEWEB)

Earwaker, J.W.S. [Department of Medical Imaging, Holy Spirit Hospital, Brisbane (Australia); Cotten, A. [Service de Radiologie OsteoArticulaire, Hopital Roger Salengro, Lille (France)

2003-06-01

The SAPHO syndrome was a term coined to include a variety of musculoskeletal disorders associated with skin conditions, mainly palmoplantar pustulosis and acne conglobata. It is more correctly a spectrum which includes the following: skin lesions, osteoarticular manifestations of synovitis hyperostosis and osteitis affecting particular target sites, and.a clinical course marked by relapses and remissions. The major sites of involvement are the anterior chest wall, the spine, long bones, flat bones, and large and small joints. The distribution and severity of involvement varies from the adult to the pediatric form of chronic recurrent multifocal osteomyelitis (CRMO). The diagnosis of SAPHO syndrome is not difficult when the typical osteoarticular lesions are located in characteristic target sites. The diagnosis is more difficult if atypical sites are involved and there is no skin disease. (orig.)

Historical contributions from the Harvard system to adult spine surgery.

Science.gov (United States)

Schoenfeld, Andrew J

2011-10-15

Literature review. To document the historical contributions from the Harvard Medical School system to the field of adult spine surgery. Despite the fact that significant contributions to the discipline of spinal surgery have derived from the Harvard system, no prior study documents the history of the Harvard spine services in a cohesive narrative. This historical perspective reviews the history of adult spine surgery within the Harvard system and outlines the significant contributions made by orthopedic and neurosurgical practitioners to the field. Literature reviews were performed from historical works, as well as scientific publications to fashion a cohesive review covering the history of spine surgery at Harvard from the early 19th century to the present. The development of the spine surgical services at the three main Harvard hospitals, and significant spine surgical personalities within the system, are discussed, including W. Jason Mixter, MD, Joseph S. Barr Sr., MD, and Marius N. Smith-Petersen, MD. Substantial developments that have arisen from the Harvard teaching hospitals include the recognition of disc herniation as the cause of radicular symptoms in the lower extremities, the description of lumbar discectomy as a surgical treatment for radicular pain, osteotomy for the correction of spinal deformity, and the first attempt to create a systematic algorithm capable of informing treatment for cervical spine trauma. Despite humble beginnings, the surgeons and scientists at Harvard have influenced nearly every facet of spine surgery over the course of the last two centuries.

Biphasic synaptic Ca influx arising from compartmentalized electrical signals in dendritic spines.

Directory of Open Access Journals (Sweden)

Brenda L Bloodgood

2009-09-01

Full Text Available Excitatory synapses on mammalian principal neurons are typically formed onto dendritic spines, which consist of a bulbous head separated from the parent dendrite by a thin neck. Although activation of voltage-gated channels in the spine and stimulus-evoked constriction of the spine neck can influence synaptic signals, the contribution of electrical filtering by the spine neck to basal synaptic transmission is largely unknown. Here we use spine and dendrite calcium (Ca imaging combined with 2-photon laser photolysis of caged glutamate to assess the impact of electrical filtering imposed by the spine morphology on synaptic Ca transients. We find that in apical spines of CA1 hippocampal neurons, the spine neck creates a barrier to the propagation of current, which causes a voltage drop and results in spatially inhomogeneous activation of voltage-gated Ca channels (VGCCs on a micron length scale. Furthermore, AMPA and NMDA-type glutamate receptors (AMPARs and NMDARs, respectively that are colocalized on individual spine heads interact to produce two kinetically and mechanistically distinct phases of synaptically evoked Ca influx. Rapid depolarization of the spine triggers a brief and large Ca current whose amplitude is regulated in a graded manner by the number of open AMPARs and whose duration is terminated by the opening of small conductance Ca-activated potassium (SK channels. A slower phase of Ca influx is independent of AMPAR opening and is determined by the number of open NMDARs and the post-stimulus potential in the spine. Biphasic synaptic Ca influx only occurs when AMPARs and NMDARs are coactive within an individual spine. These results demonstrate that the morphology of dendritic spines endows associated synapses with specialized modes of signaling and permits the graded and independent control of multiple phases of synaptic Ca influx.

An unusual presentation of Brown-Sequard syndrome.

Science.gov (United States)

Herr, R D; Barrett, J

1987-11-01

We report the case of a man with Brown-Sequard syndrome following a fall in which he sustained fractures of the thoracic and lumbosacral spine. Despite characteristic neurological findings, the diagnosis was delayed due to the absence of history of penetrating spinal trauma and incorrect attribution of unilateral-like weakness and numbness to lumbosacral trauma. A directed history and examination revealed that the patient was stabbed in the back with a penknife while leaving a bus and stepped down onto a paralyzed leg, which collapsed beneath him. The patient was given an antibiotic, underwent a negative peritoneal lavage, and had myelography and nerve conduction velocity confirmatory for Brown-Sequard syndrome. With rehabilitation he became ambulatory with a cane one month after the stabbing.

DXA measurements in Rett syndrome reveal small bones with low bone mass.

Science.gov (United States)

Roende, Gitte; Ravn, Kirstine; Fuglsang, Kathrine; Andersen, Henrik; Nielsen, Jytte Bieber; Brøndum-Nielsen, Karen; Jensen, Jens-Erik Beck

2011-09-01

Low bone mass is reported in growth-retarded patients harboring mutations in the X-linked methyl-CpG-binding protein 2 (MECP2) gene causing Rett syndrome (RTT). We present the first study addressing both bone mineral density (BMD) and bone size in RTT. Our object was to determine whether patients with RTT do have low BMD when correcting for smaller bones by examination with dual-energy X-ray absorptiometry (DXA). We compared areal BMD (aBMD(spine) and aBMD(total hip) ) and volumetric bone mineral apparent density (vBMAD(spine) and vBMAD(neck) ) in 61 patients and 122 matched healthy controls. Further, spine and hip aBMD and vBMAD of patients were associated with clinical risk factors of low BMD, low-energy fractures, MECP2 mutation groups, and X chromosome inactivation (XCI). Patients with RTT had reduced bone size on the order of 10% and showed lower values of spine and hip aBMD and vBMAD (p bone mass and small bones are evident in RTT, indicating an apparent low-bone-formation phenotype. Copyright © 2011 American Society for Bone and Mineral Research.

Sensing of substratum rigidity and directional migration by fast-crawling cells

Science.gov (United States)

Okimura, Chika; Sakumura, Yuichi; Shimabukuro, Katsuya; Iwadate, Yoshiaki

2018-05-01

Living cells sense the mechanical properties of their surrounding environment and respond accordingly. Crawling cells detect the rigidity of their substratum and migrate in certain directions. They can be classified into two categories: slow-moving and fast-moving cell types. Slow-moving cell types, such as fibroblasts, smooth muscle cells, mesenchymal stem cells, etc., move toward rigid areas on the substratum in response to a rigidity gradient. However, there is not much information on rigidity sensing in fast-moving cell types whose size is ˜10 μ m and migration velocity is ˜10 μ m /min . In this study, we used both isotropic substrata with different rigidities and an anisotropic substratum that is rigid on the x axis but soft on the y axis to demonstrate rigidity sensing by fast-moving Dictyostelium cells and neutrophil-like differentiated HL-60 cells. Dictyostelium cells exerted larger traction forces on a more rigid isotropic substratum. Dictyostelium cells and HL-60 cells migrated in the "soft" direction on the anisotropic substratum, although myosin II-null Dictyostelium cells migrated in random directions, indicating that rigidity sensing of fast-moving cell types differs from that of slow types and is induced by a myosin II-related process.

Palmitoylation-dependent CDKL5-PSD-95 interaction regulates synaptic targeting of CDKL5 and dendritic spine development.

Science.gov (United States)

Zhu, Yong-Chuan; Li, Dan; Wang, Lu; Lu, Bin; Zheng, Jing; Zhao, Shi-Lin; Zeng, Rong; Xiong, Zhi-Qi

2013-05-28

The X-linked gene cyclin-dependent kinase-like 5 (CDKL5) is mutated in severe neurodevelopmental disorders, including some forms of atypical Rett syndrome, but the function and regulation of CDKL5 protein in neurons remain to be elucidated. Here, we show that CDKL5 binds to the scaffolding protein postsynaptic density (PSD)-95, and that this binding promotes the targeting of CDKL5 to excitatory synapses. Interestingly, this binding is not constitutive, but governed by palmitate cycling on PSD-95. Furthermore, pathogenic mutations that truncate the C-terminal tail of CDKL5 diminish its binding to PSD-95 and synaptic accumulation. Importantly, down-regulation of CDKL5 by RNA interference (RNAi) or interference with the CDKL5-PSD-95 interaction inhibits dendritic spine formation and growth. These results demonstrate a critical role of the palmitoylation-dependent CDKL5-PSD-95 interaction in localizing CDKL5 to synapses for normal spine development and suggest that disruption of this interaction by pathogenic mutations may be implicated in the pathogenesis of CDKL5-related disorders.

Three Cases of Spine Fractures after an Airplane Crash.

Science.gov (United States)

Lee, Han Joo; Moon, Bong Ju; Pennant, William A; Shin, Dong Ah; Kim, Keung Nyun; Yoon, Do Heum; Ha, Yoon

2015-10-01

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings.

Three Cases of Spine Fractures after an Airplane Crash

Science.gov (United States)

Lee, Han Joo; Moon, Bong Ju; Pennant, William A.; Shin, Dong Ah; Kim, Keung Nyun; Yoon, Do Heum

2015-01-01

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings. PMID:27169094

Development of the young spine questionnaire

DEFF Research Database (Denmark)

Lauridsen, Henrik Hein; Hestbæk, Lise

2013-01-01

.7% (cervical pain today) and 97.9% (thoracic pain today). To improve the understanding of the spinal boundaries we added bony landmarks to the spinal drawings after pilot test I. This resulted in an improved sense of spinal boundary location in pilot test II. Correlations between the rFPS and the interview...... pain score ranged between 0.67 (cervical spine) and 0.79 (lumbar spine). Conclusions The Young Spine Questionnaire contains questions that assess spinal pain and its consequences. The items have been tested for content understanding and agreement between questionnaire scores and interview findings......Background Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Consequently, preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has...

Spine Shape Predicts Vertebral Fractures in Postmenopausal Women

DEFF Research Database (Denmark)

de Bruijne, Marleen; Pettersen, P.C.; A. Ghosh

2008-01-01

Early diagnosis and treatment of patients at high risk of developing fragility fractures is crucial in the management of osteoporosis. The purpose of this study was to investigate whether the shape of the spine as can be observed from lateral X-rays is indicative for the risk of future development...... of fragility fractures in the spine. The study included 568 elderly women of whom 455 maintained skeletal integrity during the mean observation period of 4.8 years and 113 sustained at least one vertebral fracture in the same period. At baseline, none of the women had experienced a previous osteoporotic...... and intervertebral disks, alignment of vertebrae, and spinal curvature. The positions of the points were subsequently used as the input features to train a pattern classification system to discriminate between spines of women maintaining skeletal health and spines sustaining a fracture in the near future...

Postoperative 3D spine reconstruction by navigating partitioning manifolds

Energy Technology Data Exchange (ETDEWEB)

Kadoury, Samuel, E-mail: samuel.kadoury@polymtl.ca [Department of Computer and Software Engineering, Ecole Polytechnique Montreal, Montréal, Québec H3C 3A7 (Canada); Labelle, Hubert, E-mail: hubert.labelle@recherche-ste-justine.qc.ca; Parent, Stefan, E-mail: stefan.parent@umontreal.ca [CHU Sainte-Justine Hospital Research Center, Montréal, Québec H3T 1C5 (Canada)

2016-03-15

Purpose: The postoperative evaluation of scoliosis patients undergoing corrective treatment is an important task to assess the strategy of the spinal surgery. Using accurate 3D geometric models of the patient’s spine is essential to measure longitudinal changes in the patient’s anatomy. On the other hand, reconstructing the spine in 3D from postoperative radiographs is a challenging problem due to the presence of instrumentation (metallic rods and screws) occluding vertebrae on the spine. Methods: This paper describes the reconstruction problem by searching for the optimal model within a manifold space of articulated spines learned from a training dataset of pathological cases who underwent surgery. The manifold structure is implemented based on a multilevel manifold ensemble to structure the data, incorporating connections between nodes within a single manifold, in addition to connections between different multilevel manifolds, representing subregions with similar characteristics. Results: The reconstruction pipeline was evaluated on x-ray datasets from both preoperative patients and patients with spinal surgery. By comparing the method to ground-truth models, a 3D reconstruction accuracy of 2.24 ± 0.90 mm was obtained from 30 postoperative scoliotic patients, while handling patients with highly deformed spines. Conclusions: This paper illustrates how this manifold model can accurately identify similar spine models by navigating in the low-dimensional space, as well as computing nonlinear charts within local neighborhoods of the embedded space during the testing phase. This technique allows postoperative follow-ups of spinal surgery using personalized 3D spine models and assess surgical strategies for spinal deformities.

Postoperative 3D spine reconstruction by navigating partitioning manifolds

International Nuclear Information System (INIS)

Kadoury, Samuel; Labelle, Hubert; Parent, Stefan

2016-01-01

Purpose: The postoperative evaluation of scoliosis patients undergoing corrective treatment is an important task to assess the strategy of the spinal surgery. Using accurate 3D geometric models of the patient’s spine is essential to measure longitudinal changes in the patient’s anatomy. On the other hand, reconstructing the spine in 3D from postoperative radiographs is a challenging problem due to the presence of instrumentation (metallic rods and screws) occluding vertebrae on the spine. Methods: This paper describes the reconstruction problem by searching for the optimal model within a manifold space of articulated spines learned from a training dataset of pathological cases who underwent surgery. The manifold structure is implemented based on a multilevel manifold ensemble to structure the data, incorporating connections between nodes within a single manifold, in addition to connections between different multilevel manifolds, representing subregions with similar characteristics. Results: The reconstruction pipeline was evaluated on x-ray datasets from both preoperative patients and patients with spinal surgery. By comparing the method to ground-truth models, a 3D reconstruction accuracy of 2.24 ± 0.90 mm was obtained from 30 postoperative scoliotic patients, while handling patients with highly deformed spines. Conclusions: This paper illustrates how this manifold model can accurately identify similar spine models by navigating in the low-dimensional space, as well as computing nonlinear charts within local neighborhoods of the embedded space during the testing phase. This technique allows postoperative follow-ups of spinal surgery using personalized 3D spine models and assess surgical strategies for spinal deformities

The skills of erect full-spine radiograph with Philips DR

International Nuclear Information System (INIS)

Yang Guangqi; Yang Xufeng; Wu Tengfang; Wen Xingwei

2009-01-01

Objective: To investigate the image stitching methods and skills of erect full-spine P-A radiograph with Philips DR. Methods: Proper spinal projecting position and exposure factors were selected to get the radiogragh of full-spine. Three methods were used to stitch images. The image deviation was evaluated with photoshop to judge the quality of the stitching full-spine images. Results: Among ninety-eight patients, the full-spine images were stitched successfully by automatic method in 78 patients. Other stiching images were justified with manual stitching method and were good enough for diagnosis. The border of vertebral body, pedicle of vertebral arch and spinous process were revealed clearly in 96 patients. The shift of vertebral body at stitching point was within 1 mm in 83 patients, 2mm in 11 patients, 3mm in 2 patients. Conclusion: Full spine radiography with DDR can provide clinical diagnosis information with reliable images. High quality and reliable full-spine images can be got with proper spinal projecting position, appropriate image postprocess software and suitable stitching method. (authors)

Rigid body formulation in a finite element context with contact interaction

Science.gov (United States)

Refachinho de Campos, Paulo R.; Gay Neto, Alfredo

2018-03-01

The present work proposes a formulation to employ rigid bodies together with flexible bodies in the context of a nonlinear finite element solver, with contact interactions. Inertial contributions due to distribution of mass of a rigid body are fully developed, considering a general pole position associated with a single node, representing a rigid body element. Additionally, a mechanical constraint is proposed to connect a rigid region composed by several nodes, which is useful for linking rigid/flexible bodies in a finite element environment. Rodrigues rotation parameters are used to describe finite rotations, by an updated Lagrangian description. In addition, the contact formulation entitled master-surface to master-surface is employed in conjunction with the rigid body element and flexible bodies, aiming to consider their interaction in a rigid-flexible multibody environment. New surface parameterizations are presented to establish contact pairs, permitting pointwise interaction in a frictional scenario. Numerical examples are provided to show robustness and applicability of the methods.

Rendering the Topological Spines

Energy Technology Data Exchange (ETDEWEB)

Nieves-Rivera, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-05-05

Many tools to analyze and represent high dimensional data already exits yet most of them are not flexible, informative and intuitive enough to help the scientists make the corresponding analysis and predictions, understand the structure and complexity of scientific data, get a complete picture of it and explore a greater number of hypotheses. With this in mind, N-Dimensional Data Analysis and Visualization (ND²AV) is being developed to serve as an interactive visual analysis platform with the purpose of coupling together a number of these existing tools that range from statistics, machine learning, and data mining, with new techniques, in particular with new visualization approaches. My task is to create the rendering and implementation of a new concept called topological spines in order to extend ND²AV's scope. Other existing visualization tools create a representation preserving either the topological properties or the structural (geometric) ones because it is challenging to preserve them both simultaneously. Overcoming such challenge by creating a balance in between them, the topological spines are introduced as a new approach that aims to preserve them both. Its render using OpenGL and C++ and is currently being tested to further on be implemented on ND²AV. In this paper I will present what are the Topological Spines and how they are rendered.

Effect of rigid inclusions on sintering

International Nuclear Information System (INIS)

Rahaman, M.N.; De Jonghe, L.C.

1988-01-01

The predictions of recent theoretical studies on the effect of inert, rigid inclusions on the sintering of ceramic powder matrices are examined and compared with experimental data. The densification of glass matrix composites with inclusion volume fractions of ≤0.15 can be adequately explained by Scherer's theory for viscous sintering with rigid inclusions. Inclusions cause a vast reduction in the densification rates of polycrystalline matrix composites even at low inclusion volume fractions. Models put forward to explain the sintering of polycrystalline matrix composites are discussed

Persistent post-traumatic headache, postconcussion syndrome, and whiplash injuries: the evidence for a non-traumatic basis with an historical review.

Science.gov (United States)

Evans, Randolph W

2010-04-01

There has been intense controversy about postconcussion syndrome since Erichsen's publication in 1866 on railway brain and railway spine. The fascinating history of this debate will be reviewed and then the non-organic explanations for postconcussion syndrome, headaches after head injury, and chronic whiplash injuries and headaches will be explored including the following: psychogenic, psychosocial, sociocultural, base rate misattribution, chronic pain, compensation and litigation, and malingering.

The use of radiological guidelines to achieve a sustained reduction in the number of radiographic examinations of the cervical spine, lumbar spine and knees performed for GPs

International Nuclear Information System (INIS)

Glaves, J.

2005-01-01

AIM: To determine if the use of request guidelines can achieve a sustained reduction in the number of radiographic examinations of the cervical spine, lumbar spine and knee joints performed for general practitioners (GPs). METHODS: GPs referring to three community hospitals and a district general hospital were circulated with referral guidelines for radiography of the cervical spine, lumbar spine and knee, and all requests for these three examinations were checked. Requests that did not fit the guidelines were returned to the GP with an explanatory letter and a further copy of the guidelines. Where applicable, a large-joint replacement algorithm was also enclosed. If the GP maintained the opinion that the examination was indicated, she or he had the option of supplying further justifying information in writing or speaking to a consultant radiologist. RESULTS: Overall the number of radiographic examinations fell by 68% in the first year, achieving a 79% reduction in the second year. For knees, lumbar spine and cervical spine radiographs the total reductions were 77%, 78% and 86%, respectively. CONCLUSION: The use of referral guidelines, reinforced by request checking and clinical management algorithms, can produce a dramatic and sustained reduction in the number of radiographs of the cervical spine, lumbar spine and knees performed for GPs

Rigid-Plastic Post-Buckling Analysis of Columns and Quadratic Plates

DEFF Research Database (Denmark)

Jönsson, Jeppe

2008-01-01

the compressive load as a function of the transverse displacement. An estimate of the magnitude of the transverse displacement prior to the forming of the collapse mechanism is introduced into the compressive load function, determined by the virtual work equation, thereby revealing a qualified estimate...... yield lines accommodate differential rotations of rigid parts and the area “collapse” yield lines accommodate local area changes of the rigid parts thereby preserving compatibility of the rigid parts of a plate. The approach will be illustrated for rigid plastic column analysis and for a quadratic plate...

[Application of Finite Element Method in Thoracolumbar Spine Traumatology].

Science.gov (United States)

Zhang, Min; Qiu, Yong-gui; Shao, Yu; Gu, Xiao-feng; Zeng, Ming-wei

2015-04-01

The finite element method (FEM) is a mathematical technique using modern computer technology for stress analysis, and has been gradually used in simulating human body structures in the biomechanical field, especially more widely used in the research of thoracolumbar spine traumatology. This paper reviews the establishment of the thoracolumbar spine FEM, the verification of the FEM, and the thoracolumbar spine FEM research status in different fields, and discusses its prospects and values in forensic thoracolumbar traumatology.

Microscope sterility during spine surgery.

Science.gov (United States)

Bible, Jesse E; O'Neill, Kevin R; Crosby, Colin G; Schoenecker, Jonathan G; McGirt, Matthew J; Devin, Clinton J

2012-04-01

Prospective study. Assess the contamination rates of sterile microscope drapes after spine surgery. The use of the operating microscope has become more prevalent in certain spine procedures, providing superior magnification, visualization, and illumination of the operative field. However, it may represent an additional source of bacterial contamination and increase the risk of developing a postoperative infection. This study included 25 surgical spine cases performed by a single spine surgeon that required the use of the operative microscope. Sterile culture swabs were used to obtain samples from 7 defined locations on the microscope drape after its use during the operation. The undraped technician's console was sampled in each case as a positive control, and an additional 25 microscope drapes were swabbed immediately after they were applied to the microscope to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates using a semiquantitative technique. No growth was observed on any of the 25 negative control drapes. In contrast, 100% of preoperative and 96% of postoperative positive controls demonstrated obvious contamination. In the postoperative group, all 7 sites of evaluation were found to be contaminated with rates of 12% to 44%. Four of the 7 evaluated locations were found to have significant contamination rates compared with negative controls, including the shafts of the optic eyepieces on the main surgeon side (24%, P = 0.022), "forehead" portion on both the main surgeon (24%, P = 0.022) and assistant sides (28%, P = 0.010), and "overhead" portion of the drape (44%, P = 0.0002). Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact

Characteristic MRI and MR Myelography Findings for the Facet Cyst Hematoma at T12-L1 Spine: A Case Report

International Nuclear Information System (INIS)

Chung, Seung Eun; Lee, Sang Ho; Kim, Tae Hong; Choi, Gun; Paeng, Sung Suk

2011-01-01

A facet cyst is a very rare condition in the thoracolumbar spine and more so, hemorrhage into a cyst is extremely rare. We present a case of a facet cyst hematoma in the T12-L1 spine. A 69-year-old woman complained of chronic back pain with right lower extremity pain, and weakness for 3 years. MRI and MR myelography showed an extradural mass at the T12-L1 level with heterogeneous signal intensity on both T1-and T2-weighted images, which was continuous to the right T12-L1 facet joint. The neighboring facet joint showed severe degeneration on the CT scan. The mass a was simple hematoma covered with a thin fibrous membrane and connected with facet joint macroscopically and microscopically. The pathogenesis of the facet cyst hematoma is not clear but it can compress nerve roots or dura mater and cause radiculopathy or cauda equina syndrome. Surgical removal should be recommended for symptomatic relief.

Characteristic MRI and MR Myelography Findings for the Facet Cyst Hematoma at T12-L1 Spine: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Chung, Seung Eun [Dept of Diagnostic Radiology, Wooridul Spine Hospital, Seoul (Korea, Republic of); Lee, Sang Ho [Dept. of Neurosurgery, Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Dept. of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Choi, Gun [Dept. of Neurosurgery, Seoul Wooridul Hospital, Seoul (Korea, Republic of); Paeng, Sung Suk [Dept of Radiology, Wooridul Spine Hospital, Seoul (Korea, Republic of)

2011-05-15

A facet cyst is a very rare condition in the thoracolumbar spine and more so, hemorrhage into a cyst is extremely rare. We present a case of a facet cyst hematoma in the T12-L1 spine. A 69-year-old woman complained of chronic back pain with right lower extremity pain, and weakness for 3 years. MRI and MR myelography showed an extradural mass at the T12-L1 level with heterogeneous signal intensity on both T1-and T2-weighted images, which was continuous to the right T12-L1 facet joint. The neighboring facet joint showed severe degeneration on the CT scan. The mass a was simple hematoma covered with a thin fibrous membrane and connected with facet joint macroscopically and microscopically. The pathogenesis of the facet cyst hematoma is not clear but it can compress nerve roots or dura mater and cause radiculopathy or cauda equina syndrome. Surgical removal should be recommended for symptomatic relief.

About deformation and rigidity in relativity

International Nuclear Information System (INIS)

Coll, Bartolome

2007-01-01

The notion of deformation involves that of rigidity. In relativity, starting from Born's early definition of rigidity, some other ones have been proposed, offering more or less interesting aspects but also accompanied of undesired or even pathological properties. In order to clarify the origin of these difficulties presented by the notion of rigidity in relativity, we analyze with some detail significant aspects of the unambiguous classical, Newtonian, notion. In particular, the relative character of its kinetic definition is pointed out, allowing to predict and to understand the limitations imposed by Herglotz-Noether theorem. Also, its equivalent dynamic definition is obtained and, in contrast, its absolute character is shown. But in spite of this absolute character, the dynamic definition is shown to be not extensible to relativity. The metric deformation of Minkowski space by the presence of a gravitational field is interpreted as a universal deformation, and it is shown that, under natural conditions, only a simple deformation law is possible, relating locally, but in an one-to-one way, gravitational fields and gauge classes of two-forms. We argue that fields of unit vectors associated to the internal gauge class of two-forms of every space-time (and, in particular, of Minkowski space-time) are the relativistic analogues of the classical accelerated observers, i.e. of the classical rigid motions. Some other consequences of the universal law of gravitational deformation are commented

Genus Ranges of 4-Regular Rigid Vertex Graphs.

Science.gov (United States)

Buck, Dorothy; Dolzhenko, Egor; Jonoska, Nataša; Saito, Masahico; Valencia, Karin

2015-01-01

A rigid vertex of a graph is one that has a prescribed cyclic order of its incident edges. We study orientable genus ranges of 4-regular rigid vertex graphs. The (orientable) genus range is a set of genera values over all orientable surfaces into which a graph is embedded cellularly, and the embeddings of rigid vertex graphs are required to preserve the prescribed cyclic order of incident edges at every vertex. The genus ranges of 4-regular rigid vertex graphs are sets of consecutive integers, and we address two questions: which intervals of integers appear as genus ranges of such graphs, and what types of graphs realize a given genus range. For graphs with 2 n vertices ( n > 1), we prove that all intervals [ a, b ] for all a genus ranges. For graphs with 2 n - 1 vertices ( n ≥ 1), we prove that all intervals [ a, b ] for all a genus ranges. We also provide constructions of graphs that realize these ranges.

Deficiency of the vestibular spine in atrioventricular septal defects in human fetuses with down syndrome

NARCIS (Netherlands)

Blom, Nico A.; Ottenkamp, Jaap; Wenink, Arnold G. C.; Gittenberger-de Groot, Adriana C.

2003-01-01

Data on the morphogenesis of atrioventricular septal defect (AVSD) in Down syndrome are lacking to support molecular studies on Down syndrome heart critical region. Therefore, we studied the development of complete AVSD in human embryos and fetuses with trisomy 21 using 3-dimensional graphic

Dual Quaternion Variational Integrator for Rigid Body Dynamic Simulation

OpenAIRE

Xu, Jiafeng; Halse, Karl Henning

2016-01-01

In rigid body dynamic simulations, often the algorithm is required to deal with general situations where both reference point and inertia matrix are arbitrarily de- fined. We introduce a novel Lie group variational integrator using dual quaternion for simulating rigid body dynamics in all six degrees of freedom. Dual quaternion is used to represent rigid body kinematics and one-step Lie group method is used to derive dynamic equations. The combination of these two becomes the first Lie group ...

Anatomy of the Spine

Science.gov (United States)

... curve of the neck is described as a lordosis or lordotic curve, and looks like a “C” ... like the cervical spine, creating a normal lumbar lordosis. The five lumbar vertebral bodies are the weight- ...

Management of thoracolumbar spine trauma An overview

Directory of Open Access Journals (Sweden)

S Rajasekaran

2015-01-01

Full Text Available Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. This review provides an overview of the epidemiology, biomechanical principles, radiological and clinical evaluation, classification and management principles. Literature review of all relevant articles published in PubMed covering thoracolumbar spine fractures with or without neurologic deficit was performed. The search terms used were thoracolumbar, thoracic, lumbar, fracture, trauma and management. All relevant articles and abstracts covering thoracolumbar spine fractures with and without neurologic deficit were reviewed. Biomechanically the thoracolumbar spine is predisposed to a higher incidence of spinal injuries. Computed tomography provides adequate bony detail for assessing spinal stability while magnetic resonance imaging shows injuries to soft tissues (posterior ligamentous complex [PLC] and neurological structures. Different classification systems exist and the most recent is the AO spine knowledge forum classification of thoracolumbar trauma. Treatment includes both nonoperative and operative methods and selected based on the degree of bony injury, neurological involvement, presence of associated injuries and the integrity of the PLC. Significant advances in imaging have helped in the better understanding of thoracolumbar fractures, including information on canal morphology and injury to soft tissue structures. The ideal classification that is simple, comprehensive and guides management is still elusive. Involvement of three columns, progressive neurological deficit, significant kyphosis and canal compromise with neurological deficit are accepted indications for surgical stabilization through anterior, posterior or combined approaches.

Surgeon Reported Outcome Measure for Spine Trauma an International Expert Survey Identifying Parameters Relevant for The Outcome of Subaxial Cervical Spine Injuries

NARCIS (Netherlands)

Sadiqi, Said; Verlaan, Jorrit Jan; Lehr, A. M.; Dvorak, Marcel F.; Kandziora, Frank; Rajasekaran, S.; Schnake, Klaus J.; Vaccaro, Alexander R.; Oner, F. C.

2016-01-01

STUDY DESIGN.: International web-based survey OBJECTIVE.: To identify clinical and radiological parameters that spine surgeons consider most relevant when evaluating clinical and functional outcomes of subaxial cervical spine trauma patients. SUMMARY OF BACKGROUND DATA.: While an outcome instrument

Radiologic features in histiocytosis syndrome

International Nuclear Information System (INIS)

Hong, Sung Mo; Cho, Byung Jae; Yeon, Kyung Mo

1980-01-01

Histiocytosis syndrome is not rare disease of unknown etiology, characterized by development of granulomatous lesions with histiocytic proliferation. Authors analyzed 22 cases, which had been confirmed as histiocytosis syndrome from 1971 to Feb. 1980 with special attention to 15 cases showing positive findings on radiological examinations. The results are as follows. 1. Overall male to female ratio was about 2:1. The majority were between 1 and 7 years of age. 2. Skeletal system was involved in orders as follows: skull, pelvis, femur, rib, spine. 3. Four cases of pulmonary involvement were experienced. All cases had interstitial involvement with reticulonodular densities on roentgenograms. 4. We had experienced a pituitary tumor, presumably localized histiocytic mass, in a patient with diabetes insipidus. 5. In long bone involvement, diaphysis or metaphysis was usually involved, but in one patient, lesion were extended into epiphysis. 6. One case of platyspondyly was found, with symmetrical compression

Radiologic features in histiocytosis syndrome

Energy Technology Data Exchange (ETDEWEB)

Hong, Sung Mo; Cho, Byung Jae; Yeon, Kyung Mo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

1980-12-15

Histiocytosis syndrome is not rare disease of unknown etiology, characterized by development of granulomatous lesions with histiocytic proliferation. Authors analyzed 22 cases, which had been confirmed as histiocytosis syndrome from 1971 to Feb. 1980 with special attention to 15 cases showing positive findings on radiological examinations. The results are as follows. 1. Overall male to female ratio was about 2:1. The majority were between 1 and 7 years of age. 2. Skeletal system was involved in orders as follows: skull, pelvis, femur, rib, spine. 3. Four cases of pulmonary involvement were experienced. All cases had interstitial involvement with reticulonodular densities on roentgenograms. 4. We had experienced a pituitary tumor, presumably localized histiocytic mass, in a patient with diabetes insipidus. 5. In long bone involvement, diaphysis or metaphysis was usually involved, but in one patient, lesion were extended into epiphysis. 6. One case of platyspondyly was found, with symmetrical compression.

Dose conformation to the spine during palliative treatments using dynamic wedges

Energy Technology Data Exchange (ETDEWEB)

Ormsby, Matthew A., E-mail: Matthew.Ormsby@usoncology.com [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States); Herndon, R. Craig; Kaczor, Joseph G. [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States)

2013-07-01

Radiation therapy is commonly used to alleviate pain associated with metastatic disease of the spine. Often, isodose lines are manipulated using dynamic or physical wedges to encompass the section of spine needing treatment while minimizing dose to normal tissue. We will compare 2 methods used to treat the entire thoracic spine. The first method treats the thoracic spine with a single, nonwedged posterior-anterior (PA) field. Dose is prescribed to include the entire spine. Isodose lines tightly conform to the top and bottom vertebrae, but vertebrae between these 2 received more than enough coverage. The second method uses a combination of wedges to create an isodose line that mimics the curvature of the thoracic spine. This “C”-shaped curvature is created by overlapping 2 fields with opposing dynamic wedges. Machine constraints limit the treatment length and therefore 2 isocenters are used. Each of the 2 PA fields contributes a portion of the total daily dose. This technique creates a “C”-shaped isodose line that tightly conforms to the thoracic spine, minimizing normal tissue dose. Spinal cord maximum dose is reduced, as well as mean dose to the liver, esophagus, and heart.

Palmitoylation-dependent CDKL5–PSD-95 interaction regulates synaptic targeting of CDKL5 and dendritic spine development

Science.gov (United States)

Zhu, Yong-Chuan; Li, Dan; Wang, Lu; Lu, Bin; Zheng, Jing; Zhao, Shi-Lin; Zeng, Rong; Xiong, Zhi-Qi

2013-01-01

The X-linked gene cyclin-dependent kinase-like 5 (CDKL5) is mutated in severe neurodevelopmental disorders, including some forms of atypical Rett syndrome, but the function and regulation of CDKL5 protein in neurons remain to be elucidated. Here, we show that CDKL5 binds to the scaffolding protein postsynaptic density (PSD)-95, and that this binding promotes the targeting of CDKL5 to excitatory synapses. Interestingly, this binding is not constitutive, but governed by palmitate cycling on PSD-95. Furthermore, pathogenic mutations that truncate the C-terminal tail of CDKL5 diminish its binding to PSD-95 and synaptic accumulation. Importantly, down-regulation of CDKL5 by RNA interference (RNAi) or interference with the CDKL5–PSD-95 interaction inhibits dendritic spine formation and growth. These results demonstrate a critical role of the palmitoylation-dependent CDKL5–PSD-95 interaction in localizing CDKL5 to synapses for normal spine development and suggest that disruption of this interaction by pathogenic mutations may be implicated in the pathogenesis of CDKL5-related disorders. PMID:23671101

Fatal Cervical Spine Injury Following a Bicycle Crash

Directory of Open Access Journals (Sweden)

Uhrenholt Lars

2017-06-01

Full Text Available Spinal injury following direct loading of the head and neck is a rare sequel of bicycle crashes. Fatal head injuries following bicycle crashes have been described in great detail and safety measures such as bicycle helmets have been developed accordingly. Less frequently, however, potentially severe cervical spine injuries have been described. We present the case of a middle-aged female who sustained an ultimately fatal cervical spine injury following a collision with a car whilst biking wearing a helmet. We discuss the literature regarding the protective effects of bicycle helmets, the relevance to cervical spine injury and legislation on mandatory use of helmets for injury prevention.

The Almost Periodic Rigidity of Crystallographic Bar-Joint Frameworks

Directory of Open Access Journals (Sweden)

Ghada Badri

2014-04-01

Full Text Available A crystallographic bar-joint framework, C in Rd, is shown to be almost periodically infinitesimally rigid if and only if it is strictly periodically infinitesimally rigid and the rigid unit mode (RUM spectrum, Ω (C, is a singleton. Moreover, the almost periodic infinitesimal flexes of C are characterised in terms of a matrix-valued function, ΦC(z, on the d-torus, Td, determined by a full rank translation symmetry group and an associated motif of joints and bars.

Wobbling motion: A γ-rigid or γ-soft mode?

International Nuclear Information System (INIS)

Casten, R.F.; McCutchan, E.A.; Beausang, C.W.; Zamfir, N.V.; Zhang Jingye

2003-01-01

For even-even nuclei, it is shown that the predicted B(E2) values from the odd spin states of the quasi-γ band in a γ-soft nucleus to the yrast band are quite similar to those predicted for the one-phonon wobbling mode of a rigidly triaxial nucleus. This suggests that the observation of wobbling points to axial asymmetry, but not necessarily to rigid triaxiality. However, another observable that does distinguish γ-soft from γ-rigid structure is identified

Dendritic Spines in Depression: What We Learned from Animal Models

OpenAIRE

Qiao, Hui; Li, Ming-Xing; Xu, Chang; Chen, Hui-Bin; An, Shu-Cheng; Ma, Xin-Ming

2016-01-01

Depression, a severe psychiatric disorder, has been studied for decades, but the underlying mechanisms still remain largely unknown. Depression is closely associated with alterations in dendritic spine morphology and spine density. Therefore, understanding dendritic spines is vital for uncovering the mechanisms underlying depression. Several chronic stress models, including chronic restraint stress (CRS), chronic unpredictable mild stress (CUMS), and chronic social defeat stress (CSDS), have ...

Bertolotti's syndrome. A cause of back pain in young people.

Science.gov (United States)

Quinlan, J F; Duke, D; Eustace, S

2006-09-01

Bertolotti's syndrome is characterised by anomalous enlargement of the transverse process(es) of the most caudal lumbar vertebra which may articulate or fuse with the sacrum or ilium and cause isolated L4/5 disc disease. We analysed the elective MR scans of the lumbosacral spine of 769 consecutive patients with low back pain taken between July 2003 and November 2004. Of these 568 showed disc degeneration. Bertolotti's syndrome was present in 35 patients with a mean age of 32.7 years (15 to 60). This was a younger age than that of patients with multiple disc degeneration, single-level disease and isolated disc degeneration at the L4/5 level (p Bertolotti's syndrome in our study was 4.6% (35 of 769). It was present in 11.4% (20 patients) of the under-30 age group. Our findings suggest that Bertolotti's syndrome must form part of a list of differential diagnoses in the investigation of low back pain in young people.

Astrocytic Contributions to Synaptic and Learning Abnormalities in a Mouse Model of Fragile X Syndrome.

Science.gov (United States)

Hodges, Jennifer L; Yu, Xinzhu; Gilmore, Anthony; Bennett, Hannah; Tjia, Michelle; Perna, James F; Chen, Chia-Chien; Li, Xiang; Lu, Ju; Zuo, Yi

2017-07-15

Fragile X syndrome (FXS) is the most common type of mental retardation attributable to a single-gene mutation. It is caused by FMR1 gene silencing and the consequent loss of its protein product, fragile X mental retardation protein. Fmr1 global knockout (KO) mice recapitulate many behavioral and synaptic phenotypes associated with FXS. Abundant evidence suggests that astrocytes are important contributors to neurological diseases. This study investigates astrocytic contributions to the progression of synaptic abnormalities and learning impairments associated with FXS. Taking advantage of the Cre-lox system, we generated and characterized mice in which fragile X mental retardation protein is selectively deleted or exclusively expressed in astrocytes. We performed in vivo two-photon imaging to track spine dynamics/morphology along dendrites of neurons in the motor cortex and examined associated behavioral defects. We found that adult astrocyte-specific Fmr1 KO mice displayed increased spine density in the motor cortex and impaired motor-skill learning. The learning defect coincided with a lack of enhanced spine dynamics in the motor cortex that normally occurs in response to motor skill acquisition. Although spine density was normal at 1 month of age in astrocyte-specific Fmr1 KO mice, new spines formed at an elevated rate. Furthermore, fragile X mental retardation protein expression in only astrocytes was insufficient to rescue most spine or behavioral defects. Our work suggests a joint astrocytic-neuronal contribution to FXS pathogenesis and reveals that heightened spine formation during adolescence precedes the overabundance of spines and behavioral defects found in adult Fmr1 KO mice. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Advantages and disadvantages of nonfusion technology in spine surgery.

Science.gov (United States)

Huang, Russel C; Girardi, Federico P; Lim, Moe R; Cammisa, Frank P

2005-07-01

Nonfusion technology in spine surgery may improve outcomes by reducing surgical morbidity and the incidence of adjacent level degeneration; however, new technologies also introduce new short- and long-term complications. There is currently no evidence that nonfusion implants are superior to fusion in mid- to long-term follow-up. Understanding the potential risks and benefits of nonfusion technology is essential for spine surgeons and their patients. This article reviews the current evidence relating to the potential risks and benefits of nonfusion technology in spine surgery.

Late whiplash syndrome: a clinical and magnetic resonance imaging study.

Science.gov (United States)

Bonuccelli, U; Pavese, N; Lucetti, C; Renna, M R; Gambaccini, G; Bernardini, S; Canapicchi, R; Carrozzi, L; Murri, L

1999-01-01

Cervical hyperextension injuries are common and are associated with significant morbidity. Clinically two syndromes are described: "acute" whiplash syndrome and "late" whiplash syndrome (in which the patients are still symptomatic after six months despite normal physical and radiological examination). In order to clarify the pathology of the persistent pain in late whiplash syndrome we performed a cervical spine magnetic resonance imaging (MRI) in 33 consecutive patients suffering from this condition. Twenty-six patients (78.8%) showed MRI abnormalities, the most common MRI finding (57.6%) was pre-existent spondylosis. Indeed, the group of patients with spondylosis and other MRI changes had higher clinical scores than those without MRI abnormalities as measured by a three-point grading system based upon the symptoms and signs shown. Several MRI changes, most of them already demonstrable by standard X-ray were seen among 33 patients suffering from late whiplash syndrome. Although no one of these findings appears to be specific and certainly related to the previous neck injury, they could represent a risk factor for a longer pain duration.

Pediatric spine imaging post scoliosis surgery

International Nuclear Information System (INIS)

Alsharief, Alaa N.; El-Hawary, Ron; Schmit, Pierre

2018-01-01

Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

Pediatric spine imaging post scoliosis surgery

Energy Technology Data Exchange (ETDEWEB)

Alsharief, Alaa N. [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada); The Hospital for Sick Children, University of Toronto, Department of Diagnostic Imaging, Toronto (Canada); King Saud University, Department of Medical Imaging, King Abdul-Aziz Medical City, King Khaled National Guard Hospital-Western Region, Jeddah (Saudi Arabia); El-Hawary, Ron [Dalhousie University, Orthopedic Surgery Department, IWK Children' s Health Center, Halifax, NS (Canada); Schmit, Pierre [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada)

2018-01-15

Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

A novel first aid stretcher for immobilization and transportation of spine injured patients.

Science.gov (United States)

Liu, Yan-Sheng; Feng, Ya-Ping; Xie, Jia-Xin; Luo, Zhuo-Jing; Shen, Cai-Hong; Niu, Fang; Zou, Jian; Tang, Shao-Feng; Hao, Jiang; Xu, Jia-Xiang; Xiao, Li-Ping; Xu, Xiao-Ming; Zhu, Hui

2012-01-01

Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its intrinsic advantages in

A novel first aid stretcher for immobilization and transportation of spine injured patients.

Directory of Open Access Journals (Sweden)

Yan-Sheng Liu

Full Text Available Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its

Robotics and the spine: a review of current and ongoing applications.

Science.gov (United States)

Shweikeh, Faris; Amadio, Jordan P; Arnell, Monica; Barnard, Zachary R; Kim, Terrence T; Johnson, J Patrick; Drazin, Doniel

2014-03-01

Robotics in the operating room has shown great use and versatility in multiple surgical fields. Robot-assisted spine surgery has gained significant favor over its relatively short existence, due to its intuitive promise of higher surgical accuracy and better outcomes with fewer complications. Here, the authors analyze the existing literature on this growing technology in the era of minimally invasive spine surgery. In an attempt to provide the most recent, up-to-date review of the current literature on robotic spine surgery, a search of the existing literature was conducted to obtain all relevant studies on robotics as it relates to its application in spine surgery and other interventions. In all, 45 articles were included in the analysis. The authors discuss the current status of this technology and its potential in multiple arenas of spinal interventions, mainly spine surgery and spine biomechanics testing. There are numerous potential advantages and limitations to robotic spine surgery, as suggested in published case reports and in retrospective and prospective studies. Randomized controlled trials are few in number and show conflicting results regarding accuracy. The present limitations may be surmountable with future technological improvements, greater surgeon experience, reduced cost, improved operating room dynamics, and more training of surgical team members. Given the promise of robotics for improvements in spine surgery and spine biomechanics testing, more studies are needed to further explore the applicability of this technology in the spinal operating room. Due to the significant cost of the robotic equipment, studies are needed to substantiate that the increased equipment costs will result in significant benefits that will justify the expense.

Biologics in spine arthrodesis.

Science.gov (United States)

Kannan, Abhishek; Dodwad, Shah-Nawaz M; Hsu, Wellington K

2015-06-01

Spine fusion is a tool used in the treatment of spine trauma, tumors, and degenerative disorders. Poor outcomes related to failure of fusion, however, have directed the interests of practitioners and scientists to spinal biologics that may impact fusion at the cellular level. These biologics are used to achieve successful arthrodesis in the treatment of symptomatic deformity or instability. Historically, autologous bone grafting, including iliac crest bong graft harvesting, had represented the gold standard in spinal arthrodesis. However, due to concerns over potential harvest site complications, supply limitations, and associated morbidity, surgeons have turned to other bone graft options known for their osteogenic, osteoinductive, and/or osteoconductive properties. Current bone graft selection includes autograft, allograft, demineralized bone matrix, ceramics, mesenchymal stem cells, and recombinant human bone morphogenetic protein. Each pose their respective advantages and disadvantages and are the focus of ongoing research investigating the safety and efficacy of their use in the setting of spinal fusion. Rh-BMP2 has been plagued by issues of widespread off-label use, controversial indications, and a wide range of adverse effects. The risks associated with high concentrations of exogenous growth factors have led to investigational efforts into nanotechnology and its application in spinal arthrodesis through the binding of endogenous growth factors. Bone graft selection remains critical to successful fusion and favorable patient outcomes, and orthopaedic surgeons must be educated on the utility and limitations of various biologics in the setting of spine arthrodesis.

Scoliosis in Steinert syndrome: a case report.

Science.gov (United States)

Themistocleous, George S; Sapkas, George S; Papagelopoulos, Panayiotis J; Stilianessi, Eugenia V; Papadopoulos, Elias Ch; Apostolou, Constantinos D

2005-01-01

Steinert syndrome is described as an autosomal dominant condition characterized by progressive muscular wasting, myotonia, musculoskeletal manifestations and rare spinal defects. Little is reported about spinal deformity associated with this syndrome. We present a patient with Steinert syndrome complicated by scoliosis. In the literature on muscular dystrophy, other than Duchenne, little mention is given to the problem of scoliosis in general and its treatment in particular. A case report of a patient with Steinert syndrome associated with thoracic scoliosis and hypokyphosis is presented. A 17-year-old boy presented with King type II right thoracic scoliosis (T5-T11, Cobb angle of 40 degrees) and hypokyphosis--10 degrees. He was treated with posterior stabilization and instrumentation at level T3-L2 with a postoperative correction of the scoliotic curve to 20 degrees. Histopathologic examination of the muscles confirmed the diagnosis of Steinert myotonic dystrophy. At 30-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. Scoliosis in Steinert syndrome shares the characteristic of an arthrogrypotic neuromuscular curve and demands the extensive soft tissue release for optimal surgical correction. Intraoperative observations included profound tissue bleeding, abnormally tough soft tissues and a difficult recovery from anaesthesia.

Quantum mechanics of a generalised rigid body

International Nuclear Information System (INIS)

Gripaios, Ben; Sutherland, Dave

2016-01-01

We consider the quantum version of Arnold’s generalisation of a rigid body in classical mechanics. Thus, we quantise the motion on an arbitrary Lie group manifold of a particle whose classical trajectories correspond to the geodesics of any one-sided-invariant metric. We show how the derivation of the spectrum of energy eigenstates can be simplified by making use of automorphisms of the Lie algebra and (for groups of type I) by methods of harmonic analysis. We show how the method can be extended to cosets, generalising the linear rigid rotor. As examples, we consider all connected and simply connected Lie groups up to dimension 3. This includes the universal cover of the archetypical rigid body, along with a number of new exactly solvable models. We also discuss a possible application to the topical problem of quantising a perfect fluid. (paper)

Stochasticity in Ca2+ increase in spines enables robust and sensitive information coding.

Directory of Open Access Journals (Sweden)

Takuya Koumura

Full Text Available A dendritic spine is a very small structure (∼0.1 µm3 of a neuron that processes input timing information. Why are spines so small? Here, we provide functional reasons; the size of spines is optimal for information coding. Spines code input timing information by the probability of Ca2+ increases, which makes robust and sensitive information coding possible. We created a stochastic simulation model of input timing-dependent Ca2+ increases in a cerebellar Purkinje cell's spine. Spines used probability coding of Ca2+ increases rather than amplitude coding for input timing detection via stochastic facilitation by utilizing the small number of molecules in a spine volume, where information per volume appeared optimal. Probability coding of Ca2+ increases in a spine volume was more robust against input fluctuation and more sensitive to input numbers than amplitude coding of Ca2+ increases in a cell volume. Thus, stochasticity is a strategy by which neurons robustly and sensitively code information.

Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study

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Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.

2013-01-01

Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with comparison cohorts of nonsurvivors versus survivors and elderly versus nonelderly. Linear regression analysis was utilized to demonstrate trends with statistical significance. There were 965 patients with traumatic spine injuries with 2,333 spine trauma levels. The general cohort showed a trimodal age distribution, male-to-female ratio of 2:2, motor vehicle accidents as the primary spine trauma mechanism, 47.7% patients with severe polytrauma as graded using the Injury Severity Score (ISS), 17.3% with traumatic brain injury (TBI), the majority of patients with one spine injury level, 7% neurological deficit rate, 12.8% spine trauma operative rate, and 5.2% mortality rate. Variables with statistical significance trending toward mortality were the elderly, motor vehicle occupants, severe ISS, TBI, C1–2 dissociations, and American Spinal Injury Association (ASIA) A, B, and C neurological grades. Variables with statistical significance trending toward the elderly were females; low falls; one spine injury level; type 2 odontoid fractures; subaxial cervical spine distraction injuries; ASIA A, B, and C neurological grades; and patients without neurological deficits. Of the general cohort, 50.3% of spine trauma survivors were discharged home, and 48.1% were discharged to rehabilitation facilities. This study provides baseline spine trauma epidemiological data. The trimodal age distribution of patients with traumatic spine injuries calls for further studies and intervention targeted

Comparison of tracheal intubation using the Airtraq® and Mc Coy laryngoscope in the presence of rigid cervical collar simulating cervical immobilisation for traumatic cervical spine injury

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Padmaja Durga

2012-01-01

Full Text Available Background: It is difficult to visualise the larynx using conventional laryngoscopy in the presence of cervical spine immobilisation. Airtraq® provides for easy and successful intubation in the neutral neck position. Objective: To evaluate the effectiveness of Airtraq in comparison with the Mc Coy laryngoscope, when performing tracheal intubation in patients with neck immobilisation using hard cervical collar and manual in-line axial cervical spine stabilisation. Methods: A randomised, cross-over, open-labelled study was undertaken in 60 ASA I and II patients aged between 20 and 50 years, belonging to either gender, scheduled to undergo elective surgical procedures. Following induction and adequate muscle relaxation, they were intubated using either of the techniques first, followed by the other. Intubation time and Intubation Difficulty Score (IDS were noted using Mc Coy laryngoscope and Airtraq. The anaesthesiologist was asked to grade the ease of intubation on a Visual Analogue Scale (VAS of 1-10. Chi-square test was used for comparison of categorical data between the groups and paired sample t-test for comparison of continuous data. IDS score and VAS were compared using Wilcoxon Signed ranked test. Results: The mean intubation time was 33.27 sec (13.25 for laryngoscopy and 28.95 sec (18.53 for Airtraq (P=0.32. The median IDS values were 4 (interquartile range (IQR 1-6 and 0 (IQR 0-1 for laryngoscopy and Airtraq, respectively (P=0.007. The median Cormack Lehane glottic view grade was 3 (IQR 2-4 and 1 (IQR 1-1 for laryngoscopy and Airtraq, respectively (P=0.003. The ease of intubation on VAS was graded as 4 (IQR 3-5 for laryngoscopy and 2 (IQR 2-2 for Airtraq (P=0.033. There were two failures to intubate with the Airtraq. Conclusion: Airtraq improves the ease of intubation significantly when compared to Mc Coy blade in patients immobilised with cervical collar and manual in-line stabilisation simulating cervical spine injury.

Opposite effects of fear conditioning and extinction on dendritic spine remodelling.

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Lai, Cora Sau Wan; Franke, Thomas F; Gan, Wen-Biao

2012-02-19

It is generally believed that fear extinction is a form of new learning that inhibits rather than erases previously acquired fear memories. Although this view has gained much support from behavioural and electrophysiological studies, the hypothesis that extinction causes the partial erasure of fear memories remains viable. Using transcranial two-photon microscopy, we investigated how neural circuits are modified by fear learning and extinction by examining the formation and elimination of postsynaptic dendritic spines of layer-V pyramidal neurons in the mouse frontal association cortex. Here we show that fear conditioning by pairing an auditory cue with a footshock increases the rate of spine elimination. By contrast, fear extinction by repeated presentation of the same auditory cue without a footshock increases the rate of spine formation. The degrees of spine remodelling induced by fear conditioning and extinction strongly correlate with the expression and extinction of conditioned fear responses, respectively. Notably, spine elimination and formation induced by fear conditioning and extinction occur on the same dendritic branches in a cue- and location-specific manner: cue-specific extinction causes formation of dendritic spines within a distance of two micrometres from spines that were eliminated after fear conditioning. Furthermore, reconditioning preferentially induces elimination of dendritic spines that were formed after extinction. Thus, within vastly complex neuronal networks, fear conditioning, extinction and reconditioning lead to opposing changes at the level of individual synapses. These findings also suggest that fear memory traces are partially erased after extinction.

Clostridium difficile colitis in patients undergoing lumbar spine surgery.

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Skovrlj, Branko; Guzman, Javier Z; Silvestre, Jason; Al Maaieh, Motasem; Qureshi, Sheeraz A

2014-09-01

Retrospective database analysis. To investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after lumbar spine surgery. C. difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on estimates of C. difficile infection rates and its consequences on patient outcomes and health care resources among patients undergoing lumbar spine surgery. The Nationwide Inpatient Sample was examined from 2002 to 2011. Patients were included for study based on International Classification of Diseases, Ninth Revision, Clinical Modification, procedural codes for lumbar spine surgery for degenerative diagnoses. Baseline patient characteristics were determined and multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. The incidence of C. difficile infection in patients undergoing lumbar spine surgery is 0.11%. At baseline, patients infected with C. difficile were significantly older (65.4 yr vs. 58.9 yr, Pinfection. Small hospital size was associated with decreased odds (odds ratio [OR], 0.5; Pinfection. Uninsured (OR, 1.62; Pinfection. C. difficile increased hospital length of stay by 8 days (Pdifficile infection after lumbar spine surgery carries a 36.4-fold increase in mortality and costs approximately $10,658,646 per year to manage. These data suggest that great care should be taken to avoid C. difficile colitis in patients undergoing lumbar spine surgery because it is associated with longer hospital stays, greater overall costs, and increased inpatient mortality. 3.

Performance Indicators in Spine Surgery.

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St-Pierre, Godefroy Hardy; Yang, Michael H; Bourget-Murray, Jonathan; Thomas, Ken C; Hurlbert, Robin John; Matthes, Nikolas

2018-02-15

Systematic review. To elucidate how performance indicators are currently used in spine surgery. The Patient Protection and Affordable Care Act has given significant traction to the idea that healthcare must provide value to the patient through the introduction of hospital value-based purchasing. The key to implementing this new paradigm is to measure this value notably through performance indicators. MEDLINE, CINAHL Plus, EMBASE, and Google Scholar were searched for studies reporting the use of performance indicators specific to spine surgery. We followed the Prisma-P methodology for a systematic review for entries from January 1980 to July 2016. All full text articles were then reviewed to identify any measure of performance published within the article. This measure was then examined as per the three criteria of established standard, exclusion/risk adjustment, and benchmarking to determine if it constituted a performance indicator. The initial search yielded 85 results among which two relevant studies were identified. The extended search gave a total of 865 citations across databases among which 15 new articles were identified. The grey literature search provided five additional reports which in turn led to six additional articles. A total of 27 full text articles and reports were retrieved and reviewed. We were unable to identify performance indicators. The articles presenting a measure of performance were organized based on how many criteria they lacked. We further examined the next steps to be taken to craft the first performance indicator in spine surgery. The science of performance measurement applied to spine surgery is still in its infancy. Current outcome metrics used in clinical settings require refinement to become performance indicators. Current registry work is providing the necessary foundation, but requires benchmarking to truly measure performance. 1.

EMS Adherence to a Pre-hospital Cervical Spine Clearance Protocol

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Johnson, David

2001-10-01

Full Text Available Purpose: To determine the degree of adherence to a cervical spine (c-spine clearance protocol by pre-hospital Emergency Medical Services (EMS personnel by both self-assessment and receiving hospital assessment, to describe deviations from the protocol, and to determine if the rate of compliance by paramedic self-assessment differed from receiving hospital assessment. Methods: A retrospective sample of pre-hospital (consecutive series and receiving hospital (convenience sample assessments of the compliance with and appropriateness of c-spine immobilization. The c-spine clearance protocol was implemented for Orange County EMS just prior to the April-November 1999 data collection period. Results: We collected 396 pre-hospital and 162 receiving hospital data forms. From the pre-hospital data sheet. the percentage deviation from the protocol was 4.096 (16/396. Only one out of 16 cases that did not comply with the protocol was due to over immobilization (0.2%. The remaining 15 cases were under immobilized, according to protocol. Nine of the under immobilized cases (66% that should have been placed in c-spine precautions met physical assessment criteria in the protocol, while the other five cases met mechanism of injury criteria. The rate of deviations from protocol did not differ over time. The receiving hospital identified 8.0% (13/162; 6/16 over immobilized, 7/16 under immobilized of patients with deviations from the protocol; none was determined to have actual c-spine injury. Conclusion: The implementation of a pre-hospital c-spine clearance protocol in Orange County was associated with a moderate overall adherence rate (96% from the pre-hospital perspective, and 92% from the hospital perspective, p=.08 for the two evaluation methods. Most patients who deviated from protocol were under immobilized, but no c-spine injuries were missed. The rate of over immobilization was better than previously reported, implying a saving of resources.

Acquired pathology of the pediatric spine and spinal cord

International Nuclear Information System (INIS)

Palasis, Susan; Hayes, Laura L.

2015-01-01

Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis. (orig.)

Acquired pathology of the pediatric spine and spinal cord

Energy Technology Data Exchange (ETDEWEB)

Palasis, Susan; Hayes, Laura L. [Children' s Healthcare of Atlanta, Department of Radiology at Scottish Rite, Atlanta, GA (United States)

2015-09-15

Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis. (orig.)

Customizable rigid head fixation for infants: technical note.

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Udayakumaran, Suhas; Onyia, Chiazor U

2016-01-01

The need and advantages of rigid fixation of the head in cranial surgeries are well documented (Berryhill et al., Otolaryngol Head Neck Surg 121:269-273, 1999). Head fixation for neurosurgical procedures in infants and in early years has been a challenge and is fraught with risk. Despite the fact that pediatric pins are designed, rigid head fixation involving direct application of pins to the head of infants and slightly older children is still generally not safe (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). Yet, there are some surgeries in which some form of rigid fixation is required (Agrawal and Steinbok, Childs Nerv Syst 22:1473-1474, 2006). We describe a simple technique to achieve rigid fixation of the head in infants for neurosurgical procedures. This involves applying a head band made of Plaster of Paris (POP) around the head and then applying the fixation pins of the fixation frame directly on to the POP. We have used this technique of head fixation successfully for infants with no complications.

"Mind the trap": mindfulness practice reduces cognitive rigidity.

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Jonathan Greenberg

Full Text Available Two experiments examined the relation between mindfulness practice and cognitive rigidity by using a variation of the Einstellung water jar task. Participants were required to use three hypothetical jars to obtain a specific amount of water. Initial problems were solvable by the same complex formula, but in later problems ("critical" or "trap" problems solving was possible by an additional much simpler formula. A rigidity score was compiled through perseverance of the complex formula. In Experiment 1, experienced mindfulness meditators received significantly lower rigidity scores than non-meditators who had registered for their first meditation retreat. Similar results were obtained in randomized controlled Experiment 2 comparing non-meditators who underwent an eight meeting mindfulness program with a waiting list group. The authors conclude that mindfulness meditation reduces cognitive rigidity via the tendency to be "blinded" by experience. Results are discussed in light of the benefits of mindfulness practice regarding a reduced tendency to overlook novel and adaptive ways of responding due to past experience, both in and out of the clinical setting.

Swespine: the Swedish spine register : the 2012 report.

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Strömqvist, Björn; Fritzell, Peter; Hägg, Olle; Jönsson, Bo; Sandén, Bengt

2013-04-01

Swespine, the Swedish National Spine Register, has existed for 20 years and is in general use within the country since over 10 years regarding degenerative lumbar spine disorders. Today there are protocols for registering all disorders of the entire spinal column. Patient-based pre- and postoperative questionnaires, completed before surgery and at 1, 2, 5 and 10 years postoperatively. Among patient-based data are VAS pain, ODI, SF-36 and EQ-5D. Postoperatively evaluation of leg and back pain as compared to preoperatively ("global assessment"), overall satisfaction with outcome and working conditions are registered in addition to the same parameters as preoperatively evaluation. A yearly report is produced including an analytic part of a certain topic, in this issue disc prosthesis surgery. More than 75,000 surgically treated patients are registered to date with an increasing number yearly. The present report includes 7,285 patients; 1-, 2- and 5-year follow-up data of previously operated patients are also included for lumbar disorders as well as for disc prosthesis surgery. For the degenerative lumbar spine disorders (disc herniation, spinal stenosis, spondylolisthesis and DDD) significant improvements are seen in all aspects as exemplified by pronounced improvement regarding EQ-5D and ODI. Results seem to be stable over time. Spinal stenosis is the most common indication for spine surgery. Disc prosthesis surgery yields results on a par with fusion surgery in disc degenerative pain. The utility of spine surgery is well documented by the results. Results of spine surgery as documented on a national basis can be utilized for quality assurance and quality improvement as well as for research purposes, documenting changes over time and bench marking when introducing new surgical techniques. A basis for international comparisons is also laid.

Recurrent spine surgery patients in hospital administrative database

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M. Sami Walid

2012-02-01

Full Text Available Introduction: Hospital patient databases are typically used by administrative staff to estimate loss-profit ratios and to help with the allocation of hospital resources. These databases can also be very useful in following rehospitalization. This paper studies the recurrence of spine surgery patients in our hospital population based on administrative data analysis. Methods: Hospital data on 4,958 spine surgery patients operated between 2002 and 2009 were retrospectively reviewed. After sorting the cohort per ascending discharge date, the patient official name, consisting of first, middle and last names, was used as the variable determining duplicate cases in the SPSS statistical program, designating the first case in each group as primary. Yearly recurrence rate and change in procedure distribution were studied. In addition, hospital charges and length of stay were compared using the Wilcoxon-Mann-Whitney test. Results: Of 4,958 spine surgery patients 364 (7.3% were categorized as duplicate cases by SPSS. The number of primary cases from which duplicate cases emerged was 327 meaning that some patients had more than two spine surgeries. Among primary patients (N=327 the percentage of excision of intervertebral disk procedures was 33.3% and decreased to 15.1% in recurrent admissions of the same patients (N=364. This decrease was compensated by an increase in lumbar fusion procedures. On the other hand, the rate of cervical fusion remained the same. The difference in hospital charges between primary and duplicate patients was $2,234 for diskectomy, $6,319 for anterior cervical fusion, $8,942 for lumbar fusion – lateral technique, and $12,525 for lumbar fusion – posterior technique. Recurrent patients also stayed longer in hospital, up to 0.9 day in lumbar fusion – posterior technique patients. Conclusion: Spine surgery is associated with an increasing possibility of additional spine surgery with rising invasiveness and cost.

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

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2010-10-01

...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist of... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...

[Hand-arm vibration syndrome in caisson miners].

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Kákosy, T; Németh, L; Hazay, B; Posgay, M; Diner, J

1997-07-06

Authors examined 43 caisson-miners with symptoms of the upper extremities because of suspicion of hand-arm vibration syndrome. Also vibration measurements were performed on the pneumatic hammer used by the workers. The acceleration of the vibration exceeded 2.5-3.5 times the maximum allowable level according to the ISO 5349. Symptoms and signs of hand-arm vibration syndrome were found in 39 cases (90.7%). The vascular, peripheral neurological and locomotor system of the upper extremities were affected in similar frequency: 54.8; 51.6 and 51.2%, respectively. The most common angiological alteration was the Raynaud's phenomenon. Neurologically predominated the tunnel syndromes. Among the osteoarticular lesions the degenerative phenomena were the most frequent. In most cases more than one pathological alteration occurred. Fatigue fracture of the spinous process of vertebra D. I. appeared in one single case, degenerative changes of cervical spine in 34 patients (79.1%). The very common occurrence of the locomotor alterations and tunnel syndromes respectively can be explained probably also by the high physical stress required by this profession. The detailed examination of the locomotor system is very important by the periodical screening of the caisson-miners.

78 FR 68906 - Agency Information Collection (Back (Thoracolumbar Spine) Conditions Disability Benefits...

Science.gov (United States)

2013-11-15

... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire). Type of Review: New data collection... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits... Control No. 2900- NEW (Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire)'' in any...

The Management of Unstable Cervical Spine Injuries

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Venu M. Nemani

2014-01-01

Full Text Available Injuries to the cervical spine can cause potentially devastating morbidity and even mortality. In this review we discuss the anatomy and biomechanics of the cervical spine. The evaluation and treatment of cervical spine injuries begins with the prompt immobilization of suspected injuries in the field. Once an assessment of the patient's neurological status is made, imaging studies are obtained, which can include X-rays, CT, and MRI. Careful scrutiny of the imaging studies for bony and/or ligamentous injury allows the physician to determine the mechanism of injury, which guides treatment. The ultimate treatment plan can consist of non-operative or operative management, and depends on patient specific factors (medical condition and neurological status, the mechanism of injury, and the resultant degree of instability. With prompt diagnosis and appropriate management, the morbidity of these injuries can be minimized.

Rigidity of outermost MOTS: the initial data version

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Galloway, Gregory J.

2018-03-01

In the paper Commun Anal Geom 16(1):217-229, 2008, a rigidity result was obtained for outermost marginally outer trapped surfaces (MOTSs) that do not admit metrics of positive scalar curvature. This allowed one to treat the "borderline case" in the author's work with R. Schoen concerning the topology of higher dimensional black holes (Commun Math Phys 266(2):571-576, 2006). The proof of this rigidity result involved bending the initial data manifold in the vicinity of the MOTS within the ambient spacetime. In this note we show how to circumvent this step, and thereby obtain a pure initial data version of this rigidity result and its consequence concerning the topology of black holes.

APPLICATION OF RIGID LINKS IN STRUCTURAL DESIGN MODELS

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Sergey Yu. Fialko

2017-09-01

Full Text Available A special finite element modelling rigid links is proposed for the linear static and buckling analysis. Unlike the classical approach based on the theorems of rigid body kinematics, the proposed approach preserves the similarity between the adjacency graph for a sparse matrix and the adjacency graph for nodes of the finite element model, which allows applying sparse direct solvers more effectively. Besides, the proposed approach allows significantly reducing the number of nonzero entries in the factored stiffness matrix in comparison with the classical one, which greatly reduces the duration of the solution. For buckling problems of structures containing rigid bodies, this approach gives correct results. Several examples demonstrate its efficiency.

Simulation of the Lumbar Spine as a Multi-Module Paralel Manipulator

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M. Ceccarelli

2011-01-01

Full Text Available In this paper a simulation of movements of lumbar spine is proposed by using a model with serially connected parallel manipulators. An analysis has been computed for the human spine structure and its movements, in order to simulate the motions and forces that actuate a spine specifically in the lumbar segment. A mechanical model has been designed with available identified parameters of human spine, by using characteristics of parallel manipulators and spring stiffness. This model is suitable to properly simulate the trunk behavior at macroscopic level but also the smooth behavior of intervertebral discs and actuating motions of muscles and tendons. Simulation results for spring actions and joints reaction forces can give an evaluation of the forces that intervertebral discs supports during motions of a real spine.

Dendritic Spines in Depression: What We Learned from Animal Models

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Hui Qiao

2016-01-01

Full Text Available Depression, a severe psychiatric disorder, has been studied for decades, but the underlying mechanisms still remain largely unknown. Depression is closely associated with alterations in dendritic spine morphology and spine density. Therefore, understanding dendritic spines is vital for uncovering the mechanisms underlying depression. Several chronic stress models, including chronic restraint stress (CRS, chronic unpredictable mild stress (CUMS, and chronic social defeat stress (CSDS, have been used to recapitulate depression-like behaviors in rodents and study the underlying mechanisms. In comparison with CRS, CUMS overcomes the stress habituation and has been widely used to model depression-like behaviors. CSDS is one of the most frequently used models for depression, but it is limited to the study of male mice. Generally, chronic stress causes dendritic atrophy and spine loss in the neurons of the hippocampus and prefrontal cortex. Meanwhile, neurons of the amygdala and nucleus accumbens exhibit an increase in spine density. These alterations induced by chronic stress are often accompanied by depression-like behaviors. However, the underlying mechanisms are poorly understood. This review summarizes our current understanding of the chronic stress-induced remodeling of dendritic spines in the hippocampus, prefrontal cortex, orbitofrontal cortex, amygdala, and nucleus accumbens and also discusses the putative underlying mechanisms.

MULLIGAN MOBILIZATION VERSUS STRETCHING ON THE MANAGEMENT OF PIRIFORMIS SYNDROME A COMPARATIVE STUDY

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Samahir Abuaraki Elbkheet

2016-04-01

Full Text Available Background: Piriformis syndrome is a commonly overlooked specific cause of low back pain. Apart from mimicking the sciatica-like symptoms, unilateral piriformis tightness can cause rotational dysfunction and pain in the lumbar region. This could lead to low back pain which is a common musculo skeletal problem and a major reason for activity limitation. Stretching the piriformis tightened muscle is a preferred choice of treatment against surgical intervention to release the muscle. Mulligan’s mobilization is based on movement with mobilization which is proven to be effective in many musculo skeletal dysfunctions including the lumbar spine. The purpose of this study is to explore and compare the two treatment methods in relieving the low back pain in clinical conditions with piriformis syndrome. Methods: In this experimental study, 40 patients with piriformis syndrome were selected and divided into two groups. One group was given only piriformis stretching for the tightened muscle and the other group given Mulligan mobilization for lumbo sacral joints. VAS and lower limb functional index were taken to compare before and after the treatment regime of 4 weeks. Results: There was no significant difference between the two groups in both pain scale and lower limb mobility and function. But there was significant improvement in pain relief and LLFI after the treatment regime in both groups compared to the pre-treatment status. Conclusion: Even as the piriformis syndrome is caused by the tightness of the muscle, the consequence in the lower back and lumbar spine mobility can be improved by a Mulligan mobilization as a single mode of intervention.

Ocean acidification impacts spine integrity but not regenerative capacity of spines and tube feet in adult sea urchins

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Emerson, Chloe E.; Reinardy, Helena C.; Bates, Nicholas R.

2017-01-01

Increasing atmospheric carbon dioxide (CO2) has resulted in a change in seawater chemistry and lowering of pH, referred to as ocean acidification. Understanding how different organisms and processes respond to ocean acidification is vital to predict how marine ecosystems will be altered under future scenarios of continued environmental change. Regenerative processes involving biomineralization in marine calcifiers such as sea urchins are predicted to be especially vulnerable. In this study, the effect of ocean acidification on regeneration of external appendages (spines and tube feet) was investigated in the sea urchin Lytechinus variegatus exposed to ambient (546 µatm), intermediate (1027 µatm) and high (1841 µatm) partial pressure of CO2 (pCO2) for eight weeks. The rate of regeneration was maintained in spines and tube feet throughout two periods of amputation and regrowth under conditions of elevated pCO2. Increased expression of several biomineralization-related genes indicated molecular compensatory mechanisms; however, the structural integrity of both regenerating and homeostatic spines was compromised in high pCO2 conditions. Indicators of physiological fitness (righting response, growth rate, coelomocyte concentration and composition) were not affected by increasing pCO2, but compromised spine integrity is likely to have negative consequences for defence capabilities and therefore survival of these ecologically and economically important organisms. PMID:28573022

Ocean acidification impacts spine integrity but not regenerative capacity of spines and tube feet in adult sea urchins.

Science.gov (United States)

Emerson, Chloe E; Reinardy, Helena C; Bates, Nicholas R; Bodnar, Andrea G

2017-05-01

Increasing atmospheric carbon dioxide (CO 2 ) has resulted in a change in seawater chemistry and lowering of pH, referred to as ocean acidification. Understanding how different organisms and processes respond to ocean acidification is vital to predict how marine ecosystems will be altered under future scenarios of continued environmental change. Regenerative processes involving biomineralization in marine calcifiers such as sea urchins are predicted to be especially vulnerable. In this study, the effect of ocean acidification on regeneration of external appendages (spines and tube feet) was investigated in the sea urchin Lytechinus variegatus exposed to ambient (546 µatm), intermediate (1027 µatm) and high (1841 µatm) partial pressure of CO 2 ( p CO 2 ) for eight weeks. The rate of regeneration was maintained in spines and tube feet throughout two periods of amputation and regrowth under conditions of elevated p CO 2 . Increased expression of several biomineralization-related genes indicated molecular compensatory mechanisms; however, the structural integrity of both regenerating and homeostatic spines was compromised in high p CO 2 conditions. Indicators of physiological fitness (righting response, growth rate, coelomocyte concentration and composition) were not affected by increasing p CO 2 , but compromised spine integrity is likely to have negative consequences for defence capabilities and therefore survival of these ecologically and economically important organisms.

High frequency permeameter with semi-rigid pick-up coil

International Nuclear Information System (INIS)

Shin, Sung-Yong; Shin, Kwang-Ho . E-mail : khshin@star.ks.ac.kr; Kim, Jong-sung; Kim, Young-Hak; Lim, Sang-Ho; Sa-gong, Geon

2006-01-01

In this study, we propose the application of semi-rigid cable loop as a single turn shielded loop pick-up coil for the high frequency permeameter. Since the semi-rigid cable pick-up coil has simple structure, it is very easy to make the pick-up coil with bending and conventional soldering. The permeability of cobalt base amorphous ribbon was investigated using the developed permeameter for demonstrating its performance. The permeability of the amorphous ribbon was driven from the S-parameters measured using a network analyzer and permameter having the semi-rigid pick-up coil

Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

International Nuclear Information System (INIS)

Kim, Jung Ryul; Song, Ji Hun; Lee, Ju Hong; Lee, Sang Yong; Yoo, Wan Hee

2008-01-01

Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

Hypoglossal Nerve Palsy After Cervical Spine Surgery

OpenAIRE

Ames, Christopher P.; Clark, Aaron J.; Kanter, Adam S.; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

2017-01-01

Study Design: Multi-institutional retrospective study. Objective: The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. Methods: A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. Results: No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy...

Incorrect dosage of IQSEC2, a known intellectual disability and epilepsy gene, disrupts dendritic spine morphogenesis

Science.gov (United States)

Hinze, S J; Jackson, M R; Lie, S; Jolly, L; Field, M; Barry, S C; Harvey, R J; Shoubridge, C

2017-01-01

There is considerable genetic and phenotypic heterogeneity associated with intellectual disability (ID), specific learning disabilities, attention-deficit hyperactivity disorder, autism and epilepsy. The intelligence quotient (IQ) motif and SEC7 domain containing protein 2 gene (IQSEC2) is located on the X-chromosome and harbors mutations that contribute to non-syndromic ID with and without early-onset seizure phenotypes in both sexes. Although IQ and Sec7 domain mutations lead to partial loss of IQSEC2 enzymatic activity, the in vivo pathogenesis resulting from these mutations is not known. Here we reveal that IQSEC2 has a key role in dendritic spine morphology. Partial loss-of-function mutations were modeled using a lentiviral short hairpin RNA (shRNA) approach, which achieved a 57% knockdown of Iqsec2 expression in primary hippocampal cell cultures from mice. Investigating gross morphological parameters after 8 days of in vitro culture (8DIV) identified a 32% reduction in primary axon length, in contrast to a 27% and 31% increase in the number and complexity of dendrites protruding from the cell body, respectively. This increase in dendritic complexity and spread was carried through dendritic spine development, with a 34% increase in the number of protrusions per dendritic segment compared with controls at 15DIV. Although the number of dendritic spines had normalized by 21DIV, a reduction was noted in the number of immature spines. In contrast, when modeling increased dosage, overexpression of wild-type IQSEC2 led to neurons with shorter axons that were more compact and displayed simpler dendritic branching. Disturbances to dendritic morphology due to knockdown of Iqsec2 were recapitulated in neurons from Iqsec2 knockout mice generated in our laboratory using CRISPR/Cas9 technology. These observations provide evidence of dosage sensitivity for IQSEC2, which normally escapes X-inactivation in females, and links these disturbances in expression to alterations in

Sports-related injuries of the spine

International Nuclear Information System (INIS)

Hochmuth, K.; Mack, M.G.; Vogl, T.J.; Kurth, A.A.; Zichner, L.

2002-01-01

Different sports show different patterns and frequencies of injuries, which are discussed in this paper. About 3% of all sports accidents relate to the spine. These injuries often have far-reaching consequences for the patients. A very early and extensive diagnosis of all changes is decisive for the start of an adequate therapy and thus for the prognosis of the injury. Radiological diagnosis is also of decisive importance for the documentation of late injuries and in the question of rehabilitation. Here special focus is put on MRT and CT diagnostics.A healthy spine of humans is normally able to resist all static and dynamic strains of the usual sports. However, anomalies and dysfunctions of the spine can reduce its capacity to resist strain. The recommendations of sporting activities are given according to the extent of deflection and the expected growth. The importance of radiology in primary diagnosis and in the follow-up due to typical changes like scoliosis, Morbus Scheuerman, spondylolysis and spondylolisthesis is discussed here as well. (orig.) [de

Durable bistable auxetics made of rigid solids

Science.gov (United States)

Shang, Xiao; Liu, Lu; Rafsanjani, Ahmad; Pasini, Damiano

2018-02-01

Bistable Auxetic Metamaterials (BAMs) are a class of monolithic perforated periodic structures with negative Poisson's ratio. Under tension, a BAM can expand and reach a second state of equilibrium through a globally large shape transformation that is ensured by the flexibility of its elastomeric base material. However, if made from a rigid polymer, or metal, BAM ceases to function due to the inevitable rupture of its ligaments. The goal of this work is to extend the unique functionality of the original kirigami architecture of BAM to a rigid solid base material. We use experiments and numerical simulations to assess performance, bistability and durability of rigid BAMs at 10,000 cycles. Geometric maps are presented to elucidate the role of the main descriptors of BAM architecture. The proposed design enables the realization of BAM from a large palette of materials, including elastic-perfectly plastic materials and potentially brittle materials.

Utility of semi-rigid thoracoscopy in undiagnosed exudative pleural effusion.

Science.gov (United States)

Nattusamy, Loganathan; Madan, Karan; Mohan, Anant; Hadda, Vijay; Jain, Deepali; Madan, Neha Kawatra; Arava, Sudheer; Khilnani, Gopi C; Guleria, Randeep

2015-01-01

Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed pleural effusion. Literature on its utility from developing countries is limited. We herein describe our initial experience on the utility of semi-rigid thoracoscopy from a tertiary care teaching and referral center in north India. We also perform a systematic review of studies reporting the utility of semi-rigid thoracoscopy from India. The primary objective was to evaluate the diagnostic utility of semi-rigid thoracoscopy in patients with undiagnosed exudative pleural effusion. Semi-rigid thoracoscopy was performed under local anesthesia and conscious sedation in the bronchoscopy suite. A total of 48 patients underwent semi-rigid thoracoscopy between August 2012 and December 2013 for undiagnosed pleural effusion. Mean age was 50.9 ± 14.1 years (range: 17-78 years). Pre-procedure clinico-radiological diagnoses were malignant pleural effusion [36 patients (75%)], tuberculosis (TB) [10 (20.83%) patients], and empyema [2 patients (4.17%)]. Patients with empyema underwent the procedure for pleural biopsy, optimal placement of intercostal tube and adhesiolysis. Thoracoscopic pleural biopsy diagnosed pleural malignancy in 30 (62.5%) patients and TB in 2 (4.17%) patients. Fourteen (29.17%) patients were diagnosed with non-specific pleuritis and normal pleura was diagnosed on a pleural biopsy in 2 (4.17%) patients. Overall, a definitive diagnosis of either pleural malignancy or TB was obtained in 32 (66.7%) patients. Combined overall sensitivity, specificity, positive predictive value and negative predictive value of thoracoscopic pleural biopsy for malignant pleural effusion were 96.77%, 100%, 100% and 66.67%, respectively. There was no procedure-related mortality. On performing a systematic review of literature, four studies on semi-rigid thoracoscopy from India were identified. Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed exudative

Age-Based Comparison of Human Dendritic Spine Structure Using Complete Three-Dimensional Reconstructions

Science.gov (United States)

Benavides-Piccione, Ruth; Fernaud-Espinosa, Isabel; Robles, Victor; Yuste, Rafael; DeFelipe, Javier

2013-01-01

Dendritic spines of pyramidal neurons are targets of most excitatory synapses in the cerebral cortex. Recent evidence suggests that the morphology of the dendritic spine could determine its synaptic strength and learning rules. However, unfortunately, there are scant data available regarding the detailed morphology of these structures for the human cerebral cortex. In the present study, we analyzed over 8900 individual dendritic spines that were completely 3D reconstructed along the length of apical and basal dendrites of layer III pyramidal neurons in the cingulate cortex of 2 male humans (aged 40 and 85 years old), using intracellular injections of Lucifer Yellow in fixed tissue. We assembled a large, quantitative database, which revealed a major reduction in spine densities in the aged case. Specifically, small and short spines of basal dendrites and long spines of apical dendrites were lost, regardless of the distance from the soma. Given the age difference between the cases, our results suggest selective alterations in spines with aging in humans and indicate that the spine volume and length are regulated by different biological mechanisms. PMID:22710613

Value of prehospital assessment of spine fracture by paramedics

NARCIS (Netherlands)

ten Brinke, J. G.; Gebbink, W. K.; Pallada, L.; Saltzherr, T. P.; Hogervorst, M.; Goslings, J. C.

2017-01-01

Current guidelines state that trauma patients at risk of spine injury should undergo prehospital spine immobilization to reduce the risk of neurological deterioration. Although this approach has been accepted and implemented as a standard for decades, there is little scientific evidence to support

Surgical management of metastatic tumors of the cervical spine.

Science.gov (United States)

Davarski, Atanas N; Kitov, Borislav D; Zhelyazkov, Christo B; Raykov, Stefan D; Kehayov, Ivo I; Koev, Ilyan G; Kalnev, Borislav M

2013-01-01

To present the results from the clinical presentation, the imaging diagnostics, surgery and postoperative status of 17 patients with cervical spine metastases, to analyse all data and make the respective conclusions and compare them with the available data in the literature. The study analysed data obtained by patients with metastatic cervical tumours treated in St George University Hospital over a period of seven years. All patients underwent diagnostic imaging tests which included, separately or in combination, cervical x-rays, computed tomography scan and magnetic-resonance imaging. Severity of neurological damage and its pre- and postoperative state was graded according to the Frankel Scale. For staging and operating performance we used the Tomita scale and Harrington classification. Seven patients had only one affected vertebra, 4 patients--two vertebrae, one patient--three vertebrae, 2 patients--four vertebrae, and in the other 3 patients more than one segment was affected. Surgery was performed in 12 patients. One level anterior corpectomy was performed in 6 patients, three patients had two-level surgery, and one patient--three-level corpectomy; in the remaining 2 cases we used posterior approach in surgery. Complete corpectomy was performed in 4 patients, subtotal corpectomy was used in 6 patients and partial--in 2 patients. Anterior stabilization system ADD plus (Ulrich GmbH & Co. KG, Ulm, Germany) was implanted in 2 patients; in 8 patients anterior titanium plate and bone graft were used, and in 1 patient--posterior cervical stabilization system. Because of the pronounced pain syndrome and frequent neurological lesions as a result of the cervical spine metastases use of surgery is justified. The main purpose is to maximize tumor resection, achieve optimal spinal cord and nerve root decompression and stabilize the affected segment.

A multi-national report on methods for institutional credentialing for spine radiosurgery

International Nuclear Information System (INIS)

Gerszten, Peter C; Shin, John H; Winey, Brian; Oh, Kevin; Sweeney, Reinhart A; Guckenberger, Matthias; Sahgal, Arjun; Sheehan, Jason P; Kersh, Ronald; Chen, Stephanie; Flickinger, John C; Quader, Mubina; Fahim, Daniel; Grills, Inga

2013-01-01

Stereotactic body radiotherapy and radiosurgery are rapidly emerging treatment options for both malignant and benign spine tumors. Proper institutional credentialing by physicians and medical physicists as well as other personnel is important for the safe and effective adoption of spine radiosurgery. This article describes the methods for institutional credentialing for spine radiosurgery at seven highly experienced international institutions. All institutions (n = 7) are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided spine radiosurgery. A questionnaire consisting of 24 items covering various aspects of institutional credentialing for spine radiosurgery was completed by all seven institutions. Close agreement was observed in most aspects of spine radiosurgery credentialing at each institution. A formal credentialing process was believed to be important for the implementation of a new spine radiosurgery program, for patient safety and clinical outcomes. One institution has a written policy specific for spine radiosurgery credentialing, but all have an undocumented credentialing system in place. All institutions rely upon an in-house proctoring system for the training of both physicians and medical physicists. Four institutions require physicians and medical physicists to attend corporate sponsored training. Two of these 4 institutions also require attendance at a non-corporate sponsored academic society radiosurgery course. Corporate as well as non-corporate sponsored training were believed to be complimentary and both important for training. In 5 centers, all cases must be reviewed at a multidisciplinary conference prior to radiosurgery treatment. At 3 centers, neurosurgeons are not required to be involved in all cases if there is no evidence for instability or spinal cord compression. Backup physicians and physicists are required at only 1 institution, but all institutions have more

Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction.

Science.gov (United States)

Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique

2016-12-01

Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case.

Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction

Science.gov (United States)

Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique

2015-01-01

Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case. PMID:28018799

Spondylocarpotarsal synostosis syndrome: MRI evaluation of vertebral and disk malformation

International Nuclear Information System (INIS)

Breitling, Magnus; Rabin, Michael; Lemire, Edmond G.

2006-01-01

Spondylocarpotarsal synostosis syndrome (SSS) is a rare autosomal recessive condition characterized primarily by vertebral malsegmentation, carpal/tarsal coalition, and a dysmorphic appearance. Differentiating SSS from other congenital scoliosis syndromes requires evaluation of the vertebrae, ribs, soft tissues, and spinal cord. The enhanced resolution over plain radiographs seen with MRI allows more detailed assessment of vertebral malformation and surrounding anatomy. Diagnosis of the underlying cause of congenital scoliosis might be enhanced using this technology. We report on a 12-year-old girl of unaffected parents with SSS who was evaluated with MRI sequences of the spine to show various types of malsegmentation. Additionally, there is the new finding of fusion of teeth, with developmental failure of a canine incisor. (orig.)

Spondylocarpotarsal synostosis syndrome: MRI evaluation of vertebral and disk malformation

Energy Technology Data Exchange (ETDEWEB)

Breitling, Magnus; Rabin, Michael [University of Saskatchewan, Department of Medical Imaging, Saskatoon, Saskatchewan (Canada); Lemire, Edmond G. [University of Saskatchewan, Division of Medical Genetics, Department of Pediatrics, Saskatoon (Canada)

2006-08-15

Spondylocarpotarsal synostosis syndrome (SSS) is a rare autosomal recessive condition characterized primarily by vertebral malsegmentation, carpal/tarsal coalition, and a dysmorphic appearance. Differentiating SSS from other congenital scoliosis syndromes requires evaluation of the vertebrae, ribs, soft tissues, and spinal cord. The enhanced resolution over plain radiographs seen with MRI allows more detailed assessment of vertebral malformation and surrounding anatomy. Diagnosis of the underlying cause of congenital scoliosis might be enhanced using this technology. We report on a 12-year-old girl of unaffected parents with SSS who was evaluated with MRI sequences of the spine to show various types of malsegmentation. Additionally, there is the new finding of fusion of teeth, with developmental failure of a canine incisor. (orig.)

Algebraic Methods for Counting Euclidean Embeddings of Rigid Graphs

NARCIS (Netherlands)

I.Z. Emiris; E.P. Tsigaridas; A. Varvitsiotis (Antonios); E.R. Gasner

2009-01-01

textabstract The study of (minimally) rigid graphs is motivated by numerous applications, mostly in robotics and bioinformatics. A major open problem concerns the number of embeddings of such graphs, up to rigid motions, in Euclidean space. We capture embeddability by polynomial systems

Rigid body dynamics of mechanisms

CERN Document Server

Hahn, Hubert

2003-01-01

The second volume of Rigid Body Dynamics of Mechanisms covers applications via a systematic method for deriving model equations of planar and spatial mechanisms. The necessary theoretical foundations have been laid in the first volume that introduces the theoretical mechanical aspects of mechatronic systems. Here the focus is on the application of the modeling methodology to various examples of rigid-body mechanisms, simple planar ones as well as more challenging spatial problems. A rich variety of joint models, active constraints, plus active and passive force elements is treated. The book is intended for self-study by working engineers and students concerned with the control of mechanical systems, i.e. robotics, mechatronics, vehicles, and machine tools. The examples included are a likely source from which to choose models for university lectures.

Audit of blood transfusion practice during anaesthesia for spine ...

African Journals Online (AJOL)

Background: Blood loss during spine surgery is often considerable, necessitating blood transfusion. The elective nature and other peculiarities of most spine surgeries, however, make them amenable to several blood conservation techniques, such that reduction in allogeneic blood transfusion is considered high priority in ...

Static flexural properties of hedgehog spines conditioned in coupled temperature and relative humidity environments.

Science.gov (United States)

Kennedy, Emily B; Hsiung, Bor-Kai; Swift, Nathan B; Tan, Kwek-Tze

2017-11-01

Hedgehogs are agile climbers, scaling trees and plants to heights exceeding 10m while foraging insects. Hedgehog spines (a.k.a. quills) provide fall protection by absorbing shock and could offer insights for the design of lightweight, material-efficient, impact-resistant structures. There has been some study of flexural properties of hedgehog spines, but an understanding of how this keratinous biological material is affected by various temperature and relative humidity treatments, or how spine color (multicolored vs. white) affects mechanics, is lacking. To bridge this gap in the literature, we use three-point bending to analyze the effect of temperature, humidity, spine color, and their interactions on flexural strength and modulus of hedgehog spines. We also compare specific strength and stiffness of hedgehog spines to conventional engineered materials. We find hedgehog spine flexural properties can be finely tuned by modifying environmental conditioning parameters. White spines tend to be stronger and stiffer than multicolored spines. Finally, for most temperature and humidity conditioning parameters, hedgehog spines are ounce for ounce stronger than 201 stainless steel rods of the same diameter but as pliable as styrene rods with a slightly larger diameter. This unique combination of strength and elasticity makes hedgehog spines exemplary shock absorbers, and a suitable reference model for biomimicry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Incidental findings on MRI of the spine

Energy Technology Data Exchange (ETDEWEB)

Kamath, S.; Jain, N.; Goyal, N.; Mansour, R. [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom); Mukherjee, K. [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom)], E-mail: kausikmukherjee@doctors.org.uk

2009-04-15

MRI is widely used as the imaging of choice for spinal disorders and may reveal either a clinically insignificant incidental abnormality or a significant lesion, unrelated to the spine, which may explain the patient's symptoms. This article attempts to establish the importance of such findings and describes a sensible approach to the reporting of MRI examinations of the spine with special attention to the incidental findings commonly encountered. The MRI characteristics of such findings are briefly described.

Osteoid Osteoma of Cervical Spine in two adjacent Vertebrae

Directory of Open Access Journals (Sweden)

MR Etemadifar

2005-09-01

Full Text Available Osteoid osteoma is a benign bone tumor, mainly seen in 10-30 years male. Spine is a relatively common site and almost always, posterior elements are involved. Plain X-Ray-, CT scan and Isotope scan help to identify and localize spine lesions. We described one 18 years old boy with 3 years low neck pain. Isotope scan, MRI and CT scan showed two lesions in C7 and T1. Gross inspection and histopathology examination confirmed osteoid osteoma in two adjacent vertebrae which has not been reported elsewhere in the literature. Key words: Osteoid Osteoma, Spine, Multifocal

Hypoglossal Nerve Palsy After Cervical Spine Surgery.

Science.gov (United States)

Ames, Christopher P; Clark, Aaron J; Kanter, Adam S; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Multi-institutional retrospective study. The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy (0.01%). This deficit resolved with conservative management. The rate by institution ranged from 0% to 1.28%. Although not directly injured by the surgical procedure, the transient nerve injury might have been related to patient positioning as has been described previously in the literature. Hypoglossal nerve injury during cervical spine surgery is an extremely rare complication. Institutional rates may vary. Care should be taken during posterior cervical surgery to avoid hyperflexion of the neck and endotracheal tube malposition.

Screening of the spine in adolescents

DEFF Research Database (Denmark)

Aartun, Ellen; Degerfalk, Anna; Kentsdotter, Linn

2014-01-01

BACKGROUND: Evidence on the reliability of clinical tests used for the spinal screening of children and adolescents is currently lacking. The aim of this study was to determine the inter- and intra-rater reliability and measurement error of clinical tests commonly used when screening young spines......-segmental mobility and end range pain in the spine. Seventy-five of the 111 subjects were re-examined after one to four hours to test intra-rater reliability. Percentage agreement and Cohen's Kappa were calculated for binary variables, and interclass correlation (ICC) and Bland-Altman plots with Limits of Agreement...

Functional diagnostics of the cervical spine by using computer tomography

International Nuclear Information System (INIS)

Dvorak, J.; Hayek, J.; Grob, D.

1988-01-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7 0 , and C1/C2 more than 54 0 could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29 0 to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast. (orig.)

Functional diagnostics of the cervical spine by using computer tomography

Energy Technology Data Exchange (ETDEWEB)

Dvorak, J; Hayek, J; Grob, D; Penning, L; Panjabi, M M; Zehnder, R

1988-04-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7/sup 0/, and C1/C2 more than 54/sup 0/ could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29/sup 0/ to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.

Biomimetic "Cactus Spine" with Hierarchical Groove Structure for Efficient Fog Collection.

Science.gov (United States)

Bai, Fan; Wu, Juntao; Gong, Guangming; Guo, Lin

2015-07-01

A biomimetic "cactus spine" with hierarchical groove structure is designed and fabricated using simple electrospinning. This novel artificial cactus spine possesses excellent fog collection and water transportation ability. A model cactus equipped with artificial spines also shows a great water storage capacity. The results can be helpful in the development of water collectors and may make a contribution to the world water crisis.

Hereditary haemochromatosis: a case of iron accumulation in the basal ganglia associated with a parkinsonian syndrome

DEFF Research Database (Denmark)

Nielsen, J.E.; Jensen, L. Neerup; Krabbe, K.

1995-01-01

. A patient is reported with hereditary haemochromatosis and a syndrome of dementia, dysarthria, a slowly progressive gait disturbance, imbalance, muscle weakness, rigidity, bradykinesia, tremor, ataxia, and dyssynergia. The findings on MRI of a large signal decrease in the basal ganglia, consistent...

Analysis of cervical spine function in healthy persons

International Nuclear Information System (INIS)

Weh, L.; Roettker, H.

1990-01-01

Radiograms were taken of subjects with no symptoms of cervical spine problems; the cervical spine was evaluated in the spontaneous posture and at maximal flexion and extension. The position and movement of the vertebra, intervertebral height and gliding were calculated. The results showed that (1) lordosis in women occurred less pronouncedly than in men, and that there was an increase with age; (2) C 2-3 was the least flexible segment and mobility increased in the caudal direction; mobility decreased with age and the segments of the lower cervical spine with the highest mobility decreased the most; (3) all posterior and ventral intervertebral heights showed a decrease with age at C 5-6 and C 6-7; (4) vertebral gliding decreased with age. (orig.) [de

CREB Regulates Experience-Dependent Spine Formation and Enlargement in Mouse Barrel Cortex

Directory of Open Access Journals (Sweden)

Annabella Pignataro

2015-01-01

Full Text Available Experience modifies synaptic connectivity through processes that involve dendritic spine rearrangements in neuronal circuits. Although cAMP response element binding protein (CREB has a key function in spines changes, its role in activity-dependent rearrangements in brain regions of rodents interacting with the surrounding environment has received little attention so far. Here we studied the effects of vibrissae trimming, a widely used model of sensory deprivation-induced cortical plasticity, on processes associated with dendritic spine rearrangements in the barrel cortex of a transgenic mouse model of CREB downregulation (mCREB mice. We found that sensory deprivation through prolonged whisker trimming leads to an increased number of thin spines in the layer V of related barrel cortex (Contra in wild type but not mCREB mice. In the barrel field controlling spared whiskers (Ipsi, the same trimming protocol results in a CREB-dependent enlargement of dendritic spines. Last, we demonstrated that CREB regulates structural rearrangements of synapses that associate with dynamic changes of dendritic spines. Our findings suggest that CREB plays a key role in dendritic spine dynamics and synaptic circuits rearrangements that account for new brain connectivity in response to changes in the environment.

What is the role of autologous blood transfusion in major spine surgery?

Science.gov (United States)

Kumar, Naresh; Chen, Yongsheng; Nath, Chinmoy; Liu, Eugene Hern Choon

2012-06-01

Major spine surgery is associated with significant blood loss, which has numerous complications. Blood loss is therefore an important concern when undertaking any major spine surgery. Blood loss can be addressed by reducing intraoperative blood loss and replenishing perioperative blood loss. Reducing intraoperative blood loss helps maintain hemodynamic equilibrium and provides a clearer operative field during surgery. Homologous blood transfusion is still the mainstay for replenishing blood loss in major spine surgery across the world, despite its known adverse effects. These significant adverse effects can be seen in up to 20% of patients. Autologous blood transfusion avoids the risks associated with homologous blood transfusion and has been shown to be cost-effective. This article reviews the different methods of autologous transfusion and focuses on the use of intraoperative cell salvage in major spine surgery. Autologous blood transfusion is a proven alternative to homologous transfusion in major spine surgery, avoiding most, if not all of these adverse effects. However, autologous blood transfusion rates in major spine surgery remain low across the world. Autologous blood transfusion may obviate the need for homologous transfusion completely. We encourage spine surgeons to consider autologous blood transfusion wherever feasible.

The influence of spine surgeons' experience on the classification and intraobserver reliability of the novel AOSpine thoracolumbar spine injury classification system : an international study

NARCIS (Netherlands)

Sadiqi, Said; Oner, F. Cumhur; Dvorak, Marcel F.; Aarabi, Bizhan; Schroeder, Gregory D.; Vaccaro, Alexander R.

2015-01-01

Study Design. International validation study. Objective. To investigate the influence of the spine surgeons' level of experience on the intraobserver reliability of the novel AOSpine Thoracolumbar Spine Injury Classification system, and the appropriate classification according to this system.

Evaluation of spine boards for X-ray diagnostics

International Nuclear Information System (INIS)

Linsenmaier, U.; Kroetz, M.; Papst, E.; Rieger, J.; Pfeifer, K.J.; Kranz, K.G.; Russ, W.; Mutscher, W.

2001-01-01

Purpose: Spine boards are frequently used in preclinical emergency care. Different models were examined with regard to their feasibility for plain film radiography and computed tomography (CT). Methods: Five current spine board models were measured for their dimensions and weight. Transmission of radiation [μGyls] and dose area product [cGy x cm 2 ] were determined with a patient equivalent aluminium phantom. Image artifacts, image quality and resolution of anatomic details were evaluated with an anthropomorphic Alderson phantom. Results: With only 6.3 kg new models show a 28% reduction in weight, three spine boards generate lateral artifacts due to a narrow width of 41 - 42 cm. Radiation transmission of all boards was similar, however dose area products differed by up to 59%. Image quality was impaired in 4 out 5 boards because of image artifacts, CT scanning was not impaired with all boards. Conclusion: Only one board (Ferno Millenia trademark ) showed sufficient properties for plain film radiography and CT. There is no suitable spine board for preclinical and clinical applications as well as for trauma radiology, further improvements of current designs are essential. (orig.) [de

A musculoskeletal lumbar and thoracic model for calculation of joint kinetics in the spine

International Nuclear Information System (INIS)

Kim, Yong Cheol; Ta, Duc manh; Koo, Seung Bum; Jung Moon Ki

2016-01-01

The objective of this study was to develop a musculoskeletal spine model that allows relative movements in the thoracic spine for calculation of intra-discal forces in the lumbar and thoracic spine. The thoracic part of the spine model was composed of vertebrae and ribs connected with mechanical joints similar to anatomical joints. Three different muscle groups around the thoracic spine were inserted, along with eight muscle groups around the lumbar spine in the original model from AnyBody. The model was tested using joint kinematics data obtained from two normal subjects during spine flexion and extension, axial rotation and lateral bending motions beginning from a standing posture. Intra-discal forces between spine segments were calculated in a musculoskeletal simulation. The force at the L4-L5 joint was chosen to validate the model's prediction against the lumbar model in the original AnyBody model, which was previously validated against clinical data.

A musculoskeletal lumbar and thoracic model for calculation of joint kinetics in the spine

Energy Technology Data Exchange (ETDEWEB)

Kim, Yong Cheol; Ta, Duc manh; Koo, Seung Bum [Chung-Ang University, Seoul (Korea, Republic of); Jung Moon Ki [AnyBody Technology A/S, Aalborg (Denmark)

2016-06-15

The objective of this study was to develop a musculoskeletal spine model that allows relative movements in the thoracic spine for calculation of intra-discal forces in the lumbar and thoracic spine. The thoracic part of the spine model was composed of vertebrae and ribs connected with mechanical joints similar to anatomical joints. Three different muscle groups around the thoracic spine were inserted, along with eight muscle groups around the lumbar spine in the original model from AnyBody. The model was tested using joint kinematics data obtained from two normal subjects during spine flexion and extension, axial rotation and lateral bending motions beginning from a standing posture. Intra-discal forces between spine segments were calculated in a musculoskeletal simulation. The force at the L4-L5 joint was chosen to validate the model's prediction against the lumbar model in the original AnyBody model, which was previously validated against clinical data.

Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome

Directory of Open Access Journals (Sweden)

Hanna AF

2017-08-01

Full Text Available Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith Department of Pain Management, Florida Spine Institute, Clearwater, FL, USA Abstract: Post-treatment Lyme disease syndrome (PTLDS is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption. Keywords: chronic Lyme, late Lyme, pain, analgesic, suicidality, depression

Three-dimensional CT of the pediatric spine

International Nuclear Information System (INIS)

Starshak, R.J.; Crawford, C.R.; Waisman, R.C.; Sty, J.R.

1987-01-01

CT of the spine has been shown to be useful in evaluating congenital, neoplastic, inflammatory, and traumatic lesions. Any portion of the neural arch may be involved by these disease processes. The complex nature of the spinal column can make evaluation of these abnormalities difficult on axial CT. This is especially true if the spine is distorted by scoliosis, kyphosis, or lordosis. This exhibit illustrates the advantages and drawbacks of three-dimensional CT reconstructed images of spinal abnormalities in children

Associative memory through rigid origami

Science.gov (United States)

Murugan, Arvind; Brenner, Michael

2015-03-01

Mechanisms such as Miura Ori have proven useful in diverse contexts since they have only one degree of freedom that is easily controlled. We combine the theory of rigid origami and associative memory in frustrated neural networks to create structures that can ``learn'' multiple generic folding mechanisms and yet can be robustly controlled. We show that such rigid origami structures can ``recall'' a specific learned mechanism when induced by a physical impulse that only need resemble the desired mechanism (i.e. robust recall through association). Such associative memory in matter, seen before in self-assembly, arises due to a balance between local promiscuity (i.e., many local degrees of freedom) and global frustration which minimizes interference between different learned behaviors. Origami with associative memory can lead to a new class of deployable structures and kinetic architectures with multiple context-dependent behaviors.

Functionally rigid bistable [2]rotaxanes

DEFF Research Database (Denmark)

Nygaard, Sune; Leung, Ken C-F; Aprahamian, Ivan

2007-01-01

defines an unambiguous distance of 1.5 nm over which the ring moves between the MPTTF and NP units. The degenerate NP/NP [2]rotaxane was used to investigate the shuttling barrier by dynamic 1H NMR spectroscopy for the movement of the CBPQT4+ ring across the new rigid spacer. It is evident from...... better control over the position of the ring component in the ground state but also for control over the location of the CBPQT4+ ring during solution-state switching experiments, triggered either chemically (1H NMR) or electrochemically (cyclic voltammetry). In this instance, the use of the rigid spacer......Two-station [2]rotaxanes in the shape of a degenerate naphthalene (NP) shuttle and a nondegenerate monopyrrolotetrathiafulvalene (MPTTF)/NP redox-controllable switch have been synthesized and characterized in solution. Their dumbbell-shaped components are composed of polyether chains interrupted...

Rigid external maxillary distraction and rhinoplasty for pyknodysostosis.

Science.gov (United States)

Varol, Altan; Sabuncuoglu, Fidan Alakus; Sencimen, Metin; Akcam, Timur; Olmez, Hüseyin; Basa, Selçuk

2011-05-01

This article reports the treatment of an 33-year-old female patient with pyknodysostosis by rigid external distraction II midface distraction system. The patient with pyknodysostosis described in this report had severe midfacial hypoplasia. Correction of this by use of routine orthognathic surgery would require osteosynthesis and bone grafting. Risk of infection and/or nonunion after such a surgical procedure was considered too great, and therefore the possibility of treatment by distraction osteogenesis of the maxilla was evaluated. The rigid external distraction II midface distraction system was used to relocate the hypoplastic maxilla at anterior-inferior projection. Distraction osteogenesis should be considered as the primary reconstructive method for maxillofacial deformities in patients with sclerosing bone dysplasias, since this is the second reported case treated successfully with rigid external distraction.

78 FR 65451 - Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...

Science.gov (United States)

2013-10-31

... (Cervical Spine) Conditions Disability Benefits Questionnaire) Activity Under OMB Review AGENCY: Veterans... Control No. 2900-- NEW (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire)'' in any...) Conditions Disability Benefits Questionnaire).'' SUPPLEMENTARY INFORMATION: Title: (Neck (Cervical Spine...

History of cervical spine surgery: from nihilism to advanced reconstructive surgery.

Science.gov (United States)

Dweik, A; Van den Brande, E; Kossmann, T; Maas, A I R

2013-11-01

Review of literature. To review and analyze the evolution of cervical spine surgery from ancient times to current practice. The aim is to present an accessible overview, primarily intended for a broad readership. Descriptive literature review and analysis of the development of cervical spine surgery from the prehistoric era until today. The first evidence for surgical treatment of spinal disorders dates back to approximately 1500 BC. Conservative approaches to treatment have been the hallmark for thousands of years, but over the past 50 years progress has been rapid. We illustrate how nations have added elements to this complex subject and how knowledge has surpassed borders and language barriers. Transferral of knowledge occurred from Babylon (Bagdad) to Old Egypt, to the Greek and Roman empires and finally via the Middle East (Bagdad and Damascus) back to Europe. Recent advances in the field of anesthesia, imaging and spinal instrumentation have changed long-standing nihilism in the treatment of cervical spine pathologies to the current practice of advanced reconstructive surgery of the cervical spine. A critical approach to the evaluation of benefits and complications of these advanced surgical techniques for treatment of cervical spine disorders is required. Advances in surgery now permit full mechanical reconstruction of the cervical spine. However, despite substantial experimental progress, spinal cord repair and restoration of lost functions remain a challenge. Modern surgeons are still looking for the best way to manage spine disorders.

Craniocervical instability in children with Down’s syndrome

Directory of Open Access Journals (Sweden)

Nikita O Khusainov

2016-09-01

Full Text Available Introduction. Pathology of the craniovertebral zone in children with Down’s syndrome is a very important topic, because of the high risk for developing neurological complications in these patients, after even a minor trauma. Material and methods. We performed a review of the literature highlighting the disorders of the cervical spine in children with Down’s syndrome. Results. We gathered data on the etiology, pathogenesis, and clinical presentation of craniocervical instability in children with Down’s syndrome. We reviewed the existing surgical treatment options, and presented our own clinical cases. We also developed a protocol for the management of these patients. Discussions. Understanding the several forms of craniocervical instability in children with Down’s syndrome is very important. As it is a very dangerous condition that can lead to devastating neurological deficits, all medical specialties working with these patients should be aware of them. There are clinical and radiological criteria for this condition that can help in the management of such patients. Surgical treatment is an effective option, but it has a high complication rate and rarely results in neurological improvement.

The diagnostic role of thoracoscope in undiagnosed pleural effusion: Rigid versus flexible

Directory of Open Access Journals (Sweden)

Mostafa Mahmoud Abdel Mageid Shaheen

2014-07-01

Conclusions: Thoracoscopy using either fibreoptic bronchoscope or rigid thoracoscope is safe and well tolerated. Rigid thoracoscope has a higher diagnostic yield, easier handling, better orientation and is less expensive. Nevertheless, fibreoptic bronchoscope is an alternative technique if rigid thoracoscopy is not available.

Cobb Angle Changes in Thoracic and Lumbar Spine Fractures ...

African Journals Online (AJOL)

The annual incidence of spinal column fracture is 350 per million populations. with Motor vehicular accident being the major single cause of spine injuries. The victims are predominantly young and male. The aim of this study to evaluate the clinical outcome of conservative treatment of closed thoracic and lumbar spine ...

Spinal CT scan, 2. Lumbar and sacral spines

Energy Technology Data Exchange (ETDEWEB)

Nakagawa, Hiroshi (Aichi Medical Univ., Aichi (Japan))

1982-08-01

Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival.

Comparison study on CNR and SNR of thoracic spine lateral radiography

Energy Technology Data Exchange (ETDEWEB)

Kim, Ki Won [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Min, Jung Whan; Lyu, Kwang Yeul [Dept. of Radiology, Shingu University, Sungnam (Korea, Republic of); Kim, Jung Min [Dept. of Radiological Science, College of Health Science, Korea University, Seoul (Korea, Republic of); Jeong, Hei Woun [Dept. of Radiological Science, Beakseok Culture University, Cheonan (Korea, Republic of); Lee, Joo Ah [Dept. of Oncology, Catholic University of Korea Incheon St.Mary,s Hospital, Incheon (Korea, Republic of); Jung, Jae Hong [Dept. of Oncology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Sung, Dong Chan [Dept. of Radiology, Dong Guk University Medical Center, Seoul (Korea, Republic of); Park, Soon Cheol [Dept. of Radiology, Kang Dong Kyung Hee University Medical Center, Seoul (Korea, Republic of)

2013-12-15

This study was proven for the T-spine breathing technique in lateral projection, using computer radiography (CR), charge coupled device (CCD), indirect digital radiography (IDR) and direct digital radiography (DDR). All images were evaluated and compared with CNR and SNR measured with the mean pixels and the standard deviation as setting ROI of spinous process, pedicle, vertebral body, intervertebral foramen and intervertebral disk using Image J. In experiment results of 4 type detectors, T-spine breathing technique was indicated as excellent in ROI of spinous process, pedicle, vertebral body, intervertebral foramen and intervertebral disk. As T-spine breathing technique indicated excellent images compared to the existing T-spine lateral radiography, this method would be useful for elderly patients who have difficulty in deep exhalation. This study was indicated the application possibility of T-spine breathing technique by presenting contrast to noise ratio (CNR) and signal to noise ratio (SNR) with quantitative value in 4 type detectors.

Multidetector CT of blunt cervical spine trauma in adults.

Science.gov (United States)

Dreizin, David; Letzing, Michael; Sliker, Clint W; Chokshi, Falgun H; Bodanapally, Uttam; Mirvis, Stuart E; Quencer, Robert M; Munera, Felipe

2014-01-01

A number of new developments in cervical spine imaging have transpired since the introduction of 64-section computed tomographic (CT) scanners in 2004. An increasing body of evidence favors the use of multidetector CT as a stand-alone screening test for excluding cervical injuries in polytrauma patients with obtundation. A new grading scale that is based on CT and magnetic resonance (MR) imaging findings, the cervical spine Subaxial Injury Classification and Scoring (SLIC) system, is gaining acceptance among spine surgeons. Radiographic measurements described for the evaluation of craniocervical distraction injuries are now being reevaluated with the use of multidetector CT. Although most patients with blunt trauma are now treated nonsurgically, evolution in the understanding of spinal stability, as well as the development of new surgical techniques and hardware, has driven management strategies that are increasingly favorable toward surgical intervention. It is therefore essential that radiologists recognize findings that distinguish injuries with ligamentous instability or a high likelihood of nonfusion that require surgical stabilization from those that are classically stable and can be treated with a collar or halo vest alone. The purpose of this article is to review the spectrum of cervical spine injuries, from the craniocervical junction through the subaxial spine, and present the most widely used grading systems for each injury type. ©RSNA, 2014.

Rigid origami vertices: conditions and forcing sets

Directory of Open Access Journals (Sweden)

Zachary Abel

2016-04-01

Full Text Available We develop an intrinsic necessary and sufficient condition for single-vertex origami crease patterns to be able to fold rigidly.  We classify such patterns in the case where the creases are pre-assigned to be mountains and valleys as well as in the unassigned case.  We also illustrate the utility of this result by applying it to the new concept of minimal forcing sets for rigid origami models, which are the smallest collection of creases that, when folded, will force all the other creases to fold in a prescribed way.

Type number and rigidity of fibred surfaces

International Nuclear Information System (INIS)

Markov, P E

2001-01-01

Infinitesimal l-th order bendings, 1≤l≤∞, of higher-dimensional surfaces are considered in higher-dimensional flat spaces (for l=∞ an infinitesimal bending is assumed to be an analytic bending). In terms of the Allendoerfer type number, criteria are established for the (r,l)-rigidity (in the terminology of Sabitov) of such surfaces. In particular, an (r,l)-infinitesimal analogue is proved of the classical theorem of Allendoerfer on the unbendability of surfaces with type number ≥3 and the class of (r,l)-rigid fibred surfaces is distinguished

Evaluating a method for automated rigid registration

DEFF Research Database (Denmark)

Darkner, Sune; Vester-Christensen, Martin; Larsen, Rasmus

2007-01-01

to point distance. T-test for common mean are used to determine the performance of the two methods (supported by a Wilcoxon signed rank test). The performance influence of sampling density, sampling quantity, and norms is analyzed using a similar method.......We evaluate a novel method for fully automated rigid registration of 2D manifolds in 3D space based on distance maps, the Gibbs sampler and Iterated Conditional Modes (ICM). The method is tested against the ICP considered as the gold standard for automated rigid registration. Furthermore...

SENILE DEGENERATIVE CHANGES IN ADULT LUMBAR SPINE! - A PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Garjesh Singh

2015-11-01

Full Text Available : BACKGROUND: Low back pain (LBP is a common presenting complaint affecting mostly middle aged and older person and traditionally considered as ageing process, but now-a-days large number of younger people are also affected by this debilitating chronic disorder. The cause of early onset of degenerative spine disease is multifactorial, but genetical predisposition plays very important role. AIMS AND OBJECTIVE: To find out association between genetic predisposition and degenerative spine disease in adult patients and to assess the pattern of MRI findings of various degenerative diseases in lumbo-sacral spine. MATERIAL AND METHOD: The present cross-sectional study had been performed among 100 selected patients in 1yr period, who presented with chief complaint of chronic low back pain. After taking detailed clinical and professional history, MRI of lumbosacral spine had been performed. Total 100 patients were divided in two groups on the basis of genetical predisposition. Prevalence and spectrum of degenerative changes were compared between both groups. RESULTS: Hundred patients of 20 to 35-year age had been selected with mean age of 27yr. Out of 100 patients; 47 were male and 53 were female. The most common degenerative findings were desiccation of disc (95% followed by disc bulge, herniation, spinal canal stenosis, ligamentum flavum hypertrophy, facet joint hypertrophy and modic changes. L4-L5 and L5- S1 were the most commonly involved spinal levels for any degenerative pathology. CONCLUSION: Good association is seen between early onset of degenerative spine disease and genetical predisposition in patients who have history of similar type degenerative spine disease in one or more first degree relatives in comparison to those patients who do not have any genetical predisposition. So it can be concluded that heredity play important role in early onset of degenerative spine disease in adults.

Standardized X-ray reports of the spine in osteogenesis imperfecta

International Nuclear Information System (INIS)

Koerber, Friederike; Demant, A.W.; Koerber, S.; Semler, O.; Schoenau, E.; Lackner, K.J.

2011-01-01

Purpose: In this study we present a standard for radiological reports in patients with osteogenesis imperfecta (OI). The parameters can be used to describe X-rays of the lateral spine and give an impartial description of anatomical structures during a treatment with bisphosphonates. Material and Methods: In this retrospective analysis we included 48 patients with OI (31 female, 17 male [1.5 months - 19 years, mean age 9.0 years]). Lateral spine X-rays were analyzed by 2 radiologists before and during treatment. The parameters of the standardized report are degree of kyphoscoliosis, compression of single vertebrae, predominant type of vertebral deformities and extent of vertebral compression (score 1 - 5). Results: There was no clear trend in the change of compression of single vertebrae. Some vertebrae with ventral compression showed an upgrowth to vertebrae with harmonic compression. Other deformities showed only marginal changes. In 26 patients the kyphoscoliosis improved (mean 10 degrees), in 36 patients the thoracic vertebrae compression increased and in 30 patients the vertebral height in the lumbar spine increased. The improvement of vertebral height was 1 point in the thoracic and lumbar spine. Conclusion: We propose a standardized report of X-rays of the lateral spine in patients with OI with quantitative and semiquantitative parameters using morphological criteria. These include compression of single vertebrae, degree of kyphoscoliosis, vertebral deformities and the severity of vertebral compression in the thoracic and lumbar spine. (orig.)

Brain-derived neurotrophic factor mediates estradiol-induced dendritic spine formation in hippocampal neurons

Science.gov (United States)

Murphy, Diane D.; Cole, Nelson B.; Segal, Menahem

1998-01-01

Dendritic spines are of major importance in information processing and memory formation in central neurons. Estradiol has been shown to induce an increase of dendritic spine density on hippocampal neurons in vivo and in vitro. The neurotrophin brain-derived neurotrophic factor (BDNF) recently has been implicated in neuronal maturation, plasticity, and regulation of GABAergic interneurons. We now demonstrate that estradiol down-regulates BDNF in cultured hippocampal neurons to 40% of control values within 24 hr of exposure. This, in turn, decreases inhibition and increases excitatory tone in pyramidal neurons, leading to a 2-fold increase in dendritic spine density. Exogenous BDNF blocks the effects of estradiol on spine formation, and BDNF depletion with a selective antisense oligonucleotide mimics the effects of estradiol. Addition of BDNF antibodies also increases spine density, and diazepam, which facilitates GABAergic neurotransmission, blocks estradiol-induced spine formation. These observations demonstrate a functional link between estradiol, BDNF as a potent regulator of GABAergic interneurons, and activity-dependent formation of dendritic spines in hippocampal neurons. PMID:9736750

Spine epidural and sacroiliac joints injections--when and how to perform.

Science.gov (United States)

D'Orazio, Federico; Gregori, Lorenzo Maria; Gallucci, Massimo

2015-05-01

To review the state-of-the-art of image-guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results. We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints. Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures. Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Pediatric cervical spine trauma imaging: a practical approach

Energy Technology Data Exchange (ETDEWEB)

Egloff, Alexia M.; Kadom, Nadja; Vezina, Gilbert; Bulas, Dorothy [Children' s National Medical Center, Department of Imaging and Radiology, Washington, DC (United States)

2009-05-15

Cervical spine trauma in children is rare and the diagnosis can be challenging due to anatomical and biomechanical differences as compared to adults. A variety of algorithms have been used in adults to accurately diagnose injuries, but have not been fully studied in pediatric patients. In this article we review suggested imaging protocols and the general characteristics, types of injuries, and measurements used to diagnose cervical spine injuries in children. (orig.)

Lateral rigidity of cracked concrete structures

International Nuclear Information System (INIS)

Castellani, A.; Chesi, C.

1979-01-01

Numerical results are discussed on the lateral rigidity of reinforced concrete structures with a given crack distribution. They have been favourably checked with experimental results for cylindrical shells under the effect of a thermal gradient producing vertical cracking or vertical plus horizontal cracking. The main effects characterizing the concrete behaviour are: (1) The shear transfer across a crack; (2) The shear transfer degradation after cyclic loading; (3) The tension stiffening provided by the concrete between crack and crack, in the normal stress transfer; (4) The temperature effect on the elastic moduli of concrete, when cracks are of thermal origin. Only the 1st effect is discussed on an experimental basis. Two broad cathegories of reinforced concrete structures have been investigated in this respect: shear walls of buildings and cylindrical containment structures. The main conclusions so far reached are: (1) Vertical cracks are unlikely to decrease the lateral rigidity to less than 80% of the original one, and to less than 90% when they do not involve the entire thickness of the wall; (2) The appearence of horizontal cracks can reduce the lateral rigidity by some 30% or more; (3) A noticeable but not yet evaluated influence is shown by cyclic loading. (orig.)

Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

Science.gov (United States)

Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

1992-10-01

Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.

Science.gov (United States)

Dickerman, Rob D; Lefkowitz, Michael; Epstein, Joseph A

2005-10-15

Case report with review of the literature. To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy. Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature. Case study with extensive review of the literature. The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement. Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.

Connections rigidity effect on probability of fracture in steel moment frames

Directory of Open Access Journals (Sweden)

Gholamreza Abdollahzadeh

2017-08-01

Full Text Available Connections in steel moment frames are idealized in full pinned and full rigid conditions. Because with this assumption, in spite of real behavior of connection, real story drifts are less anticipated and maybe frame is designed without performance of bracing. There are several methods for modeling actual behavior of semi rigid connections. In this method a connection with certain rigidity is modeled by a rotational spring with corresponding stiffness. This stiffness is achieved by certain formula. In other words, each percent of rigidity corresponds to one rotational spring stiffness. In this research in order to evaluate the real behavior of connection in analysis and designing process and fracture probability one frame including four stories and one bay with three types of connection has been modeled and designed in ETABS. Each model has an individual rigidity which is equal to 10, 75 and 90 percent. With respect to maximum drift and different PGA in roof, probabilities of low, medium, high and complete fracture were calculated. For this purpose, with applying different PGA to modeled frames, amounts of drift in the roof are achieved. Then these values are compared with given values in American code. Finally, investigation showed that when rigidity in frame connections increases, the probability of frame fracture decreases. In other words, fully rigid assumption of connection in analysis process leads to decreasing in real probability of fracture in frames which is a noticeable risk in building designing processes.

Rigid-plastic seismic design of reinforced concrete structures

DEFF Research Database (Denmark)

Costa, Joao Domingues; Bento, R.; Levtchitch, V.

2007-01-01

structural strength with respect to a pre-defined performance parameter using a rigid-plastic response spectrum, which is characteristic of the ground motion alone. The maximum strength demand at any point is solely dependent on the intensity of the ground motion, which facilitates the task of distributing......In this paper a new seismic design procedure for Reinforced Concrete (R/C) structures is proposed-the Rigid-Plastic Seismic Design (RPSD) method. This is a design procedure based on Non-Linear Time-History Analysis (NLTHA) for systems expected to perform in the non-linear range during a lifetime...... earthquake event. The theoretical background is the Theory of Plasticity (Rigid-Plastic Structures). Firstly, a collapse mechanism is chosen and the corresponding stress field is made safe outside the regions where plastic behaviour takes place. It is shown that this allows the determination of the required...