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Sample records for thoracolumbar vertebral body

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

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

    2018-06-01

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

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

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    Hao Chen

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

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

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

    2015-12-05

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

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

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

    2018-02-01

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

  6. Relevant signs of stable and unstable thoracolumbar vertebral column trauma

    International Nuclear Information System (INIS)

    Gehweiler, J.A.; Daffner, R.H.; Osborne, R.L.

    1981-01-01

    One-hundred and seventeen patients with acute thoracolumbar vertebral column fracture or fracture-dislocations were analyzed and classified into stable (36%) and unstable (64%). Eight helpful roentgen signs were observed that may serve to direct attention to serious underlying, often occult, fractures and dislocations. The changes fall into four principal groups: abnormal soft tissues, abnormal vertebral alignment, abnormal joints, and widened vertebral canal. All stable and unstable lesions showed abnormal soft tissues, while 70% demonstrated kyphosis and/or scoliosis, and an abnormal adjacent intervertebral disk space. All unstable lesions showed one or more of the following signs: displaced vertebra, widened interspinous space, abnormal apophyseal joint(s), and widened vertebral canal. (orig.)

  7. Prevalence of thoracolumbar vertebral fractures on multidetector CT

    International Nuclear Information System (INIS)

    Bartalena, Tommaso; Giannelli, Giovanni; Rinaldi, Maria Francesca; Rimondi, Eugenio; Rinaldi, Giovanni; Sverzellati, Nicola; Gavelli, Giampaolo

    2009-01-01

    Objective: To evaluate the prevalence of osteoporotic vertebral fractures in patients undergoing multidetector computed tomography (MDCT) of the chest and/or abdomen. Materials and methods: 323 consecutive patients (196 males, 127 females) with a mean age of 62.6 years (range 20-88) who had undergone chest and/or abdominal MDCT were evaluated. Sagittal reformats of the spine obtained from thin section datasets were reviewed by two radiologists and assessed for vertebral fractures. Morphometric analysis using electronic calipers was performed on vertebral bodies which appeared abnormal upon visual inspection. A vertebral body height loss of 15% or more was considered a fracture and graded as mild (15-24%), moderate (25-49%) or severe (more than 50%). Official radiology reports were reviewed and whether the vertebral fractures had been reported or not was noted. Results: 31 out of 323 patients (9.5%) had at least 1 vertebral fracture and 7 of those patients had multiple fractures for a total of 41 fractures. Morphometric grading revealed 10 mild, 16 moderate and 15 severe fractures. Prevalence was higher in women (14.1%) than men (6.6%) and increased with patients age with a 17.1% prevalence in post-menopausal women. Only 6 out 41 vertebral fractures (14.6%) had been noted in the radiology final report while the remaining 35 (85.45) had not. Conclusion: although vertebral fractures represent frequent incidental findings on multidetector CT studies and may be easily identified on sagittal reformats, they are often underreported by radiologists, most likely because of unawareness of their clinical importance.

  8. Stenosis of the thoracolumbar vertebral canal in a Basset Hound

    International Nuclear Information System (INIS)

    Stigen, Ø.; Hagen, G.; Kolbjørnsen, Ø.

    1990-01-01

    A three-month-old female basset hound was referred to the Norwegian College of Veterinary Medicine with a history of progressive paresis of the pelvic limbs. Following neurological examination and the study of myelograms, extradural masses causing spinal cord compressions at the T 12.13 and T 13 -L 1 junctions were diagnosed. At necropsy bone-tissue of the vertebral laminae was found to have formed stenoses of the vertebral canal producing compressions of the spinal cord. Irreversible tissue-damage was observed in histological sections prepared from the compressed areas of the spinal cord

  9. Vertebral body osteomyelitis in the horse

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

    1986-01-01

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

  10. Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture

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    Tsuyoki Minato

    2016-01-01

    Full Text Available We present a rare case of spinal epidural hematoma (SEH after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Computed tomography revealed a T12 dislocation fracture of AO type B2, multiple bilateral rib fractures, and a right hemopneumothorax. Four days after the injury, in order to promote early orthostasis and to improve respiratory status, we performed thoracolumbar posterior fusion surgery without decompression; the patient had back pain but no neurological deficits. Three hours after surgery, he complained of acute pain and severe weakness of his bilateral lower extremities; with allodynia below the level of his umbilicus, postoperative SEH was diagnosed. We performed immediate revision surgery. After removal of the hematoma, his symptoms improved gradually, and he was discharged ambulatory one month after revision surgery. Through experience of this case, we should strongly consider the possibility of preexisting SEH before surgery, even in patients with no neurological deficits. We should also consider perioperative coagulopathy in patients with multiple trauma, as in this case.

  11. Percutaneous Vertebral Augmentation with Polyethylene Mesh and Allograft Bone for Traumatic Thoracolumbar Fractures

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    C. Schulz

    2015-01-01

    Full Text Available Purpose. In cases of traumatic thoracolumbar fractures, percutaneous vertebral augmentation can be used in addition to posterior stabilisation. The use of an augmentation technique with a bone-filled polyethylene mesh as a stand-alone treatment for traumatic vertebral fractures has not yet been investigated. Methods. In this retrospective study, 17 patients with acute type A3.1 fractures of the thoracic or lumbar spine underwent stand-alone augmentation with mesh and allograft bone and were followed up for one year using pain scales and sagittal endplate angles. Results. From before surgery to 12 months after surgery, pain and physical function improved significantly, as indicated by an improvement in the median VAS score and in the median pain and work scale scores. From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses. During the one-year period, there was a significant loss of correction. Conclusions. Based on this data a stand-alone approach with vertebral augmentation with polyethylene mesh and allograft bone is not a suitable therapy option for incomplete burst fractures for a young patient collective.

  12. Diffusion-Weighted MRI Assessment of Adjacent Disc Degeneration After Thoracolumbar Vertebral Fractures

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    Noriega, David C., E-mail: dcnoriega1970@gmail.com [Valladolid University Hospital, Spine Department (Spain); Marcia, Stefano, E-mail: stemarcia@gmail.com [SS. Trinità Hospital ASL 8 Cagliari, Department of Radiology (Italy); Ardura, Francisco, E-mail: fardura@ono.com [Valladolid University Hospital, Spine Department (Spain); Lite, Israel Sanchez, E-mail: israelslite@hotmail.com [Valladolid University Hospital, Radiology Department (Spain); Marras, Mariangela, E-mail: mariangela.marrasmd@gmail.com [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology (Italy); Saba, Luca, E-mail: lucasaba@tiscali.it [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology (Italy)

    2016-09-15

    ObjectiveThe purpose of this study was to assess, by the mean apparent diffusion coefficient (ADC), if a relationship exists between disc ADC and MR findings of adjacent disc degeneration after thoracolumbar fractures treated by anatomic reduction using vertebral augmentation (VAP).Materials and MethodsTwenty non-consecutive patients (mean age 50.7 years; range 45–56) treated because of vertebral fractures, were included in this study. There were 10 A3.1 and 10 A1.2 fractures (AO classification). Surgical treatment using VAP was applied in 14 cases, and conservative in 6 patients. MRI T2-weighted images and mapping of apparent diffusion coefficient (ADC) of the intervertebral disc adjacent to the fractured segment were performed after a mean follow-up of 32 months. A total of 60 discs, 3 per patient, were analysed: infra-adjacent, supra-adjacent and a control disc one level above the supra-adjacent.ResultsNo differences between patients surgically treated and those following a conservative protocol regarding the average ADC values obtained in the 20 control discs analysed were found. Considering all discs, average ADC in the supra-adjacent level was lower than in the infra-adjacent (1.35 ± 0.12 vs. 1.53 ± 0.06; p < 0.001). Average ADC values of the discs used as a control were similar to those of the infra-adjacent level (1.54 ± 0.06). Compared to surgically treated patients, discs at the supra-adjacent fracture level showed statistically significant lower values in cases treated conservatively (p < 0.001). The variation in the delay of surgery had no influence on the average values of ADC at any of the measured levels.ConclusionsADC measurements of the supra-adjacent discs after a mean follow-up of 32 months following thoracolumbar fractures, showed that restoration of the vertebral collapse by minimally invasive VAP prevents posttraumatic disc degeneration.

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

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

    2016-03-01

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

  14. Surgical treatment of congenital thoracolumbar spondyloptosis in a 2-year-old child with vertebral column resection and posterior-only circumferential reconstruction of the spine column: case report.

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    Gressot, Loyola V; Mata, Javier A; Luerssen, Thomas G; Jea, Andrew

    2015-02-01

    Spondyloptosis refers to complete dislocation of a vertebral body onto another. The L5-S1 level is frequently affected. As this condition is rare, few published reports describing its clinical features and surgical outcomes exist, especially in the pediatric patient population. The authors report the presentation, pathological findings, and radiographic studies of a 2-year-old girl who presented to Texas Children's Hospital with a history since birth of progressive spastic paraparesis. Preoperative CT and MRI showed severe spinal cord compression associated with T11-12 spondyloptosis. The patient underwent a single-stage posterior approach for complete resection of the dysplastic vertebral bodies at the apex of the spinal deformity with reconstruction and stabilization of the vertebral column using a titanium expandable cage and pedicle screws. At the 12-month follow-up, the patient remained neurologically stable without any radiographic evidence of instrumentation failure or loss of alignment. To the best of the authors' knowledge, there have been only 2 other children with congenital thoracolumbar spondyloptosis treated with the above-described strategy. The authors describe their case and review the literature to discuss the aggregate clinical features, surgical strategies, and operative outcomes for congenital thoracolumbar spondyloptosis.

  15. 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.

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

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    Kishikawa Y

    2012-04-01

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

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

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

    2017-05-01

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

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

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

    2011-08-01

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

  19. Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

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    S. Pesenti

    2015-01-01

    Full Text Available Introduction. While thoracolumbar fractures are common lesions, no strong consensus is available at the moment. Objectives. The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures. Methods. 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS. All evaluations were done preoperatively and at 1-year follow-up. Results. Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus −1° and −9°  P<0.05, resp. as well as vertebral body height (0.92 versus 1.16, P<0.05. At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up. Conclusion. Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

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

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

    2017-12-25

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

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

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

    2002-05-01

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

  2. Surgical treatment for osteoporotic thoracolumbar vertebral collapse using vertebroplasty with posterior spinal fusion: a prospective multicenter study.

    Science.gov (United States)

    Katsumi, Keiichi; Hirano, Toru; Watanabe, Kei; Ohashi, Masayuki; Yamazaki, Akiyoshi; Ito, Takui; Sawakami, Kimihiko; Sano, Atsuki; Kikuchi, Ren; Endo, Naoto

    2016-11-01

    The study aimed to investigate the clinical outcomes and limitations after vertebroplasty with posterior spinal fusion (VP+PSF) without neural decompression for osteoporotic vertebral collapse. We conducted a prospective multicenter study including 45 patients (12 men and 33 women, mean age: 77.0 years) evaluated between 2008 and 2012. Operation time, blood loss, visual analog scale (VAS) of back pain, neurological status, kyphosis angle in the fused area, and vertebral union of the collapsed vertebra were evaluated. The mean operation time was 162 min and blood loss was 381 mL. The postoperative VAS score significantly improved, and the neurological status improved in 35 patients (83 %), and none of the remaining patients demonstrated a deteriorating neurological status at two years post-operatively. The mean kyphosis angle pre-operatively, immediately post-operatively, and two years post-operatively was 23.8°, 10.7°, and 24.3°, respectively, and there was no significant difference between the angles pre-operatively and two years post-operatively. The extensive correction of kyphosis >16° was a risk factor for a higher correction loss and subsequent fracture. Union of the collapsed vertebra was observed in 43 patients (95 %) at two years post-operatively. The present study suggests that spinal stabilization rather than neural decompression is essential to treat OVC. Short-segment VP+PSF can achieve a high union rate of collapsed vertebra and provide a significant improvement in back pain or neurological status with less invasive surgery, but has a limit of kyphosis correction more than 16°.

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

    Science.gov (United States)

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

    2014-11-01

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2012-08-09

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

  6. [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.

  7. The Optimal Volume Fraction in Percutaneous Vertebroplasty Evaluated by Pain Relief, Cement Dispersion, and Cement Leakage: A Prospective Cohort Study of 130 Patients with Painful Osteoporotic Vertebral Compression Fracture in the Thoracolumbar Vertebra.

    Science.gov (United States)

    Sun, Hai-Bo; Jing, Xiao-Shan; Liu, Yu-Zeng; Qi, Ming; Wang, Xin-Kuan; Hai, Yong

    2018-06-01

    To probe the relationship among cement volume/fraction, imaging features of cement distribution, and pain relief and then to evaluate the optimal volume during percutaneous vertebroplasty. From January 2014 to January 2017, a total of 130 patients eligible for inclusion criteria were enrolled in this prospective cohort study. According to the different degrees of pain relief, cement leakage, and cement distribution, all patients were allocated to 2 groups. Clinical and radiologic characteristics were assessed to identify independent factors influencing pain relief, cement leakage, and cement distribution, including age, sex, fracture age, bone mineral density, operation time, fracture level, fracture type, modified semiquantitative severity grade, intravertebral cleft, cortical disruption in the vertebral wall, endplate disruption, type of nutrient foramen, fractured vertebral body volume, intravertebral cement volume, and volume fraction. A receiver operating characteristic curve was used to analyze the diagnostic value of the cement volume/fraction and then to obtain the optional cut-off value. The preoperative visual analog scale scores in the responders versus nonresponders patient groups were 7.37 ± 0.61 versus 7.87 ± 0.92 and the postoperative VAS scores in the responders versus nonresponders were 2.04 ± 0.61 versus 4.33 ± 0.49 at 1 week. There were no independent factors influencing pain relief. There were 95 (73.08%) patients who experienced cement leakage, and cortical disruption in the vertebral wall and cement fraction percentage were identified as independent risk factors by binary logistic regression analysis (adjusted odds ratio [OR] 2.935, 95% confidence interval [95% CI] 1.214-7.092, P = 0.017); (adjusted OR 1.134, 95% CI 1.026-1.254, P = 0.014). The area under the receiver-operating characteristic curve of volume fraction (VF%) was 0.658 (95% CI 0.549-0.768, P = 0.006 cement leakage was 21.545%, with a sensitivity of 69.50% and a

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-03-01

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

  10. Clinical and radiological results 6 years after treatment of traumatic thoracolumbar burst fractures with pedicle screw instrumentation and balloon assisted endplate reduction

    NARCIS (Netherlands)

    Verlaan, Jorrit Jan; Somers, Inne; Dhert, Wouter J A; Oner, F. Cumhur

    2015-01-01

    Background context  When used to fixate traumatic thoracolumbar burst fractures, pedicle screw constructs may fail in the presence of severe vertebral body comminution as the intervertebral disc can creep through the fractured endplates leading to insufficient anterior column support.

  11. Evolutionary allometry of the thoracolumbar centra in felids and bovids.

    Science.gov (United States)

    Jones, Katrina E

    2015-07-01

    Mammals have evolved a remarkable range of body sizes, yet their overall body plan remains unaltered. One challenge of evolutionary biology is to understand the mechanisms by which this size diversity is achieved, and how the mechanical challenges associated with changing body size are overcome. Despite the importance of the axial skeleton in body support and locomotion, and much interest in the allometry of the appendicular skeleton, little is known about vertebral allometry outside primates. This study compares evolutionary allometry of the thoracolumbar centra in two families of quadrupedal running mammals: Felidae and Bovidae. I test the hypothesis that, as size increases, the thoracolumbar region will resist increasing loads by becoming a) craniocaudally shorter, and b) larger in cross-sectional area, particularly in the sagittal plane. Length, width, and height of the thoracolumbar centra of 23 felid and 34 bovid species were taken. Thoracic, prediaphragmatic, lumbar, and postdiaphragmatic lengths were calculated, and diameters were compared at three equivalent positions: the midthoracic, the diaphragmatic and the midlumbar vertebra. Allometric slopes were calculated using a reduced major axis regression, on both raw and independent contrasts data. Slopes and elevations were compared using an ANCOVA. As size increases the thoracolumbar centra become more robust, showing preferential reinforcement in the sagittal plane. There was less allometric shortening of the thoracic than the lumbar region, perhaps reflecting constraints due to its connection with the respiratory apparatus. The thoracic region was more robust in bovids than felids, whereas the lumbar region was longer and more robust in felids than bovids. Elongation of lumbar centra increases the outlever of sagittal bending at intervertebral joints, increasing the total pelvic displacement during dorsomobile running. Both locomotor specializations and functional regionalization of the axial skeleton

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

    Science.gov (United States)

    Onai, Takayuki; Irie, Naoki; Kuratani, Shigeru

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zhifeng Zhang

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    John P Wilson

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Fusion Rates of Different Anterior Grafts in Thoracolumbar Fractures.

    Science.gov (United States)

    Antoni, Maxime; Charles, Yann Philippe; Walter, Axel; Schuller, Sébastien; Steib, Jean-Paul

    2015-11-01

    Retrospective CT analysis of anterior fusion in thoracolumbar trauma. The aim of this study was to compare fusion rates of different bone grafts and to analyze risk factors for pseudarthrosis. Interbody fusion is indicated in anterior column defects. Different grafts are used: autologous iliac crest, titanium mesh cages filled with cancellous bone, and autologous ribs. It is not clear which graft offers the most reliable fusion. Radiologic data of 116 patients (71 men, 45 women) operated for type A2, A3, B, or C fractures were analyzed. The average age was 44.6 years (range, 16-75 y) and follow-up was 2.7 years (range, 1-9 y). All patients were treated by posterior instrumentation followed by an anterior graft: 53 cases with iliac crest, 43 cases with mesh cages, and 20 with rib grafts. Fusion was evaluated on CT and classified into complete fusion, partial fusion, unipolar pseudarthrosis, and bipolar pseudarthrosis. Iliac crest fused in 66%, cages in 98%, and rib grafts in 90%. The fusion rate of cages filled with bone was significantly higher as the iliac graft fusion rate (P=0.002). The same was applied to rib grafts compared with iliac crest (P=0.041). Additional bone formation around the main graft, bridging both vertebral bodies, was observed in 31 of the 53 iliac crests grafts. Pseudarthrosis occurred more often in smokers (P=0.042). A relationship between fracture or instrumentation types, sex, age, BMI, and fusion could not be determined. Tricortical iliac crest grafts showed an unexpected high pseudarthrosis rate in thoracolumbar injuries. Their cortical bone is dense and their fusion surface is small. Rib grafts led to a better fusion when used in combination with the cancellous bone from the fractured vertebral body. Titanium mesh cages filled with cancellous bone led to the highest fusion rate and built a complete bony bridge between vertebral bodies. Smoking seemed to influence fusion. Case control study, Level III.

  19. Monosegmental fixation for the treatment of fractures of the thoracolumbar spine

    Directory of Open Access Journals (Sweden)

    Defino Helton

    2007-01-01

    Full Text Available Background : A short vertebral arthrodesis has been one of the objectives of the surgical treatment of fractures of the thoracolumbar spine. We present here clinical, functional and radiographic outcome obtained after monosegmental fixation (single posterior or combined anterior and posterior of specific types of unstable thoracolumbar fractures. Materials and Methods : Twenty four patients with fractures of the thoracolumbar spine submitted to monosegmental surgical treatment (Group I - 18 single posterior monosegmental fixations and Group II - 6 combined anterior and posterior fixations were retrospectively evaluated according to clinical, radiographic and functional parameters. The indication for surgery was instability or neurological deficit. All the procedures were indicated and performed by the senior surgeon (Helton LA Defino. Results : The patients from group I were followed-up from 2 to 12 years (mean: 6.65±2.96. The clinical, functional and radiographic results show that a single posterior monosegmental fixation is adequate and a satisfactory procedure to be used in specific types of thoracolumbar spine fractures, The patients from group II were followed-up from 9 to 15 years (mean: 13 ± 2,09 years. On group II the results of clinical evaluation showed moderate indices of residual pain and of satisfaction with the final result. The values obtained by functional evaluation showed that 66.6% of the patients were unable to return to their previous job and presented a moderate disability index (Oswestry = 16.6 and a significant reduction of quality of life based on the SF-36 questionnaire. Radiographic evaluation showed increased kyphosis of the fixed vertebral segment during the late postoperative period, accompanied by a reduction of the height of the intervertebral disk. Conclusion : It is possible to stabilize the fractures which have an anterior good load-bearing capacity by a standalone posterior monosegmental fixation. However

  20. The characteristic of rBMD distribution in lumbar vertebral body

    International Nuclear Information System (INIS)

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

    1998-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-03-01

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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  3. Subsequent Vertebral Fractures Post Cement Augmentation of the Thoracolumbar Spine: Does it Correlate With Level-specific Bone Mineral Density Scores?

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Hwee Weng, Dennis Hey; Tan, Jun Hao; Jun, Hao Tan; Tan, Chuen Seng; Chuen, Seng Tan; Tan, Hsi Ming Bryan; Ming, Bryan Tan Hsi; Lau, Puang Huh Bernard; Huh, Bernard Lau Puang; Hee, Hwan Tak; Hwan, Tak Hee

    2015-12-01

    A case-control study. In this study, we investigated the correlation between level-specific preoperative bone mineral density and subsequent vertebral fractures. We also identified factors associated with subsequent vertebral fractures. Complications of cement augmentation of the spine include subsequent vertebral fractures, leading to unnecessary morbidity and more treatment. Ability to predict at-risk vertebra will help guide management. We studied all patients with osteoporotic compression fractures who underwent cement augmentation in a single institution from November 2001 to December 2010 by a single surgeon. Association between level-specific bone mineral density T-scores and subsequent fractures was assessed. Multivariable analysis was performed to identify significant factors associated with subsequent vertebral fractures. 93 patients followed up for a mean duration of 25.1 months (12-96) had a mean age of 76.8 years (47-99). Vertebroplasty was performed in 58 patients (62.4%) on 68 levels and kyphoplasty in 35 patients (37.6%) on 44 levels. Refracture was seen in 16 patients (17.2%). The time to subsequent fracture post cement augmentation was 20.5 months (2-90). For refracture cases, 43.8% (7/16) fractured in the adjacent vertebrae. Subsequently fractured vertebra had a mean T-score of -2.860 (95% confidence interval -3.268 to -2.452) and nonfractured vertebra had a mean T-score of -2.180 (95% confidence interval -2.373 to -1.986). A T-score of -2.2 or lower is predictive of refracture at that vertebra (P = 0.047). Odds ratio increases with decreasing T-scores from -2.2 or lower to -2.6 or lower. A T-score of -2.6 or lower gives no additional predictive advantage. After multivariable analysis, age (P = 0.049) and loss of preoperative anterior vertebral height (P = 0.017) are associated with refracture. Level-specific T-scores are predictive of subsequent fractures and the odds ratio increases with lower T-scores from -2.2 or less to -2.6 or less. They

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  7. Characteristic of thoracolumbar burst fracture with mid column injury and analysis of relative surgical treatment

    International Nuclear Information System (INIS)

    Yang Binhui; Zhang Bo; Ouyang Zhen; Sun Maomin; Xia Chunlin

    2010-01-01

    Objective: By analyzing the pathologic characteristics of the thoracolumbar burst fracture with mid column injury to explore the value of surgical treatment and the relationship between the spinal cord injury and the burst fracture. Methods: With the combination of X-ray film, CT, MRI examination, in 97 patients with thoracolumbar burst fracture, the rate of spinal canal stenosis was measured. For the fracture fragments morphology, translocation, and intervertebral disc, posterior longitudinal ligament injuries, a different surgical method was selected, the percentage of wound vertebral body compression, kyphosis Cobb angle and the rate of spinal canal stenosis, spinal cord nerve function recovery were compared between preoperation and postoperation. Results: After operation, all patients were reseted. Followed-up was performed from 6 to 28 months, in 88 cases bone graft fusion was obtained after 4 to 6 months, 1 ∼ 3 levels were restored in Frankel grade of spinal cord nerve function recovery. Between preoperation and postoperation, the percentage of wounded vertebral body compression, kyphosis Cobb angle and the rate of spinal canal stenosis were significantly different (P <0. 01). For the 9 cases of combined intervertebral disc injury, fusion was not achieved in the 6 cases there were loss in vertebral body height and Cobb angle in various extent. Conclusion: There is an interrelationship between thoracolumbar burst fracture caused by the reduction of spinal canal diameter and the spinal cord injury. Different forms of occupation of intraspinal bone fragments indicate different degrees of moment of violence and spinal cord primary injury. It is important to select the appropriate surgical method for clinic. The potential impact should be sufficient attention on the stability of intervertebral disc injury. (authors)

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  11. Biomechanics of Thoracolumbar Burst and Chance-Type Fractures during Fall from Height

    Science.gov (United States)

    Ivancic, Paul C.

    2014-01-01

    Study Design In vitro biomechanical study. Objective To investigate the biomechanics of thoracolumbar burst and Chance-type fractures during fall from height. Methods Our model consisted of a three-vertebra human thoracolumbar specimen (n = 4) stabilized with muscle force replication and mounted within an impact dummy. Each specimen was subjected to a single fall from an average height of 2.1 m with average velocity at impact of 6.4 m/s. Biomechanical responses were determined using impact load data combined with high-speed movie analyses. Injuries to the middle vertebra of each spinal segment were evaluated using imaging and dissection. Results Average peak compressive forces occurred within 10 milliseconds of impact and reached 40.3 kN at the ground, 7.1 kN at the lower vertebra, and 3.6 kN at the upper vertebra. Subsequently, average peak flexion (55.0 degrees) and tensile forces (0.7 kN upper vertebra, 0.3 kN lower vertebra) occurred between 43.0 and 60.0 milliseconds. The middle vertebra of all specimens sustained pedicle and endplate fractures with comminution, bursting, and reduced height of its vertebral body. Chance-type fractures were observed consisting of a horizontal split fracture through the laminae and pedicles extending anteriorly through the vertebral body. Conclusions We hypothesize that the compression fractures of the pedicles and vertebral body together with burst fracture occurred at the time of peak spinal compression, 10 milliseconds. Subsequently, the onset of Chance-type fracture occurred at 20 milliseconds through the already fractured and weakened pedicles and vertebral body due to flexion-distraction and a forward shifting spinal axis of rotation. PMID:25083357

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

    International Nuclear Information System (INIS)

    Sizov, V.A.

    1987-01-01

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

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  15. 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

  16. Thoracolumbar spine fractures in the geriatric fracture center : early ambulation leads to good results on short term and is a successful and safe alternative compared to immobilization in elderly patients with two-column vertebral fractures

    NARCIS (Netherlands)

    Weerink, L B M; Folbert, E C; Kraai, M; Smit, R S; Hegeman, J H; van der Velde, D

    INTRODUCTION: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a

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

    Directory of Open Access Journals (Sweden)

    Rodríguez-Ruiz María

    2012-03-01

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

  18. CT in diagnosis of thoracolumbar region diseases

    International Nuclear Information System (INIS)

    Dimitrov, I.; Karadjova, M.

    2003-01-01

    The lumbalgia caused by affected thoracolumbar transition (Th 11 -L 2 ) imitates the clinical symptomatic of disc lesions in the lower lumbar segments. The syndrome is presented by a pain projected in the area of the three branchings of the spinal nerves, coming from thoracolumbar segments. The aim of this study is to determine the pathological processes, causing the clinical symptoms of this syndrome, using computer tomography. 51 patients are studied with clinically proved thoracolumbar transition syndrome: 14 men and 37 women. CT slices of 96 vertebral segments are made. Two patient are scanned at Th 11 -Th 12 and L 1 -L 2 . Only Th 12 -L 1 scans are made on 10 patients and 42 are made on two neighbouring segments (41 of them on Th 11 -Th 12 and Th 12 -L 1 and one on Th 11 -L 1 and L 1 -L 2 ). An asymmetry (facet tropism) has been found at 59 levels, 21 if them are with spondiloarthrosis. Spondiloarthrosis has been found in 24 segments - 21 of them with osteochondrosis, one with disc prolapse, and 2 with disc protrusion. It is also found osteoporotic changes osteolysis in multiple myeloma, metastasis etc. During the 3 level examination no evidence for either of the mentioned changes is obtained. The CT slices of two neighbouring segments showed an unexpected change from thoracic to lumbar type of the intervertebral joints in 34 patients. The results from this study support the hypothesis about joints origin of the clinical symptoms of the thoracolumbar transition and demonstrate the importance of the computer tomography as a diagnostic method in this disease

  19. Comparative micro computed tomography study of a vertebral body

    Science.gov (United States)

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

    2008-08-01

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

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

    Science.gov (United States)

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

    2010-12-01

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

  1. Thoracolumbar fracture with listhesis - an uncommon manifestation of child abuse

    International Nuclear Information System (INIS)

    Levin, Terry L.; Blitman, Netta M.; Berdon, Walter E.; Cassell, Ian

    2003-01-01

    Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature. This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants. We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries. Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse. Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse. (orig.)

  2. Thoracolumbar fracture with listhesis - an uncommon manifestation of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Levin, Terry L.; Blitman, Netta M. [Department of Radiology, Montefiore Medical Center, 111 E. 210th Street, Bronx, New York, NY 10467-2490 (United States); Berdon, Walter E. [Department of Radiology, Babies Hospital, New York Presbyterian Hospital, New York (United States); Cassell, Ian [Department of Radiology, Phoenix Children' s Hospital, Phoenix, AZ (United States)

    2003-05-01

    Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature. This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants. We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries. Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse. Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse. (orig.)

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    International Nuclear Information System (INIS)

    Pua, Uei; Chan, Stephen Yung-Wei

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

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

    Science.gov (United States)

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

    2006-05-01

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

  8. Fratura toracolombar tipo explosão: comparação do tratamento conservador em pacientes com e sem fratura do arco vertebral posterior Thoracolumbar burst fracture: comparing conservative treatment in patients with and without fracture of the posterior vertebral arch

    Directory of Open Access Journals (Sweden)

    Osmar Avanzi

    2008-06-01

    Full Text Available OBJETIVO: Comparar clínica e radiologicamente os resultados a longo prazo do tratamento conservador da fratura explosão toracolombar, em pacientes com e sem fratura do arco vertebral posterior, com o propósito de avaliar eventuais diferenças na evolução destes dois tipos de lesão. MÉTODOS: Foram avaliados, retrospectivamente, os prontuários e exames de imagem (radiografias e tomografias computadorizadas de 25 pacientes sem déficit neurológico, com fratura toracolombar tipo explosão tratados não cirurgicamente e comparados o grau de progressão da cifose entre os casos com fratura da lâmina (grupo 1 e sem fratura posterior (grupo 2. Desses, 13 pacientes foram submetidos à avaliação comparativa por meio da escala visual analógica de dor (VAS, da escala de dor e trabalho de Denis e do questionário de qualidade de vida SF-36. RESULTADOS: Foram analisados 25 pacientes (36% do grupo A e 74% do grupo B com tempo médio de seguimento de 111,64 meses. Não houve diferença em relação ao grau de progressão da cifose durante o seguimento entre os grupos A e B (5,22º x 4,63º - p = 0,650. Dos 13 pacientes analisados funcionalmente, 46% eram do grupo A e 54% do grupo B. Nesta avaliação, apesar da VAS pior (1,83 x 5,00 - p = 0,015 nos pacientes sem fratura posterior (grupo B, não houve diferença em relação à escala de Denis (4,00 x 5,71 - p > 0,05 e SF-36 (98,60 x 90,83 - p = 0,168 entre os dois grupos. CONCLUSÃO: A fratura do arco posterior, isoladamente, parece não ser indicativo de instabilidade ou de mau prognóstico nas fraturas toracolombares tipo explosão.OBJECTIVE: To make a clinical and radiological comparison of long term results of the conservative treatment of thoracolumbar burst fractures, in patients with and without fracture in the posterior vertebral arch, in order to assess possible differences in the evolution of the two types of lesion. METHODS: A retrospective analysis was made of the clinical records and

  9. Growth modulation and remodeling by means of posterior tethering technique for correction of early-onset scoliosis with thoracolumbar kyphosis.

    Science.gov (United States)

    Ahmad, Alaaeldin A; Aker, Loai; Hanbali, Yahia; Sbaih, Aesha; Nazzal, Zaher

    2017-06-01

    The aim of this study is to evaluate the role of the non-fusion instrumented procedure with compression adjunct to lengthening by distraction in facilitating spinal modulation of the wedged peak vertebra, in patients with congenital thoracolumbar kyphosis/kyphoscoliosis according to the Hueter-Volkmann law. The authors seek to address the progressive modulation of the most wedged vertebra by analyzing the subjects' pre-operative and latest follow-up sagittal radiograph. Ongoing data collection of 14 peak wedged vertebra modulation during surgical management of 13 patients with Type I congenital thoracolumbar kyphosis (5 patients) or kyphoscoliosis (8 patients). Age at initial surgery averaged 58.6 months, with mean follow-up of 55.6 months (24-78). All were done with hybrid rib construct with clawing fashion through a single posterior approach with at least 4 lengthenings. Two vertebral bodies were selected, the peaked deformed vertebrae within the instrumentation compression level (WICL) and the vertebrae nearest but outside the instrumentation compression process (OICL). Anterior vertebral body height (AVBH) and posterior vertebral body height (PVBH) were measured in both vertebral bodies. Regarding measured vertebrae (WICL), average preoperative AVBH/PVBH ratio significantly increased from 0.54 to 0.77 in the final follow-up. Regarding measured vertebrae (OICL), the average preoperative AVBH/PVBH ratio increased from 0.76 to 0.79 in the final follow-up. Modulation can be confirmed in the most deformed vertebrae (WICL) as the difference between the change in AVBH/PVBH ratio between vertebrae (OICL) and (WICL) was statistically significant (P modulation (WICL) in comparison with the (OICL). This calls for further studies on the impact of surgical correction of EOS on modulation of the vertebrae.

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

    Science.gov (United States)

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

    2011-06-07

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    International Nuclear Information System (INIS)

    Swanpalmer, Janos; Kullenberg, Ragnar; Hansson, Tommy

    1998-01-01

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

  13. Clinical study on the application of minimally invasive percutaneous pedicle screw fixation in single segment thoracolumbar fracture without neurological symptoms

    Directory of Open Access Journals (Sweden)

    Jin-ping LIU

    2016-04-01

    Full Text Available Objective To discuss the clinical effects of minimally invasive percutaneous pedicle screw fixation in the treatment of single segment thoracolumbar fracture without neurological symptoms.  Methods From June 2012 to October 2014, 38 neurologically intact patients with thoracolumbar fracture underwent surgeries, including open pedicle screw fixation in 16 cases and percutaneous pedicle screw fixation in 22 cases. The incision length, operation time, intraoperative blood loss, postoperative drainage and postoperative complication were recorded and compared between 2 groups. Thoracolumbar orthophoric, lateral and flexion-extension X-ray was used to measure sagittal Cobb angle and height of injured anterior vertebral body before and after operation. Modified Macnab evaluation was used to assess the curative effects 3 months after operation. Results The success rate of operations in 38 patients was 100%. There were a total of 114 vertebral bodies fused and 228 pedicle screws implanted. Patients in the percutaneous pedicle screw group had smaller incision length [(10.55 ± 1.23 cm vs (18.50 ± 2.50 cm, P = 0.000], less intraoperative blood loss [(32.55 ± 7.22 ml vs (320.50 ± 15.48 ml, P = 0.000], shorter hospital stay [(6.55 ± 1.50 d vs (13.50 ± 2.52 d, P = 0.000], and without postoperative drainage. The follow-up after operation ranged from 3 to 6 months, with the average time of (4.65 ± 1.24 months. Cobb angle was reduced (P = 0.000 and height of injured anterior vertebral body were improved signifcantly (P = 0.000 3 months after surgery in both groups. The total effective rate was 14/16 in open surgery group, and 86.36% (19/22 in percutaneous pedicle screw group, however, the difference between 2 groups was not significant (P = 1.000. Conclusions Minimally invasive percutaneous pedicle screw fixation is a surgical method with less iatrogenic injury, less intraoperative blood loss and quick recovery for patients with thoracolumbar fracture

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

    International Nuclear Information System (INIS)

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

    1984-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    OpenAIRE

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

    2018-01-01

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

  17. HISTOMORPHOLOGICAL STUDY OF THORACOLUMBAR FASCIA IN PATIENTS WITH LUMBOSACRAL DISCOPATHY

    Directory of Open Access Journals (Sweden)

    Z BEHDADIPOOR

    2000-03-01

    Full Text Available Introduction. Thoracolumbar fascia has neural ends in normal positions. It has sensory role and by inhibitory and or excitatory reflexes helps to protect vertebral column. In this research, it has been studied neural ends in thoracolumbar fascia in 42 cases. Our aim was to compare the presence of neural ends in normal individuals and those with lumbosacral discopathy. Methods. The samples were taken from one centimeter of midline at the level of L4-L5 vertebrae, since in this region the posterior layer of thoracolumbar fascia is thicker. Seven of the cases were normal and 35 were patients with lumbosacral discopathy. The samples were processed and serial sections were prepared. Six hundred and thirty sections from the serial sections were selected and 90 percent of these were stained with H&E and the rest of them were stained with Bielschowsky method. The sections were studied by light microscopy. Findings. Unlike the normal individuals, nerve corpuscles were not seen in none of our patients with lumbosacraldiscopathy.UsingBielschowsky,nerveendingswerepresentin normal individuals but they were not visible in patients with discopathy. Conclusion. It is concluded that thoracolumbar fascia in patients with discopathy had insufficient neural ends. Loss of these neural ends may be cause of decreasing proprioceptive information to nervous system and can be an initiating factor to damage the bones, ligaments and muscles.

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Krug, B; Lorenz, R; Steinbrich, W

    1988-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Snieders Marieke N

    2009-06-01

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

  2. Vertebral deformity arising from an accelerated "creep" mechanism.

    Science.gov (United States)

    Luo, Jin; Pollintine, Phillip; Gomm, Edward; Dolan, Patricia; Adams, Michael A

    2012-09-01

    Vertebral deformities often occur in patients who recall no trauma, and display no evident fracture on radiographs. We hypothesise that vertebral deformity can occur by a gradual creep mechanism which is accelerated following minor damage. "Creep" is continuous deformation under constant load. Forty-five thoracolumbar spine motion segments were tested from cadavers aged 42-92 years. Vertebral body areal BMD was measured using DXA. Specimens were compressed at 1 kN for 30 min, while creep in each vertebral body was measured using an optical MacReflex system. After 30 min recovery, each specimen was subjected to a controlled overload event which caused minor damage to one of its vertebrae. The creep test was then repeated. Vertebral body creep was measurable in specimens with BMD Creep was greater anteriorly than posteriorly (p creep by 800 % (anteriorly), 1,000 % (centrally) and 600 % (posteriorly). In 34 vertebrae with complete before-and-after data, anterior wedging occurring during the 1st creep test averaged 0.07° (STD 0.17°), and in the 2nd test (after minor damage) it averaged 0.79° (STD 1.03°). The increase was highly significant (P creep test was proportional to the severity of damage, as quantified by specimen height loss during the overload event (r (2) = 0.51, p creep to such an extent that it makes a substantial contribution to vertebral deformity.

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

    Directory of Open Access Journals (Sweden)

    Helen J. Esser

    2016-12-01

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

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

    Science.gov (United States)

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

    2018-05-17

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

  5. Incidence and mechanism of neurological deficit after thoracolumbar fractures sustained in motor vehicle collisions.

    Science.gov (United States)

    Mukherjee, Sourabh; Beck, Chad; Yoganandan, Narayan; Rao, Raj D

    2015-10-09

    OBJECT To determine the incidence of and assess the risk factors associated with neurological injury in motor vehicle occupants who sustain fractures of the thoracolumbar spine. METHODS In this study, the authors queried medical, vehicle, and crash data elements from the Crash Injury Research and Engineering Network (CIREN), a prospectively gathered multicenter database compiled from Level I trauma centers. Subjects had fractures involving the T1-L5 vertebral segments, an Abbreviated Injury Scale (AIS) score of ≥ 3, or injury to 2 body regions with an AIS score of ≥ 2 in each region. Demographic parameters obtained for all subjects included age, sex, height, body weight, and body mass index. Clinical parameters obtained included the level of the injured vertebra and the level and type of spinal cord injury. Vehicular crash data included vehicle make, seatbelt type, and usage and appropriate use of the seatbelt. Crash data parameters included the principal direction of force, change in velocity on impact (ΔV), airbag deployment, and vehicle rollover. The authors performed a univariate analysis of the incidence and the odds of sustaining spinal neurological injury associated with major thoracolumbar fractures with respect to the demographic, clinical, and crash parameters. RESULTS Neurological deficit associated with thoracolumbar fracture was most frequent at extremes of age; the highest rates were in the 0- to 10-year (26.7% [4 of 15]) and 70- to 80-year (18.4% [7 of 38]) age groups. Underweight occupants (OR 3.52 [CI 1.055-11.7]) and obese occupants (OR 3.27 [CI 1.28-8.31]) both had higher odds of sustaining spinal cord injury than occupants with a normal body mass index. The highest risk of neurological injury existed in crashes in which airbags deployed and the occupant was not restrained by a seatbelt (OR 2.35 [CI 0.087-1.62]). Reduction in the risk of neurological injuries occurred when 3-point seatbelts were used correctly in conjunction with the

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

    Science.gov (United States)

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

    2018-03-15

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

    Kikuchi, Tetsujiro

    1988-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M.B. Ogurkowska

    2010-09-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

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

    2007-06-01

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

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

    Science.gov (United States)

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

    2012-07-01

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

  16. [Comparison of the grafting technique in treatment of thoracolumbar burst fractures:transpedicular intracorporeal versus posterolateral].

    Science.gov (United States)

    Li, Li; Shi, Ya-Min; Hou, Shu-Xun; Wang, Hua-Dong; Guo, Ji-Dong

    2011-02-01

    To retrospectively investigate the outcome of transpedicular intracorporeal grafting and posterolateral grafting in treatment of thoracolumbar burst fractures. Forty-six patients treated with transpedicular intracorporeal grafting from January 1999 to December 2009 and followed up for 19-119 months (average 67 ± 13 months) were reviewed retrospectively, and were compared with 18 patients who had underwent posterolateral fusion during the same period through radiographic analysis. Radiographic measurements included Cobb angle, vertebral wedge angle (VWA), ratio between anterior and posterior vertebral height (APHR), upper inter-vertebral angle, lower inter-vertebral angle on X-ray, CT and MRI. In transpedicular intracorporeal grafting group, the VWA was corrected from 27.2° ± 6.5° to 7.0° ± 3.0° and the APHR from (53.3 ± 11.8)% to (92.3 ± 2.4)%. In posterolateral fusion group, the VWA was corrected from 23.9° ± 4.4° to 8.8° ± 2.1° and the APHR from (60.7 ± 10.0)% to (88.5 ± 3.3)%. Transpedicular intracorporeal grafting group showed better postoperative correction results than posterolateral fusion group (P < 0.05), and had less loss of correction of Cobb angle, VWA and APHR at final follow-up (P < 0.05). The transpedicular intracorporeal grafting can improve injured vertebral body morphology recovery better than posterolateral bone grafting, but can not prevent the late loss of correction after implant removal.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

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

    Science.gov (United States)

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

    2011-09-01

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

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

    International Nuclear Information System (INIS)

    Momma, Fumiyuki; Amagasa, Masaharu; Nakazawa, Teruo

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    International Nuclear Information System (INIS)

    Xu Feng; Ma Yubo; Yuan Qi

    2012-01-01

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

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

    Science.gov (United States)

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

    2006-08-01

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

  4. Thoracolumbar Langerhans cell histiocytosis in a toddler

    Directory of Open Access Journals (Sweden)

    Zhi Gang Lan

    2018-01-01

    Full Text Available Introduction: Langerhans cell histiocytosis (LCH is a rare uni or multisystem disorder associated with extreme production of immunoreactive Langerhans cells. Although this disorder has been reported in all age groups, spinal involvement especially thoracolumbar spine is seldom reported in toddlers. Case presentation: We present a one (1 year, four (4 months female child with a history of recurrent fever, irritability and severe anemia of one (1 month duration. CT-scan and MRI revealed a collapsed twelfth thoracic vertebra (T12 body height greater than 95% with a huge intradural soft tissue mass. T12 cortectomy via posterior thoracolumbar approach was used to decompress the soft tissue part followed by interbody fusion with titanium cage filled with autologous iliac crest bone graft, fixation using plates and screws. Conclusion: We are of the view that surgical decompression of spinal LHC lesions with interbody fusion with titanium cage filled with autologous iliac crest bone graft and fixation using plates and screws is very crucial in relieving neurological deficits. However, the patient will need repeated surgeries as she advances with age in a timely manner to avert any neurological deficit that may occur. Keywords: Langerhans cell histiocytosis (LCH, Letterer-Siwe disease, Hand-Schüller-Christian disease, Eosinophilic granuloma

  5. Radiologic abnormalities of the thoraco-lumbar spine in athletes

    Energy Technology Data Exchange (ETDEWEB)

    Hellstroem, M.; Jacobsson, B.; Swaerd, L.; Peterson, L. (Sahlgrenska Sjukhuset, Goeteborg (Sweden). Dept. of Radiology Oestra Sjukhuset, Goeteborg (Sweden). Dept. of Orthopedics King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Dept. of Radiology)

    1990-03-01

    A radiologic study of the thoraco-lumbar spine was performed in 143 (117 male and 26 female) athletes (wrestlers, gymnasts, soccer players and tennis players), aged 14 to 25 years and 30 male nonathletes, aged 19 to 25 years. Film interpretation was made after mixing the films from all groups and without knowledge of the individual's identity. Various types of radiologic abnormalities occured in both athletes and non-athletes but were more common among athletes, especially male-gymnasts and wrestlers. Abnormalities of the vertebral ring apophysis occurred exclusively in athletes. Combinations of different types of abnormalities were most common in male gymnasts and wrestlers. (orig.).

  6. Radiologic abnormalities of the thoraco-lumbar spine in athletes

    International Nuclear Information System (INIS)

    Hellstroem, M.; Jacobsson, B.; Swaerd, L.; Peterson, L.; Oestra Sjukhuset, Goeteborg; King Faisal Specialist Hospital and Research Centre, Riyadh

    1990-01-01

    A radiologic study of the thoraco-lumbar spine was performed in 143 (117 male and 26 female) athletes (wrestlers, gymnasts, soccer players and tennis players), aged 14 to 25 years and 30 male nonathletes, aged 19 to 25 years. Film interpretation was made after mixing the films from all groups and without knowledge of the individual's identity. Various types of radiologic abnormalities occured in both athletes and non-athletes but were more common among athletes, especially male-gymnasts and wrestlers. Abnormalities of the vertebral ring apophysis occurred exclusively in athletes. Combinations of different types of abnormalities were most common in male gymnasts and wrestlers. (orig.)

  7. Epithelioid hemangioendothelioma and multiple thoraco-lumbar lateral meningoceles: two rare pathological entities in a patient with NF-1

    International Nuclear Information System (INIS)

    Reis, C.; Carneiro, E.; Fonseca, J.; Salgado, A.; Pereira, P.; Vaz, R.; Pinto, R.; Capelinha, A.F.; Lopes, J.M.

    2005-01-01

    Epithelioid hemangioendothelioma (EHE) is a rare vascular soft-tissue tumour of intermediate malignancy. Neurofibromatosis type I (NF-1) is a genetic syndrome associated with soft tissue sarcoma and higher risk of developing neoplasia. Lateral meningoceles are uncommon entities, being mostly associated with NF-1. We report a case of a 31-year-old woman, with NF-1 and past history of right thalamic/peduncular astrocytoma WHO grade II, admitted to the Neurosurgery Department in December 2003 due to severe low back pain, irradiating to the left leg without a radicular pattern. Thoraco-lumbar magnetic resonance imaging (MRI) showed a large left posterior paravertebral expansive lesion, bilateral and multiple thoraco-lumbar lateral meningoceles and dural ectasias with scalloping of the vertebral bodies. Biopsy of the paravertebral mass lesion disclosed EHE. We present this case because of the novel association between NF-1 and EHE, and the unusual aggressiveness of the neoplasia. Additionally, we highlight the co-existence of bilateral and multiple lateral meningoceles. (orig.)

  8. Radiological outcome of transpedicular screws fixation in the management of thoracolumbar spine injury

    International Nuclear Information System (INIS)

    Haq, M.I.U.

    2015-01-01

    Traumatic fracture of the spine is a serious neurosurgical condition that has serious impact on the patient's quality of life. Thoracolumbar junction is the most common site of spinal injuries. The aims of management of thoracolumbar spinal fractures are to restore vertebral column stability, and to obtain spinal canal decompression. This ultimately leads to early mobilization of the patients. This study was conducted to compare preoperative and post-operative vertebral height, kyphotic angle and sagittal index in patients treated with pedicle screws and rods in thoracolumbar spine fractures. Methods: This cross-sectional study was conducted in the department of Neurosurgery, Hayatabad Medical Complex, Peshawar from 1st February 2010 to 31st July 2011. A total 161 patients with unstable thoracolumber spine fracture were included in this study. In these patients fixation was done through transpedicle screws with rods. Anteroposterior and lateral views X-rays of thoraco-lumbar spine were done pre and post operatively. Results: Out of 161 patients, 109 (67.7%) were males and 52 (32.3%) females. The age of patients ranged from 20 to 70 years (mean 42.2 years) with 71 (44.1%) in the age range of 31-40 years. Preoperative average vertebral height was 9.4194 mm while postoperative average was 19.642 mm. The mean kyphosis was 23.06 degree preoperatively. Immediately after surgery the average correction of kyphosis was 9.45 degree. The pre-operative average sagittal index was 19.38 degree, which was reduced to an average 5.41 degree post operatively. Conclusions: Transpedicular fixation for unstable thoraco-lumbar spinal fractures achieves a stable fracture segment with improvement of vertebral height, kyphotic angle and sagittal index. Hence, preventing the secondary spinal deformities. (author)

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

    Science.gov (United States)

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

    2012-11-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Iain MacEwan, MD

    2017-04-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

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

    1998-04-01

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

  14. Functional anatomy of the caudal thoracolumbar and lumbosacral spine in the horse.

    Science.gov (United States)

    Stubbs, N C; Hodges, P W; Jeffcott, L B; Cowin, G; Hodgson, D R; McGowan, C M

    2006-08-01

    Research in spinal biomechanics and functional anatomy has advanced back pain research in man. Yet, despite the performance limiting nature of back pain in horses, there are few data for the equine spine. To describe aspects of functional anatomy of the equine thoracolumbar and lumbosacral (LS) spine and potential effects on performance. The first study investigated variations in LS vertebral formula by post mortem examination of 120 horses. Midline vertebral transection was carried out on 65 Thoroughbred (TB), 24 Standardbred (SB) and 31 other breeds. The second study investigated morphology and biomechanics of the deep stabilising epaxial muscles of 13 horses using MRI (n = 3), anatomical dissection (n = 11) and biomechanical analysis (n = 6). The spinous process angular orientation relative to the vertebral body, was analysed at vertebrae T13, T18, L3, L5, L6 and S1. LS variations were found in 33.3% of the total group, 40.0% TB and 45.2% others, but 0% SB. Sacralisation of lumbar vertebra (L) 6 with LS motion between L5 and L6 occurred in 32.3% TB and 29.0% others. Five segmental multifidus fascicles were identified originating from spinous processes and vertebral laminae running craniocaudally onto the mammillary processes and lateral border of the sacrum, crossing between 1-5 intervertebral discs. Sacrocaudalis dorsalis (SCD) lateralis muscle was an extension of multifidus from L4, L5 and L6 depending on the vertebral formula whereas SCD medialis mm originated from S3. Both inserted on caudal vertebrae. Based on the location and direction of fibres, the principal action of the deep epaxial muscles was dorsoventral sagittal rotation. This action was dependent on vertebral spinous process/body orientation. We hypothesise that equine multifidus and SCD lateralis muscles act as caudal sagittal rotators of their vertebra of origin, as is the case in man, allowing dynamic stabilisation during dorsoventral motion. Equine multifidus anatomy and function are

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2018-05-23

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

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

    Science.gov (United States)

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

    2011-07-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

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

    Czech Academy of Sciences Publication Activity Database

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

    2013-01-01

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

  5. 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.

  6. CT-findings in pain syndromes originated from thoraco-lumbar junction

    International Nuclear Information System (INIS)

    Dimitrov, I.; Karadjova, M.; Malchanova, V.

    2007-01-01

    The thoraco-lumbar junction syndrome imitates, as far as clinical symptoms are concerned, low back pain, caused by disc protrusion in the lower lumbar vertebral segments. It is manifested by referred pain in the area, innervated by posterior and anterior primary rami (dorsal and ventral rami), belonging to thoraco-lumbar junction vertebral segments (Th11-L2). Eighty one patients with clinically diagnosed thoraco-lumbar junction syndrome underwent CT-investigations, that aimed establishing pathological processes, leading to this clinical symptomatology. 148 vertebral levels were examined. In 67 patients we scanned two consecutive levels to find the type of change of the zygapophyseal joints. We found facet tropism (asymmetry) in 72 patients (88.8%) or in 117 levels (79.6%), degenerated faced joints in 63 patients (77.8%), pathology of the intervertebral disc - in 33 patients (43.1%) including 5 patients (6.2%) with disc prolapse. When investigating on two subsequent segments (Th11-Th12 and Th12-L1) sudden anatomical change in orientation of facets occurred in 55 patients (82%). Our findings support the hypothesis of the facet-joint origin of this ailment. (authors)

  7. Thoracolumbar spine loading associated with kinematics of the young and the elderly during activities of daily living.

    Science.gov (United States)

    Ignasiak, Dominika; Rüeger, Andrea; Sperr, Ramona; Ferguson, Stephen J

    2018-03-21

    Excessive mechanical loading of the spine is a critical factor in vertebral fracture initiation. Most vertebral fractures develop spontaneously or due to mild trauma, as physiological loads during activities of daily living might exceed the failure load of osteoporotic vertebra. Spinal loading patterns are affected by vertebral kinematics, which differ between elderly and young individuals. In this study, the effects of age-related changes in spine kinematics on thoracolumbar spinal segmental loading during dynamic activities of daily living were investigated using combined experimental and modeling approach. Forty-four healthy volunteers were recruited into two age groups: young (N = 23, age = 27.1 ± 3.8) and elderly (N = 21, age = 70.1 ± 3.9). The spinal curvature was assessed with a skin-surface device and the kinematics of the spine and lower extremities were recorded during daily living tasks (flexion-extension and stand-sit-stand) with a motion capture system. The obtained data were used as input for a musculoskeletal model with a detailed thoracolumbar spine representation. To isolate the effect of kinematics on predicted loads, other model properties were kept constant. Inverse dynamics simulations were performed in the AnyBody Modeling System to estimate corresponding spinal loads. The maximum compressive loads predicted for the elderly motion patterns were lower than those of the young for L2/L3 and L3/L4 lumbar levels during flexion and for upper thoracic levels during stand-to-sit (T1/T2-T8/T9) and sit-to-stand (T3/T4-T6/T7). However, the maximum loads predicted for the lower thoracic levels (T9/T10-L1/L2), a common site of vertebral fractures, were similar compared to the young. Nevertheless, these loads acting on the vertebrae of reduced bone quality might contribute to a higher fracture risk for the elderly. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

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

    Science.gov (United States)

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

    2014-01-01

    Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques. PMID:25620987

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-01

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

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

    International Nuclear Information System (INIS)

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

    2018-01-01

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kim Hak-Jun

    2008-08-01

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

  16. Vertebral osteomyelitis without disc involvement

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-10-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  18. Clinical characterization of thoracolumbar and lumbar intervertebral disk extrusions in English Cocker Spaniels.

    Science.gov (United States)

    Cardy, Thomas J A; Tzounos, Caitlin E; Volk, Holger A; De Decker, Steven

    2016-02-15

    To assess the anatomic distribution of thoracolumbar and lumbar intervertebral disk extrusions (IVDEs) in English Cocker Spaniels as compared with findings in Dachshunds and to characterize clinical findings in English Cocker Spaniels with thoracolumbar or lumbar IVDEs affecting various regions of the vertebral column. Retrospective observational study. 81 English Cocker Spaniels and 81 Dachshunds with IVDEs. Signalment, clinical signs, neurologic examination findings, and affected intervertebral disk spaces (IVDSs) were recorded for both breeds. Management methods and outcomes were recorded for English Cocker Spaniels. Lesions were categorized as thoracolumbar (IVDSs T9-10 through L1-2), midlumbar (L2-3 through L4-5), or caudal lumbar (L5-6 through L7-S1). Midlumbar and caudal lumbar IVDEs were significantly more common in English Cocker Spaniels than in Dachshunds. English Cocker Spaniels with caudal lumbar IVDEs had a longer median duration of clinical signs before evaluation and more commonly had unilateral pelvic limb lameness or spinal hyperesthesia as the predominant clinical sign than did those with IVDEs at other sites. Those with caudal lumbar IVDEs less commonly had neurologic deficits and had a higher median neurologic grade (indicating lesser severity), shorter mean postoperative hospitalization time, and faster mean time to ambulation after surgery than those with other sites affected. These variables did not differ between English Cocker Spaniels with thoracolumbar and midlumbar IVDEs. Caudal and midlumbar IVDEs were more common in English Cocker Spaniels than in Dachshunds. English Cocker Spaniels with caudal lumbar IVDE had clinical signs and posttreatment responses that differed from those in dogs with midlumbar or thoracolumbar IVDE.

  19. 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.)

  20. 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.)

  1. MR Imaging of Supraspinous Ligament Injury in the Thoracolumbar Spine

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ju Hee; Hwang, Ji Young; Lee, Sun Wha; Koh, Young Do [Ewha Womans University, Seoul (Korea, Republic of)

    2009-10-15

    We wanted to evaluate the MRI features and their diagnostic accuracy for SSL injury in the thoracolumbar spine. From December 2003 to June 2006, among 42 surgically treated patients with spinal fracture, the 35 patients who underwent MRI and who were surgically evaluated for SSL injury were included in this study. The sagittal MR images were evaluated for the presence of SSL injury and its level, location and distraction gap, the level and compression ratio of the fractured body, and the presence of ISL or yellow ligament injury and posterior osseous fracture. The sensitivity, specificity and accuracy of MRI were calculated. The distraction gap of the SSL and the compression ratio of the fractured body or posterior osseous fracture were statistically analyzed. Thirty-one among the 33 patients with surgically confirmed SSL injury were diagnosed on MRI. SSL injury was mostly seen at the thoracolumbar junction and near the upper spinous process. The mean distraction gap was 4.3 mm. The level of the fractured body was most commonly in the lower vertebra of the injured SSL level and the mean compression ratio was 21.8%. Combined SSL, ISL and yellow ligament injury were mostly seen. The sensitivity, specificity and accuracy were 93.9%, 50% and 91.4%, respectively. There was a statistically significant difference of the distraction gap of the injured SSL depending on the presence of posterior osseous fracture. MRI is an accurate modality for evaluating SSL injury and the associated findings.

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Combined posteroanterior fusion versus transforaminal lumbar interbody fusion (TLIF) in thoracolumbar burst fractures.

    Science.gov (United States)

    Schmid, Rene; Lindtner, Richard Andreas; Lill, Markus; Blauth, Michael; Krappinger, Dietmar; Kammerlander, Christian

    2012-04-01

    The optimal treatment strategy for burst fractures of the thoracolumbar junction is discussed controversially in the literature. Whilst 360° fusion has shown to result in better radiological outcome, recent studies have failed to show its superiority concerning clinical outcome. The morbidity associated with the additional anterior approach may account for these findings. The aim of this prospective observational study was therefore to compare two different techniques for 360° fusion in thoracolumbar burst fractures using either thoracoscopy or a transforaminal approach (transforaminal lumbar interbody fusion (TLIF)) to support the anterior column. Posterior reduction and short-segmental fixation using angular stable pedicle screw systems were performed in all patients as a first step. Monocortical strut grafts were used for the anterior support in the TLIF group, whilst tricortical grafts or titanium vertebral body replacing implants of adjustable height were used in the combined posteroanterior group. At final follow-up, the radiological outcome was assessed by performing X-rays in a standing position. The clinical outcome was measured using five validated outcome scores. The morbidity associated with the approaches and the donor site was assessed as well. There were 21 patients in the TLIF group and 14 patients in the posteroanterior group included. The postoperative loss of correction was higher in the TLIF group (4.9°±8.3° versus 3.4°±6.4°, p>0.05). There were no significant differences regarding the outcome scores between the two groups. There were no differences in terms of return to employment, leisure activities and back function either. More patients suffered from donor-site morbidity in the TLIF group, whilst the morbidity associated with the surgical approach was higher in the posteroanterior group. The smaller donor-site morbidity in the posteroanterior group is counterbalanced by an additional morbidity associated with the anterior approach

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

    Background In clinical practice lateral images of the chest are performed for various reasons. As these lateral chest X rays show the vertebrae of the thoracic and thoraco-lumbar region, we wondered if these X-rays can be used for evaluation of vertebral fractures instead of separate thoracic spine

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  7. Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

    OpenAIRE

    Shi,Chen; Zhang,Mi; Cheng,An-Yuan; Huang,Zi-Feng

    2018-01-01

    Chen Shi,1,* Mi Zhang,2,* An-Yuan Cheng,1 Zi-Feng Huang1 1Department of Trauma Surgery, Wuhan No 1 Hospital, Wuhan, China; 2Department of Orthopedics, Wuhan No 5 Hospital, Wuhan, China *These authors contributed equally to this work Objective: We studied the efficacy of zoledronic acid (ZOL) infusion on radiographic and clinical outcomes after percutaneous kyphoplasty (PKP) for elderly patients with osteoporotic thoracolumbar fractures (osteoporotic vertebral compression fractures...

  8. Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

    OpenAIRE

    Shi C; Zhang M; Cheng AY; Huang ZF

    2018-01-01

    Chen Shi,1,* Mi Zhang,2,* An-Yuan Cheng,1 Zi-Feng Huang1 1Department of Trauma Surgery, Wuhan No 1 Hospital, Wuhan, China; 2Department of Orthopedics, Wuhan No 5 Hospital, Wuhan, China *These authors contributed equally to this work Objective: We studied the efficacy of zoledronic acid (ZOL) infusion on radiographic and clinical outcomes after percutaneous kyphoplasty (PKP) for elderly patients with osteoporotic thoracolumbar fractures (osteoporotic vertebral compression fractures [OV...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  11. The Retrospective Analysis of Posterior Short-Segment Pedicle Instrumentation without Fusion for Thoracolumbar Burst Fracture with Neurological Deficit

    Directory of Open Access Journals (Sweden)

    Zhouming Deng

    2014-01-01

    Full Text Available This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF. The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation. The mean operation time was 93 min (range: 62–110 min and the mean intraoperative blood loss was 452 mL in all cases. The average canal encroachment was 50.04% and 10.92% prior to the surgery and at last followup, respectively (P<0.01. The preoperative kyphotic angle was 17.2 degree (±6.87 degrees, whereas it decreased to 8.42 degree (±4.99 degrees at last followup (P<0.01. Besides, the mean vertebral body height increased from 40.15% (±9.40% before surgery to 72.34% (±12.32% at last followup (P<0.01. 45 patients showed 1-2 grades improvement in Frankel’s scale at last followup. This technique allows for satisfactory canal clearance and restoration of vertebral body height and kyphotic angle, and it may promote the recovery of neurological function. However, further research is still necessary to confirm the efficacy of this treatment.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  14. 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...

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

    OpenAIRE

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

    2016-01-01

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

  16. Surgical outcome of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in thoracolumbar tuberculosis

    Directory of Open Access Journals (Sweden)

    Md. Anowarul Islam

    2017-05-01

    Full Text Available Spinal tuberculosis causes severe complications like neurological and spinal deformity which may lead to respiratory distress, costo-pelvic impingement, paraplegia and consequent reduction in the quality and longevity of life. The aim of the present treatment is to avoid the consequence of neural complications and gain near-normal spine. Mechanical factor causes pathological fracture or dislocation of an affected vertebral body. Surgical decompression ensues further instability. Reconstruction of spinal column by pedicle screw and rod provide stability and prevents secondary neural damage and deformity thereby helps in early mobilization. Prospective study was done to evaluate the results in 20 cases of spinal tuberculosis in thoracolumbar region associated with neurological deficit. We operated our cases (12 males and 8 females by posterolateral decompression, fusion and stabilization by pedicle screw and rod along with antitubercular drug treatment. All patients were with neurological deficit, single level involvement and 10 to 30 degree of mild kyphosis. After surgery, kyphosis improved from 20.7 ± 5.5 degrees to 12.5 ± 3.9 degree. Bony fusion was in 65.0% cases. Neurological improvement and pain subsided in all the patients.

  17. Spondylectomy and lateral lumbar interbody fusion for thoracolumbar kyphosis in an adult with achondroplasia

    Science.gov (United States)

    Miyazaki, Masashi; Kanezaki, Shozo; Notani, Naoki; Ishihara, Toshinobu; Tsumura, Hiroshi

    2017-01-01

    Abstract Rationale: Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. Patient concerns: A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication. Diagnoses: Plain radiographs revealed a high-grade thoracolumbar kyphotic deformity with diffuse degenerative changes in the lumbar spine. The apex was located at L2, the local kyphotic angle from L1 to L3 was 105°, and the anterior area was fused from the L1 to L3 vertebrae. MRI revealed significant canal and lateral recess stenosis secondary to facet hypertrophy. Interventions: We planned a front-back correction of the anterior and posterior spinal elements. We first performed anterior release at the fused part from L1 to L3 and XLIF at L3/4 and L4/5. Next, the patient was placed in the prone position. Spondylectomy at the L2 vertebra and posterior fusion from T10 to L5 were performed. Postoperative radiographs revealed L1 to L3 kyphosis of 32°. Outcomes: No complications occurred during or after surgery. Postoperatively, the patient's low back pain and neurological claudication were resolved. No worsening of kyphosis was observed 24 months postoperatively. Lessons: Circumferential decompression of the spinal cord at the apical vertebral level and decompression of lumbar canal stenosis were necessary. Front-back correction of the anterior and posterior spinal elements via spondylectomy and lateral lumbar interbody fusion is a reasonable surgical option for thoracolumbar kyphosis and developmental canal stenosis in patients with achondroplasia. PMID:29245270

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

    Science.gov (United States)

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

    2018-01-01

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

  19. Prediction of posterior ligamentous complex injury in thoracolumbar fractures using non-MRI imaging techniques.

    Science.gov (United States)

    Rajasekaran, Shanmuganathan; Maheswaran, Anupama; Aiyer, Siddharth N; Kanna, Rishi; Dumpa, Srikanth Reddy; Shetty, Ajoy Prasad

    2016-06-01

    We aimed to formulate a radiological index based on plain radiographs and computer tomography (CT) to reliably detect posterior ligamentous complex (PLC) injury without need for MRI. Sixty out of 148 consecutive thoracolumbar fractures with doubtful PLC were assessed with MRI, CT and radiographs. PLC injury was assessed with the following radiological parameters: superior-inferior end plate angle (SIEA), vertebral body height (BH), local kyphosis (LK), inter-spinous distance (ISD) and inter-pedicular distance (IPD) and correlated with MRI findings of PLC injury. Statistical analysis was performed to identify the predictive values for the parameters to identify PLC damage. MRI identified PLC injury in 25/60 cases. The ISD and LK were found to be significant predictors of PLC injury. On radiographs the mean LK with PLC damage was 25.86° compared to 21.02° with an intact PLC (p = 0.006). The ISD difference was 6.70 mm in cases with PLC damage compared to 2.86 mm with an intact PLC (p = 0.011). In CT images, the mean LK with PLC damage was 22.96° compared to 18.44° with an intact PLC ( p = 0.019). The ISD difference was 3.10 mm with PLC damage compared to 1.62 mm without PLC damage (p = 0.005). On plain radiographs the presence of LK greater than 20 °(CI 64-95) and ISD difference greater than 2 mm (CI 70-97) can predict PLC injury. These guidelines may be utilised in the emergency room especially when the associated cost, availability and time delay in performing MRI are a concern.

  20. Vertebral chondroblastoma

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  1. Vertebral chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-02-01

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

  2. Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.

    Science.gov (United States)

    Kaye, Ian David; Passias, Peter

    2018-03-01

    Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-15

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

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

    Science.gov (United States)

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

    2010-01-01

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

  6. How long and low can you go? Effect of conformation on the risk of thoracolumbar intervertebral disc extrusion in domestic dogs.

    Science.gov (United States)

    Packer, Rowena M A; Hendricks, Anke; Volk, Holger A; Shihab, Nadia K; Burn, Charlotte C

    2013-01-01

    Intervertebral disc extrusion (IVDE) is a common neurological disorder in certain dog breeds, resulting in spinal cord compression and injury that can cause pain and neurological deficits. Most disc extrusions are reported in chondrodystrophic breeds (e.g. Dachshunds, Basset Hounds, Pekingese), where selection for 'long and low' morphologies is linked with intervertebral discs abnormalities that predispose dogs to IVDE. The aim of this study was to quantify the relationship between relative thoracolumbar vertebral column length and IVDE risk in diverse breeds. A 14 month cross-sectional study of dogs entering a UK small animal referral hospital for diverse disorders including IVDE was carried out. Dogs were measured on breed-defining morphometrics, including back length (BL) and height at the withers (HW). Of 700 dogs recruited from this referral population, measured and clinically examined, 79 were diagnosed with thoracolumbar IVDE following diagnostic imaging ± surgery. The BL:HW ratio was positively associated with IVDE risk, indicating that relatively longer dogs were at increased risk, e.g. the probability of IVDE was 0.30 for Miniature Dachshunds when BL:HW ratio equalled 1.1, compared to 0.68 when BL:HW ratio equalled 1.5. Additionally, both being overweight and skeletally smaller significantly increased IVDE risk. Therefore, selection for longer backs and miniaturisation should be discouraged in high-risk breeds to reduce IVDE risk. In higher risk individuals, maintaining a lean body shape is particularly important to reduce the risk of IVDE. Results are reported as probabilities to aid decision-making regarding breed standards and screening programmes reflecting the degree of risk acceptable to stakeholders.

  7. How long and low can you go? Effect of conformation on the risk of thoracolumbar intervertebral disc extrusion in domestic dogs.

    Directory of Open Access Journals (Sweden)

    Rowena M A Packer

    Full Text Available Intervertebral disc extrusion (IVDE is a common neurological disorder in certain dog breeds, resulting in spinal cord compression and injury that can cause pain and neurological deficits. Most disc extrusions are reported in chondrodystrophic breeds (e.g. Dachshunds, Basset Hounds, Pekingese, where selection for 'long and low' morphologies is linked with intervertebral discs abnormalities that predispose dogs to IVDE. The aim of this study was to quantify the relationship between relative thoracolumbar vertebral column length and IVDE risk in diverse breeds. A 14 month cross-sectional study of dogs entering a UK small animal referral hospital for diverse disorders including IVDE was carried out. Dogs were measured on breed-defining morphometrics, including back length (BL and height at the withers (HW. Of 700 dogs recruited from this referral population, measured and clinically examined, 79 were diagnosed with thoracolumbar IVDE following diagnostic imaging ± surgery. The BL:HW ratio was positively associated with IVDE risk, indicating that relatively longer dogs were at increased risk, e.g. the probability of IVDE was 0.30 for Miniature Dachshunds when BL:HW ratio equalled 1.1, compared to 0.68 when BL:HW ratio equalled 1.5. Additionally, both being overweight and skeletally smaller significantly increased IVDE risk. Therefore, selection for longer backs and miniaturisation should be discouraged in high-risk breeds to reduce IVDE risk. In higher risk individuals, maintaining a lean body shape is particularly important to reduce the risk of IVDE. Results are reported as probabilities to aid decision-making regarding breed standards and screening programmes reflecting the degree of risk acceptable to stakeholders.

  8. Risk Factors for the Failure of Spinal Burst Fractures Treated Conservatively According to the Thoracolumbar Injury Classification and Severity Score (TLICS: A Retrospective Cohort Trial.

    Directory of Open Access Journals (Sweden)

    Jieliang Shen

    Full Text Available The management of thoracolumbar (TL burst fractures is still controversial. The thoracolumbar injury classification and severity score (TLICS algorithm is now widely used to guide clinical decision making, however, in clinical practice, we come to realize that TLICS also has its limitations for treating patients with total scores less than 4, for which conservative treatment may not be optimal in all cases.The aim of this study is to identify several risk factors for the failure of conservative treatment of TL burst fractures according to TLICS algorithm.From June 2008 to December 2013, a cohort of 129 patients with T10-l2 TL burst fractures with a TLISC score ≤3 treated non-operatively were identified and included into this retrospective study. Age, sex, pain intensity, interpedicular distance (IPD, canal compromise, loss of vertebral body height and kyphotic angle (KA were selected as potential risk factors and compared between the non-operative success group and the non-operative failure group.One hundred and four patients successfully completed non-operative treatment, the other 25 patients were converted to surgical treatment because of persistent local back pain or progressive neurological deficits during follow-up. Our results showed that age, visual analogue scale (VAS score and IPD, KA were significantly different between the two groups. Furthermore, regression analysis indicated that VAS score and IPD could be considered as significant predictors for the failure of conservative treatment.The recommendation of non-operative treatment for TLICS score ≤3 has limitations in some patients, and VAS score and IPD could be considered as risk factors for the failure of conservative treatment. Thus, conservative treatment should be decided with caution in patients with greater VAS scores or IPD. If non-operative management is decided, a close follow-up is necessary.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-04-01

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

  10. Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

    International Nuclear Information System (INIS)

    Henes, Frank Oliver; Groth, Michael; Kramer, Harald; Schaefer, Christian; Regier, Marc; Derlin, Thorsten; Adam, Gerhard; Bannas, Peter

    2014-01-01

    Objectives: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures. Methods: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland–Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT. Results: HU measurements demonstrated a high interrater reliability (ICC = 0.984). ROC curve analysis (AUC = 0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone. Conclusions: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary

  11. Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Henes, Frank Oliver, E-mail: f.henes@uke.de [Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Groth, Michael [Department of Diagnostic and Interventional Neuroradiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Kramer, Harald [Department of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, 81377 Munich (Germany); Department of Radiology, University of Wisconsin – Madison, Clinical Science Center, 600 Highland Avenue, Madison, WI 53792 (United States); Schaefer, Christian [Department of Trauma-, Hand- and Reconstructive Surgery, Spine Center, Center for Surgical Sciences, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Regier, Marc; Derlin, Thorsten; Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany)

    2014-01-15

    Objectives: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures. Methods: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland–Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT. Results: HU measurements demonstrated a high interrater reliability (ICC = 0.984). ROC curve analysis (AUC = 0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone. Conclusions: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary.

  12. Constipation after thoraco-lumbar fusion surgery.

    Science.gov (United States)

    Stienen, Martin N; Smoll, Nicolas R; Hildebrandt, Gerhard; Schaller, Karl; Tessitore, Enrico; Gautschi, Oliver P

    2014-11-01

    Thoraco-lumbar posterior fusion surgery is a frequent procedure used for patients with spinal instability due to tumor, trauma or degenerative disease. In the perioperative phase, many patients may experience vomiting, bowel irritation, constipation, or may even show symptoms of adynamic ileus possibly due to immobilization and high doses of opioid analgesics and narcotics administered during and after surgery. Retrospective single-center study on patients undergoing thoraco-lumbar fusion surgery for degenerative lumbar spine disease with instability in 2012. Study groups were built according to presence/absence of postoperative constipation, with postoperative constipation being defined as no bowel movement on postoperative days 0-2. Ninety-nine patients (39 males, 60 females) with a mean age of 57.1 ± 17.3 years were analyzed, of which 44 patients with similar age, gender, BMI and ASA-grades showed constipation (44.4%). Occurrence of constipation was associated with longer mean operation times (247 ± 62 vs. 214 ± 71 min; p=0.012), higher estimated blood loss (545 ± 316 vs. 375 ± 332 ml; pconstipation. One patient with constipation developed a sonographically confirmed paralytic ileus. Patients with constipation showed a tendency toward longer postoperative hospitalization (7.6 vs. 6.7 days, p=0.136). The rate of constipation was high after thoraco-lumbar fusion surgery. Moreover, it was associated with longer surgery time, higher blood loss, and higher postoperative morphine doses. Further trials are needed to prove if the introduction of faster and less invasive surgery techniques may have a positive side effect on bowel movement after spine surgery as they may reduce operation times, blood loss and postoperative morphine use. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2012-06-15

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

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

    Science.gov (United States)

    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

  15. Effect of MELT method on thoracolumbar connective tissue: The full study.

    Science.gov (United States)

    Sanjana, Faria; Chaudhry, Hans; Findley, Thomas

    2017-01-01

    Altered connective tissue structure has been identified in adults with chronic low back pain (LBP). A self-care treatment for managing LBP is the MELT method. The MELT method is a hands-off, self-treatment that is said to alleviate chronic pain, release tension and restore mobility, utilizing specialized soft treatments balls, soft body roller and techniques mimicking manual therapy. The objective of this study was to determine whether thickness of thoracolumbar connective tissue and biomechanical and viscoelastic properties of myofascial tissue in the low back region change in subjects with chronic LBP as a result of MELT. This study was designed using a quasi experimental pre-post- design that analyzed data from subjects who performed MELT. Using ultrasound imaging and an algorithm developed in MATLAB, thickness of thoracolumbar connective tissue was analyzed in 22 subjects. A hand-held digital palpation device, called the MyotonPRO, was used to assess biomechanical properties such as stiffness, elasticity, tone and mechanical stress relaxation time of the thoracolumbar myofascial tissue. A forward bending test assessing flexibility and pain scale was added to see if MELT affected subjects with chronic LBP. A significant decrease in connective tissue thickness and pain was observed in participants. Significant increase in flexibility was also recorded. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-26

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

  17. Location of Vertebral Fractures is Associated with Bone Mineral Density and History of Traumatic Injury.

    Science.gov (United States)

    Watt, Jennifer; Crilly, Richard

    2017-04-01

    The upper and lower thoracolumbar spine have been associated with different biomechanical outcomes. This concept, as it applies to osteoporotic fracture risk, has not been well documented. This was a case-control study of 120 patients seen in an osteoporosis clinic. Vertebral fractures were identified from lateral radiographs using Genant's semi-quantitative assessment method. An association between bone mineral density (BMD) T-scores and vertebral fracture location was assessed. In an additional analysis, the association between a history of any traumatic injury and possible predictor variables was also explored. The median age of patients was 75 (IQR 67-80), and 84.2% of patients were female. A history of trauma was reported by 46.7% of patients. A vertebral fracture in the lower thoracolumbar spine (T11-L4) was associated with significantly higher femoral neck (p trochanteric (p = 0.002), intertrochanteric (p fractures in the lower thoracolumbar spine. A fracture in the upper thoracolumbar spine (T4-T10) decreased the odds of having a history of traumatic injury (OR 0.32, 95% CI 0.14-0.76, p = 0.01), while a non-vertebral fracture increased the odds of such an injury (OR 2.41, 95% CI 1.10-5.32, p = 0.03). Vertebral fractures in the lower thoracolumbar spine are associated with higher BMD T-scores. This should be studied further to understand possible correlations with patients' future fracture risk.

  18. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

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

    2002-01-01

    of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly....... No gender-related differences were found in any of the relationships. Neither static histomorphometry nor biomechanical testing of iliac crest bone biopsies is a good predictor of vertebral bone strength.......The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...

  19. Spondylectomy and lateral lumbar interbody fusion for thoracolumbar kyphosis in an adult with achondroplasia: A case report.

    Science.gov (United States)

    Miyazaki, Masashi; Kanezaki, Shozo; Notani, Naoki; Ishihara, Toshinobu; Tsumura, Hiroshi

    2017-12-01

    Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication. Plain radiographs revealed a high-grade thoracolumbar kyphotic deformity with diffuse degenerative changes in the lumbar spine. The apex was located at L2, the local kyphotic angle from L1 to L3 was 105°, and the anterior area was fused from the L1 to L3 vertebrae. MRI revealed significant canal and lateral recess stenosis secondary to facet hypertrophy. We planned a front-back correction of the anterior and posterior spinal elements. We first performed anterior release at the fused part from L1 to L3 and XLIF at L3/4 and L4/5. Next, the patient was placed in the prone position. Spondylectomy at the L2 vertebra and posterior fusion from T10 to L5 were performed. Postoperative radiographs revealed L1 to L3 kyphosis of 32°. No complications occurred during or after surgery. Postoperatively, the patient's low back pain and neurological claudication were resolved. No worsening of kyphosis was observed 24 months postoperatively. Circumferential decompression of the spinal cord at the apical vertebral level and decompression of lumbar canal stenosis were necessary. Front-back correction of the anterior and posterior spinal elements via spondylectomy and lateral lumbar interbody fusion is a reasonable surgical option for thoracolumbar kyphosis and developmental canal stenosis in patients with achondroplasia.

  20. Acrylic kyphoplasty in recent nonosteoporotic fractures of the thoracolumbar junction: a prospective clinical and 3D radiologic study of 54 patients.

    Science.gov (United States)

    Saget, Mathieu; Teyssedou, Simon; Prebet, Remi; Vendeuvre, Tanguy; Gayet, Louis-Etienne; Pries, Pierre

    2014-08-01

    Prospective clinical and radiological study. To evaluate the impact of stand-alone acrylic kyphoplasty in the treatment of recent traumatic fractures of the thoracolumbar spine in young patients. The management of fractures of the thoracolumbar spine without neurological deficit remains controversial. For a long time clinicians could only chose between functional treatment, orthopedic treatment, and traditional surgery. The recent advent of minimally invasive surgical techniques is an interesting alternative. Fifty-four patients with a mean age of 45.8±18.2 years and who had recently sustained a fracture of the thoracolumbar junction were enrolled into the study. Balloon kyphoplasty was performed using acrylic cement. Radiologic assessments (computed tomography scans) and clinical assessments (including Visual Analog Scale and Oswestry Disability Index scores) were used to determine kyphoplasty success and measure patient recovery over 2 years. Kyphoplasty reduced mean vertebral kyphosis from 12.8±5.0 degrees at trauma to 8.2±5.1 degrees at 2-year follow-up. Mean vertebral kyphosis was corrected by -5.7±4.7 degrees (P=0.0001) at the point of first verticalization, with no significant change at the 2-year follow-up visit (+1.1±4.3 degrees, P=0.1058). Kyphoplasty significantly augmented the height of the 6 anterior and intermediate segments. Maximum mean augmentation of intermediate vertebral height after 6 months was (11.6%±15.5%, P<0.0001). Patients tolerated the procedure well and 56% of them returned to work 3 months after kyphoplasty. Kyphoplasty is safe and effective in the correction of nonosteoporotic fractures of the thoracolumbar junction in young patients, and remains stable for at least 2 years postsurgery.

  1. CT diagnosis in the evaluation of vertebral trauma

    International Nuclear Information System (INIS)

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

    1984-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yihui Shi

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

  3. Spreading epidural hematoma and deep subcutaneous edema: indirect MRI signs of posterior ligamentous complex injury in thoracolumbar burst fractures

    International Nuclear Information System (INIS)

    Kim, Na Ra; Hong, Sung Hwan; Choi, Ja-Young; Myung, Jae Sung; Chang, Bong-Soon; Lee, Joon Woo; Kang, Heung Sik; Moon, Sung Gyu

    2010-01-01

    The purpose of this study was to evaluate the diagnostic value of a spreading epidural hematoma (SEH) and deep subcutaneous edema (DSE) as indirect signs of posterior ligamentous complex (PLC) injuries on MR imaging of thoracolumbar burst fractures. We retrospectively reviewed spinal MR images of 43 patients with thoracolumbar burst fractures: 17 patients with PLC injuries (study group) and 26 without PLC injuries (control group). An SEH was defined as a hemorrhagic infiltration into the anterior or posterior epidural space that spread along more than three vertebrae including the level of the fracture. A DSE was regarded as a fluid-like signal lesion in the deep subcutaneous layer of the back, and its epicenter was at the burst fracture level. The frequency of the SEH/DSE in the two groups was analyzed. In addition, the association between each sign and the degree of vertebral collapse, the severity of central canal compromise, and surgical decisions were analyzed. Magnetic resonance images showed an SEH in 20 out of 43 patients (46%) and a DSE in 17 (40%). The SEH and DSE were more commonly seen in the study group with PLC injuries (SEH, 15 out of 17 patients, 80%; DSE, 16 out of 17 patients, 94%) than in the control group without PLC injuries (SEH, 5 out of 26, 19%; DSE, 1 out of 26, 4%) (P <0.0001). The SEH and DSE were significantly associated with surgical management decisions (17 out of 20 patients with SEH, 85%, vs 8 out of the 23 without SEH, 35%, P =0.002; 15 out of 17 with DSE, 88%, vs 10 out of 26 without DSE, 38%, P =0.002). The SEH and DSE did not correlate with the degree of vertebral collapse or the severity of central canal compromise. The SEH and DSE may be useful secondary MR signs of posterior ligamentous complex injury in thoracolumbar burst fractures. (orig.)

  4. 78 FR 36308 - Proposed Information Collection: (Back (Thoracolumbar Spine) Conditions Disability Benefits...

    Science.gov (United States)

    2013-06-17

    ...-NEW (Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire). Type of Review: New... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... comments on information needed to adjudicate the claim for VA disability benefits related to a claimant's...

  5. Congenital abnormalities of the vertebral column in ferrets.

    Science.gov (United States)

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

    2015-01-01

    Vertebral column pathologies requiring surgical intervention have been described in pet ferrets, however little information is available on the normal vertebral formula and congenital variants in this species. The purpose of this retrospective study was to describe vertebral formulas and prevalence of congenital vertebral anomalies in a sample of pet ferrets. Radiographs of 172 pet ferrets (96 males and 76 females) were included in this retrospective study. In 143 ferrets (83.14%), five different formulas of the vertebral column were recorded with normal morphology of vertebrae (rib attachment included) but with a variable number of thoracic (Th), lumbar (L), and sacral (S) vertebrae. The number of cervical (C) vertebrae was constant in all examined animals. Observed vertebral formulas were C7/Th14/L6/S3 (51.74%), C7/Th14/L6/S4 (22.10%), C7/Th14/L7/S3 (6.98%), C7/Th15/L6/S3 (1.74%), and C7/Th15/L6/S4 (0.58%). Formula C7/Th14/L6/S4 was significantly more common in males than in females (P < 0.05). Congenital spinal abnormalities were found in 29 ferrets (16.86%), mostly localized in the thoracolumbar and lumbosacral regions. The cervical region was affected in only one case. Transitional vertebrae represented the most common congenital abnormalities (26 ferrets) in the thoracolumbar (13 ferrets) and lumbosacral regions (10 ferrets) or simultaneously in both regions (three ferrets). Other vertebral anomalies included block (two ferrets) and wedge vertebra (one ferret). Spina bifida was not detected. Findings from the current study indicated that vertebral formulas may vary in ferrets and congenital abnormalities are common. This should be taken into consideration for surgical planning. © 2014 American College of Veterinary Radiology.

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

    Science.gov (United States)

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

    2001-10-01

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

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

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    Christopher M Dalton

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

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

    International Nuclear Information System (INIS)

    Sizov, V.A.

    1988-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Science.gov (United States)

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

    2013-08-15

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

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

    International Nuclear Information System (INIS)

    Meng Quanfei; Jiang Bo; Chen Yingming; Zhang Chaohui

    2000-01-01

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

  13. Quantitative morphologic assessment of thoracolumbar vertebrae in Korean women by morphometric x-ray absorptiometry

    International Nuclear Information System (INIS)

    Cheon, Bong Jin; Huh, Jin Do; Kim, Sung Min; Oh, Kyong Seung; Kim, Jong Min; Jung, Gyoo Sik; Joh, Young Duk

    1999-01-01

    To compare the accuracy of lateral radiography of the spine with that of morphometric X-ray absorptiometry(MXA) in vertebral morphometry, and to evaluate normal vertebral morphometry using MXA in Korean women. A spine phantom was constructed using copper pipe. Its anterior and posterior heights were measured directly, with lateral radiographs and with MXA, and the values thus obtained were compared. Inter- and intra-observer variations were evaluated by three radiologists. The vertebral morphometry of 30 young women volunteers were imaged using thoracic and lumbar lateral radiographs and MXA, and analysis included the measurement of anterior and posterior heights from T4 to L4. We also obtained the vertebral morphometry of 200 normal Korean women who underwent MXA between March 1995 and February 1996, though those with osteoporosis and other spinal lesions were excluded from this study. Thoracolumbar vertebral indexes were statistically correlated with age, height and bone mineral density. There were no statistically significant differences in the heights of spine phantom measured by MXA compared with actual size (mean difference=0.28mm). Simple radiographs were magnified by 23.7% at a phantom-table distance of 15cm, and distortion ranged from 0.5% to 22.5%, depending on phantom level and phantom-table distance. In the study of volunteers, the magnification rate between a simple radiograph and MXA was about 26.6%. Anterior height increased progressively from the thoracic to the lumbar spine, though posterior height peaked at L2, and L4 was less than anterior height. In Korean women, indices of vertebral morphometry decreased significantly with aging, with the most prominent decrease occurring during the seventh decade. The mineral density of spinal bone decreased markedly after the sixth decade. Radiographs showed more magnification and distortion than did MXA, though between morphometric X-ray absorptiometry (MXA) and actual size, there was no significant

  14. Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture

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    WU Han

    2013-02-01

    Full Text Available 【Abstract】Objective: The main treatment method used for thoracolumbar fractures is open reduction and in-ternal fixation. Commonly there are three surgical approaches: anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis. Methods: A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterior- or paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach (24 patients, screw and rod system via posterior approach (38 patients or paraspinal approach (32 patients. Clinical evaluations included operation duration, blood loss, inci-sion length, preoperative and postoperative Oswestry dis-ability index (ODI. Results: The average operation duration (94.1 min±13.7 min, blood loss (86.7 ml±20.0 ml, length of incision (9.3 mm± 0.7 mm and postoperative ODI (6±0.5 were signifi-cantly lower (P<0.05 in paraspinal approach group than in traditional posterior approach group (operation duration 94.1 min±13.7 min, blood loss 143.3 ml±28.3 ml, length of incision 15.4 cm±2.1 cm and ODI 12±0.7 and anterior approach group (operation duration 176.3 min±20.7 min, blood loss 255.1 ml±38.4 ml, length of incision 18.6 cm±2.4 cm and ODI 13±2.4. There was not statistical difference in terms of Cobb angle on radiographs among the three approaches. Conclusion: The anterior approach surgery is conve-nient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thora-columbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages

  15. [Comparison of effectiveness between two surgical methods in treatment of thoracolumbar brucella spondylitis].

    Science.gov (United States)

    Yang, Xinming; Zuo, Xianhong; Jia, Yongli; Chang, Yuefei; Zhang, Peng; Ren, Yixing

    2014-10-01

    To compare the effectiveness between the method of simple posterior debridement combined with bone grafting and fusion and internal fixation and the method of one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in the treatment of thoracolumbar brucella spondylitis so as to provide the reference for the clinical treatment. A retrospective analysis was made on the clinical data of 148 cases of thoracolumbar brucella spondylitis between January 2002 and January 2012. Simple posterior debridement combined with bone grafting and fusion and internal fixation was used in 78 cases (group A), and one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in 70 cases (group B). There was no significant difference in gender, age, disease duration, involved vertebral segments, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) score, neural function grade of America Spinal Injury Association (ASIA), and kyphosis Cobb angle before operation between 2 groups (P > 0.05). The peri operation period indexes (hospitalization time, operation time, and intraoperative blood loss) and the clinical effectiveness indexes (VAS score, ASIA grade, Cobb angle, and ESR) were compared; the bone fusion and the internal fixation were observed. Incision infection and paravertebral and/or psoas abscess occurred in 2 and 3 cases of group A respectively. All incisions healed by first intention and 2 cases had pneumothorax in group B. The operation time and the hospitalization time of group A were significantly shorter than those of group B (P average. The VAS, ESR, and Cobb angle were significantly decreased at each time point after operation when compared with preoperative ones in 2 groups (P 0.05). The neurological function was significantly improved at 3 months after operation; there were 1 case of ASIA grade C, 14 cases of grade D, and 63 cases of grade E in group A, and

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

    International Nuclear Information System (INIS)

    Shen Yu; Shen Huiliang; Fang Xiutong; Zhang Wenbo

    2012-01-01

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

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

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

    2016-01-01

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

  18. Evaluation of the Results of Posterior Decompression, Corpectomy and Instrumentation in Traumatic Unstable Thoraco-Lumbar Burst Fractures

    Directory of Open Access Journals (Sweden)

    Md. Anowarul Islam

    2012-06-01

    Full Text Available Background: Thoraco-lumbar burst fractures occur as a result of axial load which often causes displacement of the middle column into the vertebral canal. Posterior surgery reduces the morbid outcomes of different other approaches. Objective: To evaluate the clinical and radiological success of posterior corpectomy and instrumentation in the management of traumatic unstable thoraco-lumbar burst fractures. Methods: It is a prospective interventional study carried out in Bangabandhu Sheikh Mujib Medical University and different private hospitals in Dhaka from July 2008 to December 2011. Total 18 patients; 13 male and 05 female within an age range of 21-40 years were selected. Total 09 cases involved L1, 05 cases at D12, 02 cases at D11 and at L2 each. Neurological status was assessed by Frankel‘s grading and pain status by Visual Analogue Score (VAS. Paired t-test was used for statistical analysis. Results: All the patients were followed up for minimum 1 year. Eleven out of 12 patients with Frankel grade-B and 04 patients out of 06 with Frankel grade-C recovered fully and could walk without support (p<0.05. Overall 03 patients ended with some degrees of persistant neurological deficit. The mean postoperative pain improvement and kyphotic angle correction was significant  (p<0.05. Conclusion: Decompression through posterior approach by laminectomy, corpectomy and fusion by cage with bone graft and stabilization by pedicle screw and rod significantly improves the clinical and radiological outcome in management of traumatic unstable thoraco-lumbar burst fractures.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10998 BSMMU J 2012; 5(1:35-41 

  19. Rapid onset aggressive vertebral haemangioma.

    Science.gov (United States)

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

    2011-03-01

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

  20. MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Kurugoglu, Sebuh; Kanberoglu, Kaya; Mihmanli, Ismail; Cokyuksel, Oktay [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University (Turkey); Kanberoglu, Ayfer [Department of Physical Medicine, SSK Istanbul Hospital, Istanbul (Turkey)

    2002-03-01

    Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

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

    Science.gov (United States)

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

    2018-03-01

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

  2. Rehabilitation of children at the inpatient stage after surgical treatment of unstable fractures of the thoracolumbar and lumbar spine

    Directory of Open Access Journals (Sweden)

    Alla V. Ovechkina

    2017-12-01

    Full Text Available Introduction. The modern approach to the treatment of unstable fractures of the thoracolumbar and lumbar spine in children is surgical stabilization at the early stages after trauma by using metal structures that quickly restore vertical functionality to the patient and shorten the period of inpatient treatment. However, the issues related to restorative treatment have not been sufficiently addressed. Aim. To develop an algorithm for restorative treatment of children at the inpatient stage after surgical treatment of unstable uncomplicated fractures of the thoracolumbar and lumbar spine. Material and methods. Based on the results of treatment of 73 patients aged 9 to 17 years with unstable uncomplicated vertebral fractures, an algorithm of stage-by-stage rehabilitation by means of therapeutic gymnastics depending on the severity of the injury, method of surgical stabilization of the spine, physical condition of the child, and time passed after the operation was developed. Results and discussion. The use of differentiated groups of respiratory gymnastics and isometric and dynamic exercises for muscle groups restored vertical functionality to patients in 1–3 days after surgery, restored spine and motor functions, and shortened the duration of inpatient treatment to a range of 10–14 days. Conclusion. The developed algorithm for physical rehabilitation of children after surgical treatment of unstable injuries of the thoracic and lumbar spine by using metal structures at the inpatient stage contributed to the selection of the most rational and effective program of restorative treatment.

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

    Directory of Open Access Journals (Sweden)

    A. N. Shkarubo

    2010-01-01

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

  4. Instability in Thoracolumbar Trauma: Is a New Definition Warranted?

    Science.gov (United States)

    Abbasi Fard, Salman; Skoch, Jesse; Avila, Mauricio J; Patel, Apar S; Sattarov, Kamran V; Walter, Christina M; Baaj, Ali A

    2017-10-01

    Review of the articles. The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries. Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society. The determination of spinal instability is an important task for spine surgeons, as treatment strategies rely heavily on this assessment. However, a clinically applicable definition of spinal stability remains elusive. A review of the Medline database between 1930 and 2014 was performed limited to papers in English. Spinal instability, thoracolumbar, and spinal stability were used as search terms. Case reports were excluded. We reviewed listed references from pertinent search results and located relevant manuscripts from these lists as well. The search produced a total of 694 published articles. Twenty-five articles were eligible after abstract screening and underwent full review. A definition for spinal instability was described in only 4 of them. Definitions were primarily based on biomechanical and classification studies. No definitive parameters were outlined to define stability. Thirty-six years after White and Panjabi's original definition of instability, and many classification schemes later, there remains no practical and meaningful definition for spinal instability in thoracolumbar trauma. Surgeon expertise and experience remains an important factor in stability determination. We propose that, at an initial assessment, a distinction should be made between immediate and delayed instability. This designation should better guide surgeons in decision making and patient counseling.

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  7. Which is the ideal point of time to perform intraoperative 3D imaging in dorsal stabilisation of thoracolumbar spine fractures? A matched pair analysis.

    Science.gov (United States)

    Beck, M; Mittlmeier, T; Gierer, P; Rotter, R; Harms, C; Gradl, G

    2010-10-01

    After dorsal stabilisation of vertebral fractures by an internal fixateur the postoperative computed tomography is a standard procedure to control the positions of the pedicle screws, the success of the reposition, the clearance of the spinal canal and to plane an additive secondary ventral stabilisation. An intraoperative scan with a 3D image intensifier may clarify these questions directly after the implantation with the possibility of an immediate correction of the implants. The aim of this study was to find out the optimal point of time to perform an intraoperative 3D scan and if a postoperative computed tomography is dispensable. Intraoperative 3D scans were carried out on 33 patients with thoracolumbar spine fractures (T11-L5) after bi-segmental fixateur interne montage (Group 1). A matched pair group of 33 patients (Group 2) with a 3D scan after implantation of pedicle screws was built. A postoperative computed tomography of the instrumented spinal section was done in all patients. The following measurements were done in sagittal and axial reconstruction planes and were compared: classification of screw positions, maximal axial diameter of pedicles, cortical perforation of the screws. Additionally in Group 1 the distance between the upper and lower end plates of the injured section, the height of posterior vertebral body wall, the dislocation of the posterior wall and the minimal diameter of the spinal canal were measured. The intraoperative scoring of pedicle screws positions and the measurement of pedicle width showed in both groups a significant accordance with the computed tomography determinations. The measurements "posterior wall dislocation" and "diameter of spinal canal" were only possible in 24 3D scans and showed a significant difference compared with the CT data. The picture quality in Group 2 was scored significantly better than for Group 1 with the complete assembly of the fixateur. The ideal point of time for an intraoperative 3D imaging with

  8. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  9. Thoracolumbar spine model with articulated ribcage for the prediction of dynamic spinal loading.

    Science.gov (United States)

    Ignasiak, Dominika; Dendorfer, Sebastian; Ferguson, Stephen J

    2016-04-11

    Musculoskeletal modeling offers an invaluable insight into the spine biomechanics. A better understanding of thoracic spine kinetics is essential for understanding disease processes and developing new prevention and treatment methods. Current models of the thoracic region are not designed for segmental load estimation, or do not include the complex construct of the ribcage, despite its potentially important role in load transmission. In this paper, we describe a numerical musculoskeletal model of the thoracolumbar spine with articulated ribcage, modeled as a system of individual vertebral segments, elastic elements and thoracic muscles, based on a previously established lumbar spine model and data from the literature. The inverse dynamics simulations of the model allow the prediction of spinal loading as well as costal joints kinetics and kinematics. The intradiscal pressure predicted by the model correlated well (R(2)=0.89) with reported intradiscal pressure measurements, providing a first validation of the model. The inclusion of the ribcage did not affect segmental force predictions when the thoracic spine did not perform motion. During thoracic motion tasks, the ribcage had an important influence on the predicted compressive forces and muscle activation patterns. The compressive forces were reduced by up to 32%, or distributed more evenly between thoracic vertebrae, when compared to the predictions of the model without ribcage, for mild thoracic flexion and hyperextension tasks, respectively. The presented musculoskeletal model provides a tool for investigating thoracic spine loading and load sharing between vertebral column and ribcage during dynamic activities. Further validation for specific applications is still necessary. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Wang, Hui; Ding, Wenyuan

    2018-01-01

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

  11. Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study.

    Science.gov (United States)

    Kaul, Rahul; Chhabra, Harvinder Singh; Vaccaro, Alexander R; Abel, Rainer; Tuli, Sagun; Shetty, Ajoy Prasad; Das, Kali Dutta; Mohapatra, Bibhudendu; Nanda, Ankur; Sangondimath, Gururaj M; Bansal, Murari Lal; Patel, Nishit

    2017-05-01

    The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries. Clinical and radiological data of 50 consecutive patients admitted at a single centre with a diagnosis of an acute traumatic thoracolumbar spine injury were distributed to eleven attending spine surgeons from six different institutions in the form of PowerPoint presentation, who classified them according to both classifications. After time span of 6 weeks, cases were randomly rearranged and sent again to same surgeons for re-classification. Interobserver and intraobserver reliability for each component of TLICS and new AOSpine classification were evaluated using Fleiss Kappa coefficient (k value) and Spearman rank order correlation. Moderate interrater and intrarater reliability was seen for grading fracture type and integrity of posterior ligamentous complex (Fracture type: k = 0.43 ± 0.01 and 0.59 ± 0.16, respectively, PLC: k = 0.47 ± 0.01 and 0.55 ± 0.15, respectively), and fair to moderate reliability (k = 0.29 ± 0.01 interobserver and 0.44+/0.10 intraobserver, respectively) for total score according to TLICS. Moderate interrater (k = 0.59 ± 0.01) and substantial intrarater reliability (k = 0.68 ± 0.13) was seen for grading fracture type regardless of subtype according to AOSpine classification. Near perfect interrater and intrarater agreement was seen concerning neurological status for both the classification systems. Recently proposed AOSpine classification has better reliability for identifying fracture morphology than the existing TLICS. Additional studies are clearly necessary concerning the application of these classification systems across multiple physicians at different level of training and trauma centers to evaluate not

  12. Imaging of vertebral fracture in osteoporosis

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

    The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10weeks of

  14. The increased prevalence of cervical spondylosis in patients with adult thoracolumbar spinal deformity.

    Science.gov (United States)

    Schairer, William W; Carrer, Alexandra; Lu, Michael; Hu, Serena S

    2014-12-01

    Retrospective cohort study. To assess the concomitance of cervical spondylosis and thoracolumbar spinal deformity. Patients with degenerative cervical spine disease have higher rates of degeneration in the lumbar spine. In addition, degenerative cervical spine changes have been observed in adult patients with thoracolumbar spinal deformities. However, to the best of our knowledge, there have been no studies quantifying the association between cervical spondylosis and thoracolumbar spinal deformity in adult patients. Patients seen by a spine surgeon or spine specialist at a single institution were assessed for cervical spondylosis and/or thoracolumbar spinal deformity using an administrative claims database. Spinal radiographic utilization and surgical intervention were used to infer severity of spinal disease. The relative prevalence of each spinal diagnosis was assessed in patients with and without the other diagnosis. A total of 47,560 patients were included in this study. Cervical spondylosis occurred in 13.1% overall, but was found in 31.0% of patients with thoracolumbar spinal deformity (OR=3.27, Pspondylosis (OR=3.26, Pspondylosis or thoracolumbar spinal deformity had significantly higher rates of the other spinal diagnosis. This correlation was increased with increased severity of disease. Patients with both diagnoses were significantly more likely to have received a spine fusion. Further research is warranted to establish the cause of this correlation. Clinicians should use this information to both screen and counsel patients who present for cervical spondylosis or thoracolumbar spinal deformity.

  15. Whole-body low-dose computed tomography in multiple myeloma staging: Superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extraskeletal findings compared to radiography with similar radiation exposure.

    Science.gov (United States)

    Lambert, Lukas; Ourednicek, Petr; Meckova, Zuzana; Gavelli, Giampaolo; Straub, Jan; Spicka, Ivan

    2017-04-01

    The primary objective of the present prospective study was to compare the diagnostic performance of conventional radiography (CR) and whole-body low-dose computed tomography (WBLDCT) with a comparable radiation dose reconstructed using hybrid iterative reconstruction technique, in terms of the detection of bone lesions, skeletal fractures, vertebral compressions and extraskeletal findings. The secondary objective was to evaluate lesion attenuation in relation to its size. A total of 74 patients underwent same-day skeletal survey by CR and WBLDCT. In CR and WBLDCT, two readers assessed the number of osteolytic lesions at each region and stage according to the International Myeloma Working Group (IMWG) criteria. A single reader additionally assessed extraskeletal findings and their significance, the number of vertebral compressions and bone fractures. The radiation exposure was 2.7±0.9 mSv for WBLDCT and 2.5±0.9 mSv for CR (P=0.054). CR detected bone involvement in 127 out of 486 regions (26%; Prib fractures compared with CR (188 vs. 47; Pfractures, vertebral compressions and extraskeletal findings, which results in up- or downstaging in 24% patients according to the IMWG criteria. The attenuation of osteolytic lesions can be measured with the avoidance of the partial volume effect.

  16. Varied overstrain injuries of the vertebral column conditioned by evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W

    1983-08-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components.

  17. Varied overstrain injuries of the vertebral column conditioned by evolution

    International Nuclear Information System (INIS)

    Kohlbach, W.

    1983-01-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components. (orig.) [de

  18. Varied overstrain injuries of the vertebral column conditioned by evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbach, W.

    1983-08-01

    During physiological growth of the juvenile vertebral column, various stages of stability occur which are characterized by the condition of the marginal rim of the vertebral bodies. If the vertebral juvenile column is overstrained, these variations in stability results in a variety of damage to vertebral bodies and vertebral disks. One of these lesions corresponds to Scheuermann's disease (osteochondrosis of vertebral epiphyses in juveniles). Damage of the vertebral column due to overstrain can occur only if the overstrain is applied in upright position. Since Man alone can damage his vertebral column in upright position (as a result of his evolutionary development), Scheuermann's thesis is confirmed that Scheuermann's disease is confined to Man. Spondylolysis/spondylolisthesis is also a damage caused by overstrain. Here, too, the damage can occur only if the load is exercised in upright position, with the exception of a slanted positioning of the intervertebral components.

  19. First performance evaluation of software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine at CT.

    Science.gov (United States)

    Scholtz, Jan-Erik; Wichmann, Julian L; Kaup, Moritz; Fischer, Sebastian; Kerl, J Matthias; Lehnert, Thomas; Vogl, Thomas J; Bauer, Ralf W

    2015-03-01

    To evaluate software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine on CT in terms of accuracy, potential for time savings and workflow improvement. 77 patients (28 women, 49 men, mean age 65.3±14.4 years) with known or suspected spinal disorders (degenerative spine disease n=32; disc herniation n=36; traumatic vertebral fractures n=9) underwent 64-slice MDCT with thin-slab reconstruction. Time for automatic labeling of the thoracolumbar spine and reconstruction of double-angulated axial images of the pathological vertebrae was compared with manually performed reconstruction of anatomical aligned axial images. Reformatted images of both reconstruction methods were assessed by two observers regarding accuracy of symmetric depiction of anatomical structures. In 33 cases double-angulated axial images were created in 1 vertebra, in 28 cases in 2 vertebrae and in 16 cases in 3 vertebrae. Correct automatic labeling was achieved in 72 of 77 patients (93.5%). Errors could be manually corrected in 4 cases. Automatic labeling required 1min in average. In cases where anatomical aligned axial images of 1 vertebra were created, reconstructions made by hand were significantly faster (pquality with excellent inter-observer agreement. The evaluated software for automatic labeling and anatomically aligned, double-angulated axial image reconstruction of the thoracolumbar spine on CT is time-saving when reconstructions of 2 and more vertebrae are performed. Checking results of automatic labeling is necessary to prevent errors in labeling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Stature estimation based on vertebral morphometry by dual energy X-rays absorptiometry imaging in Italian females

    Directory of Open Access Journals (Sweden)

    Chantal Milani

    2017-02-01

    Full Text Available Anthropological profile in forensic context includes the assessment of parameters as ancestry, sex, age and stature of an individual by the analysis of skeletal remains. Stature can be estimated from decomposed and fully or partially skeletonized remains by means of anatomical or mathematical methods applied on the whole skeleton or single bones. Many authors calculated regression formulae for the living stature estimation by these methods, in particular based on a population similar to the remains recovered. Long bones are commonly used for stature estimation, but, when they are missing, methods involving different parts of the skeleton are needed. In this preliminary study we measured heights of the vertebral bodies in a female Caucasian Italian population, evaluated by images of morphometric X-ray absorptiometry based on dual-energy X-ray absorptiometry in living subjects investigated for routine diagnostic purposes. Thoracic and lumbar segments of the spine were measured and statistical analysis was performed, thus obtaining regression formulae for estimated living stature from thoraco-lumbar spine segments (T6-T12, L1-L4 and T6-L4. We propose this method for stature evaluation in physical or forensic anthropology when the spine is available and long bones are missing.

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

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Fonseca Damasceno

    2006-01-01

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

  2. MR imaging of tuberculous vertebral osteomyelitis: pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Gouliamos, A.D.; Kehagias, D.T.; Lahanis, S.; Moulopoulou, E.S.; Kalovidouris, A.A.; Trakadas, S.J.; Vlahos, L.j. [Dept. of Radiology, University of Athens (Greece); Athanassopoulou, A.A. [Dept. of Radiology, Asklipiion Hospital, Athens (Greece)

    2001-04-01

    Vertebral osteomyelitis is one of the most common manifestations of tuberculosis. Magnetic resonance imaging is considered the main imaging modality for the diagnosis, the demonstration of the extent of the disease, and follow-up studies. Vertebral destruction involving two consecutive levels with sparing of the intervertebral disc, disc herniation into the vertebral body, epidural involvement, and paraspinal abscess are the most common MRI findings suggestive of tuberculous vertebral osteomyelitis. (orig.)

  3. V. Terrestrial vertebrates

    Science.gov (United States)

    Dean Pearson; Deborah Finch

    2011-01-01

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

  4. Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures.

    Science.gov (United States)

    Geith, Tobias; Schmidt, Gerwin; Biffar, Andreas; Dietrich, Olaf; Dürr, Hans Roland; Reiser, Maximilian; Baur-Melnyk, Andrea

    2012-11-01

    The objective of our study was to compare the diagnostic value of qualitative diffusion-weighted imaging (DWI), quantitative DWI, and chemical-shift imaging in a single prospective cohort of patients with acute osteoporotic and malignant vertebral fractures. The study group was composed of patients with 26 osteoporotic vertebral fractures (18 women, eight men; mean age, 69 years; age range, 31 years 6 months to 86 years 2 months) and 20 malignant vertebral fractures (nine women, 11 men; mean age, 63.4 years; age range, 24 years 8 months to 86 years 4 months). T1-weighted, STIR, and T2-weighted sequences were acquired at 1.5 T. A DW reverse fast imaging with steady-state free precession (PSIF) sequence at different delta values was evaluated qualitatively. A DW echo-planar imaging (EPI) sequence and a DW single-shot turbo spin-echo (TSE) sequence at different b values were evaluated qualitatively and quantitatively using the apparent diffusion coefficient. Opposed-phase sequences were used to assess signal intensity qualitatively. The signal loss between in- and opposed-phase images was determined quantitatively. Two-tailed Fisher exact test, Mann-Whitney test, and receiver operating characteristic analysis were performed. Sensitivities, specificities, and accuracies were determined. Qualitative DW-PSIF imaging (delta = 3 ms) showed the best performance for distinguishing between benign and malignant fractures (sensitivity, 100%; specificity, 88.5%; accuracy, 93.5%). Qualitative DW-EPI (b = 50 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.50]) and DW single-shot TSE imaging (b = 100 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.18]; b = 400 s/mm(2) [p = 0.18]; b = 600 s/mm(2) [p = 0.39]) did not indicate significant differences between benign and malignant fractures. DW-EPI using a b value of 500 s/mm(2) (p = 0.01) indicated significant differences between benign and malignant vertebral fractures. Quantitative DW-EPI (p = 0.09) and qualitative opposed-phase imaging (p = 0

  5. First performance evaluation of software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine at CT

    Energy Technology Data Exchange (ETDEWEB)

    Scholtz, Jan-Erik, E-mail: janerikscholtz@gmail.com; Wichmann, Julian L.; Kaup, Moritz; Fischer, Sebastian; Kerl, J. Matthias; Lehnert, Thomas; Vogl, Thomas J.; Bauer, Ralf W.

    2015-03-15

    Highlights: •Automatic segmentation and labeling of the thoracolumbar spine. •Automatically generated double-angulated and aligned axial images of spine segments. •High grade of accurateness for the symmetric depiction of anatomical structures. •Time-saving and may improve workflow in daily practice. -- Abstract: Objectives: To evaluate software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine on CT in terms of accuracy, potential for time savings and workflow improvement. Material and methods: 77 patients (28 women, 49 men, mean age 65.3 ± 14.4 years) with known or suspected spinal disorders (degenerative spine disease n = 32; disc herniation n = 36; traumatic vertebral fractures n = 9) underwent 64-slice MDCT with thin-slab reconstruction. Time for automatic labeling of the thoracolumbar spine and reconstruction of double-angulated axial images of the pathological vertebrae was compared with manually performed reconstruction of anatomical aligned axial images. Reformatted images of both reconstruction methods were assessed by two observers regarding accuracy of symmetric depiction of anatomical structures. Results: In 33 cases double-angulated axial images were created in 1 vertebra, in 28 cases in 2 vertebrae and in 16 cases in 3 vertebrae. Correct automatic labeling was achieved in 72 of 77 patients (93.5%). Errors could be manually corrected in 4 cases. Automatic labeling required 1 min in average. In cases where anatomical aligned axial images of 1 vertebra were created, reconstructions made by hand were significantly faster (p < 0.05). Automatic reconstruction was time-saving in cases of 2 and more vertebrae (p < 0.05). Both reconstruction methods revealed good image quality with excellent inter-observer agreement. Conclusion: The evaluated software for automatic labeling and anatomically aligned, double-angulated axial image reconstruction of the thoracolumbar spine on CT is time

  6. THORACOLUMBAR BURST FRACTURE: STRUCTURAL CHANGES AND CLINICAL OUTCOME OF TREATMENT

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2016-03-01

    Full Text Available ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05 between initial collapse and SF-36 domains in both groups (operated and non-operated. Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

  7. The radiological diagnosis of thoracolumbar disc disease in the Dachshund

    International Nuclear Information System (INIS)

    Kirberger, R.M.; Roos, C.J.; Lubbe, A.M.

    1992-01-01

    The accuracy of survey radiographs in the diagnosis of acute thoracolumbar disc disease in 36 Dachshunds was determined by comparison with lumbar myelographic findings using iohexol. The value of making radiographs immediately after injection of contrast medium and the effectiveness of oblique radiographs in determining the exact circumferential distribution of extruding or protruding disc material were assessed. The presence of a double contrast medium column, resistance to injection and the presence of cerebrospinal fluid flow during needle placement was also evaluated. The location of the affected disc was accurately determined on survey radiographs in only 26 dogs. The myelographic technique used in this study resulted in the correct intervertebral space being identified, together with the exact circumferential distribution of disc material, in 35 dogs. Survey radiographs alone are inadequate for localization of protruding or extruding disc material

  8. Preliminary clinical research of vertebral body stenting combined with absorbable bone cements for osteoporotic vertebral compression fractures%椎体支架联合可吸收骨水泥治疗骨质疏松性椎体压缩骨折的临床疗效

    Institute of Scientific and Technical Information of China (English)

    贾崇哲; 贾璞; 陈浩; 包利; 冯飞; 刘青山; 杨阳; 唐海

    2016-01-01

    目的 分析经皮椎体后凸成形术(PKP)中运用椎体支架联合可吸收骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果. 方法 前瞻性研究2014年1月-2016年1月应用椎体支架联合可吸收骨水泥治疗OVCF患者.比较术前、术后3d、3、6个月视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体高度恢复情况、椎体后凸Cobb角的变化及其并发症.结果 共纳入15例患者,其中男8例,女7例;年龄51~83岁,平均68.6岁,均完成6个月随访.所有患者均顺利完成手术,无术中、术后并发症发生.VAS评分由术前(7.67±0.62)分改善至术后3d的(2.60 ±0.63)分,术后3个月的(2.00 ±0.65)分,术后6个月的(1.26±0.80)分;ODI由术前(55.62±6.14)%改善至术后3d的(30.84±2.70)%,术后3个月的(21.88±2.42)%,术后6个月的(17.07±2.82)%.术后3d、3个月、6个月与术前比较,VAS评分和ODI显著降低(P均<0.05).椎体前缘高度由术前(2.50 ±0.48) cm恢复为术后3d的(2.59 ±0.49)cm,术后6个月的(2.60±0.50)cm.椎体中部高度由术前(2.27 ±0.38)cm恢复为术后3d的(2.33±0.38) cm,术后6个月的(2.35±0.38) cm.椎体后缘高度由术前(3.09±0.48)cm恢复为术后3d的(3.14±0.46)cm,术后6个月的(3.18±0.50) cm.术后椎体前缘、中部高度较术前均有所恢复(P<0.05),且高度在3d、6个月时丢失不明显(P>0.05);术后椎体后缘高度较术前恢复不明显(P>0.05).Cobb角术前为(8.93±6.58).,恢复为术后3d的(8.03±6.02)°,术后3个月的(8.06±6.08).,术后6个月的(7.93±6.09).,术后Cobb角较术前有所改善(P均<0.05),且随访期间Cobb角变化不明显(P>0.05). 结论 PKP术中椎体支架联合可吸收骨水泥治疗OVCF可改善和维持椎体前缘、中部高度及Cobb角,早期随访效果满意.%Objective To observe the clinical effect and safety of using vertebral body stenting combined with absorbable bone cements during percutaneous kyphoplasty (PKP) for osteoporotic

  9. Vertebrate Embryonic Cleavage Pattern Determination.

    Science.gov (United States)

    Hasley, Andrew; Chavez, Shawn; Danilchik, Michael; Wühr, Martin; Pelegri, Francisco

    2017-01-01

    The pattern of the earliest cell divisions in a vertebrate embryo lays the groundwork for later developmental events such as gastrulation, organogenesis, and overall body plan establishment. Understanding these early cleavage patterns and the mechanisms that create them is thus crucial for the study of vertebrate development. This chapter describes the early cleavage stages for species representing ray-finned fish, amphibians, birds, reptiles, mammals, and proto-vertebrate ascidians and summarizes current understanding of the mechanisms that govern these patterns. The nearly universal influence of cell shape on orientation and positioning of spindles and cleavage furrows and the mechanisms that mediate this influence are discussed. We discuss in particular models of aster and spindle centering and orientation in large embryonic blastomeres that rely on asymmetric internal pulling forces generated by the cleavage furrow for the previous cell cycle. Also explored are mechanisms that integrate cell division given the limited supply of cellular building blocks in the egg and several-fold changes of cell size during early development, as well as cytoskeletal specializations specific to early blastomeres including processes leading to blastomere cohesion. Finally, we discuss evolutionary conclusions beginning to emerge from the contemporary analysis of the phylogenetic distributions of cleavage patterns. In sum, this chapter seeks to summarize our current understanding of vertebrate early embryonic cleavage patterns and their control and evolution.

  10. Physiological Background of Differences in Quantitative Diffusion-Weighted Magnetic Resonance Imaging Between Acute Malignant and Benign Vertebral Body Fractures: Correlation of Apparent Diffusion Coefficient With Quantitative Perfusion Magnetic Resonance Imaging Using the 2-Compartment Exchange Model.

    Science.gov (United States)

    Geith, Tobias; Biffar, Andreas; Schmidt, Gerwin; Sourbron, Steven; Dietrich, Olaf; Reiser, Maximilian; Baur-Melnyk, Andrea

    2015-01-01

    To test the hypothesis that apparent diffusion coefficient (ADC) in vertebral bone marrow of benign and malignant fractures is related to the volume of the interstitial space, determined with dynamic contrast-enhanced (DCE) magnetic resonance imaging. Patients with acute benign (n = 24) and malignant (n = 19) vertebral body fractures were examined at 1.5 T. A diffusion-weighted single-shot turbo-spin-echo sequence (b = 100 to 600 s/mm) and DCE turbo-FLASH sequence were evaluated. Regions of interest were manually selected for each fracture. Apparent diffusion coefficient was determined with a monoexponential decay model. The DCE magnetic resonance imaging concentration-time curves were analyzed using a 2-compartment tracer-kinetic model. Apparent diffusion coefficient showed a significant positive correlation with interstitial volume in the whole study population (Pearson r = 0.66, P correlation between ADC and the permeability-surface area product could be observed when analyzing the whole study population (Spearman rs = 0.40, P = 0.008), but not when separately examining the subgroups. Plasma flow showed a significant correlation with ADC in benign fractures (Pearson r = 0.23, P = 0.03). Plasma volume did not show significant correlations with ADC. The results support the hypothesis that the ADC of a lesion is inversely correlated to its cellularity. This explains previous observations that ADC is reduced in more malignant lesions.

  11. Imaging assessment of vertebral burst fracture

    International Nuclear Information System (INIS)

    Ding Jianlin; Liang Lihua; Wang Yujia

    2006-01-01

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

  12. Reduced thoracolumbar fascia shear strain in human chronic low back pain

    Directory of Open Access Journals (Sweden)

    Konofagou Elisa E

    2011-09-01

    Full Text Available Abstract Background The role played by the thoracolumbar fascia in chronic low back pain (LBP is poorly understood. The thoracolumbar fascia is composed of dense connective tissue layers separated by layers of loose connective tissue that normally allow the dense layers to glide past one another during trunk motion. The goal of this study was to quantify shear plane motion within the thoracolumbar fascia using ultrasound elasticity imaging in human subjects with and without chronic low back pain (LBP. Methods We tested 121 human subjects, 50 without LBP and 71 with LBP of greater than 12 months duration. In each subject, an ultrasound cine-recording was acquired on the right and left sides of the back during passive trunk flexion using a motorized articulated table with the hinge point of the table at L4-5 and the ultrasound probe located longitudinally 2 cm lateral to the midline at the level of the L2-3 interspace. Tissue displacement within the thoracolumbar fascia was calculated using cross correlation techniques and shear strain was derived from this displacement data. Additional measures included standard range of motion and physical performance evaluations as well as ultrasound measurement of perimuscular connective tissue thickness and echogenicity. Results Thoracolumbar fascia shear strain was reduced in the LBP group compared with the No-LBP group (56.4% ± 3.1% vs. 70.2% ± 3.6% respectively, p Conclusion Thoracolumbar fascia shear strain was ~20% lower in human subjects with chronic low back pain. This reduction of shear plane motion may be due to abnormal trunk movement patterns and/or intrinsic connective tissue pathology. There appears to be some sex-related differences in thoracolumbar fascia shear strain that may also play a role in altered connective tissue function.

  13. Imaging the vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Davies, John R.; Weissberg, Peter L. [Addenbrooke' s Hospital and University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Gillard, Jonathan H. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospitald, University Department of Radiology, Cambridge (United Kingdom)

    2005-07-01

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  14. Imaging the vertebral artery

    International Nuclear Information System (INIS)

    Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M.; Davies, John R.; Weissberg, Peter L.; Gillard, Jonathan H.

    2005-01-01

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  15. Long-term effects of localized spinal radiation therapy on vertebral fractures and focal lesions appearance in patients with multiple myeloma

    International Nuclear Information System (INIS)

    Lecouvet, Frederic; Richard, Francoise; Berg, B. Vande; Malghem, Jacques; Maldague, Baudouin; Ferrant, Augustin; Michaux, J.-L.

    1997-01-01

    The occurrence of new vertebral fractures and focal marrow lesions was determined and compared in irradiated and nonirradiated vertebrae of 12 patients with multiple myeloma (MM), prospectively followed using magnetic resonance imaging (MRI) of the thoraco-lumbar spine after localized spinal radiation therapy. During follow-up (mean 35 months), fractures appeared in 5% of irradiated vertebrae and in 20% of nonirradiated vertebrae; new focal lesions appeared in 4% of irradiated vertebrae and in 27% of nonirradiated vertebrae. This study demonstrates a beneficial long-term effect of localized radiation therapy, consisting of a reduced incidence of vertebral fractures and focal marrow lesions in irradiated vertebrae. (author)

  16. The thoracolumbar fascia: anatomy, function and clinical considerations

    Science.gov (United States)

    Willard, F H; Vleeming, A; Schuenke, M D; Danneels, L; Schleip, R

    2012-01-01

    In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a ‘hydraulic amplifier’, assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  18. Surgical management of contiguous multilevel thoracolumbar tuberculous spondylitis.

    Science.gov (United States)

    Qureshi, Muhammad Asad; Khalique, Ahmed Bilal; Afzal, Waseem; Pasha, Ibrahim Farooq; Aebi, Max

    2013-06-01

    Tuberculous spondylitis (TBS) is the most common form of extra-pulmonary tuberculosis. The mainstay of TBS management is anti-tuberculous chemotherapy. Most of the patients with TBS are treated conservatively; however in some patients surgery is indicated. Most common indications for surgery include neurological deficit, deformity, instability, large abscesses and necrotic tissue mass or inadequate response to anti-tuberculous chemotherapy. The most common form of TBS involves a single motion segment of spine (two adjoining vertebrae and their intervening disc). Sometimes TBS involves more than two adjoining vertebrae, when it is called multilevel TBS. Indications for correct surgical management of multilevel TBS is not clear from literature. We have retrospectively reviewed 87 patients operated in 10 years for multilevel TBS involving the thoracolumbar spine at our spine unit. Two types of surgeries were performed on these patients. In 57 patients, modified Hong Kong operation was performed with radical debridement, strut grafting and anterior instrumentation. In 30 patients this operation was combined with pedicle screw fixation with or without correction of kyphosis by osteotomy. Patients were followed up for correction of kyphosis, improvement in neurological deficit, pain and function. Complications were noted. On long-term follow-up (average 64 months), there was 9.34 % improvement in kyphosis angle in the modified Hong Kong group and 47.58 % improvement in the group with pedicle screw fixation and osteotomy in addition to anterior surgery (p debridement and anterior column reconstruction.

  19. Endplates Changes Related to Age and Vertebral Segment

    Directory of Open Access Journals (Sweden)

    Carlos Fernando P. S. Herrero

    2014-01-01

    Full Text Available Endplate separations are defined as the presence of a space between the hyaline cartilage and the cortical bone of the adjacent vertebral body. This study evaluates endplate separations from the vertebral body and intervertebral discs and verifies if endplate separation is related to age and the spinal level. Groups were formed based on age (20–40 and 41–85 years old and the vertebral segment (T7-T8 and L4-L5 segments. Histological analysis included assessment of the length of the vertebral endplates, the number and dimensions of the separations, and orientation of the collagen fibers, in the mid-sagittal slice. Two indexes were created: the separation index (number of separations/vertebral length and separation extension index (sum of all separations/vertebral length. The results of the study demonstrated a direct relationship between the density of separations in the endplate and two variables: age and spinal level.

  20. Vertebral morphometry by dual-energy X-ray absorptiometry

    International Nuclear Information System (INIS)

    Boyanov, M.

    2002-01-01

    Vertebral fractures are a key feature of overt osteoporosis. Different X-ray morphometric techniques have been developed for quantification of changes in vertebral body shape. In recent years, a new method was implemented based on dual-energy X-ray absorptiometry. Morphometric X-ray absorptiometry, MXA, is a source of lower radiation and there is no image distortion. Several aspects of its application are under heavy discussion: image quality, accuracy and precision, reference databases, age changes in vertebral shape. The differential diagnosis of vertebral fracture/deformity is difficult. MXA has prove its value in large epidemiological studies on prevalence of vertebral deformities, as well in assessing the effects of different diseases and medications on vertebral body architecture. MXA is a promising method for future research and clinical work. (author)

  1. Assisted techniques for vertebral cementoplasty: Why should we do it?

    International Nuclear Information System (INIS)

    Muto, M.; Marcia, S.; Guarnieri, G.; Pereira, V.

    2015-01-01

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications

  2. Assisted techniques for vertebral cementoplasty: Why should we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Muto, M., E-mail: mutomar@tiscali.it [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Marcia, S. [Section of Radiology—Santissima Trinità Hospital, Cagliari (Italy); Guarnieri, G. [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Pereira, V. [Unit of Interventional Neuroradiology–HUG, Geneva (Switzerland)

    2015-05-15

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications.

  3. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

    2015-03-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  4. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    International Nuclear Information System (INIS)

    Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

    2015-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  5. Kyphoplasty for severe osteoporotic vertebral compression fractures

    International Nuclear Information System (INIS)

    Bao Zhaohua; Wang Genlin; Yang Huilin; Meng Bin; Chen Kangwu; Jiang Weimin

    2010-01-01

    Objective: To evaluate the clininal efficacy of kyphoplasty for severe osteoporotic vertebral compression fractures. Methods: Forty-five patients with severe osteoporotic compressive fractures were treated by kyphoplasty from Jan 2005 to Jan 2009. The compressive rate of the fractured vertebral bodies was more than 75%. According to the morphology of the vertebral compression fracture bodies the unilateral or bilateral balloon kyphoplasty were selected. The anterior vertebral height was measured on a standing lateral radiograph at pre-operative, post-operative (one day after operation) and final follow-up time. A visual analog scale(VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain status and functional activity. Results: The mean follow-up was for 21.7 months (in range from 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from preoperative (18.7 ± 3.1)% to postoperative (51.4 ± 2.3)%, the follow-up period (50.2 ± 2.7)%. There was a significant improvement between preoperative and postoperative values (P 0.05). The VAS was 8.1 ± 1.4 at preoperative, 2.6 ± 0.9 at postoperative, 2.1 ± 0.5 at final follow-up time; and the ODI was preoperative 91.1 ± 2.3, postoperative 30.7 ± 7.1, follow-up period 26.1 ± 5.1. There was statistically significant improvement in the VAS and ODI in the post-operative assessment compared with the pre-operative assessment (P 0.05). Asymptomatic cement leakage occurred in three cases. New vertebral fracture occurred in one case. Conclusion: The study suggests that balloon kyphoplasty is a safe and effective procedure in the treatment of severe osteoporotic vertebral compression fractures. (authors)

  6. Anterior Z-plate and titanic mesh fixation for acute burst thoracolumbar fracture.

    Science.gov (United States)

    Xu, Jian-Guang; Zeng, Bing-Fang; Zhou, Wei; Kong, Wei-Qing; Fu, Yi-Shan; Zhao, Bi-Zeng; Zhang, Tao; Lian, Xiao-Feng

    2011-04-01

    A retrospective study. To evaluate the clinical outcome, effectiveness, and security of the surgical management of acute thoracolumbar burst fracture with corpectomy, titanic mesh autograft, and Z-plate fixation by anterior approach. Many surgical methods were adopted to treat acute burst thoracolumbar fracture. But the optimal surgical management remains controversial. A retrospective review of a consecutive series of 48 patients with thoracolumbar burst fracture treated with anterior corpectomy, titanic mesh autograft, and Z-plate internal fixation was carried out. Preoperative clinical and radiographic data of all cases were originally collected. Surgical indications were motor neurologic deficit and thoracolumbar column instability. Twenty-two patients (45.8%) with acute thoracolumbar burst fractures presented with a neurologic deficit. The postoperative recovery of neural function, restoration of anterior cortex collapse, kyphotic angle, and spinal canal compromise were observed. The preoperative kyphotic angle was improved to a mean of 5.6°, radiographic height restored to 95.8% of the adjacent normal levels, and canal compromise was 0%. None of the patients had neurologic deterioration. Mean follow-up time was 32.4 months (range, 24-47 months). All 22 patients with neurologic deficit demonstrated at least one Frankel grade improvement on final observation, with 16 (73%) patients had accomplished complete neurologic recovery. Forty-six (96%) patients reported minimal or no pain at final follow-up observation, and 40 (83%) patients who had been working before injury returned to original work. The authors considered spinal cord decompression with anterior corpectomy and stability reconstruction with titanic mesh autograft and Z-plate fixation at same time in one incision as an effective technique for unstable thoracolumbar burst fracture with and without neurologic deficit.

  7. The origin of the vertebrate skeleton

    Science.gov (United States)

    Pivar, Stuart

    2011-01-01

    The anatomy of the human and other vertebrates has been well described since the days of Leonardo da Vinci and Vesalius. The causative origin of the configuration of the bones and of their shapes and forms has been addressed over the ensuing centuries by such outstanding investigators as Goethe, Von Baer, Gegenbauer, Wilhelm His and D'Arcy Thompson, who sought to apply mechanical principles to morphogenesis. However, no coherent causative model of morphogenesis has ever been presented. This paper presents a causative model for the origin of the vertebrate skeleton, based on the premise that the body is a mosaic enlargement of self-organized patterns engrained in the membrane of the egg cell. Drawings illustrate the proposed hypothetical origin of membrane patterning and the changes in the hydrostatic equilibrium of the cytoplasm that cause topographical deformations resulting in the vertebrate body form.

  8. Prospective analysis of magnetic resonance imaging accuracy in diagnosing traumatic injuries of the posterior ligamentous complex of the thoracolumbar spine.

    Science.gov (United States)

    Pizones, Javier; Sánchez-Mariscal, Felisa; Zúñiga, Lorenzo; Álvarez, Patricia; Izquierdo, Enrique

    2013-04-20

    Prospective cohort study. To study magnetic resonance imaging (MRI) accuracy in diagnosing posterior ligamentous complex (PLC) damage, when applying the new dichotomic instability criteria in a prospective cohort of patients with vertebral fracture. Recent studies dispute MRI accuracy to diagnose PLC injuries. They analyze the complex based on 3 categories (intact/indeterminate/rupture), including the indeterminate in the ruptured group (measurement bias) in the accuracy analysis. Moreover, fractures with conservative treatment (selection bias) are not included. Both facts reduce the specificity. A recent study has proposed new criteria where posterior instability is determined with supraspinous ligament (SSL) rupture. Prospective study of patients with acute thoracolumbar fracture, using radiography and MRI (FS-T2-w/short-tau inversion-recovery sequences). 1. The integrity (ruptured/unruptured) of each isolated component of the PLC (facet capsules, interspinous ligament, SSL, and ligamentum flavum) was assessed via MRI and surgical findings. 2. PLC integrity as a whole was assessed, adopting the new dichotomic stability criteria from previous studies. In the MR images, PLC is considered ruptured when the SSL is found discontinued, and intact when not (this excludes the "indeterminate" category). In surgically treated fractures, PLC stability as a whole was assessed dynamically (ruptured/unruptured). In conservative fractures, PLC stability was assessed according to change in vertebral kyphosis measured with the local kyphotic angle at 2-year follow-up (ruptured if difference is > 5°/unruptured if difference is PLC damage. Fifty-eight vertebral fractures were studied (38 surgical, 20 conservative), of which 50% were in males; average age, 40.4 years. MRI sensitivity for injury diagnosis of each isolated PLC component varied between 92.3% (interspinous ligament) and 100% (ligamentum flavum). Specificity varied between 52% (facet capsules) and 100% (SSL). PLC

  9. Progressive non-infectious anterior vertebral fusion in a baby with Saethre-Chotzen-acrocephalosyndactyly type III syndrome

    Directory of Open Access Journals (Sweden)

    Ali Al Kaissi

    2015-09-01

    Full Text Available We report on a 3-months old baby of Austrian origin and product of non-consanguineous parents. Abnormal craniofacial contour was the main deformity. The overall clinico-radiographic features were consistent with Saether-Chotzen-acrocephalosyndactyly type III syndrome. Bi-directional sequencing of the exon 8 and of the FGFR3-genes, exons 7 of FGFR3 (Fibroblast growth factor receptor3 genes, the exon 5 of the FGFR1 gene, revealed no mutations. Sagittal MRI imaging of the spine showed anterior vertebral fusion along the thoraco-lumbar vertebrae compatible with the non-infectious type.

  10. Head segmentation in vertebrates

    OpenAIRE

    Kuratani, Shigeru; Schilling, Thomas

    2008-01-01

    Classic theories of vertebrate head segmentation clearly exemplify the idealistic nature of comparative embryology prior to the 20th century. Comparative embryology aimed at recognizing the basic, primary structure that is shared by all vertebrates, either as an archetype or an ancestral developmental pattern. Modern evolutionary developmental (Evo-Devo) studies are also based on comparison, and therefore have a tendency to reduce complex embryonic anatomy into overly simplified patterns. Her...

  11. A mechanical perspective on vertebral segmentation

    NARCIS (Netherlands)

    Truskinovsky, L.; Vitale, G.; Smit, T.H.

    2014-01-01

    Segmentation is a characteristic feature of the vertebrate body plan. The prevailing paradigm explaining its origin is the 'clock and wave-front' model, which assumes that the interaction of a molecular oscillator (clock) with a traveling gradient of morphogens (wave) pre-defines spatial

  12. The surgical algorithm for the AOSpine thoracolumbar spine injury classification system

    NARCIS (Netherlands)

    Vaccaro, Alexander R.; Schroeder, Gregory D.; Kepler, Christopher K.; Cumhur Oner, F.; Vialle, Luiz R.; Kandziora, Frank; Koerner, John D.; Kurd, Mark F.; Reinhold, Max; Schnake, Klaus J.; Chapman, Jens; Aarabi, Bizhan; Fehlings, Michael G.; Dvorak, Marcel F.

    2016-01-01

    Purpose: The goal of the current study is to establish a surgical algorithm to accompany the AOSpine thoracolumbar spine injury classification system. Methods: A survey was sent to AOSpine members from the six AO regions of the world, and surgeons were asked if a patient should undergo an initial

  13. Treatment of traumatic thoracolumbar spine fractures : A multicenter prospective randomized study of operative versus nonsurgical treatment

    NARCIS (Netherlands)

    Siebenga, Jan; Leferink, Vincent J. M.; Segers, Michiel J. M.; Elzinga, Matthijs J.; Bakker, Fred C.; Haarman, Henk J. Th. M.; Rommens, Pol M.; ten Duis, Henk-Jan; Patka, Peter

    2006-01-01

    Study Design. Multicenter prospective randomized trial. Objective. To test the hypotheses that thoracolumbar AO Type A spine fractures without neurologic deficit, managed with short-segment posterior stabilization will show an improved radiographic outcome and at least the same functional outcome as

  14. Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses

    DEFF Research Database (Denmark)

    Fuglbjerg, Vibeke; Nielsen, J.V.; Thomsen, Preben Dybdahl

    2010-01-01

    in the literature. Objectives: To evaluate factors of affecting the accuracy of intra-articular injections of the APJs in the caudal thoracolumbar region. Method: One-hundred-and-fifty-four injections with blue dye were performed on APJs including the T14-L6 region in 12 horses subjected to euthanasia for reasons...

  15. The posterior layer of the thoracolumbar fascia. Its function in load transfer from spine to legs.

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.L.; Vleeming, A; Stoeckart, R.; Wingerden, Jan Paul; Snijders, Chris

    1996-01-01

    STUDY DESIGN: The superficial and deep lamina of the posterior layer of the thoracolumbar fascia have been studied anatomically and biomechanically. In embalmed human specimens, the posterior layer has been loaded by simulating the action of various muscles. The effect has been studied using raster

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  18. Acute Thoracolumbar Spinal Cord Injury: Relationship of Cord Compression to Neurological Outcome.

    Science.gov (United States)

    Skeers, Peta; Battistuzzo, Camila R; Clark, Jillian M; Bernard, Stephen; Freeman, Brian J C; Batchelor, Peter E

    2018-02-21

    Spinal cord injury in the cervical spine is commonly accompanied by cord compression and urgent surgical decompression may improve neurological recovery. However, the extent of spinal cord compression and its relationship to neurological recovery following traumatic thoracolumbar spinal cord injury is unclear. The purpose of this study was to quantify maximum cord compression following thoracolumbar spinal cord injury and to assess the relationship among cord compression, cord swelling, and eventual clinical outcome. The medical records of patients who were 15 to 70 years of age, were admitted with a traumatic thoracolumbar spinal cord injury (T1 to L1), and underwent a spinal surgical procedure were examined. Patients with penetrating injuries and multitrauma were excluded. Maximal osseous canal compromise and maximal spinal cord compression were measured on preoperative mid-sagittal computed tomography (CT) scans and T2-weighted magnetic resonance imaging (MRI) by observers blinded to patient outcome. The American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades from acute hospital admission (≤24 hours of injury) and rehabilitation discharge were used to measure clinical outcome. Relationships among spinal cord compression, canal compromise, and initial and final AIS grades were assessed via univariate and multivariate analyses. Fifty-three patients with thoracolumbar spinal cord injury were included in this study. The overall mean maximal spinal cord compression (and standard deviation) was 40% ± 21%. There was a significant relationship between median spinal cord compression and final AIS grade, with grade-A patients (complete injury) exhibiting greater compression than grade-C and D patients (incomplete injury) (p compression as independently influencing the likelihood of complete spinal cord injury (p compression. Greater cord compression is associated with an increased likelihood of severe neurological deficits (complete injury) following

  19. The pattern and prevalence of vertebral artery injury in patients with ...

    African Journals Online (AJOL)

    Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA) in patients with cervical spine fractures. Method.

  20. Vertebral physitis: a radiographic diagnosis to be separated from discospondylitis: a preliminary report

    International Nuclear Information System (INIS)

    Jimenez, M.M.; O'Callaghan, M.W.

    1995-01-01

    A retrospective study was initiated to investigate the incidence, radiographic appearance and progression of vertebral physitis, a condition the authors propose as a separate radiographic diagnosis from discospondylitis. From 30 dogs with an initial radiographic diagnosis of discospondylitis, six dogs (five less than two years old) had radiographic signs believed to represent vertebral physitis. Bone lysis initially confined to the caudal physeal zone of affected vertebrae and sparing the vertebral endplates characterized the vertebral physitis lesions. Subsequent collapse of the caudoventral vertebral body and reactive spondylosis arising only from the caudal vertebral margins followed as the lesions progressed. By contrast, discospondylitis lesions originated as symmetric lysis of the vertebral endplates with reactive sclerosis in both vertebral bodies, and subsequent symmetric spondylosis. As a result of the differing radiographic patterns demonstrated by the physitis and discospondylitis lesions the author's also propose an alternative pathogenesis from that which is generally accepted for discospondylitis

  1. Reproducibility of central lumbar vertebral BMD

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  2. Subcutaneous fluid collection: An imaging marker for treatment response of infectious thoracolumbar spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Kakigi, Takahide, E-mail: tkakigi@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan); Okada, Tomohisa, E-mail: tomokada@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan); Sakai, Osamu, E-mail: osamu.sakai@bmc.org [Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118 (United States); Iwamoto, Yoshitaka, E-mail: iwacame@hotmail.co.jp [Department of General Internal Medicine, Rakuwakai Otowa Hospital, 2 Otowachoinji-cho, Yamashina-ku, Kyoto 607-8062 (Japan); Kubo, Soichi, E-mail: kubo-s@mbox.kyoto-inet.or.jp [Department of Radiology, Rakuwakai Otowa Hospital, 2 Otowachoinji-cho, Yamashina-ku, Kyoto 607-8062 (Japan); Yamamoto, Akira, E-mail: yakira@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan); Togashi, Kaori, E-mail: nmdioffice@kuhp.kyoto-ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan)

    2015-07-15

    Highlights: • No imaging marker for treatment response of spondylodiscitis (SD) has been proposed. • Volume changes of subcutaneous fluid collection (SFC) had significant correlation with changes of C-reactive protein (CRP). • SFC can be used as an imaging marker for treatment response of SD on magnetic resonance imaging (MRI). - Abstract: Purpose: To evaluate prevalence of subcutaneous fluid collection (SFC) in infectious thoracolumbar spondylodiscitis (SD) compared with control patients and to investigate correlation between volume changes of SFC and treatment response of SD. Materials and methods: This retrospective study was approved by our institutional review board. From April 2011 to March 2012, 49 patients (24 SD and 25 non-SD patients) were enrolled. Prevalence of SFC was evaluated respectively for SD and non-SD patients using magnetic resonance imaging (MRI) on the sagittal short tau inversion recovery (STIR) imaging or fat-saturated T2-weighted imaging (T2WI), and compared. In SD patients with SFC, correlation was investigated between SFC volume on the 1st MRI and initial clinical status. The same analysis was conducted also for SFC volume changes from the 1st to 2nd or last MRI. Results: SFC was found in 20 patients with SD (83.3%) and 3 non-SD patients (12%) with significant difference (p < .001). In 20 SD patients with SFC, 17 patients had follow-up MRI. For the 1st MRI, no significant correlation was found between volume of SFC and initial status of patients, including body weight, body mass index (BMI), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). However, significant positive correlations were found between changes of C-reactive protein (CRP) and SFC volume from the 1st to 2nd as well as from the 1st to the last MRI (each p < .05). Conclusion: SD patients had significantly higher prevalence of SFC than non-SD patients. Volume changes of SFC had significant correlation with changes of CRP, which can be used as an imaging

  3. Subcutaneous fluid collection: An imaging marker for treatment response of infectious thoracolumbar spondylodiscitis

    International Nuclear Information System (INIS)

    Kakigi, Takahide; Okada, Tomohisa; Sakai, Osamu; Iwamoto, Yoshitaka; Kubo, Soichi; Yamamoto, Akira; Togashi, Kaori

    2015-01-01

    Highlights: • No imaging marker for treatment response of spondylodiscitis (SD) has been proposed. • Volume changes of subcutaneous fluid collection (SFC) had significant correlation with changes of C-reactive protein (CRP). • SFC can be used as an imaging marker for treatment response of SD on magnetic resonance imaging (MRI). - Abstract: Purpose: To evaluate prevalence of subcutaneous fluid collection (SFC) in infectious thoracolumbar spondylodiscitis (SD) compared with control patients and to investigate correlation between volume changes of SFC and treatment response of SD. Materials and methods: This retrospective study was approved by our institutional review board. From April 2011 to March 2012, 49 patients (24 SD and 25 non-SD patients) were enrolled. Prevalence of SFC was evaluated respectively for SD and non-SD patients using magnetic resonance imaging (MRI) on the sagittal short tau inversion recovery (STIR) imaging or fat-saturated T2-weighted imaging (T2WI), and compared. In SD patients with SFC, correlation was investigated between SFC volume on the 1st MRI and initial clinical status. The same analysis was conducted also for SFC volume changes from the 1st to 2nd or last MRI. Results: SFC was found in 20 patients with SD (83.3%) and 3 non-SD patients (12%) with significant difference (p < .001). In 20 SD patients with SFC, 17 patients had follow-up MRI. For the 1st MRI, no significant correlation was found between volume of SFC and initial status of patients, including body weight, body mass index (BMI), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). However, significant positive correlations were found between changes of C-reactive protein (CRP) and SFC volume from the 1st to 2nd as well as from the 1st to the last MRI (each p < .05). Conclusion: SD patients had significantly higher prevalence of SFC than non-SD patients. Volume changes of SFC had significant correlation with changes of CRP, which can be used as an imaging

  4. Imaging of vertebral trauma

    International Nuclear Information System (INIS)

    Daffner, R.H.

    1999-01-01

    This translation of the toolbook published in the 'US-ART' series, offers invaluable help to medical radiologists in the diagnostic imaging and evaluation of complex vertebral traumas which are on the rise, inter alia due to increasingly dangerous leisure sports. (orig./CB) [de

  5. Management of osteoporotic vertebral fractures

    OpenAIRE

    Dionyssiotis, Yannis

    2010-01-01

    Yannis DionyssiotisRhodes General Hospital, Rhodes, GreeceAbstract: Osteoporotic vertebral fractures are associated with considerable reduction of quality of life, morbidity, and mortality. The management of patients with vertebral fractures should include treatment for osteoporosis and measures to reduce pain and improve mobility. This article provides information for management and rehabilitation of vertebral fractures based on clinical experience and literature.Keywords: vertebral fracture...

  6. The role of the notochord in amniote vertebral column segmentation.

    Science.gov (United States)

    Ward, Lizzy; Pang, Angel S W; Evans, Susan E; Stern, Claudio D

    2018-07-01

    The vertebral column is segmented, comprising an alternating series of vertebrae and intervertebral discs along the head-tail axis. The vertebrae and outer portion (annulus fibrosus) of the disc are derived from the sclerotome part of the somites, whereas the inner nucleus pulposus of the disc is derived from the notochord. Here we investigate the role of the notochord in vertebral patterning through a series of microsurgical experiments in chick embryos. Ablation of the notochord causes loss of segmentation of vertebral bodies and discs. However, the notochord cannot segment in the absence of the surrounding sclerotome. To test whether the notochord dictates sclerotome segmentation, we grafted an ectopic notochord. We find that the intrinsic segmentation of the sclerotome is dominant over any segmental information the notochord may possess, and no evidence that the chick notochord is intrinsically segmented. We propose that the segmental pattern of vertebral bodies and discs in chick is dictated by the sclerotome, which first signals to the notochord to ensure that the nucleus pulposus develops in register with the somite-derived annulus fibrosus. Later, the notochord is required for maintenance of sclerotome segmentation as the mature vertebral bodies and intervertebral discs form. These results highlight differences in vertebral development between amniotes and teleosts including zebrafish, where the notochord dictates the segmental pattern. The relative importance of the sclerotome and notochord in vertebral patterning has changed significantly during evolution. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  7. MR imaging in the assessment of the thoracolumbar spine in elite male gymnasts

    International Nuclear Information System (INIS)

    Nyman, R.; Svard, L.; Hellstrom, M.; Jakobsson, B.; Peterson, L.

    1989-01-01

    Gymnasts training on elite level from childhood to adulthood might do serious damage to the motion segments in the thoracolumbar spine. This paper reports on twenty-five elite gymnasts (age range, 18-29 years) investigated with 0.5-T MR imaging and compared with 17 aged-matched normal males. A significantly higher number of changes in configuration of the vertebrae, apophyseal changes, end plate nodes, degenerated disks, and disk bulging in the thoracolumbar spine were found among the gymnasts. The number of degenerated disks among the gymnasts were comparable to that found at the age group of 65. Disk degeneration and change of configuration of the vertebrae were also found to correlate significantly with symptoms of back pain

  8. Osteomielitis vertebral piógena Pyogenic vertebral osteomyelitis

    Directory of Open Access Journals (Sweden)

    Pedro P. Perrotti

    2009-10-01

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

  9. Midterm Follow-Up of Vertebral Geometry and Remodeling of the Vertebral Bidisk Unit (VDU) After Percutaneous Vertebroplasty of Osteoporotic Vertebral Fractures

    International Nuclear Information System (INIS)

    Pitton, Michael Bernhard; Koch, Ulrike; Drees, Philip; Dueber, Christoph

    2009-01-01

    The purpose of this study was to investigate geometrical stability and preservation of height gain of vertebral bodies after percutaneous vertebroplasty during 2 years' follow-up and to elucidate the geometric remodeling process of the vertebral bidisk unit (VDU) of the affected segment. Patients with osteoporotic vertebral compression fractures with pain resistant to analgetic drugs were treated with polymethylmethacrylate vertebroplasty. Mean ± standard error cement volume was 5.1 ± 2.0 ml. Vertebral geometry was documented by sagittal and coronal reformations from multidetector computed tomography data sets: anterior, posterior, and lateral vertebral heights, end plate angles, and compression index (CI = anterior/posterior height). Additionally, the VDU (vertebral bodies plus both adjacent disk spaces) was calculated from the multidetector computed tomography data sets: anterior, posterior, and both lateral aspects. Patients were assigned to two groups: moderate compression with CI of >0.75 (group 1) and severe compression with CI of o vs. -1.0 ± 2.7 o , P o , P < 0.01) and compression indices (+0.11 ± 0.15, P < 0.01). Thus, posterior height loss of vertebrae and adjacent intervertebral disk spaces contributed to a remodeling of the VDU, resulting in some compensation of the kyphotic malposition of the affected vertebral segment. Vertebroplasty improved vertebral geometry during midterm follow-up. In severe vertebral compression, significant height gain and improvement of end plate angles were achieved. The remodeling of the VDUs contributes to reduction of kyphosis and an overall improvement of the statics of the spine.

  10. Reliability and reproducibility analysis of the AOSpine thoracolumbar spine injury classification system by Chinese spinal surgeons.

    Science.gov (United States)

    Cheng, Jie; Liu, Peng; Sun, Dong; Qin, Tingzheng; Ma, Zikun; Liu, Jingpei

    2017-05-01

    The objective of this study was to analyze the interobserver reliability and intraobserver reproducibility of the new AOSpine thoracolumbar spine injury classification system in young Chinese orthopedic surgeons with different levels of experience in spinal trauma. Previous reports suggest that the new AOSpine thoracolumbar spine injury classification system demonstrates acceptable interobserver reliability and intraobserver reproducibility. However, there are few studies in Asia, especially in China. The AOSpine thoracolumbar spine injury classification system was applied to 109 patients with acute, traumatic thoracolumbar spinal injuries by two groups of spinal surgeons with different levels of clinical experience. The Kappa coefficient was used to determine interobserver reliability and intraobserver reproducibility. The overall Kappa coefficient for all cases was 0.362, which represents fair reliability. The Kappa statistic was 0.385 for A-type injuries and 0.292 for B-type injuries, which represents fair reliability, and 0.552 for C-type injuries, which represents moderate reliability. The Kappa coefficient for intraobserver reproducibility was 0.442 for A-type injuries, 0.485 for B-type injuries, and 0.412 for C-type injuries. These values represent moderate reproducibility for all injury types. The raters in Group A provided significantly better interobserver reliability than Group B (P < 0.05). There were no between-group differences in intraobserver reproducibility. This study suggests that the new AO spine injury classification system may be applied in day-to-day clinical practice in China following extensive training of healthcare providers. Further prospective studies in different healthcare providers and clinical settings are essential for validation of this classification system and to assess its utility.

  11. Sex reversal in vertebrates

    OpenAIRE

    2016-01-01

    This special topic issue of Sexual Development gives an overview of sex reversal in vertebrates, from fishes naturally changing their sex, to rodents escaping the mammalian SRY-determining system. It offers eight up-to-date reviews on specific subjects in sex reversal, considering fishes, amphibians, reptiles, birds, marsupials, and placental mammals, including humans. The broad scope of represented animals makes this ideal for students and researchers, especially those interested in the...

  12. Vertebral involvement in SAPHO syndrome: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Nachtigal, A.; Cardinal, E.; Bureau, N.J. [Dept. of Radiology, Univ. de Montreal, QC (Canada); Sainte-Marie, L.G. [Dept. of Internal Medicine, Univ. de Montreal, QC (Canada); Milette, F. [Department of Pathology, Univ. de Montreal, QC (Canada)

    1999-03-01

    We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis. (orig.) With 6 figs., 17 refs.

  13. Vertebral column aggressive osteoblastoma: two cases report and literature review

    International Nuclear Information System (INIS)

    Sabedotti, Ismail Fernando; Sabedotti, Valdir

    2007-01-01

    Osteoblastoma is a bone neoplasy that in most circumstances present a low aggressive aspect on radiographic studies, but in some cases may acquire an aggressive pattern, rupturing the bone cortex and invading nearby structures. Most cases occur on the vertebral column, especially at the posterior arch and occasionally involving the vertebral body. Differential diagnosis of the aggressive form is made with osteosarcomas. This review reports two cases of osteoblastomas involving vertebral column, with an aggressive pattern on radiologic studies, and their histologic confirmation. (author)

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

    Science.gov (United States)

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

    2018-04-01

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

  15. SU-F-T-106: A Dosimetric Study of Intensity Modulated Radiation Therapy to Decrease Radiation Dose to the Thoracic Vertebral Bodies in Patients Receiving Concurrent Chemoradiation for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    DiCostanzo, Dominic; Barney, Christian L.; Bazan, Jose G. [The Ohio State University, Columbus, Ohio (United States)

    2016-06-15

    Purpose: Recent clinical studies have shown a correlation between radiation dose to the thoracic vertebral bodies (TVB) and the development of hematologic toxicity (HT) in patients receiving chemoradiation (CRT) for lung cancer (LuCa). The feasibility of a bone-marrow sparing (BMS) approach in this group of patients is unknown. We hypothesized that radiation dose to the TVB can be reduced with an intensity modulated radiation therapy(IMRT)/volumetric modulated arc radiotherapy(VMAT) without affecting plan quality. Methods: We identified LuCa cases treated with curative intent CRT using IMRT/VMAT from 4/2009 to 2/2015. The TVBs from T1–T10 were retrospectively contoured. No constraints were placed on the TVB structure initially. A subset were re-planned with BMS-IMRT/VMAT with an objective or reducing the mean TVB dose to <23 Gy. The following data were collected on the initial and BMS plans: mean dose to planning target volume (PTV), lungs-PTV, esophagus, heart; lung V20; cord max dose. Pairwise comparisons were performed using the signed rank test. Results: 94 cases received CRT with IMRT/VMAT. We selected 11 cases (7 IMRT, 4 VMAT) with a range of initial mean TVB doses (median 35.7 Gy, range 18.9–41.4 Gy). Median prescription dose was 60 Gy. BMS-IMRT/VMAT significantly reduced the mean TVB dose by a median of 10.2 Gy (range, 1.0–16.7 Gy, p=0.001) and reduced the cord max dose by 2.9 Gy (p=0.014). BMS-IMRT/VMAT had no impact on lung mean (median +17 cGy, p=0.700), lung V20 (median +0.5%, p=0.898), esophagus mean (median +13 cGy, p=1.000) or heart mean (median +16 cGy, p=0.365). PTV-mean dose was not affected by BMS-IMRT/VMAT (median +13 cGy, p=0.653). Conclusion: BMS-IMRT/VMAT was able to significantly reduce radiation dose to the TVB without compromising plan quality. Prospective evaluation of BMS-IMRT/VMAT in patients receiving CRT for LuCa is warranted to determine if this approach results in clinically significant reductions in HT.

  16. Anthropometric measurements and vertebral deformities. European Vertebral Osteoporosis Study (EVOS) Group.

    Science.gov (United States)

    Johnell, O; O'Neill, T; Felsenberg, D; Kanis, J; Cooper, C; Silman, A J

    1997-08-15

    To investigate the association between anthropometric indices and morphometrically determined vertebral deformity, the authors carried out a cross-sectional study using data from the European Vertebral Osteoporosis Study (EVOS), a population-based study of vertebral osteoporosis in 36 European centers from 19 countries. A total of 16,047 EVOS subjects were included in this analysis, of whom 1,973 subjects (915 males, 1,058 females) (12.3%) aged 50 years or over had one or more vertebral deformities ("cases"). The cases were compared with the 14,074 subjects (6,539 males, 7,535 females) with morphometrically normal spines ("controls"). Data were collected on self-reported height at age 25 years and minimum weight after age 25 years, as well as on current measured height and weight. Body mass index (BMI) and height and weight change were calculated from these data. The relations between these variables and vertebral deformity were examined separately by sex with logistic regression adjusting for age, smoking, and physical activity. In females, there was a significant trend of decreasing risk with increasing quintile of current weight, current BMI, and weight gain since age 25 years. In males, subjects in the lightest quintile for these measures were at increased risk but there was no evidence of a trend. An ecologic analysis by country revealed a negative correlation between mean BMI and the prevalence of deformity in females but not in males. The authors conclude that low body weight is associated with presence of vertebral deformity.

  17. X-ray image segmentation for vertebral mobility analysis

    International Nuclear Information System (INIS)

    Benjelloun, Mohammed; Mahmoudi, Said

    2008-01-01

    The goal of this work is to extract the parameters determining vertebral motion and its variation during flexion-extension movements using a computer vision tool for estimating and analyzing vertebral mobility. To compute vertebral body motion parameters we propose a comparative study between two segmentation methods proposed and applied to lateral X-ray images of the cervical spine. The two vertebra contour detection methods include (1) a discrete dynamic contour model (DDCM) and (2) a template matching process associated with a polar signature system. These two methods not only enable vertebra segmentation but also extract parameters that can be used to evaluate vertebral mobility. Lateral cervical spine views including 100 views in flexion, extension and neutral orientations were available for evaluation. Vertebral body motion was evaluated by human observers and using automatic methods. The results provided by the automated approaches were consistent with manual measures obtained by 15 human observers. The automated techniques provide acceptable results for the assessment of vertebral body mobility in flexion and extension on lateral views of the cervical spine. (orig.)

  18. Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only

    NARCIS (Netherlands)

    Been, H. D.; Bouma, G. J.

    1999-01-01

    This retrospective study compares clinical outcome following two different types of surgery for thoracolumbar burst fractures. Forty-six patients with thoracolumbar burst fractures causing encroachment of the spinal canal greater than 50% were operated on within 30 days performing either: combined

  19. Total motion generated in the unstable thoracolumbar spine during management of the typical trauma patient: a comparison of methods in a cadaver model.

    Science.gov (United States)

    Prasarn, Mark L; Zhou, Haitao; Dubose, Dewayne; Rossi, Gianluca Del; Conrad, Bryan P; Horodyski, Marybeth; Rechtine, Glenn R

    2012-05-01

    The proper prehospital and inpatient management of patients with unstable spinal injuries is critical for prevention of secondary neurological compromise. The authors sought to analyze the amount of motion generated in the unstable thoracolumbar spine during various maneuvers and transfers that a trauma patient would typically be subjected to prior to definitive fixation. Five fresh cadavers with surgically created unstable L-1 burst fractures were tested. The amount of angular motion between the T-12 and L-2 vertebral segments was measured using a 3D electromagnetic motion analysis device. A complete sequence of maneuvers and transfers was then performed that a patient would be expected to go through from the time of injury until surgical fixation. These maneuvers and transfers included spine board placement and removal, bed transfers, lateral therapy, and turning the patient prone onto the operating table. During each of these, the authors performed what they believed to be the most commonly used versus the best techniques for preventing undesirable motion at the injury level. When placing a spine board there was more motion in all 3 planes with the log-roll technique, and this difference reached statistical significance for axial rotation (p = 0.018) and lateral bending (p = 0.003). Using logrolling for spine board removal resulted in increased motion again, and this was statistically significant for flexion-extension (p = 0.014). During the bed transfer and lateral therapy, the log-roll technique resulted in more motion in all 3 planes (p ≤ 0.05). When turning the cadavers prone for surgery there was statistically more angular motion in each plane for manually turning the patient versus the Jackson table turn (p ≤ 0.01). The total motion was decreased by almost 50% in each plane when using an alternative to the log-roll techniques during the complete sequence (p ≤ 0.007). Although it is unknown how much motion in the unstable spine is necessary to cause

  20. Radiotherapy of vertebral hemangiomas

    International Nuclear Information System (INIS)

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo

    1997-01-01

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

  1. CT and MRI of vertebral haemangiomas

    International Nuclear Information System (INIS)

    Braitinger, S.; Weigert, F.; Held, P.; Obletter, N.; Breit, A.

    1989-01-01

    A retrospective comparative study of CT and MRI was carried out involving 38 vertebral haemangiomas; this revealed a typical signal pattern on MRI from benign lesions. It consists of a hyper-intense signal from the bone marrow affecting the T 1 /T 2 sequences; this may be focal or involve the entire vertebral body. These characteristic signals were compared with CT images of the spine. The areas of bone that produce the high intensity signals on MRI appear on CT as spongey patterns with hypertrophic trabeculae surrounding mostly areas with negative absorption values. An analysis of the changes in the spongiosa has revealed three clearly defined types. The signals derived from haemangiomas extending beyond the bone have an intensity of normal spongiosa; this corresponds with an absence of fat, as demonstrated by CT. Extra-osseous components have low intensity T 1 signals that increase in T 2 sequences. (orig.) [de

  2. Radiological diagnosis of chronic spinal cord compressive lesion at thoraco-lumbar junction

    Energy Technology Data Exchange (ETDEWEB)

    Koyanagi, Izumi; Isu, Toyohiko; Iwasaki, Yoshinobu; Akino, Minoru; Abe, Hiroshi; Tashiro, Kunio; Miyasaka, Kazuo; Abe, Satoru; Kaneda, Kiyoshi

    1988-10-01

    Radiological findings in five cases with chronic spinal cord compressive lesion at thoraco-lumbar junction were reported. Three cases had spondylosis and two cases had ossification of yellow ligament (OYL). The levels of the lesions were T12/L1 in three cases and T11/12 in two cases. Two out of three spondylotic patients had also OYL at the same level. The five cases consisted of three men and two women. The ages ranged from 42 to 60 years old with a mean age of 53 years old. Neurologically, every patient showed flaccid paresis and sensory disturbance of the legs. Two cases had sensory disturbance of stocking type. The intervals from the onset of the symptoms to the final diagnosis were 6 months, 7 years, 8 years, 11 years and 12 years. Myelography showed anterior spinal cord compression by bony spur in spondylotic patients, and posterior compression by OYL in other cases. Myelography in flexion posture disclosed the cord compression by bony spur more clearly in two out of three spondylotic patients. Delayed CT-myelography showed intramedullary filling of contrast material in two cases, which indicated degenerative change or microcavitation due to long term compression of the spinal cord. MRI was taken in three spondylotic patients and could directly show compression of the spinal cord. Difficulty in detecting abnormality at thoraco-lumbar junction on plain roentgenogram, and similarity of the symptoms to peripheral nerve disease often lead to a delay in diagnosis. The significance of dynamic myelography and delayed CT-myelography when dealing with such a lesion was discussed here. MRI is also a useful method for diagnosing a compressive lesion at the thoraco-lumbar junction.

  3. Radiological diagnosis of chronic spinal cord compressive lesion at thoraco-lumbar junction

    International Nuclear Information System (INIS)

    Koyanagi, Izumi; Isu, Toyohiko; Iwasaki, Yoshinobu; Akino, Minoru; Abe, Hiroshi; Tashiro, Kunio; Miyasaka, Kazuo; Abe, Satoru; Kaneda, Kiyoshi

    1988-01-01

    Radiological findings in five cases with chronic spinal cord compressive lesion at thoraco-lumbar junction were reported. Three cases had spondylosis and two cases had ossification of yellow ligament (OYL). The levels of the lesions were T12/L1 in three cases and T11/12 in two cases. Two out of three spondylotic patients had also OYL at the same level. The five cases consisted of three men and two women. The ages ranged from 42 to 60 years old with a mean age of 53 years old. Neurologically, every patient showed flaccid paresis and sensory disturbance of the legs. Two cases had sensory disturbance of stocking type. The intervals from the onset of the symptoms to the final diagnosis were 6 months, 7 years, 8 years, 11 years and 12 years. Myelography showed anterior spinal cord compression by bony spur in spondylotic patients, and posterior compression by OYL in other cases. Myelography in flexion posture disclosed the cord compression by bony spur more clearly in two out of three spondylotic patients. Delayed CT-myelography showed intramedullary filling of contrast material in two cases, which indicated degenerative change or microcavitation due to long term compression of the spinal cord. MRI was taken in three spondylotic patients and could directly show compression of the spinal cord. Difficulty in detecting abnormality at thoraco-lumbar junction on plain roentgenogram, and similarity of the symptoms to peripheral nerve disease often lead to a delay in diagnosis. The significance of dynamic myelography and delayed CT-myelography when dealing with such a lesion was discussed here. MRI is also a useful method for diagnosing a compressive lesion at the thoraco-lumbar junction. (author)

  4. Early diagnosis of thoracolumbar spine fractures in children. A prospective study.

    Science.gov (United States)

    Leroux, J; Vivier, P-H; Ould Slimane, M; Foulongne, E; Abu-Amara, S; Lechevallier, J; Griffet, J

    2013-02-01

    Early detection of spine fractures in children is difficult because the clinical examination does not always raise worrisome symptoms and the vertebrae are still cartilaginous, and consequently incompletely visualized on routine X-rays. Therefore, diagnosis is often delayed or missed. The search for a "breath arrest" sensation at the moment of the trauma improves early detection of thoracolumbar spine fractures in children. This was a prospective monocentric study including all children consulting at the paediatric emergency unit of a single university hospital with a thoracolumbar spine trauma between January 2008 and March 2009. All children had the same care. Pain was quantified when they arrived using the visual analog scale. Clinical examination searched for a "breath arrest" sensation at the moment of the trauma and noted the circumstances of the accident. X-rays and MRI were done in all cases. Fifty children were included with a mean age of 11.4 years. Trauma occurred during games or sports in 94% of the cases. They fell on the back in 72% cases. Twenty-three children (46%) had fractures on the MRI, with a mean number of four fractured vertebrae (range, 1-10). Twenty-one of them (91%) had a "breath arrest" sensation. Fractures were not visualized on X-rays in five cases (22%). Twenty-seven children had no fracture; 19 of them (70%) did not feel a "breath arrest". Fractures were suspected on X-rays in 15 cases (56%). The search for a "breath arrest" sensation at the moment of injury improves early detection of thoracolumbar spine fractures in children (Se=87%, Sp=67%, PPV=69%, NPV=86%). When no fracture is apparent on X-rays and no "breath arrest" sensation is expressed by the child, the clinician can be sure there is no fracture (Se=26%, Sp=100%, PPV=100%, NPV=53%). Level III. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  5. Value of diffusion - weighted magnetic resonance imaging in the assessment of bone marrow in vertebral metastases

    International Nuclear Information System (INIS)

    Herneth, A.M.; Philipp, M.; Trattnig, S.; Imhof, H.; Naude, J.; Beichel, R.

    2000-01-01

    Aim of the study. The aim of the study was the evaluation of the diffusion coefficient (ADC) of vertebral metastasis and regular vertebral bodies with diffusion weighted MRI (DWI). DWI evaluates the tissue-specific molecular diffusion of protons. In tissues with high cell densities (neoplasm) a decreased ADC can be expected due to restricted diffusion according to an exaggerated amount of intra- and intercellular membranes (i.e. diffusion barriers). Methods. In 5 breast cancer patients the ADC of both known vertebral metastases and of adjacent regular vertebral bodies were measured with DWI (1.0 T; Phased-Array-Body-Coil; b: 880 and 440 s/mm 2 ). Results. The ADC of regular vertebral bodies (1.3±0.23x10 -3 s/mm 2 ) was significantly (p -3 s/mm 2 ). Conclusions. These data demonstrate that the ADC can be reliably measured in vertebral bodies. The quantitative evaluation of the ADC in vertebral bodies seems to be an objective and comparable parameter for differentiating malign from benign vertebral tissue. (orig.) [de

  6. Balloon kyphoplasty for aged osteoporotic vertebral compressive fractures using domestic instruments

    International Nuclear Information System (INIS)

    Sun Gang; Jin Peng; Yi Yuhai; Xie Zhiyong; Zhang Xuping; Zhang Kangli

    2006-01-01

    Objective: To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful osteoporosis vertebral compressive fractures using instruments made in China. Methods: 10 cases of painful osteoporotic vertebral compressive fractures, involved 11 vertebrae. Under X-ray fluoroscopy monitoring, the inflatable balloon were inserted into the fractured vertebral body via transpedicular route bilaterally. The balloon was inflated with injected contrast agent to restore vertebral height and form a cavity within vertebral body. The cavity was then filled with bone cement in toothpaste state period. The postoperative symptoms and the radiographic findings of vertebral height recovery were observed. Results: Balloon kyphoplasty was successful in all 10 cases with dramatic pain relief within 48 hours after the procedure without clinical complications. The height restoration of vertebral body was satisfactory with correction of kyphosis up to 6 degree-24 degree. Leakage of a small quantity of bone cement occurred at only the anterior border of the vertebral body. Conclusions: Kyphoplasty using domestic instruments for painful osteoporotic vertebral compressive fractures was effective and safe. (authors)

  7. Vertebral basilar artery dissections

    International Nuclear Information System (INIS)

    Zimmerman, R.A.; Bilaniuk, L.T.; Hackney, D.B.; Grossman, R.I.; Goldberg, H.I.; Atlas, S.W.

    1988-01-01

    Eleven patients (ten male, one female; range, 2-56 years) presented with posterior circulation ischemic symptoms and were evaluated with computed tomography (CT) (eta=11), arteriography (eta=11), and magnetic resonance (MR) imaging (eta=6). Angiography showed dissection of a vertebral artery (eta=8), a basilar artery (eta=1), or a combination of both (eta=2). On CT and/or MR images, infarctions were demonstrated in ten of 11 cases. Most frequently involved were the thalmus (eta=7), cerebellum (eta=6), occipital lobes (eta=4), and pons (eta=3). The site of infarction did not correlate with the side or site of angiographic abnormality. In six cases evaluated by all modalities, MR imaging showed more extensive and widespread infarction than did CT and also showed whether or not the infarcts were hemorrhagic. MR imaging was able to demonstrate the presence of intramural dissecting hematoma prior to angiography and to indicate whether or not flow was reconstituted on follow-up examination

  8. Transpedicular hydroxyapatite grafting with indirect reduction for thoracolumbar burst fractures with neurological deficit: A prospective study

    Directory of Open Access Journals (Sweden)

    Toyone Tomoaki

    2007-01-01

    Full Text Available Background: The major problem after posterior correction and instrumentation in the treatment of thoracolumbar burst fractures is failure to support the anterior spinal column leading to loss of correction of kyphosis and hardware breakage. We conducted a prospective consecutive series to evaluate the outcome of the management of acute thoracolumbar burst fractures by transpedicular hydroxyapatite (HA grafting following indirect reduction and pedicle screw fixation. Materials and Methods: Eighteen consecutive patients who had thoracolumbar burst fractures and associated incomplete neurological deficit, operatively treated within four days of admission. Following indirect reduction and pedicle screw fixation, transpedicular intracorporeal HA grafting to the fractured vertebrae was performed. Mean operative time was 125 min and mean blood loss was 150 ml. Their implants were removed within one year and were prospectively followed for at least two years. Results: The neurological function of all 18 patients improved by at least one ASIA grade, with nine (50% patients demonstrating complete neurological recovery. Sagittal alignment was improved from a mean preoperative kyphosis of 17°to -2°(lordosis by operation, but was found to have slightly deteriorated to 1° at final follow-up observation. The CT images demonstrated a mean spinal canal narrowing pre-operatively immediate post-operative and at final followup of 60%, 22% and 11%, respectively . There were no instances of hardware failure. No patient reported severe pain or needed daily dosages of analgesics at the final follow-up. The two-year postoperative MRI demonstrated an increase of one grade in disc degeneration (n = 17 at the disc above and in 11 patients below the fractured vertebra. At the final follow-up, flexion-extension radiographs revealed that a median range of motion was 4, 6 and 34 degrees at the cranial segment of the fractured vertebra, caudal segment and L1-S1, respectively

  9. Matrix metalloproteinases outside vertebrates.

    Science.gov (United States)

    Marino-Puertas, Laura; Goulas, Theodoros; Gomis-Rüth, F Xavier

    2017-11-01

    The matrix metalloproteinase (MMP) family belongs to the metzincin clan of zinc-dependent metallopeptidases. Due to their enormous implications in physiology and disease, MMPs have mainly been studied in vertebrates. They are engaged in extracellular protein processing and degradation, and present extensive paralogy, with 23 forms in humans. One characteristic of MMPs is a ~165-residue catalytic domain (CD), which has been structurally studied for 14 MMPs from human, mouse, rat, pig and the oral-microbiome bacterium Tannerella forsythia. These studies revealed close overall coincidence and characteristic structural features, which distinguish MMPs from other metzincins and give rise to a sequence pattern for their identification. Here, we reviewed the literature available on MMPs outside vertebrates and performed database searches for potential MMP CDs in invertebrates, plants, fungi, viruses, protists, archaea and bacteria. These and previous results revealed that MMPs are widely present in several copies in Eumetazoa and higher plants (Tracheophyta), but have just token presence in eukaryotic algae. A few dozen sequences were found in Ascomycota (within fungi) and in double-stranded DNA viruses infecting invertebrates (within viruses). In contrast, a few hundred sequences were found in archaea and >1000 in bacteria, with several copies for some species. Most of the archaeal and bacterial phyla containing potential MMPs are present in human oral and gut microbiomes. Overall, MMP-like sequences are present across all kingdoms of life, but their asymmetric distribution contradicts the vertical descent model from a eubacterial or archaeal ancestor. This article is part of a Special Issue entitled: Matrix Metalloproteinases edited by Rafael Fridman. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Importance of MRI in the diagnosis of vertebral involvement in generalized cystic lymphangiomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Renjen, Pooja; Kovanlikaya, Arzu; Brill, Paula W. [New York Presbyterian Hospital/Weill Cornell Medical Center, Department of Radiology, New York, NY (United States); Narula, Navneet [New York Presbyterian Hospital/Weill Cornell Medical Center, Department of Pathology, New York, NY (United States)

    2014-11-15

    A 9-year-old boy presented with the sudden onset of pleuritic chest pain and on CT was found to have a large pleural effusion, mediastinal fluid, splenic lesions and multiple apparently sclerotic vertebral bodies. Subsequent MRI showed that those vertebral bodies that appeared sclerotic were in fact normal, and the vertebral bodies initially interpreted as normal had an abnormal T1 and T2 hyperintense signal on MRI and were relatively lucent on CT. MRI also demonstrated abnormal heterogeneous T2 hyperintense paraspinal tissue and several multicystic soft tissue masses. Biopsy of two adjacent vertebral bodies, one relatively sclerotic and one lucent, demonstrated findings of bony remodeling without a specific diagnosis. Biopsy of an infiltrative mediastinal mass confirmed the diagnosis of generalized cystic lymphangiomatosis. MRI should be included in the assessment of vertebral involvement in this condition because CT and biopsy findings may be nonspecific. (orig.)

  11. Rotations in a Vertebrate Setting

    Science.gov (United States)

    McCollum, Gin

    2003-05-01

    Rotational movements of the head are often considered to be measured in a single three dimensional coordinate system implemented by the semicircular canals of the vestibular system of the inner ear. However, the vertebrate body -- including the nervous system -- obeys rectangular symmetries alien to rotation groups. At best, nervous systems mimic the physical rotation group in a fragmented way, only partially reintegrating physical movements in whole organism responses. The vestibular canal reference frame is widely used in nervous systems, for example by eye movements. It is used to some extent even in the cerebrum, as evidenced by the remission of hemineglect -- in which half of space is ignored -- when the vestibular system is stimulated. However, reintegration of space by the organism remains incomplete. For example, compensatory eye movements (which in most cases aid visual fixation) may disagree with conscious self-motion perception. In addition, movement-induced nausea, illusions, and cue-free perceptions demonstrate symmetry breaking or incomplete spatial symmetries. As part of a long-term project to investigate rotation groups in nervous systems, we have analyzed the symmetry group of a primary vestibulo-spinal projection.

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

    Science.gov (United States)

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

    2017-08-01

    The vertebral column is the paradigm of the metameric architecture of the vertebrate body. Because the number of somites is a convenient parameter to stage early human embryos, we explored whether the closure of the vertebral canal could be used similarly for staging embryos between 7 and 10 weeks of development. Human embryos (5-10 weeks of development) were visualized using Amira 3D ® reconstruction and Cinema 4D ® remodelling software. Vertebral bodies were identifiable as loose mesenchymal structures between the dense mesenchymal intervertebral discs up to 6 weeks and then differentiated into cartilaginous structures in the 7th week. In this week, the dense mesenchymal neural processes also differentiated into cartilaginous structures. Transverse processes became identifiable at 6 weeks. The growth rate of all vertebral bodies was exponential and similar between 6 and 10 weeks, whereas the intervertebral discs hardly increased in size between 6 and 8 weeks and then followed vertebral growth between 8 and 10 weeks. The neural processes extended dorsolaterally (6th week), dorsally (7th week) and finally dorsomedially (8th and 9th weeks) to fuse at the midthoracic level at 9 weeks. From there, fusion extended cranially and caudally in the 10th week. Closure of the foramen magnum required the development of the supraoccipital bone as a craniomedial extension of the exoccipitals (neural processes of occipital vertebra 4), whereas a growth burst of sacral vertebra 1 delayed closure until 15 weeks. Both the cranial- and caudal-most vertebral bodies fused to form the basioccipital (occipital vertebrae 1-4) and sacrum (sacral vertebrae 1-5). In the sacrum, fusion of its so-called alar processes preceded that of the bodies by at least 6 weeks. In conclusion, the highly ordered and substantial changes in shape of the vertebral bodies leading to the formation of the vertebral canal make the development of the spine an excellent, continuous staging system for

  13. Evolutionary growth process of highly conserved sequences in vertebrate genomes.

    Science.gov (United States)

    Ishibashi, Minaka; Noda, Akiko Ogura; Sakate, Ryuichi; Imanishi, Tadashi

    2012-08-01

    Genome sequence comparison between evolutionarily distant species revealed ultraconserved elements (UCEs) among mammals under strong purifying selection. Most of them were also conserved among vertebrates. Because they tend to be located in the flanking regions of developmental genes, they would have fundamental roles in creating vertebrate body plans. However, the evolutionary origin and selection mechanism of these UCEs remain unclear. Here we report that UCEs arose in primitive vertebrates, and gradually grew in vertebrate evolution. We searched for UCEs in two teleost fishes, Tetraodon nigroviridis and Oryzias latipes, and found 554 UCEs with 100% identity over 100 bps. Comparison of teleost and mammalian UCEs revealed 43 pairs of common, jawed-vertebrate UCEs (jUCE) with high sequence identities, ranging from 83.1% to 99.2%. Ten of them retain lower similarities to the Petromyzon marinus genome, and the substitution rates of four non-exonic jUCEs were reduced after the teleost-mammal divergence, suggesting that robust conservation had been acquired in the jawed vertebrate lineage. Our results indicate that prototypical UCEs originated before the divergence of jawed and jawless vertebrates and have been frozen as perfect conserved sequences in the jawed vertebrate lineage. In addition, our comparative sequence analyses of UCEs and neighboring regions resulted in a discovery of lineage-specific conserved sequences. They were added progressively to prototypical UCEs, suggesting step-wise acquisition of novel regulatory roles. Our results indicate that conserved non-coding elements (CNEs) consist of blocks with distinct evolutionary history, each having been frozen since different evolutionary era along the vertebrate lineage. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Perisano Carlo

    2009-09-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

  16. Increased Seat Dump Angle in a Manual Wheelchair Is Associated With Changes in Thoracolumbar Lordosis and Scapular Kinematics During Propulsion.

    Science.gov (United States)

    Cloud, Beth A; Zhao, Kristin D; Ellingson, Arin M; Nassr, Ahmad; Windebank, Anthony J; An, Kai-Nan

    2017-10-01

    To quantify and compare spinal curvature and shoulder kinematics throughout the manual wheelchair (MWC) propulsion cycle for individuals with spinal cord injury (SCI) who were seated at 2 different seat dump angles. Single-group, repeated-measures study. Academic medical center. Individuals (N=28) with SCI or spinal cord disease who used MWCs completed a telephone screening, and 21 of them were eligible and completed the study. Participants' personal MWCs were modified to have seat dump angles of 0° or 14°, with a vertical backrest. Participants completed at least 3 propulsion cycles in each condition, during which spine and shoulder motion data were collected with fiberoptic and electromagnetic sensors, respectively. Thoracolumbar spinal curvature, glenohumeral kinematics, and scapulothoracic kinematics at the start of push (SP), mid-push (MP), end of push (EP), and mid-recovery. Participants had significantly less lordosis in the 14° condition for all propulsion events. Median differences ranged from 2.0° to 4.6°. Lordosis differences were more pronounced in those with low SCI. Scapulothoracic internal rotation was increased in the 14° condition at SP and MP (mean differences, 2.5° and 2.7°, respectively). Relative downward rotation increased in the 14° condition at SP and MP (mean differences, 2.4° and 2.1°, respectively). Scapulothoracic differences were more pronounced in those with high SCI. No glenohumeral rotations were significantly different between the conditions. Scapulothoracic kinematics and spinal curvature differences during propulsion may be associated with the position of other body segments or postural stability. Because no differences were observed at the glenohumeral joint, the risk of subacromial impingement may not be affected by this seat angle change. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. A great number of old vertebral fractures expressing instability are pedicle fractures. With the use of 64-line multi slice computerized tomography

    International Nuclear Information System (INIS)

    Kobayashi, Akihiko; Nishida, Kenki; Ogawa, Koichi; Takahashi, Yuichi; Nakahara, Masayuki; Hijikata, Yasukazu

    2008-01-01

    We examined old vertebral fractures expressing instability with the use of 64-line CT. From April 2006 to December 2006, CT photographic images of 15 unstable fractures were examined in detail. We confirmed gas or liquid in all vertebral bodies. In 5 cases (33%), vertebral body protruding into the canal was observed. Four cases (23%) had other vertebral fractures. In addition, 12 pedicle fractures (73%) were seen. We confirmed many pedicle fractures in vertebral fractures expressing instability. These results suggest that pedicle fracture is a risk factor for back pain associated with vertebral fracture. (author)

  18. Vertebral morphology influences the development of Schmorl's nodes in the lower thoracic vertebrae.

    Science.gov (United States)

    Plomp, Kimberly A; Roberts, Charlotte A; Viðarsdóttir, Una Strand

    2012-12-01

    Schmorl's nodes are the result of herniations of the nucleus pulposus into the adjacent vertebral body and are commonly identified in both clinical and archaeological contexts. The current study aims to identify aspects of vertebral shape that correlate with Schmorl's nodes. Two-dimensional statistical shape analysis was performed on digital images of the lower thoracic spine (T10-T12) of adult skeletons from the late medieval skeletal assemblages from Fishergate House, York, St. Mary Graces and East Smithfield Black Death cemeteries, London, and postmedieval Chelsea Old Church, London. Schmorl's nodes were scored on the basis of their location, depth, and size. Results indicate that there is a correlation between the shape of the posterior margin of the vertebral body and pedicles and the presence of Schmorl's nodes in the lower thoracic spine. The size of the vertebral body in males was also found to correlate with the lesions. Vertebral shape differences associated with the macroscopic characteristics of Schmorl's nodes, indicating severity of the lesion, were also analyzed. The shape of the pedicles and the posterior margin of the vertebral body, along with a larger vertebral body size in males, have a strong association with both the presence and severity of Schmorl's nodes. This suggests that shape and/or size of these vertebral components are predisposing to, or resulting in, vertically directed disc herniation. Copyright © 2012 Wiley Periodicals, Inc.

  19. The varying distribution of intra- and inter-vertebral height ratios determines the prevalence of vertebral fractures.

    Science.gov (United States)

    Zebaze, Roger Martin Djoumessi; Djoumessi, Roger Martin Zebaze; Maalouf, Ghassan; Wehbe, Joseph; Nehme, Alexandre; Maalouf, Naim; Seeman, Ego

    2004-08-01

    Credible inferences regarding the burden of vertebral fractures (VFs) cannot be made without a globally accepted quantitative definition of 'fracture'. Currently, differences in anterior, middle, or posterior vertebral heights (VHs) within a vertebra, or between adjacent vertebrae, are used to define 'fracture'. However, VH differences are essential for the construction of thoracolumbar curves, evolutionary adaptations that provide stability in bipedal stance and gait. As there is no reference standard to distinguish anatomical variation from fracture, approaches to defining a VF use a reference range of VH ratios derived in premenopausal women or derived by trimming, a method that iteratively removes the tails of a distribution of VH ratios to produce a normal distribution. From this, reference ranges of VH ratio means and standard deviations (SDs) are obtained and a nominal deviation of 15% or more, or 3 SD or more is regarded as a 'fracture'. We measured VHs by quantitative vertebral morphometry (QVM) and bone mineral density (BMD) by dual energy X-ray absorptiometry in 697 Lebanese women (age 20-89 years) to compare the prevalence of VF ascertained by published methods and a new method that uses the premenopausal range (without trimming) and requires two VH abnormalities. VF prevalence using published methods reached 60% to 70% in pre- and post-menopausal women, and in women with normal or high BMD because VH ratios were not normally distributed and cut-offs used to define VF fracture fell within the observed distribution of the data. The new method resulted in a VF prevalence of 3.3% in younger and 14% in older women, 7% (high), 10% (middle), and 20% (low) BMD tertiles consistent with the notion that the method detected VF due to bone fragility. We suggest that using a fixed trimming method to define reference range and cut-offs or applying fixed cut-offs to identify VFs in populations, where these ratios are not normally distributed, may result in the capture

  20. Primary extracranial vertebral artery aneurysms.

    Science.gov (United States)

    Morasch, Mark D; Phade, Sachin V; Naughton, Peter; Garcia-Toca, Manuel; Escobar, Guillermo; Berguer, Ramon

    2013-05-01

    Extracranial vertebral artery aneurysms are uncommon and are usually associated with trauma or dissection. Primary cervical vertebral aneurysms are even rarer and are not well described. The presentation and natural history are unknown and operative management can be difficult. Accessing aneurysms at the skull base can be difficult and, because the frail arteries are often afflicted with connective tissue abnormalities, direct repair can be particularly challenging. We describe the presentation and surgical management of patients with primary extracranial vertebral artery aneurysms. In this study we performed a retrospective, multi-institutional review of patients with primary aneurysms within the extracranial vertebral artery. Between January 2000 and January 2011, 7 patients, aged 12-56 years, were noted to have 9 primary extracranial vertebral artery aneurysms. All had underlying connective tissue or another hereditary disorder, including Ehler-Danlos syndrome (n=3), Marfan's disease (n=2), neurofibromatosis (n=1), and an unspecified connective tissue abnormality (n=1). Eight of 9 aneurysms were managed operatively, including an attempted bypass that ultimately required vertebral ligation; the contralateral aneurysm on this patient has not been treated. Open interventions included vertebral bypass with vein, external carotid autograft, and vertebral transposition to the internal carotid artery. Special techniques were used for handling the anastomoses in patients with Ehler-Danlos syndrome. Although endovascular exclusion was not performed in isolation, 2 hybrid procedures were performed. There were no instances of perioperative stroke or death. Primary extracranial vertebral artery aneurysms are rare and occur in patients with hereditary disorders. Operative intervention is warranted in symptomatic patients. Exclusion and reconstruction may be performed with open and hybrid techniques with low morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights

  1. Ancient deuterostome origins of vertebrate brain signalling centres.

    Science.gov (United States)

    Pani, Ariel M; Mullarkey, Erin E; Aronowicz, Jochanan; Assimacopoulos, Stavroula; Grove, Elizabeth A; Lowe, Christopher J

    2012-03-14

    Neuroectodermal signalling centres induce and pattern many novel vertebrate brain structures but are absent, or divergent, in invertebrate chordates. This has led to the idea that signalling-centre genetic programs were first assembled in stem vertebrates and potentially drove morphological innovations of the brain. However, this scenario presumes that extant cephalochordates accurately represent ancestral chordate characters, which has not been tested using close chordate outgroups. Here we report that genetic programs homologous to three vertebrate signalling centres-the anterior neural ridge, zona limitans intrathalamica and isthmic organizer-are present in the hemichordate Saccoglossus kowalevskii. Fgf8/17/18 (a single gene homologous to vertebrate Fgf8, Fgf17 and Fgf18), sfrp1/5, hh and wnt1 are expressed in vertebrate-like arrangements in hemichordate ectoderm, and homologous genetic mechanisms regulate ectodermal patterning in both animals. We propose that these genetic programs were components of an unexpectedly complex, ancient genetic regulatory scaffold for deuterostome body patterning that degenerated in amphioxus and ascidians, but was retained to pattern divergent structures in hemichordates and vertebrates. © 2012 Macmillan Publishers Limited. All rights reserved

  2. iDNA screening: Disease vectors as vertebrate samplers.

    Science.gov (United States)

    Kocher, Arthur; de Thoisy, Benoit; Catzeflis, François; Valière, Sophie; Bañuls, Anne-Laure; Murienne, Jérôme

    2017-11-01

    In the current context of global change and human-induced biodiversity decline, there is an urgent need for developing sampling approaches able to accurately describe the state of biodiversity. Traditional surveys of vertebrate fauna involve time-consuming and skill-demanding field methods. Recently, the use of DNA derived from invertebrate parasites (leeches and blowflies) was suggested as a new tool for vertebrate diversity assessment. Bloodmeal analyses of arthropod disease vectors have long been performed to describe their feeding behaviour, for epidemiological purposes. On the other hand, this existing expertise has not yet been applied to investigate vertebrate fauna per se. Here, we evaluate the usefulness of hematophagous dipterans as vertebrate samplers. Blood-fed sand flies and mosquitoes were collected in Amazonian forest sites and analysed using high-throughput sequencing of short mitochondrial markers. Bloodmeal identifications highlighted contrasting ecological features and feeding behaviour among dipteran species, which allowed unveiling arboreal and terrestrial mammals of various body size, as well as birds, lizards and amphibians. Additionally, lower vertebrate diversity was found in sites undergoing higher levels of human-induced perturbation. These results suggest that, in addition to providing precious information on disease vector host use, dipteran bloodmeal analyses may represent a useful tool in the study of vertebrate communities. Although further effort is required to validate the approach and consider its application to large-scale studies, this first work opens up promising perspectives for biodiversity monitoring and eco-epidemiology. © 2017 John Wiley & Sons Ltd.

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

    LENUS (Irish Health Repository)

    Cawley, D T

    2011-06-01

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

  4. Cost-Utility Analysis of Pedicle Screw Removal After Successful Posterior Instrumented Fusion in Thoracolumbar Burst Fractures.

    Science.gov (United States)

    Lee, Han-Dong; Jeon, Chang-Hoon; Chung, Nam-Su; Seo, Young-Wook

    2017-08-01

    A cost-utility analysis (CUA). The aim of this study was to determine the cost-effectiveness of pedicle screw removal after posterior fusion in thoracolumbar burst fractures. Pedicle screw instrumentation is a standard fixation method for unstable thoracolumbar burst fracture. However, removal of the pedicle screw after successful fusion remains controversial because the clinical benefits remain unclear. CUA can help clinicians make appropriate decisions about optimal health care for pedicle screw removal after successful fusion in thoracolumbar burst fractures. We conducted a single-center, retrospective, longitudinal matched-cohort study of prospectively collected outcomes. In total, 88 consecutive patients who had undergone pedicle screw instrumentation for thoracolumbar burst fracture with successful fusion confirmed by computed tomography (CT) were used in this study. In total, 45 patients wanted to undergo implant removal surgery (R group), and 43 decided not to remove the implant (NR group). A CUA was conducted from the health care perspective. The direct costs of health care were obtained from the medical bill of each patient. Changes in health-related quality of life (HRQoL) scores, validated by Short Form 6D, were used to calculate quality-adjusted life-years (QALYs). Total costs and gained QALY were calculated at 1 year (1 year) and 2 years (2 years) compared with baseline. Results are expressed as an incremental cost-effectiveness ratio (ICER). Different discount rates (0%, 3%, and 5%) were applied to both cost and QALY for sensitivity analysis. Baseline patient variables were similar between the two groups (all P > 0.05). The additional benefits of implant removal (0.201 QALY at 2 years) were achieved with additional costs ($2541 at 2 years), equating to an ICER of $12,641/QALY. On the basis of the different discount rates, the robustness of our study's results was also determined. Implant removal after successful fusion in a thoracolumbar burst

  5. Retrospective analysis of whole-body multislice computed tomography findings taken in trauma patients

    Directory of Open Access Journals (Sweden)

    Ozlem Bingol

    2015-09-01

    Full Text Available Objectives: Using whole-body multislice computed tomography (MSCT excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department. Methods: Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images have been taken, were evaluated using the “Nucleus Medical Information System”. Results: The most frequent type of trauma was traffic accidents in 61.4%, falling down from the height in 22.4%, and motorcycle accidents in 11.4% of patients. Of the patients, 25.2% were discharged from the emergency, while 73.8% were hospitalized. At least one CT findings associated with trauma was present in 61.4% of our patients. Pathological findings in MSCT were most frequently detected in the head and face (35.3% and thoracic (28.6% regions, respectively. The most common finding in the head and face region was fractures. The most common pathological findings in the thoracic region were pulmonary contusion and rib fractures. A significant relationship was detected between trauma type and spinal MSCT result (p < 0.001. In a large percentage of the patients, MSCT findings were normal in the abdominal region and genitourinary system. Vertebral fractures were most frequently detected in the thoracolumbar region. Conclusions: In our study, our rate of negative CT was found to be 38.6%, which is a higher ratio compared to other studies conducte on this topic. Keywords: Emergency, Trauma, Whole-body multislice computed tomography

  6. Extinction risk is most acute for the world's largest and smallest vertebrates.

    Science.gov (United States)

    Ripple, William J; Wolf, Christopher; Newsome, Thomas M; Hoffmann, Michael; Wirsing, Aaron J; McCauley, Douglas J

    2017-10-03

    Extinction risk in vertebrates has been linked to large body size, but this putative relationship has only been explored for select taxa, with variable results. Using a newly assembled and taxonomically expansive database, we analyzed the relationships between extinction risk and body mass (27,647 species) and between extinction risk and range size (21,294 species) for vertebrates across six main classes. We found that the probability of being threatened was positively and significantly related to body mass for birds, cartilaginous fishes, and mammals. Bimodal relationships were evident for amphibians, reptiles, and bony fishes. Most importantly, a bimodal relationship was found across all vertebrates such that extinction risk changes around a body mass breakpoint of 0.035 kg, indicating that the lightest and heaviest vertebrates have elevated extinction risk. We also found range size to be an important predictor of the probability of being threatened, with strong negative relationships across nearly all taxa. A review of the drivers of extinction risk revealed that the heaviest vertebrates are most threatened by direct killing by humans. By contrast, the lightest vertebrates are most threatened by habitat loss and modification stemming especially from pollution, agricultural cropping, and logging. Our results offer insight into halting the ongoing wave of vertebrate extinctions by revealing the vulnerability of large and small taxa, and identifying size-specific threats. Moreover, they indicate that, without intervention, anthropogenic activities will soon precipitate a double truncation of the size distribution of the world's vertebrates, fundamentally reordering the structure of life on our planet.

  7. Rehabilitation in osteoporotic vertebral fractures

    OpenAIRE

    Pratelli, Elisa; Cinotti, Irene; Pasquetti, Pietro

    2010-01-01

    Vertebral fractures occur particularly in osteoporotic patients due to an increased bone fragility. Vertebral fractures influence the quality of life, mobility and mortality. Preventive training exercises and proprioception reeducation can be utilised for improving posture, balance and level of daily function and for decreasing pain. Quality of life is improved even beyond the active training period. This mini review provides information based on the literature for the rehabilitation of osteo...

  8. The relationship of older age and perioperative outcomes following thoracolumbar three-column osteotomy for adult spinal deformity: an analysis of 300 consecutive cases.

    Science.gov (United States)

    Lau, Darryl; Osorio, Joseph A; Deviren, Vedat; Ames, Christopher P

    2018-04-06

    OBJECTIVE Three-column osteotomies are increasingly being used in the elderly population to correct rigid spinal deformities. There is hesitation, however, in performing the technique in older patients because of the high risk for blood loss, longer operative times, and complications. This study assesses whether age alone is an independent risk factor for complications and length of stay. METHODS All patients with thoracolumbar adult spinal deformity (ASD) who underwent 3-column osteotomy (vertebral column resection or pedicle subtraction osteotomy) performed by the senior author from 2006 to 2016 were identified. Demographics, clinical baseline, and surgical details were collected. Outcomes of interest included perioperative complication, ICU stay, and hospital stay. Bivariate and multivariate analyses were used to assess the association of age with outcomes of interest. RESULTS A total of 300 patients were included, and 38.3% were male. The mean age was 63.7 years: 10.3% of patients were younger than 50 years, 36.0% were 50-64 years, 45.7% were 65-79 years, and 8.0% were 80 years or older. The overall mean EBL was 1999 ml. The overall perioperative complication rate was 24.7%: 18.0% had a medical complication and 7.0% had a surgical complication. There were no perioperative or 30-day deaths. Age was associated with overall complications (p = 0.002) and medical-specific complications (p column osteotomy for ASD. Comorbidities and other unknown variables that come with age are likely what put these patients at higher risk for complications. Older age, however, is independently associated with longer ICU and hospital stays.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  10. Computer simulation of two-level pedicle subtraction osteotomy for severe thoracolumbar kyphosis in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Ning Zhang

    2017-01-01

    Full Text Available Background: Advanced ankylosing spondylitis is often associated with thoracolumbar kyphosis, resulting in an abnormal spinopelvic balance and pelvic morphology. Different osteotomy techniques have been used to correct AS deformities, unfortunnaly, not all AS patients can gain spinal sagittal balance and good horizontal vision after osteotomy. Materials and Methods: Fourteen consecutive AS patients with severe thoracolumbar kyphosis who were treated with two-level PSO were studied retrospectively. All were male with a mean age of 34.9 ± 9.6 years. The followup ranged from 1–5 years. Preoperative computer simulations using the Surgimap Spinal software were performed for all patients, and the osteotomy level and angle determined from the computer simulation were used surgically. Spinal sagittal parameters were measured preoperatively, after the computer simulation, and postoperatively and included thoracic kyphosis (TK, lumbar lordosis (LL, sagittal vertical axis (SVA, pelvic incidence, pelvic tilt (PT, and sacral slope (SS. The level of correlation between the computer simulation and postoperative parameters was evaluated, and the differences between preoperative and postoperative parameters were compared. The visual analog scale (VAS for back pain and clinical outcome was also assessed. Results: Six cases underwent PSO at L1 and L3, five cases at L2 and T12, and three cases at L3 and T12. TK was corrected from 57.8 ± 15.2° preoperatively to 45.3 ± 7.7° postoperatively (P < 0.05, LL from 9.3 ± 17.5° to −52.3 ± 3.9° (P < 0.001, SVA from 154.5 ± 36.7 to 37.8 ± 8.4 mm (P < 0.001, PT from 43.3 ± 6.1° to 18.0 ± 0.9° (P < 0.001, and SS from 0.8 ± 7.0° to 26.5 ± 10.6° (P < 0.001. The LL, VAS, and PT of the simulated two-level PSO were highly consistent with, or almost the same as, the postoperative parameters. The correlations between the computer simulations and postoperative parameters were significant. The VAS decreased

  11. 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.

  12. The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures

    Directory of Open Access Journals (Sweden)

    Farzanah Ismail

    2013-06-01

    Method: A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist. Results: The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury, had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 to C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations. Conclusion: Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.

  13. Nonsurgical Corrective Union of Osteoporotic Vertebral Fracture with Once-Weekly Teriparatide

    Directory of Open Access Journals (Sweden)

    Naohisa Miyakoshi

    2015-01-01

    Full Text Available Osteoporotic vertebral fractures usually heal with kyphotic deformities with subsidence of the vertebral body when treated conservatively. Corrective vertebral union using only antiosteoporotic pharmacotherapy without surgical intervention has not been reported previously. An 81-year-old female with osteoporosis presented with symptomatic fresh L1 vertebral fracture with intravertebral cleft. Segmental vertebral kyphosis angle (VKA at L1 was 20° at diagnosis. Once-weekly teriparatide administration, hospitalized rest, and application of a thoracolumbosacral orthosis alleviated symptoms within 2 months. Corrective union of the affected vertebra was obtained with these treatments. VKA at 2 months after injury was 8° (correction, 12° and was maintained as of the latest follow-up at 7 months. Teriparatide has potent bone-forming effects and has thus been expected to enhance fracture healing. Based on the clinical experience of this case, teriparatide may have the potential to allow correction of unstable vertebral fractures without surgical intervention.

  14. Permo-Triassic vertebrate extinctions: A program

    Science.gov (United States)

    Olson, E. C.

    1988-01-01

    Since the time of the Authors' study on this subject, a great deal of new information has become available. Concepts of the nature of extinctions have changed materially. The Authors' conclusion that a catastrophic event was not responsible for the extinction of vertebrates has modified to the extent that hypotheses involving either the impact of a massive extra-terrestrial body or volcanism provide plausible but not currently fully testable hypotheses. Stated changes resulted in a rapid decrease in organic diversity, as the ratio of origins of taxa to extinctions shifted from strongly positive to negative, with momentary equilibrium being reached at about the Permo-Triassic boundary. The proximate causes of the changes in the terrestrial biota appear to lie in two primary factors: (1) strong climatic changes (global mean temperatures, temperature ranges, humidity) and (2) susceptibility of the dominant vertebrates (large dicynodonts) and the glossopteris flora to disruption of the equlibrium of the world ecosystem. The following proximate causes have been proposed: (1) rhythmic fluctuations in solar radiation, (2) tectonic events as Pangea assembled, altering land-ocean relationships, patterns of wind and water circulation and continental physiography, (3) volcanism, and (4) changes subsequent to impacts of one or more massive extra terrestrial objects, bodies or comets. These hypotheses are discussed.

  15. Axial dynamics during locomotion in vertebrates: lesson from the salamander

    OpenAIRE

    GOSSARD, JEAN-PIERRE; DUBUC, RÉJEAN; KOLTA, ARLETTE; Cabelguen, Jean-Marie; Ijspeert, Auke; Lamarque, Stéphanie; Ryczko, Dimitri

    2010-01-01

    Much of what we know about the flexibility of the locomotor networks in vertebrates is derived from studies examining the adaptation of limb movements during stepping in various conditions. However, the body movements play important roles during locomotion: they produce the thrust during undulatory locomotion and they help to increase the stride length during legged locomotion. In this chapter, we review our current knowledge about the flexibility in the neuronal circuits controlling the body...

  16. Correlation of plain radiographic and lumbar myelographic findings with surgical findings in thoracolumbar disc disease

    International Nuclear Information System (INIS)

    Oldby, N.J.; Dyce, J.; Houlton, J.E.F.

    1994-01-01

    The results of a prospective study to compare the plain radiographic and lumbar myelographic findings with the surgical findings in 70 cases of suspected thoracolumbar disc protrusion in the dog are reported. The aim was to assess the relative accuracy of disc lesion localisation using plain and contrast radiography. From the plain radiographs, the affected disc space was correctly identified in 40 cases (57.1 per cent), and incorrectly identified in seven. More than one site was identified in 11; in eight of these dogs, the affected disc space was strongly suspected. It was not possible to identify an affected disc in 12 cases. The site of disc protrusion was accurately identified by myelography in 60 dogs (85.7 per cent). In four dogs, myelography was helpful in identifying an adjacent disc and, in a further two, cord swelling was found at surgery. In one dog, neither disc material nor cord swelling was identified. Three myelograms were non-diagnostic

  17. Shark-bitten vertebrate coprolites from the Miocene of Maryland

    Science.gov (United States)

    Godfrey, Stephen J.; Smith, Joshua B.

    2010-05-01

    Coprolites (fossilized feces) preserve a wide range of biogenic components, from bacteria and spores to a variety of vertebrate tissues. Two coprolites from the Calvert Cliffs outcrop belt (Miocene-aged Chesapeake Group), MD, USA, preserve shark tooth impressions in the form of partial dental arcades. The specimens are the first known coprolites to preserve vertebrate tooth marks. They provide another example of trace fossils providing evidence of prehistoric animal behaviors that cannot be directly approached through the study of body fossils. Shark behaviors that could account for these impressions include: (1) aborted coprophagy, (2) benthic or nektonic exploration, or (3) predation.

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

    Science.gov (United States)

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

    2014-01-01

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

  19. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

    Directory of Open Access Journals (Sweden)

    van Loon Piet JM

    2012-10-01

    Full Text Available Abstract Study design A prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis. Summary of background data Conservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention. Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis. Methods A consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve Results Before treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p Conclusion Conservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

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

    Science.gov (United States)

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

    2015-09-01

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

  1. Correlation of outcome measures with epidemiological factors in thoracolumbar spinal trauma

    Directory of Open Access Journals (Sweden)

    Upendra Bidre

    2007-01-01

    Full Text Available Background : The epidemiological data of a given population on spinal trauma in India is lacking. The present study was undertaken to evaluate the profile of patients with thoracolumbar fractures in a tertiary care hospital in an urban setup. Materials and Methods : Four hundred forty patients with thoracolumbar spinal injuries admitted from January 1990 to May 2000 to the All India Institute of Medical Sciences were included in the analysis. Both retrospective data retrieval and prospective data evaluation of patients were done from January 1998 to May 2000. Epidemiological factors like age, sex and type of injury, mode of transport, time of reporting and number of transfers before admission were recorded. Frankel′s grading was used to assess neurological status. Functional assessment of all patients was done using the FIM™ instrument (Functional Independence Measure. Average follow-up was 33 months (24-41 months. Results : Of the 440 patients, females comprised 17.95% (n=79, while 82.04% (n=361 were males. As many as 40.9% (n=180 of them were in the third decade. Fall from height remained the most common cause 52.3% (n=230. Two hundred sixty (59.1% patients reported within 48 hours. Thirty-two (7.27% patients had single transfer, and all 32 showed complete independence for mobility at final follow-up. 100 of 260 (38.5% patients reporting within 48 hours developed pressure sores, while 114 of 142 (80.28% patients reporting after 5 days developed pressure sores. Conclusion : The present study highlights the magnitude of the problems of our trauma-care and transport system and the difference an effective system can make in the care of spinal injury patients. There is an urgent need for epidemiological data on a larger scale to emphasize the need for a better trauma-care system and pave way for adaptation of well-established trauma-care systems from developed countries.

  2. Multidimensional Analysis of Magnetic Resonance Imaging Predicts Early Impairment in Thoracic and Thoracolumbar Spinal Cord Injury

    Science.gov (United States)

    Mabray, Marc C.; Whetstone, William D.; Dhall, Sanjay S.; Phillips, David B.; Pan, Jonathan Z.; Manley, Geoffrey T.; Bresnahan, Jacqueline C.; Beattie, Michael S.; Haefeli, Jenny

    2016-01-01

    Abstract Literature examining magnetic resonance imaging (MRI) in acute spinal cord injury (SCI) has focused on cervical SCI. Reproducible systems have been developed for MRI-based grading; however, it is unclear how they apply to thoracic SCI. Our hypothesis is that MRI measures will group as coherent multivariate principal component (PC) ensembles, and that distinct PCs and individual variables will show discriminant validity for predicting early impairment in thoracic SCI. We undertook a retrospective cohort study of 25 patients with acute thoracic SCI who underwent MRI on admission and had American Spinal Injury Association Impairment Scale (AIS) assessment at hospital discharge. Imaging variables of axial grade, sagittal grade, length of injury, thoracolumbar injury classification system (TLICS), maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were collected. We performed an analytical workflow to detect multivariate PC patterns followed by explicit hypothesis testing to predict AIS at discharge. All imaging variables loaded positively on PC1 (64.3% of variance), which was highly related to AIS at discharge. MCC, MSCC, and TLICS also loaded positively on PC2 (22.7% of variance), while variables concerning cord signal abnormality loaded negatively on PC2. PC2 was highly related to the patient undergoing surgical decompression. Variables of signal abnormality were all negatively correlated with AIS at discharge with the highest level of correlation for axial grade as assessed with the Brain and Spinal Injury Center (BASIC) score. A multiple variable model identified BASIC as the only statistically significant predictor of AIS at discharge, signifying that BASIC best captured the variance in AIS within our study population. Our study provides evidence of convergent validity, construct validity, and clinical predictive validity for the sampled MRI measures of SCI when applied in acute thoracic and thoracolumbar SCI. PMID:26414451

  3. Minimal invasive stabilization of osteoporotic vertebral compression fractures. Methods and preinterventional diagnostics

    International Nuclear Information System (INIS)

    Grohs, J.G.; Krepler, P.

    2004-01-01

    Minimal invasive stabilizations represent a new alternative for the treatment of osteoporotic compression fractures. Vertebroplasty and balloon kyphoplasty are two methods to enhance the strength of osteoporotic vertebral bodies by the means of cement application. Vertebroplasty is the older and technically easier method. The balloon kyphoplasty is the newer and more expensive method which does not only improve pain but also restores the sagittal profile of the spine. By balloon kyphoplasty the height of 101 fractured vertebral bodies could be increased up to 90% and the wedge decreased from 12 to 7 degrees. Pain was reduced from 7,2 to 2,5 points. The Oswestry disability index decreased from 60 to 26 points. This effects persisted over a period of two years. Cement leakage occurred in only 2% of vertebral bodies. Fractures of adjacent vertebral bodies were found in 11%. Good preinterventional diagnostics and intraoperative imaging are necessary to make the balloon kyphoplasty a successful application. (orig.) [de

  4. MRI evaluation and treatment of osteoporotic vertebral compression fracture

    International Nuclear Information System (INIS)

    Yamaguchi, Ken; Otani, Koji

    2003-01-01

    The purpose of this study was to investigate the relation between Gd-DTPA enhanced MRI findings and the prognosis of the fractured vertebral body in the patients with fresh osteoporotic compression vertebral fractures. Subjects were 8 cases, 11 vertebrae. All of the cases were treated with no bed rest and no corset. MRI and radiographs were taken within 1 week after injury. MRI signal intensity of the fractured vertebral body altered low on T1WI at acute phase. When the fractured vertebrae were enhanced at whole area with Gd-DTPA at acute phase, the vertebrae showed no progression of wedge deformity by follow up radiographs. On the other hand, when the fractured vertebrae were not enhanced at whole area, the vertebrae showed progression of wedge deformity. These findings suggests that vertebral fractures in osteoporosis should be taken MRI including GD-DTPA in acute phase after injury. When the fractured vertebrae are enhanced with Gd-DTPA in whole body at acute phase, the fracture may need no special treatment. In conclusion, Gd-DTPA enhanced MRI may be useful to determine the prognosis of the osteoporotic compression fracture. (author)

  5. Vertebrate pressure-gradient receivers

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2011-01-01

    The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum and stro......The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum....... Recent vertebrates form a continuum from perfect interaural transmission (0 dB in a certain frequency band) and pronounced eardrum directionality (30-40 dB) in the lizards, over somewhat attenuated transmission and limited directionality in birds and frogs, to the strongly attenuated interaural...

  6. Complex Vertebral Malformation (CVM) in an Italian Holstein calf

    International Nuclear Information System (INIS)

    Gentile, A.; Diana, A.; Testoni, S.; Olzi, E.

    2004-01-01

    Complex Vertebral Malformation, a congenital and lethal genetic defect of Holstein breed, has been recently observed in different Countries all over the world. In this paper the AA describe the clinical and radiological aspects of CVM in a two day old female calf. The disease was characterized by low body weight, symmetrical arthrogryposis and partial rotation of all legs and scoliosis. Calf was alert and showed physiological appetite, but was not able to maintain the quadrupedal stance. Radiographs of the vertebral column showed multiple vertebral anomalies, including hemivertebrae, fused and misshapen vertebrae and ribs and scoliosis, that affected mainly the caudal, cervical and thoracic regions. At necropsy, besides the skeleton anomalies, complex malformation of the heart was observed, which included atrial and interventricular defects and patent ductus arteriosus. This is the first case of CVM completely documented and genetically tested in Italy [it

  7. The largest Silurian vertebrate and its palaeoecological implications

    Science.gov (United States)

    Choo, Brian; Zhu, Min; Zhao, Wenjin; Jia, Liaotao; Zhu, You'an

    2014-01-01

    An apparent absence of Silurian fishes more than half-a-metre in length has been viewed as evidence that gnathostomes were restricted in size and diversity prior to the Devonian. Here we describe the largest pre-Devonian vertebrate (Megamastax amblyodus gen. et sp. nov.), a predatory marine osteichthyan from the Silurian Kuanti Formation (late Ludlow, ~423 million years ago) of Yunnan, China, with an estimated length of about 1 meter. The unusual dentition of the new form suggests a durophagous diet which, combined with its large size, indicates a considerable degree of trophic specialisation among early osteichthyans. The lack of large Silurian vertebrates has recently been used as constraint in palaeoatmospheric modelling, with purported lower oxygen levels imposing a physiological size limit. Regardless of the exact causal relationship between oxygen availability and evolutionary success, this finding refutes the assumption that pre-Emsian vertebrates were restricted to small body sizes. PMID:24921626

  8. Health economic aspects of vertebral augmentation procedures.

    Science.gov (United States)

    Borgström, F; Beall, D P; Berven, S; Boonen, S; Christie, S; Kallmes, D F; Kanis, J A; Olafsson, G; Singer, A J; Åkesson, K

    2015-04-01

    We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing published studies on the cost-effectiveness of VAPs in patients with osteoporosis. Only peer-reviewed published articles that fulfilled the criteria of being regarded as full economic evaluations including both morbidity and mortality in the outcome measure in the form of quality-adjusted life years (QALYs) were included. The search identified 949 studies, of which four (0.4 %) were identified as relevant with one study added later. The reviewed studies differed widely in terms of study design, modelling framework and data used, yielding different results and conclusions regarding the cost-effectiveness of VAPs. Three out of five studies indicated in the base case results that VAPs were cost effective compared to non-surgical management (NSM). The five main factors that drove the variations in the cost-effectiveness between the studies were time horizon, quality of life effect of treatment, offset time of the treatment effect, reduced number of bed days associated with VAPs and mortality benefit with treatment. The cost-effectiveness of VAPs is uncertain. In answering the remaining questions, new cost-effectiveness analysis will yield limited benefit. Rather, studies that can reduce the uncertainty in the underlying data

  9. Vertebral Fractures and Spondylosis in Men - Original Investigation

    Directory of Open Access Journals (Sweden)

    Selmin Gülbahar

    2008-04-01

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

  10. Anterior surgical management of the cervicothoracic junction lesions at T1 and T2 vertebral bodies Manejo cirúrgico via anterior das lesões da junção cérvico-torácica nos corpos vertebrais de T1 e T2

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2008-06-01

    Full Text Available Lesions of the cervicothoracic junction have a high propensity for causing instability and present unique challenges in the surgical treatment. Several surgical approaches to this region have been described in the literature. We report our experience in the surgical treatment of six patients with unstable lesions involving the cervicothoracic junction at T1 and T2 vertebral bodies. The patients underwent an anterior left Smith-Robinson approach and manubriotomy. Mesh and cervical plate system were used for stabilization and reconstruction of the region. No complication related to the surgical procedure was observed. In our experience, in injuries involving the T1 and T2 vertebral bodies, the transmanubrial approach offers good working room to remove the lesions and anterior reconstruction.Lesões da junção cérvico-torácica têm alta tendência em causar instabilidade e apresentam grandes desafios ao tratamento cirúrgico. Diversas abordagens cirúrgicas a esta região foram descritas na literatura. Relatamos nossa experiência no tratamento cirúrgico de seis pacientes com lesões instáveis envolvendo a junção cérvico-torácica em corpos vertebrais de T1 e T2. Os pacientes foram submetidos a uma abordagem anterior de Smith-Robinson pela esquerda e manubriotomia. Mesh e placa cervical foram utilizados para estabilização e reconstrução da região. Nenhuma complicação relacionada ao procedimento cirúrgico foi observada. Em nossa experiência, em lesões que envolvem os corpos vertebrais de T1 e T2, a abordagem transmanubrial oferece bom campo de trabalho para remoção das lesões e estabilização anterior.

  11. Estudo biomecânico da fixação pedicular curta na fratura-explosão toracolombar Estudio biomecánico de fijación pedicular corta en la fracturaexplosión toracolumbar Biomechanical evaluation of short-segment fixation for thoracolumbar burst-fractures

    Directory of Open Access Journals (Sweden)

    Marcos André Sonagli

    2011-01-01

    controlada. Los parámetros de carga (N y desplazamiento (mm eran generados en un gráfico instantáneo y la rigidez (N/mm fue determinada. El test era interrumpido cuando ocurría una caída súbita en la curva en el gráfico señalando la falla de la muestra. RESULTADOS: La rigidez de las columnas fracturadas fue 53% menor que la rigidez de las columnas intactas, siendo esta diferencia estadísticamente significativa (pOBJECTIVE: Compare the biomechanical stiffness between the intact spine, the spine with burst fracture and the short-segment pedicle fixation on porcine thoracolumbar burst fracture. METHODS: 30 samples of thoracolumbar spine (T11-L3 of porcine were divided into three groups with 10 samples each. Group 1 represented the intact spine, Group 2 the spine with burst fracture and Group 3 the burst fracture associated with short-segment pedicle fixation. The burst fracture injury was created with a "V" shape cut of the third middle of the vertebral body compromising the L1 anterior and medial columns simulating the burst fracture. Group 3 was stabilized with Schanz pedicle screws. The groups were subjected to biomechanical testing in a controlled axial compression. The parameters of load (N and displacement (mm were generated in a graphic snapshot and stiffness (N/mm was determined. The test was stopped when there was a sudden drop in the curve on the chart indicating failure of the sample. RESULTS: The stiffness of the fractured spines was 53% lower than the stiffness of the intact spine and this difference was statistically significant (p < 0.05. The stiffness of the short-segment pedicle fixation was 50% higher than the fractured spine. This difference was statistically significant (p < 0.05. The stiffness of the short-segment pedicle fixation was 30% lower than the intact spine. These differences were statistically significant (p < 0.05. CONCLUSION: The short-segment pedicle fixation does not provide sufficient stability to restore the stiffness of the intact

  12. Thoracolumbar spinal neurenteric cyst with tethered cord syndrome and extreme cervical lordosis in a child: A case report and literature review.

    Science.gov (United States)

    Lan, Zhi Gang; Richard, Seidu A; Lei, Chuanfen; Huang, Siqing

    2018-04-01

    Neurenteric cysts, are rare benign tumors of the central nervous system that are mostly located in the spinal cord and predominantly seen in male children although adult form of the disorder also occurs. The etiology and treatment of this disorder is still a matter of debate. Our case further throws more light on the pathogenesis and treatment of this disorder. A 4-year-old boy presented with 5-month history of cervical lordosis and bilateral lower extremity pain that progressed to his abdomen and upper body. The pain was general, recurrent, non-persistent and progressive in nature with no paralysis. The pain was aggravated by trunk stretching and relieved when he assumed opisthotonos position so he preferred sleeping in this position at night. Magnetic resonance imaging (MRI) revealed a cystic lesion at the thoracolumbar spine with tethering of spinal cord and cervical lordosis. He was operated on successfully and the cervical lordosis and pain resolved. The child recovered well with no tumor recurrence and massive improvement of his life. The gold standard treatment for this disorder is surgery although the precise surgical approach is still a matter of debate. We are of the view that surgical approach should be individualized and aim at total excision of the cyst.

  13. Establishment of the Vertebrate Germ Layers.

    Science.gov (United States)

    Tseng, Wei-Chia; Munisha, Mumingjiang; Gutierrez, Juan B; Dougan, Scott T

    2017-01-01

    The process of germ layer formation is a universal feature of animal development. The germ layers separate the cells that produce the internal organs and tissues from those that produce the nervous system and outer tissues. Their discovery in the early nineteenth century transformed embryology from a purely descriptive field into a rigorous scientific discipline, in which hypotheses could be tested by observation and experimentation. By systematically addressing the questions of how the germ layers are formed and how they generate overall body plan, scientists have made fundamental contributions to the fields of evolution, cell signaling, morphogenesis, and stem cell biology. At each step, this work was advanced by the development of innovative methods of observing cell behavior in vivo and in culture. Here, we take an historical approach to describe our current understanding of vertebrate germ layer formation as it relates to the long-standing questions of developmental biology. By comparing how germ layers form in distantly related vertebrate species, we find that highly conserved molecular pathways can be adapted to perform the same function in dramatically different embryonic environments.

  14. Primary bone lymphoma with multiple vertebral involvement

    Directory of Open Access Journals (Sweden)

    Showkat Hussain Dar

    2013-01-01

    Full Text Available A 20-year-old student presented with 2 months history of fever and night sweats, 15 days history of low backache, progressive weakness of both limbs of 7 days duration, and urinary retention for last 24 h. Examination revealed a sensory level at D 10 dermatome and grade two power in both the lower limbs with absent reflexes. Examination of spine revealed a knuckle at T8 level, which was tender on palpation. MRI spine showed erosion of D11-12 and L1 in vertebral bodies with destruction of left pedicles, transverse processes and lamina, and a prominent psoas abscess. Post gadolinium study revealed ring-enhancing lesions in the D11-12 and L1 vertebrae as well as the dural sac. Fine needle aspiration cytology (FNAC and bone biopsy demonstrated a non-Hodgkin′s lymphoma (NHL, large cell high-grade of the spine (primary, which as per age is the youngest case of NHL ever reported in literature with multiple vertebral involvement.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  16. Learning about Vertebrate Limb Development

    Science.gov (United States)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    Sugiyama, Akira

    1994-01-01

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

  18. Common metabolic constraints on dive duration in endothermic and ectothermic vertebrates

    Directory of Open Access Journals (Sweden)

    April Hayward

    2016-10-01

    Full Text Available Dive duration in air-breathing vertebrates is thought to be constrained by the volume of oxygen stored in the body and the rate at which it is consumed (i.e., “oxygen store/usage hypothesis”. The body mass-dependence of dive duration among endothermic vertebrates is largely supportive of this model, but previous analyses of ectothermic vertebrates show no such body mass-dependence. Here we show that dive duration in both endotherms and ectotherms largely support the oxygen store/usage hypothesis after accounting for the well-established effects of temperature on oxygen consumption rates. Analyses of the body mass and temperature dependence of dive duration in 181 species of endothermic vertebrates and 29 species of ectothermic vertebrates show that dive duration increases as a power law with body mass, and decreases exponentially with increasing temperature. Thus, in the case of ectothermic vertebrates, changes in environmental temperature will likely impact the foraging ecology of divers.

  19. Evolution of endothelin receptors in vertebrates.

    Science.gov (United States)

    Braasch, Ingo; Schartl, Manfred

    2014-12-01

    Endothelin receptors are G protein coupled receptors (GPCRs) of the β-group of rhodopsin receptors that bind to endothelin ligands, which are 21 amino acid long peptides derived from longer prepro-endothelin precursors. The most basal Ednr-like GPCR is found outside vertebrates in the cephalochordate amphioxus, but endothelin ligands are only present among vertebrates, including the lineages of jawless vertebrates (lampreys and hagfishes), cartilaginous vertebrates (sharks, rays, and chimaeras), and bony vertebrates (ray-finned fishes and lobe-finned vertebrates including tetrapods). A bona fide endothelin system is thus a vertebrate-specific innovation with important roles for regulating the cardiovascular system, renal and pulmonary processes, as well as for the development of the vertebrate-specific neural crest cell population and its derivatives. Expectedly, dysregulation of endothelin receptors and the endothelin system leads to a multitude of human diseases. Despite the importance of different types of endothelin receptors for vertebrate development and physiology, current knowledge on endothelin ligand-receptor interactions, on the expression of endothelin receptors and their ligands, and on the functional roles of the endothelin system for embryonic development and in adult vertebrates is very much biased towards amniote vertebrates. Recent analyses from a variety of vertebrate lineages, however, have shown that the endothelin system in lineages such as teleost fish and lampreys is more diverse and is divergent from the mammalian endothelin system. This diversity is mainly based on differential evolution of numerous endothelin system components among vertebrate lineages generated by two rounds of whole genome duplication (three in teleosts) during vertebrate evolution. Here we review current understanding of the evolutionary history of the endothelin receptor family in vertebrates supplemented with surveys on the endothelin receptor gene complement of

  20. Constrained vertebrate evolution by pleiotropic genes

    DEFF Research Database (Denmark)

    Hu, Haiyang; Uesaka, Masahiro; Guo, Song

    2017-01-01

    applied to vertebrates than chordates. Furthermore, we found that vertebrates' conserved mid-embryonic developmental programmes are intensively recruited to other developmental processes, and the degree of the recruitment positively correlates with their evolutionary conservation and essentiality...... for normal development. Thus, we propose that the intensively recruited genetic system during vertebrates' organogenesis period imposed constraints on its diversification through pleiotropic constraints, which ultimately led to the common anatomical pattern observed in vertebrates....

  1. An invertebrate stomach's view on vertebrate ecology

    DEFF Research Database (Denmark)

    Calvignac-Spencer, Sébastien; Leendertz, Fabian H.; Gilbert, Tom

    2013-01-01

    Recent studies suggest that vertebrate genetic material ingested by invertebrates (iDNA) can be used to investigate vertebrate ecology. Given the ubiquity of invertebrates that feed on vertebrates across the globe, iDNA might qualify as a very powerful tool for 21st century population...

  2. Unconventional fixation Thoracolumbar fractures using round hole boneplates and transpedicular screws

    International Nuclear Information System (INIS)

    Behairy, Yaser M.

    2001-01-01

    In an attempt to contain the high cost of commercially available pediclescrew systems, several authors have used unconventional alternatives such aslocally made plates or dynamic compression plates (DCP) along with cancellousscrews for transpedicular fixation of the thoracolumbar spine. These plates,however, allow for a wide range of motion at the plate-screw interphase andthe construct does not provide stability in the sagittal plane. Round holebone plates, on the other hand, allow much less mobility at the plate-screwinterphase and the final construct offers better stability in the sagittalplane. Our objective was to determine the clinical, radiologic and functionalstatus of patients who underwent posterior fracture fixation using round holebone plates and cancellous screws and evaluate the construct's ability tomaintain reduction of the fracture. This was a postoperative follow-up ofpatients with fractures around the thoracolumbar junction fixed using roundhole bone plates and cancellous transpedicular screws. Round hole bone platesalong with 6.5 mm transpedicular cancellous screws were used for posteriorspinal instrumentation in neurologically intact patients with isolatedunstable fractures of the last thoracic or first lumbar vertebra. Seventeenpatients were included in this study. There mean follow-up was 10 months(range 5 to 12). All had evidence of fusion at a mean of 5 months (range 4 to7). No patients had breakage or loosening of the screws and none had breakageof the plate. The mean kyphosis angle at the fracture site was 34 degreepreoperatively, -4 degree in the immediate postoperative period, and 3 degreeon final follow-up radiographs. The percentage loss of anterior vertebralbody height was 51% in the immediate postoperative period and 16% on finalfollow-up radiographs. The use of round hole bone plates along with 6.5 mmcancellous screws inserted into the pedicles provides an angle-stableconstruct that allows for better stability in the sagittal plane

  3. A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

    Directory of Open Access Journals (Sweden)

    Kishi S

    2012-04-01

    Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

  4. Over-extending reduction combined with unilateral approach percutaneous vertebroplasty for the treatment of vertebral compression fractures due to osteoporosis

    International Nuclear Information System (INIS)

    Wei Xinjian; Ji Xianghui; Cao Fei; Zhang Fuhua

    2012-01-01

    Objective: To assess the clinical effect of over-extending reduction combined with percutaneous vertebroplasty (PVP) in treating vertebral compression fractures caused by osteoporosis. Methods: A total of 16 patients with vertebral compression fractures due to osteoporosis were treated with over-extending reduction by using traction on the operation table, and then PVP through trans-single-pedicular approach was performed on the fractured vertebra. The visual analogue scale (VAS) was used to evaluate the clinical effectiveness. The preoperative and postoperative heights of the fractured vertebral body were determined, and the vertebral height recovery ratio was calculated. Results: Technical success was achieved in 20 vertebrae of 16 cases. Bone cement leakage was observed in front of the vertebral body (n=5), in the side of vertebral body (n=20) and within the intervertebral (n=2). After the treatment VAS score decreased from preoperative 8.5±1.2 to postoperative 2.5±1.4. The vertebral height recovery ratio was (40.1±23.5)%. After the surgery, the VAS score and the vertebral height were significantly improved (P<0.05). Conclusion: The over-extending reduction combined with PVP through trans-single-pedicular approach is an effective treatment for vertebral compression fractures caused by osteoporosis. (authors)

  5. Primary Ewing's sarcoma of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-09-01

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

  6. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-15

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

  7. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karen Hind

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

  9. Zygotic Genome Activation in Vertebrates.

    Science.gov (United States)

    Jukam, David; Shariati, S Ali M; Skotheim, Jan M

    2017-08-21

    The first major developmental transition in vertebrate embryos is the maternal-to-zygotic transition (MZT) when maternal mRNAs are degraded and zygotic transcription begins. During the MZT, the embryo takes charge of gene expression to control cell differentiation and further development. This spectacular organismal transition requires nuclear reprogramming and the initiation of RNAPII at thousands of promoters. Zygotic genome activation (ZGA) is mechanistically coordinated with other embryonic events, including changes in the cell cycle, chromatin state, and nuclear-to-cytoplasmic component ratios. Here, we review progress in understanding vertebrate ZGA dynamics in frogs, fish, mice, and humans to explore differences and emphasize common features. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The origin of vertebrate limbs.

    Science.gov (United States)

    Coates, M I

    1994-01-01

    The earliest tetrapod limbs are polydactylous, morphologically varied and do not conform to an archetypal pattern. These discoveries, combined with the unravelling of limb developmental morphogenetic and regulatory mechanisms, have prompted a re-examination of vertebrate limb evolution. The rich fossil record of vertebrate fins/limbs, although restricted to skeletal tissues, exceeds the morphological diversity of the extant biota, and a systematic approach to limb evolution produces an informative picture of evolutionary change. A composite framework of several phylogenetic hypotheses is presented incorporating living and fossil taxa, including the first report of an acanthodian metapterygium and a new reconstruction of the axial skeleton and caudal fin of Acanthostega gunnari. Although significant nodes in vertebrate phylogeny remain poorly resolved, clear patterns of morphogenetic evolution emerge: median fin origination and elaboration initially precedes that of paired fins; pectoral fins initially precede pelvic fin development; evolving patterns of fin distribution, skeletal tissue diversity and structural complexity become decoupled with increased taxonomic divergence. Transformational sequences apparent from the fish-tetrapod transition are reiterated among extant lungfishes, indicating further directions for comparative experimental research. The evolutionary diversification of vertebrate fin and limb patterns challenges a simple linkage between Hox gene conservation, expression and morphology. A phylogenetic framework is necessary in order to distinguish shared from derived characters in experimental model regulatory systems. Hox and related genomic evolution may include convergent patterns underlying functional and morphological diversification. Brachydanio is suggested as an example where tail-drive patterning demands may have converged with the regulation of highly differentiated limbs in tetrapods.

  11. Built for speed: strain in the cartilaginous vertebral columns of sharks.

    Science.gov (United States)

    Porter, M E; Diaz, Candido; Sturm, Joshua J; Grotmol, Sindre; Summers, A P; Long, John H

    2014-02-01

    In most bony fishes vertebral column strain during locomotion is almost exclusively in the intervertebral joints, and when these joints move there is the potential to store and release strain energy. Since cartilaginous fishes have poorly mineralized vertebral centra, we tested whether the vertebral bodies undergo substantial strain and thus may be sites of energy storage during locomotion. We measured axial strains of the intervertebral joints and vertebrae in vivo and ex vivo to characterize the dynamic behavior of the vertebral column. We used sonomicrometry to directly measure in vivo and in situ strains of intervertebral joints and vertebrae of Squalus acanthias swimming in a flume. For ex vivo measurements, we used a materials testing system to dynamically bend segments of vertebral column at frequencies ranging from 0.25 to 1.00 Hz and a range of physiologically relevant curvatures, which were determined using a kinematic analysis. The vertebral centra of S. acanthias undergo strain during in vivo volitional movements as well as in situ passive movements. Moreover, when isolated segments of vertebral column were tested during mechanical bending, we measured the same magnitudes of strain. These data support our hypothesis that vertebral column strain in lateral bending is not limited to the intervertebral joints. In histological sections, we found that the vertebral column of S. acanthias has an intracentral canal that is open and covered with a velum layer. An open intracentral canal may indicate that the centra are acting as tunics around some sections of a hydrostat, effectively stiffening the vertebral column. These data suggest that the entire vertebral column of sharks, both joints and centra, is mechanically engaged as a dynamic spring during locomotion. Copyright © 2013 Elsevier GmbH. All rights reserved.

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Juho-Antti Junno

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

  14. Contaminant exposure in terrestrial vertebrates

    International Nuclear Information System (INIS)

    Smith, Philip N.; Cobb, George P.; Godard-Codding, Celine; Hoff, Dale; McMurry, Scott T.; Rainwater, Thomas R.; Reynolds, Kevin D.

    2007-01-01

    Here we review mechanisms and factors influencing contaminant exposure among terrestrial vertebrate wildlife. There exists a complex mixture of biotic and abiotic factors that dictate potential for contaminant exposure among terrestrial and semi-terrestrial vertebrates. Chemical fate and transport in the environment determine contaminant bioaccessibility. Species-specific natural history characteristics and behavioral traits then play significant roles in the likelihood that exposure pathways, from source to receptor, are complete. Detailed knowledge of natural history traits of receptors considered in conjunction with the knowledge of contaminant behavior and distribution on a site are critical when assessing and quantifying exposure. We review limitations in our understanding of elements of exposure and the unique aspects of exposure associated with terrestrial and semi-terrestrial taxa. We provide insight on taxa-specific traits that contribute, or limit exposure to, transport phenomenon that influence exposure throughout terrestrial systems, novel contaminants, bioavailability, exposure data analysis, and uncertainty associated with exposure in wildlife risk assessments. Lastly, we identify areas related to exposure among terrestrial and semi-terrestrial organisms that warrant additional research. - Both biotic and abiotic factors determine chemical exposure for terrestrial vertebrates

  15. A new classification for cervical vertebral injuries: influence of CT

    International Nuclear Information System (INIS)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L.

    2000-01-01

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  16. A new classification for cervical vertebral injuries: influence of CT

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L. [Department of Diagnostic Radiology, Allegheny University Hospitals, Allegheny General, Pittsburgh, PA (United States)

    2000-03-30

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  17. Use of tranexamic acid for controlling bleeding in thoracolumbar scoliosis surgery with posterior instrumentation

    Directory of Open Access Journals (Sweden)

    Vinícius Magno da Rocha

    2015-04-01

    Full Text Available OBJECTIVE: Scoliosis surgery involves major blood loss and frequently requires blood transfusion. The cost and risks involved in using allogeneic blood have motivated investigation of methods capable of reducing patients' bleeding during operations. One of these methods is to use antifibrinolytic drugs, and tranexamic acid is among these. The aim of this study was to assess the use of this drug for controlling bleeding in surgery to treat idiopathic scoliosis.METHODS: This was a retrospective study in which the medical files of 40 patients who underwent thoracolumbar arthrodesis by means of a posterior route were analyzed. Of these cases, 21 used tranexamic acid and were placed in the test group. The others were placed in the control group. The mean volumes of bleeding during and after the operation and the need for blood transfusion were compared between the two groups.RESULTS: The group that used tranexamic acid had significantly less bleeding during the operation than the control group. There was no significant difference between the groups regarding postoperative bleeding and the need for blood transfusion.CONCLUSIONS: Tranexamic acid was effective in reducing bleeding during the operation, as demonstrated in other studies. The correlation between its use and the reduction in the need for blood transfusion is multifactorial and could not be established in this study. We believe that tranexamic acid may be a useful resource and that it deserves greater attention in randomized double-blind prospective series, with proper control over variables that directly influence blood loss.

  18. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  19. Reversible postoperative blindness caused by bilateral status epilepticus amauroticus following thoracolumbar deformity correction: case report.

    Science.gov (United States)

    Ibrahim, Tarik F; Sweis, Rochelle T; Nockels, Russ P

    2017-07-01

    Postoperative vision loss (POVL) is a devastating complication and has been reported after complex spine procedures. Anterior ischemic optic neuropathy and posterior optic neuropathy are the 2 most common causes of POVL. Bilateral occipital lobe seizures causing complete blindness are rare and have not been reported as a cause of POVL after spine surgery with the patient prone. The authors report the case of a 67-year-old man without a history of seizures who underwent a staged thoracolumbar deformity correction and developed POVL 6 hours after surgery. Imaging, laboratory, and ophthalmological examination results were nonrevealing. Routine electroencephalography study results were negative, but continuous electroencephalography captured bilateral occipital lobe seizures. The patient developed nonconvulsive status epilepticus despite initial treatment with benzodiazepines and loading doses of levetiracetam and lacosamide. He was therefore intubated for status epilepticus amauroticus and received a midazolam infusion. After electrographic seizure cessation for 48 hours, the patient was weaned off midazolam. The patient was maintained on levetiracetam and lacosamide without seizure recurrence and returned to his preoperative visual baseline status.

  20. Analysis of Long Bone and Vertebral Failure Patterns

    Science.gov (United States)

    1985-02-14

    and alter the injury pattern. Classified on an anatomical, kinesiologic , £s and pathologic basis, the vertebral body fracture patterns may...814. Boyde, A. (1972) Scanning electron microscope studies of bone. In Bourne, G.H. (ed): The Biochemistry and Physiology of Bone. New York...Eyring, E.J. (1969) The biochemistry and physiology of intervertebral disk. Clin. Orthop. Rel, Res. 67: 16-18. Fick, R. (1904) Handbuch der Anatomie

  1. Vertebral artery dissection in weightlifter with performance enhancing drug use

    OpenAIRE

    Low, Andrew; Dovey, Julie; Ash-Miles, Janice

    2011-01-01

    This case report describes a transient ischaemic attack secondary to vertebral artery dissection (VAD) in a young male body builder. This occurred following weight training with weights across the back and shoulders. The patient was also known to take multiple performance enhancing agents including anabolic steroids, slimming agents, stimulants and human growth hormone. Cases of VAD have been described with cervical manipulation in the past and an association between the use of anabolic stero...

  2. The cervical vertebral maturation method: A user's guide.

    Science.gov (United States)

    McNamara, James A; Franchi, Lorenzo

    2018-03-01

    The cervical vertebral maturation (CVM) method is used to determine the craniofacial skeletal maturational stage of an individual at a specific time point during the growth process. This diagnostic approach uses data derived from the second (C2), third (C3), and fourth (C4) cervical vertebrae, as visualized in a two-dimensional lateral cephalogram. Six maturational stages of those three cervical vertebrae can be determined, based on the morphology of their bodies. The first step is to evaluate the inferior border of these vertebral bodies, determining whether they are flat or concave (ie, presence of a visible notch). The second step in the analysis is to evaluate the shape of C3 and C4. These vertebral bodies change in shape in a typical sequence, progressing from trapezoidal to rectangular horizontal, to square, and to rectangular vertical. Typically, cervical stages (CSs) 1 and CS 2 are considered prepubertal, CS 3 and CS 4 circumpubertal, and CS 5 and CS 6 postpubertal. Criticism has been rendered as to the reproducibility of the CVM method. Diminished reliability may be observed at least in part due to the lack of a definitive description of the staging procedure in the literature. Based on the now nearly 20 years of experience in staging cervical vertebrae, this article was prepared as a "user's guide" that describes the CVM stages in detail in attempt to help the reader use this approach in everyday clinical practice.

  3. Timing Embryo Segmentation: Dynamics and Regulatory Mechanisms of the Vertebrate Segmentation Clock

    Science.gov (United States)

    Resende, Tatiana P.; Andrade, Raquel P.; Palmeirim, Isabel

    2014-01-01

    All vertebrate species present a segmented body, easily observed in the vertebrate column and its associated components, which provides a high degree of motility to the adult body and efficient protection of the internal organs. The sequential formation of the segmented precursors of the vertebral column during embryonic development, the somites, is governed by an oscillating genetic network, the somitogenesis molecular clock. Herein, we provide an overview of the molecular clock operating during somite formation and its underlying molecular regulatory mechanisms. Human congenital vertebral malformations have been associated with perturbations in these oscillatory mechanisms. Thus, a better comprehension of the molecular mechanisms regulating somite formation is required in order to fully understand the origin of human skeletal malformations. PMID:24895605

  4. Iodine-123 uptake in vertebral haemangiomas in a patient with papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    Sameer Khan, S.; Dunn, J.; All-Nahhas, A.; Strickland, N.

    2008-01-01

    We present a case of a 58-year-old woman with papillary carcinoma of the thyroid and elevated thyroglobulin. Whole body 123 I scan with SPECT images demonstrated focal uptake in the thoracic spine, reported as bone metastases. Subsequent 18 F DG PET and 99m Tc HDP bone were normal. MRI and CT scans confirmed the presence of vertebral haemangiomas corresponding to the uptake seen on the 123 I scan. False-positive uptake of 123 I in benign vertebral haemangiomas should be considered in the differential diagnosis of focal vertebral uptake. (authors)

  5. Conodonts, Calcichordates and the Origin of Vertebrates

    Directory of Open Access Journals (Sweden)

    J. Bergström

    1998-01-01

    Full Text Available Interpretation of early deuterostome evolution and relationships has been hampered by the lack of soft-part preservation in most groups. In addition, a recently revealed upside-down life orientation of vertebrates (the only real notoneuralians compared to other bilateral animals has been misinterpreted as evidence for a unique body design in all deuterostomes, misleading any search for relatives. Regarding echinoderms, the variety of body plans is confusing. The interpretation of some fossils with echinoderm-type calcite skeletons as “calcichordate” ancestors of chordates, however, involves a hypothetical reconstruction of an unusual body plan and a long series of hypothetical transitions. The number of necessary steps is much lower if cephalochordates (amphioxus or lancelet are derived directly from hemichordate enteropneusts. “Sensation interpretations” of fossils (Yunnanozoon, Cathaymyrus from Burgess Shale type deposits have added further confusion. Soft-part preservation of conodont animals, with V-shaped myomeres and a notochord, shows that they were segmented chordates, while probable eyes and teeth suggest that they were already on the vertebrate side. Die Interpretation früher Deuterostomia hinsichtlich ihrer Evolution und verwandtschaftlichen Beziehungen ist in den meisten Gruppen durch den Mangel an Weichkörpererhaltung sehr erschwert. Die kürzlich entdeckte Tatsache, daß Vertebraten, d. h. die einzigen echten Notoneuralia, im Gegensatz zu anderen bilateral symmetrischen Organismen eine mit ihrer ursprünglichen Oberseite nach unten gerichtete Lebensstellung einnehmen, hat zu der irrtümlichen Ansicht geführt, daß alle Deuostomia über einen im Tierreich einzigartigen Bauplan verfügen. Diese Interpretation brachte naturgemäß jede Suche nach Verwandtschaftsverhältnissen auf Abwege. Hinsichtlich der Echinodermata ist die bauplanmäßige Variation in der Tat verwirrend. Die Interpretation einiger Fossilien mit

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

    DEFF Research Database (Denmark)

    Putzer, Michael; Rasmussen, John; Penzkofer, Rainer

    Body Modeling System and a parameterized musculoskeletal lumbar spine model for four different postures: upright standing, flexion (50°), torsion (10°) and lateral bending (15°). The linear dimensions of the vertebral body, the posterior parts of the vertebrae as well as the disc height, the orientation...... of the facet joints and the curvature of the lumbar spine have been varied. Figure 1 depicts the used musculoskeletal model in the flexed posture and a lumbar vertebra labeled with all relevant linear dimensions except the disc height. Additionally, all combinations of the three parameters vertebral body...... are consistent with the corresponding results of Han et al. (2012) and Niemeyer et al. (2012). As mentioned above, the vertebral body depth showed a recognizable effect for the flexed and lateral bended postures, too. These characteristics can be justified with increasing moments due to the changed offset...

  7. Polymethylmethacrylate distribution is associated with recompression after vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures: A retrospective study

    Science.gov (United States)

    Yao, Qi; Zhang, Genai; Ding, Lixiang; Huang, Hui

    2018-01-01

    Background Osteoporotic vertebral compression fracture, always accompanied with pain and height loss of vertebral body, has a significant negative impact on life quality of patients. Vertebroplasty or kyphoplasty is minimal invasive techniques to reconstruct the vertebral height and prevent further collapse of the fractured vertebrae by injecting polymethylmethacrylate into vertebral body. However, recompression of polymethylmethacrylate augmented vertebrae with significant vertebral height loss and aggressive local kyphotic was observed frequently after VP or KP. The purpose of this study was to investigate the effect of polymethylmethacrylate distribution on recompression of the vertebral body after vertebroplasty or kyphoplasty surgery for osteoporotic vertebral compression fracture. Methods A total of 281 patients who were diagnosed with vertebral compression fracture (T5-L5) from June 2014 to June 2016 and underwent vertebroplasty or kyphoplasty by polymethylmethacrylate were retrospectively analyzed. The X-ray films at 1 day and 12 months after surgery were compared to evaluate the recompression of operated vertebral body. Patients were divided into those without recompression (non-recompression group) and those with recompression (recompression group). Polymethylmethacrylate distribution pattern, including location and relationship to endplates, was compared between the two groups by lateral X-ray film. Multivariate logistic regression analysis was performed to assess the potential risk factors associated with polymethylmethacrylate distribution for recompression. Results One hundred and six (37.7%) patients experienced recompression after surgery during the follow-up period. The polymethylmethacrylate distributed in the middle of vertebral body showed significant differences between two groups. In non-recompression group, the polymethylmethacrylate in the middle portion of vertebral body were closer to endplates than that in the recompression group (upper

  8. Reduction of progressive thoracolumbar adolescent idiopathic scoliosis by chiropractic biophysics® (CBP®) mirror image® methods following failed traditional chiropractic treatment: a case report

    OpenAIRE

    Haggard, Joshua S.; Haggard, Jennifer B.; Oakley, Paul A.; Harrison, Deed E.

    2017-01-01

    [Purpose] To present a case demonstrating the reduction of progressive thoracolumbar scoliosis by incorporating Chiropractic BioPhysics® (CBP®) technique’s mirror image® exercises, traction and blocking procedures based on the ‘non-commutative properties of finite rotation angles under addition’ engineering law. [Subject and Methods] A 15-year-old female presented with a right thoracolumbar scoliosis having a Cobb angle from T5–L3 of 27° and suffering from headaches and lower back pains. Her ...

  9. Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis.

    Science.gov (United States)

    Diniz, Juliete M; Botelho, Ricardo V

    2017-11-01

    OBJECTIVE Thoracolumbar fractures account for 90% of spinal fractures, with the burst subtype corresponding to 20% of this total. Controversy regarding the best treatment for this condition remains. The traditional surgical approach, when indicated, involves spinal fixation and arthrodesis. Newer studies have brought the need for fusion associated with internal fixation into question. Not performing arthrodesis could reduce surgical time and intraoperative bleeding without affecting clinical and radiological outcomes. With this study, the authors aimed to assess the effect of fusion, adjuvant to internal fixation, on surgically treated thoracolumbar burst fractures. METHODS A search of the Medline and Cochrane Central Register of Controlled Trials databases was performed to identify randomized trials that compared the use and nonuse of arthrodesis in association with internal fixation for the treatment of thoracolumbar burst fractures. The search encompassed all data in these databases up to February 28, 2016. RESULTS Five randomized/quasi-randomized trials, which involved a total of 220 patients and an average follow-up time of 69.1 months, were included in this review. No significant difference between groups in the final scores of the visual analog pain scale or Low Back Outcome Scale was detected. Surgical time and blood loss were significantly lower in the group of patients who did not undergo fusion (p < 0.05). Among the evaluated radiological outcomes, greater mobility in the affected segment was found in the group of those who did not undergo fusion. No significant difference between groups in the degree of kyphosis correction, loss of kyphosis correction, or final angle of kyphosis was observed. CONCLUSIONS The data reviewed in this study suggest that the use of arthrodesis did not improve clinical outcomes, but it was associated with increased surgical time and higher intraoperative bleeding and did not promote significant improvement in radiological

  10. Comparison of thoracolumbar motion produced by manual and Jackson-table-turning methods. Study of a cadaveric instability model.

    Science.gov (United States)

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

    2008-08-01

    Patients who have sustained a spinal cord injury remain at risk for further neurologic deterioration until the spine is adequately stabilized. To our knowledge, no study has previously addressed the effects of different bed-to-operating room table transfer techniques on thoracolumbar spinal motion in an instability model. We hypothesized that the conventional logroll technique used to transfer patients from a supine position to a prone position on the operating room table has the potential to confer significantly more motion to the unstable thoracolumbar spine than the Jackson technique. Three-column instability was surgically created at the L1 level in seven cadavers. Two protocols were tested. The manual technique entailed performing a standard logroll of a supine cadaver to a prone position on an operating room Jackson table. The Jackson technique involved sliding the supine cadaver to the Jackson table, securing it to the table, and then rotating it into a prone position. An electromagnetic tracking device measured motion--i.e., angular motion (flexion-extension, lateral bending, and axial rotation) and linear translation (axial, medial-lateral, and anterior-posterior) between T12 and L2. The logroll technique created significantly more motion than the Jackson technique as measured with all six parameters. Manual logroll transfers produced an average of 13.8 degrees to 18.1 degrees of maximum angular displacement and 16.6 to 28.3 mm of maximum linear translation. The Jackson technique resulted in an average of 3.1 degrees to 5.8 degrees of maximum angular displacement (p patient safety. Performing the Jackson turn requires approximately half as many people as required for a manual logroll. This study suggests that the Jackson technique should be considered for supine-to-prone transfer of patients with known or suspected instability of the thoracolumbar spine.

  11. Short Segment Fixation Versus Short Segment Fixation With Pedicle Screws at the Fracture Level for Thoracolumbar Burst Fracture

    Directory of Open Access Journals (Sweden)

    Anghel S

    2014-04-01

    Full Text Available Objective: The most prevailing surgical procedure in the treatment of thoracolumbar burst fractures, Short Segment Fixation (SSF, is often followed by loss of correction or hardware failure which may be significant enough to require another surgical intervention. In order to take advantage of its benefits but to avoid or diminish the risk and impact of associated drawbacks, some other alternatives have been lately developed among which we refer to short segment fixation with intermediate screws (SSF+IS. This article provides a comparative picture over the effectiveness of the two above-mentioned surgical treatments, focusing on their potential to prevent the loss of correction.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  13. Obliged Removal of the Percutaneous Fixation System on the Thoracolumbar Junction in Patients with Idiopathic Scoliosis

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    Alessandro Landi

    2016-12-01

    Full Text Available Introduction Minimally invasive percutaneous surgery of the spine is used to treat thoracolumbar junction and lumbar spine fractures by percutaneous fixation. Once fusion has been obtained, it is possible to remove the percutaneous instrumentation after 6 - 12 months. We report the case of an obliged removal of the fixation system at 12 months following operation in a patient with a pre-existing compensated and asymptomatic idiopathic scoliosis. Case Presentation A 48-year-old patient affected by a compensated asymptomatic idiopathic scoliosis with an L3 type A3 fracture. The patient underwent a percutaneous short fixation L2 - L4. In the following months the patient presented progressive worsening of the low back pain and walking difficulties. The percutaneous fixation system was then removed using the same surgical access. Conclusions This particular case explains well the importance of biomechanical balance when a spinal fixation should be perform, and demonstrate how an underestimation of this aspect may cause a worsening of symptoms even if the surgical procedure was correctly performed. It is evident that the removal procedure can lead clinical benefit to a patient, in which the fixation system created a decompensation of the curvature of the spine, thus causing biomechanical alterations and generating pain. In these cases, it may be opportune to limit the fracture reduction during the surgical procedure to modify the least possible the pre-existing scoliosis and to increase the patient’s comfort after the operation. The biomechanical behaviour of the spine is specific for each patient so only a careful detection of it could lead to an optimal therapeutic result.

  14. Development of a clinical spasticity scale for evaluation of dogs with chronic thoracolumbar spinal cord injury.

    Science.gov (United States)

    Lewis, Melissa J; Olby, Natasha J

    2017-07-01

    OBJECTIVE To develop a spasticity scale for dogs with chronic deficits following severe spinal cord injury (SCI) for use in clinical assessment and outcome measurement in clinical trials. ANIMALS 20 chronically paralyzed dogs with a persistent lack of hind limb pain perception caused by an acute SCI at least 3 months previously. PROCEDURES Spasticity was assessed in both hind limbs via tests of muscle tone, clonus, and flexor and extensor spasms adapted from human scales. Measurement of patellar clonus duration and flexor spasm duration and degree was feasible. These components were used to create a canine spasticity scale (CSS; overall score range, 0 to 18). Temporal variation for individual dogs and interrater reliability were evaluated. Gait was quantified with published gait scales, and CSS scores were compared with gait scores and clinical variables. Owners were questioned regarding spasticity observed at home. RESULTS 20 dogs were enrolled: 18 with no apparent hind limb pain perception and 2 with blunted responses; 5 were ambulatory. Testing was well tolerated, and scores were repeatable between raters. Median overall CSS score was 7 (range, 3 to 11), and flexor spasms were the most prominent finding. Overall CSS score was not associated with age, SCI duration, lesion location, or owner-reported spasticity. Overall CSS score and flexor spasm duration were associated with gait scores. CONCLUSIONS AND CLINICAL RELEVANCE The CSS could be used to quantify hind limb spasticity in dogs with chronic thoracolumbar SCI and might be a useful outcome measure. Flexor spasms may represent an integral part of stepping in dogs with severe SCI.

  15. Prenatal diagnosis of isochromosome 20q in a fetus with vertebral anomaly and rocker-bottom feet

    Directory of Open Access Journals (Sweden)

    Aline Receveur

    2017-10-01

    Conclusion: The data would allow establishing a phenotype–genotype correlation. Thus, we proposed to define a recognizable syndrome combining cranio-facial dysmorphism, vertebral bodies' anomalies, feet and cerebral malformations.

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

    OpenAIRE

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

    2016-01-01

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

  17. Hemifacial spasm; The value of vertebral angiography

    International Nuclear Information System (INIS)

    Yang, Hak Seok; Kim, Myung Soon; Han, Yong Pyo

    1992-01-01

    In order to evaluate the value of vertebral angiography in assesment of hemifacial spasm, We reviewed retrospectively the vertebral angiography of 28 patients (30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery , posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa

  18. Comparative Studies of Vertebrate Platelet Glycoprotein 4 (CD36

    Directory of Open Access Journals (Sweden)

    Roger S. Holmes

    2012-09-01

    Full Text Available Platelet glycoprotein 4 (CD36 (or fatty acyl translocase [FAT], or scavenger receptor class B, member 3 [SCARB3] is an essential cell surface and skeletal muscle outer mitochondrial membrane glycoprotein involved in multiple functions in the body. CD36 serves as a ligand receptor of thrombospondin, long chain fatty acids, oxidized low density lipoproteins (LDLs and malaria-infected erythrocytes. CD36 also influences various diseases, including angiogenesis, thrombosis, atherosclerosis, malaria, diabetes, steatosis, dementia and obesity. Genetic deficiency of this protein results in significant changes in fatty acid and oxidized lipid uptake. Comparative CD36 amino acid sequences and structures and CD36 gene locations were examined using data from several vertebrate genome projects. Vertebrate CD36 sequences shared 53–100% identity as compared with 29–32% sequence identities with other CD36-like superfamily members, SCARB1 and SCARB2. At least eight vertebrate CD36 N-glycosylation sites were conserved which are required for membrane integration. Sequence alignments, key amino acid residues and predicted secondary structures were also studied. Three CD36 domains were identified including cytoplasmic, transmembrane and exoplasmic sequences. Conserved sequences included N- and C-terminal transmembrane glycines; and exoplasmic cysteine disulphide residues; TSP-1 and PE binding sites, Thr92 and His242, respectively; 17 conserved proline and 14 glycine residues, which may participate in forming CD36 ‘short loops’; and basic amino acid residues, and may contribute to fatty acid and thrombospondin binding. Vertebrate CD36 genes usually contained 12 coding exons. The human CD36 gene contained transcription factor binding sites (including PPARG and PPARA contributing to a high gene expression level (6.6 times average. Phylogenetic analyses examined the relationships and potential evolutionary origins of the vertebrate CD36 gene with vertebrate

  19. The 'Tully monster' is a vertebrate.

    Science.gov (United States)

    McCoy, Victoria E; Saupe, Erin E; Lamsdell, James C; Tarhan, Lidya G; McMahon, Sean; Lidgard, Scott; Mayer, Paul; Whalen, Christopher D; Soriano, Carmen; Finney, Lydia; Vogt, Stefan; Clark, Elizabeth G; Anderson, Ross P; Petermann, Holger; Locatelli, Emma R; Briggs, Derek E G

    2016-04-28

    Problematic fossils, extinct taxa of enigmatic morphology that cannot be assigned to a known major group, were once a major issue in palaeontology. A long-favoured solution to the 'problem of the problematica', particularly the 'weird wonders' of the Cambrian Burgess Shale, was to consider them representatives of extinct phyla. A combination of new evidence and modern approaches to phylogenetic analysis has now resolved the affinities of most of these forms. Perhaps the most notable exception is Tullimonstrum gregarium, popularly known as the Tully monster, a large soft-bodied organism from the late Carboniferous Mazon Creek biota (approximately 309-307 million years ago) of Illinois, USA, which was designated the official state fossil of Illinois in 1989. Its phylogenetic position has remained uncertain and it has been compared with nemerteans, polychaetes, gastropods, conodonts, and the stem arthropod Opabinia. Here we review the morphology of Tullimonstrum based on an analysis of more than 1,200 specimens. We find that the anterior proboscis ends in a buccal apparatus containing teeth, the eyes project laterally on a long rigid bar, and the elongate segmented body bears a caudal fin with dorsal and ventral lobes. We describe new evidence for a notochord, cartilaginous arcualia, gill pouches, articulations within the proboscis, and multiple tooth rows adjacent to the mouth. This combination of characters, supported by phylogenetic analysis, identifies Tullimonstrum as a vertebrate, and places it on the stem lineage to lampreys (Petromyzontida). In addition to increasing the known morphological disparity of extinct lampreys, a chordate affinity for T. gregarium resolves the nature of a soft-bodied fossil which has been debated for more than 50 years.

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tishya A L Wren

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

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Recognizing and reporting vertebral fractures: reducing the risk of future osteoporotic fractures

    International Nuclear Information System (INIS)

    Lentle, B.C.; Brown, J.P.; Khan, A.

    2007-01-01

    should be assessed from lateral spinal or chest radiographs according to the semiquantitative method of Genant and colleagues. Grade II and Grade III fractures as classified by this method should be given the greatest emphasis. Semiquantitative fracture recognition should include the recognition of changes such as loss of vertebral end-plate parallelism, cortical interruptions, and quantitative changes in the anterior, midbody, and posterior heights of vertebral bodies. (author)

  4. Homenaje a la columna vertebral

    Directory of Open Access Journals (Sweden)

    Joseph Brodsky

    2011-01-01

    Full Text Available Exiliado en Estados Unidos desde comienzos de la década del setenta, el poeta ruso Joseph Brodsky (1940-1996, adquiere en 1977 la nacionalidad norteamericana. Al año siguiente, una década antes de recibir el Premio Nobel, asiste como miembro de la delegación de Estados Unidos a una reunión internacional del PEN Club, en Río de Janeiro, Brasil, reunión a la que asiste también Mario Vargas Llosa. "Homenaje a la columna vertebral" es la crónica de esa experiencia y de su primera y probablemente única visita a Latinoamérica.

  5. Vertebral architecture in the earliest stem tetrapods.

    Science.gov (United States)

    Pierce, Stephanie E; Ahlberg, Per E; Hutchinson, John R; Molnar, Julia L; Sanchez, Sophie; Tafforeau, Paul; Clack, Jennifer A

    2013-02-14

    The construction of the vertebral column has been used as a key anatomical character in defining and diagnosing early tetrapod groups. Rhachitomous vertebrae--in which there is a dorsally placed neural arch and spine, an anteroventrally placed intercentrum and paired, posterodorsally placed pleurocentra--have long been considered the ancestral morphology for tetrapods. Nonetheless, very little is known about vertebral anatomy in the earliest stem tetrapods, because most specimens remain trapped in surrounding matrix, obscuring important anatomical features. Here we describe the three-dimensional vertebral architecture of the Late Devonian stem tetrapod Ichthyostega using propagation phase-contrast X-ray synchrotron microtomography. Our scans reveal a diverse array of new morphological, and associated developmental and functional, characteristics, including a possible posterior-to-anterior vertebral ossification sequence and the first evolutionary appearance of ossified sternal elements. One of the most intriguing features relates to the positional relationships between the vertebral elements, with the pleurocentra being unexpectedly sutured or fused to the intercentra that directly succeed them, indicating a 'reverse' rhachitomous design. Comparison of Ichthyostega with two other stem tetrapods, Acanthostega and Pederpes, shows that reverse rhachitomous vertebrae may be the ancestral condition for limbed vertebrates. This study fundamentally revises our current understanding of vertebral column evolution in the earliest tetrapods and raises questions about the presumed vertebral architecture of tetrapodomorph fish and later, more crownward, tetrapods.

  6. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  7. Toward understanding the evolution of vertebrate gene regulatory networks: comparative genomics and epigenomic approaches.

    Science.gov (United States)

    Martinez-Morales, Juan R

    2016-07-01

    Vertebrates, as most animal phyla, originated >500 million years ago during the Cambrian explosion, and progressively radiated into the extant classes. Inferring the evolutionary history of the group requires understanding the architecture of the developmental programs that constrain the vertebrate anatomy. Here, I review recent comparative genomic and epigenomic studies, based on ChIP-seq and chromatin accessibility, which focus on the identification of functionally equivalent cis-regulatory modules among species. This pioneer work, primarily centered in the mammalian lineage, has set the groundwork for further studies in representative vertebrate and chordate species. Mapping of active regulatory regions across lineages will shed new light on the evolutionary forces stabilizing ancestral developmental programs, as well as allowing their variation to sustain morphological adaptations on the inherited vertebrate body plan. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Variation in vertebral number and its morphological implication in Galaxias platei.

    Science.gov (United States)

    Barriga, J P; Milano, D; Cussac, V E

    2013-11-01

    Variation in the vertebral number of the puyen grande Galaxias platei was examined for specimens from 22 localities that span the entire distribution range of the species (from 40° to 55° S). The mean vertebral number (NMW ) increases towards high latitudes, i.e. Jordan's rule is applicable to this species. Owing to the wide geographic variation of the species, not only in latitude but also in altitude, the most explicative variable for NMW was mean winter air temperature, showing negative dependence. Morphological data suggest that the increment in vertebral number lies in the pre-pelvic region of the trunk and in the caudal region, but not in the segment between pelvic-fin insertion and the origin of the anal fin. As these alterations in body shape have important consequences for hydrodynamics and swimming performance, vertebral number variation in G. platei also holds implications for both individual and population fitness. © 2013 The Fisheries Society of the British Isles.

  9. Evolution and development of the vertebrate ear

    Science.gov (United States)

    Fritzsch, B.; Beisel, K. W.

    2001-01-01

    This review outlines major aspects of development and evolution of the ear, specifically addressing issues of cell fate commitment and the emerging molecular governance of these decisions. Available data support the notion of homology of subsets of mechanosensors across phyla (proprioreceptive mechanosensory neurons in insects, hair cells in vertebrates). It is argued that this conservation is primarily related to the specific transducing environment needed to achieve mechanosensation. Achieving this requires highly conserved transcription factors that regulate the expression of the relevant structural genes for mechanosensory transduction. While conserved at the level of some cell fate assignment genes (atonal and its mammalian homologue), the ear has also radically reorganized its development by implementing genes used for cell fate assignment in other parts of the developing nervous systems (e.g., neurogenin 1) and by evolving novel sets of genes specifically associated with the novel formation of sensory neurons that contact hair cells (neurotrophins and their receptors). Numerous genes have been identified that regulate morphogenesis, but there is only one common feature that emerges at the moment: the ear appears to have co-opted genes from a large variety of other parts of the developing body (forebrain, limbs, kidneys) and establishes, in combination with existing transcription factors, an environment in which those genes govern novel, ear-related morphogenetic aspects. The ear thus represents a unique mix of highly conserved developmental elements combined with co-opted and newly evolved developmental elements.

  10. Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis.

    Directory of Open Access Journals (Sweden)

    Sophie-Anne Scherrer

    Full Text Available Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity.Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50° participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20° from the moderate (20° and over spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body.Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it (F = 1.78, p = 0.101. Main effects of vertebral Positions (apex and above or below it (F = 4.20, p = 0.015 and wedging Planes (F = 34.36, p<0.001 were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6° than the superior group (2.9°, p = 0.019 and a significantly greater wedging (p≤0.03 along the sagittal plane (4.3°.Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support the claim that scoliosis could be initiated

  11. Duplication of the Left Vertebral Artery Origin: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sang Wook; Park, Dong Woo; Park, Choong Ki; Lee, Young Jun [Dept. of Radiology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri (Korea, Republic of)

    2013-01-15

    Duplication of vertebral arteries is a very rare but clinically important condition. A duplicated vertebral artery origin can influence hemodynamics, pathogenesis of vascular lesions and treatment options. In cases of vertebral artery duplication, the vertebral arteries generally enter the transverse foramen higher up than normal. Awareness of these vertebral artery variants before procedures, such as neurointervention or surgery, may be beneficial. Here, we describe a case of a 51-year-old female patient with left vertebral artery duplication which was detected incidentally.

  12. Duplication of the Left Vertebral Artery Origin: A Case Report

    International Nuclear Information System (INIS)

    Shin, Sang Wook; Park, Dong Woo; Park, Choong Ki; Lee, Young Jun

    2013-01-01

    Duplication of vertebral arteries is a very rare but clinically important condition. A duplicated vertebral artery origin can influence hemodynamics, pathogenesis of vascular lesions and treatment options. In cases of vertebral artery duplication, the vertebral arteries generally enter the transverse foramen higher up than normal. Awareness of these vertebral artery variants before procedures, such as neurointervention or surgery, may be beneficial. Here, we describe a case of a 51-year-old female patient with left vertebral artery duplication which was detected incidentally.

  13. Prevalent Vertebral Fractures in Black Women and White Women

    OpenAIRE

    Cauley, Jane A; Palermo, Lisa; Vogt, Molly; Ensrud, Kristine E; Ewing, Susan; Hochberg, Marc; Nevitt, Michael C; Black, Dennis M

    2008-01-01

    Vertebral fractures are the most common osteoporotic fracture. Hip and clinical fractures are less common in black women, but there is little information on vertebral fractures. We studied 7860 white and 472 black women ≥65 yr of age enrolled in the Study of Osteoporotic Fractures. Prevalent vertebral fractures were identified from lateral spine radiographs using vertebral morphometry and defined if any vertebral height ratio was >3 SD below race-specific means for each vertebral level. Infor...

  14. Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment.

    Science.gov (United States)

    Crawford, Bethany; Kim, Do-Gyoon; Moon, Eun-Sang; Johnson, Elizabeth; Fields, Henry W; Palomo, J Martin; Johnston, William M

    2014-08-01

    The cervical vertebral maturation (CVM) stages have been used to estimate facial growth status. In this study, we examined whether cone-beam computed tomography images can be used to detect changes of CVM-related parameters and bone mineral density distribution in adolescents during orthodontic treatment. Eighty-two cone-beam computed tomography images were obtained from 41 patients before (14.47 ± 1.42 years) and after (16.15 ± 1.38 years) orthodontic treatment. Two cervical vertebral bodies (C2 and C3) were digitally isolated from each image, and their volumes, means, and standard deviations of gray-level histograms were measured. The CVM stages and mandibular lengths were also estimated after converting the cone-beam computed tomography images. Significant changes for the examined variables were detected during the observation period (P ≤0.018) except for C3 vertebral body volume (P = 0.210). The changes of CVM stage had significant positive correlations with those of vertebral body volume (P ≤0.021). The change of the standard deviation of bone mineral density (variability) showed significant correlations with those of vertebral body volume and mandibular length for C2 (P ≤0.029). The means and variability of the gray levels account for bone mineral density and active remodeling, respectively. Our results indicate that bone mineral density distribution and the volume of the cervical vertebral body changed because of active bone remodeling during maturation. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  15. Mitotic chromosome condensation in vertebrates

    International Nuclear Information System (INIS)

    Vagnarelli, Paola

    2012-01-01

    Work from several laboratories over the past 10–15 years has revealed that, within the interphase nucleus, chromosomes are organized into spatially distinct territories [T. Cremer, C. Cremer, Chromosome territories, nuclear architecture and gene regulation in mammalian cells, Nat. Rev. Genet. 2 (2001) 292–301 and T. Cremer, M. Cremer, S. Dietzel, S. Muller, I. Solovei, S. Fakan, Chromosome territories—a functional nuclear landscape, Curr. Opin. Cell Biol. 18 (2006) 307–316]. The overall compaction level and intranuclear location varies as a function of gene density for both entire chromosomes [J.A. Croft, J.M. Bridger, S. Boyle, P. Perry, P. Teague,W.A. Bickmore, Differences in the localization and morphology of chromosomes in the human nucleus, J. Cell Biol. 145 (1999) 1119–1131] and specific chromosomal regions [N.L. Mahy, P.E. Perry, S. Gilchrist, R.A. Baldock, W.A. Bickmore, Spatial organization of active and inactive genes and noncoding DNA within chromosome territories, J. Cell Biol. 157 (2002) 579–589] (Fig. 1A, A'). In prophase, when cyclin B activity reaches a high threshold, chromosome condensation occurs followed by Nuclear Envelope Breakdown (NEB) [1]. At this point vertebrate chromosomes appear as compact structures harboring an attachment point for the spindle microtubules physically recognizable as a primary constriction where the two sister chromatids are held together. The transition from an unshaped interphase chromosome to the highly structured mitotic chromosome (compare Figs. 1A and B) has fascinated researchers for several decades now; however a definite picture of how this process is achieved and regulated is not yet in our hands and it will require more investigation to comprehend the complete process. From a biochemical point of view a vertebrate mitotic chromosomes is composed of DNA, histone proteins (60%) and non-histone proteins (40%) [6]. I will discuss below what is known to date on the contribution of these two different

  16. Mitotic chromosome condensation in vertebrates

    Energy Technology Data Exchange (ETDEWEB)

    Vagnarelli, Paola, E-mail: P.Vagnarelli@ed.ac.uk

    2012-07-15

    Work from several laboratories over the past 10-15 years has revealed that, within the interphase nucleus, chromosomes are organized into spatially distinct territories [T. Cremer, C. Cremer, Chromosome territories, nuclear architecture and gene regulation in mammalian cells, Nat. Rev. Genet. 2 (2001) 292-301 and T. Cremer, M. Cremer, S. Dietzel, S. Muller, I. Solovei, S. Fakan, Chromosome territories-a functional nuclear landscape, Curr. Opin. Cell Biol. 18 (2006) 307-316]. The overall compaction level and intranuclear location varies as a function of gene density for both entire chromosomes [J.A. Croft, J.M. Bridger, S. Boyle, P. Perry, P. Teague,W.A. Bickmore, Differences in the localization and morphology of chromosomes in the human nucleus, J. Cell Biol. 145 (1999) 1119-1131] and specific chromosomal regions [N.L. Mahy, P.E. Perry, S. Gilchrist, R.A. Baldock, W.A. Bickmore, Spatial organization of active and inactive genes and noncoding DNA within chromosome territories, J. Cell Biol. 157 (2002) 579-589] (Fig. 1A, A'). In prophase, when cyclin B activity reaches a high threshold, chromosome condensation occurs followed by Nuclear Envelope Breakdown (NEB) [1]. At this point vertebrate chromosomes appear as compact structures harboring an attachment point for the spindle microtubules physically recognizable as a primary constriction where the two sister chromatids are held together. The transition from an unshaped interphase chromosome to the highly structured mitotic chromosome (compare Figs. 1A and B) has fascinated researchers for several decades now; however a definite picture of how this process is achieved and regulated is not yet in our hands and it will require more investigation to comprehend the complete process. From a biochemical point of view a vertebrate mitotic chromosomes is composed of DNA, histone proteins (60%) and non-histone proteins (40%) [6]. I will discuss below what is known to date on the contribution of these two different classes

  17. Radiographic analysis of partial or total vertebral body resection

    International Nuclear Information System (INIS)

    Whitten, C.G.; Hammer, G.H.; El-Khoury, G.Y.; Hugus, J.; Weinstein, J.N.

    1991-01-01

    Partial and total vertebrectomies are used in the treatment of primary and metastatic neoplasms of the spine. Serial radiographic studies are crucial in the follow-up of patients with vertebrectomies. This paper presents 33 cases and illustrates radiographic examples of both successful and complicated vertebrectomies, including radiographic signs of local tumor recurrence, loosening, migration or fracture of the hardware or methylmethacrylate, bone graft failure, and progressive spinal instability

  18. Detailed analysis of the clinical effects of cell therapy for thoracolumbar spinal cord injury: an original study

    Directory of Open Access Journals (Sweden)

    Sharma A

    2013-07-01

    Full Text Available Alok Sharma,1 Nandini Gokulchandran,1 Hemangi Sane,2 Prerna Badhe,1 Pooja Kulkarni,2 Mamta Lohia,3 Anjana Nagrajan,3 Nancy Thomas3 1Department of Medical Services and Clinical Research, 2Department of Research and Development, 3Department of Neurorehabilitation, NeuroGen Brain and Spine Institute, Surana Sethia Hospital and Research Centre, Chembur, Mumbai, India Background: Cell therapy is amongst the most promising treatment strategies in spinal cord injury (SCI because it focuses on repair. There are many published animal studies and a few human trials showing remarkable results with various cell types. The level of SCI determines whether paraplegia or quadriplegia is present, and greatly influences recovery. The purpose of this study was to determine the significance of the clinical effects and long-term safety of intrathecal administration of autologous bone marrow-derived mononuclear cells, along with changes in functional independence and quality of life in patients with thoracolumbar SCI. Methods: We undertook a retrospective analysis of a clinical study in which a nonrandomized sample of 110 patients with thoracolumbar SCI underwent autologous bone marrow-derived mononuclear cell transplantation intrathecally and subsequent neurorehabilitation, with a mean follow-up of 2 years ± 1 month. Changes on any parameters were recorded at follow-up. The data were analyzed using the Wilcoxon's signed-rank test and McNemar's test. Functional Independence Measure and American Spinal Injury Association (ASIA scores were recorded, and a detailed neurological assessment was performed. Results: Overall improvement was seen in 91% of patients, including reduction in spasticity, partial sensory recovery, and improvement in trunk control, postural hypotension, bladder management, mobility, activities of daily living, and functional independence. A significant association of these symptomatic improvements with the cell therapy intervention was established

  19. Estimating the effective radiation dose imparted to patients by intraoperative cone-beam computed tomography in thoracolumbar spinal surgery.

    Science.gov (United States)

    Lange, Jeffrey; Karellas, Andrew; Street, John; Eck, Jason C; Lapinsky, Anthony; Connolly, Patrick J; Dipaola, Christian P

    2013-03-01

    Observational. To estimate the radiation dose imparted to patients during typical thoracolumbar spinal surgical scenarios. Minimally invasive techniques continue to become more common in spine surgery. Computer-assisted navigation systems coupled with intraoperative cone-beam computed tomography (CT) represent one such method used to aid in instrumented spinal procedures. Some studies indicate that cone-beam CT technology delivers a relatively low dose of radiation to patients compared with other x-ray-based imaging modalities. The goal of this study was to estimate the radiation exposure to the patient imparted during typical posterior thoracolumbar instrumented spinal procedures, using intraoperative cone-beam CT and to place these values in the context of standard CT doses. Cone-beam CT scans were obtained using Medtronic O-arm (Medtronic, Minneapolis, MN). Thermoluminescence dosimeters were placed in a linear array on a foam-plastic thoracolumbar spine model centered above the radiation source for O-arm presets of lumbar scans for small or large patients. In-air dosimeter measurements were converted to skin surface measurements, using published conversion factors. Dose-length product was calculated from these values. Effective dose was estimated using published effective dose to dose-length product conversion factors. Calculated dosages for many full-length procedures using the small-patient setting fell within the range of published effective doses of abdominal CT scans (1-31 mSv). Calculated dosages for many full-length procedures using the large-patient setting fell within the range of published effective doses of abdominal CT scans when the number of scans did not exceed 3. We have demonstrated that single cone-beam CT scans and most full-length posterior instrumented spinal procedures using O-arm in standard mode would likely impart a radiation dose within the range of those imparted by a single standard CT scan of the abdomen. Radiation dose increases

  20. Analysis of Long Bone and Vertebral Failure Patterns.

    Science.gov (United States)

    1983-03-01

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

  1. Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M. [Department of Radiology, University Hospital, Gent (Belgium); Vandekerckhove, T. [Department of Neurosurgery, University Hospital, Gent (Belgium)

    2000-06-01

    A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

  2. Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

    International Nuclear Information System (INIS)

    Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M.; Vandekerckhove, T.

    2000-01-01

    A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

  3. Organizational heterogeneity of vertebrate genomes.

    Science.gov (United States)

    Frenkel, Svetlana; Kirzhner, Valery; Korol, Abraham

    2012-01-01

    Genomes of higher eukaryotes are mosaics of segments with various structural, functional, and evolutionary properties. The availability of whole-genome sequences allows the investigation of their structure as "texts" using different statistical and computational methods. One such method, referred to as Compositional Spectra (CS) analysis, is based on scoring the occurrences of fixed-length oligonucleotides (k-mers) in the target DNA sequence. CS analysis allows generating species- or region-specific characteristics of the genome, regardless of their length and the presence of coding DNA. In this study, we consider the heterogeneity of vertebrate genomes as a joint effect of regional variation in sequence organization superimposed on the differences in nucleotide composition. We estimated compositional and organizational heterogeneity of genome and chromosome sequences separately and found that both heterogeneity types vary widely among genomes as well as among chromosomes in all investigated taxonomic groups. The high correspondence of heterogeneity scores obtained on three genome fractions, coding, repetitive, and the remaining part of the noncoding DNA (the genome dark matter--GDM) allows the assumption that CS-heterogeneity may have functional relevance to genome regulation. Of special interest for such interpretation is the fact that natural GDM sequences display the highest deviation from the corresponding reshuffled sequences.

  4. Organizational heterogeneity of vertebrate genomes.

    Directory of Open Access Journals (Sweden)

    Svetlana Frenkel

    Full Text Available Genomes of higher eukaryotes are mosaics of segments with various structural, functional, and evolutionary properties. The availability of whole-genome sequences allows the investigation of their structure as "texts" using different statistical and computational methods. One such method, referred to as Compositional Spectra (CS analysis, is based on scoring the occurrences of fixed-length oligonucleotides (k-mers in the target DNA sequence. CS analysis allows generating species- or region-specific characteristics of the genome, regardless of their length and the presence of coding DNA. In this study, we consider the heterogeneity of vertebrate genomes as a joint effect of regional variation in sequence organization superimposed on the differences in nucleotide composition. We estimated compositional and organizational heterogeneity of genome and chromosome sequences separately and found that both heterogeneity types vary widely among genomes as well as among chromosomes in all investigated taxonomic groups. The high correspondence of heterogeneity scores obtained on three genome fractions, coding, repetitive, and the remaining part of the noncoding DNA (the genome dark matter--GDM allows the assumption that CS-heterogeneity may have functional relevance to genome regulation. Of special interest for such interpretation is the fact that natural GDM sequences display the highest deviation from the corresponding reshuffled sequences.

  5. Melatonin Receptor Genes in Vertebrates

    Directory of Open Access Journals (Sweden)

    Hua Dong Yin

    2013-05-01

    Full Text Available Melatonin receptors are members of the G protein-coupled receptor (GPCR family. Three genes for melatonin receptors have been cloned. The MT1 (or Mel1a or MTNR1A and MT2 (or Mel1b or MTNR1B receptor subtypes are present in humans and other mammals, while an additional melatonin receptor subtype, Mel1c (or MTNR1C, has been identified in fish, amphibians and birds. Another melatonin related orphan receptor, GPR50, which does not bind melatonin, is found exclusively in mammals. The hormone melatonin is secreted primarily by the pineal gland, with highest levels occurring during the dark period of a circadian cycle. This hormone acts systemically in numerous organs. In the brain, it is involved in the regulation of various neural and endocrine processes, and it readjusts the circadian pacemaker, the suprachiasmatic nucleus. This article reviews recent studies of gene organization, expression, evolution and mutations of melatonin receptor genes of vertebrates. Gene polymorphisms reveal that numerous mutations are associated with diseases and disorders. The phylogenetic analysis of receptor genes indicates that GPR50 is an outgroup to all other melatonin receptor sequences. GPR50 may have separated from a melatonin receptor ancestor before the split between MTNR1C and the MTNR1A/B ancestor.

  6. Linking vertebral number to performance of aquatic escape responses in the axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Ackerly, Kerri L; Ward, Andrea B

    2015-12-01

    Environmental conditions during early development in ectothermic vertebrates can lead to variation in vertebral number among individuals of the same species. It is often seen that individuals of a species raised at cooler temperatures have more vertebrae than individuals raised at warmer temperatures, although the functional consequences of this variation in vertebral number on swimming performance are relatively unclear. To investigate this relationship, we tested how vertebral number in axolotls (Ambystoma mexicanum) affected performance of aquatic escape responses (C-starts). Axolotls were reared at four temperatures (12-24°C) encompassing their natural thermal range and then transitioned to a mean temperature (18°C) three months before C-starts were recorded. Our results showed variation in vertebral number, but that variation was not significantly affected by developmental temperature. C-start performance among axolotls was significantly correlated with caudal vertebral number, and individuals with more caudal vertebrae were able to achieve greater curvature more quickly during their responses than individuals with fewer vertebrae. However, our results show that these individuals did not achieve greater displacements or velocities, and that developmental temperature did not have any effect on C-start performance. We highlight that the most important aspects of escape swim performance (i.e., how far individuals get from a threat and how quickly they move the most important parts of the body away from that threat) are consistent across individuals regardless of developmental temperature and morphological variation. Copyright © 2015 Elsevier GmbH. All rights reserved.

  7. Review of radiological scoring methods of osteoporotic vertebral fractures for clinical and research settings

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Ling [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Rivadeneira, Fernando [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-79, CA, Rotterdam (Netherlands); Ly, Felisia; Breda, Stephan J. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Zillikens, M.C. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Department of Internal Medicine, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands); Hofman, Albert [Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Uitterlinden, Andre G. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-75B, CA, Rotterdam (Netherlands); Krestin, Gabriel P.; Oei, Edwin H.G. [Erasmus Medical Center, Department of Radiology, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands)

    2013-02-15

    Osteoporosis is the most common metabolic bone disease; vertebral fractures are the most common osteoporotic fractures. Several radiological scoring methods using different criteria for osteoporotic vertebral fractures exist. Quantitative morphometry (QM) uses ratios derived from direct vertebral body height measurements to define fractures. Semi-quantitative (SQ) visual grading is performed according to height and area reduction. The algorithm-based qualitative (ABQ) method introduced a scheme to systematically rule out non-fracture deformities and diagnoses osteoporotic vertebral fractures based on endplate depression. The concordance across methods is currently a matter of debate. This article reviews the most commonly applied standardised radiographic scoring methods for osteoporotic vertebral fractures, attaining an impartial perspective of benefits and limitations. It provides image examples and discusses aspects that facilitate large-scale application, such as automated image analysis software and different imaging investigations. It also reviews the implications of different fracture definitions for scientific research and clinical practice. Accurate standardised scoring methods for assessing osteoporotic vertebral fractures are crucial, considering that differences in definition will have implications for patient care and scientific research. Evaluation of the feasibility and concordance among methods will allow establishing their benefits and limitations, and most importantly, optimise their effectiveness for widespread application. (orig.)

  8. Review of radiological scoring methods of osteoporotic vertebral fractures for clinical and research settings

    International Nuclear Information System (INIS)

    Oei, Ling; Rivadeneira, Fernando; Ly, Felisia; Breda, Stephan J.; Zillikens, M.C.; Hofman, Albert; Uitterlinden, Andre G.; Krestin, Gabriel P.; Oei, Edwin H.G.

    2013-01-01

    Osteoporosis is the most common metabolic bone disease; vertebral fractures are the most common osteoporotic fractures. Several radiological scoring methods using different criteria for osteoporotic vertebral fractures exist. Quantitative morphometry (QM) uses ratios derived from direct vertebral body height measurements to define fractures. Semi-quantitative (SQ) visual grading is performed according to height and area reduction. The algorithm-based qualitative (ABQ) method introduced a scheme to systematically rule out non-fracture deformities and diagnoses osteoporotic vertebral fractures based on endplate depression. The concordance across methods is currently a matter of debate. This article reviews the most commonly applied standardised radiographic scoring methods for osteoporotic vertebral fractures, attaining an impartial perspective of benefits and limitations. It provides image examples and discusses aspects that facilitate large-scale application, such as automated image analysis software and different imaging investigations. It also reviews the implications of different fracture definitions for scientific research and clinical practice. Accurate standardised scoring methods for assessing osteoporotic vertebral fractures are crucial, considering that differences in definition will have implications for patient care and scientific research. Evaluation of the feasibility and concordance among methods will allow establishing their benefits and limitations, and most importantly, optimise their effectiveness for widespread application. (orig.)

  9. [Treatment of thoracolumbar burst fracture with lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh].

    Science.gov (United States)

    Zhang, Shi-min; Zhang, Zhao-jie; Liu, Yu-zhang; Zhang, Lu-tang; Li, Xing

    2011-11-01

    To discuss the efficacy of lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh in the treatment of severe thoracolumbar burst fracture. From January 2008 to January 2010, 21 patients with severe thoracolumbar burst fracture were treated with lateral anterior decompression, internal fixation with Ventrofix, bone graft with titanic mesh. There were 15 males and 6 females, ranging in age from 21 to 46 years with an average of 32.2 years. Segment of fracture: 3 cases were in T11, 6 cases in T12, 7 cases in L1, 5 cases in L2. The mean kyphosis angle was 20.1 degrees and loading of fracture was 7.8 scores. Twenty-one cases accompany with incomplete paralysis. Nerves functions were observed according to Frankel grade; correction and maintain of kyphosis angle were observed by X-rays and CT. All the patients were followed up from 12 to 34 months with an average of 18.5 years. Postoperative complication including injury of pleura in 1 case, dynamic ileus in 2 cases, ilioinguinal nerve injury in 1 case, faulty union of wound in 1 case. All the above complications got recovery after symptomatic treatment. The mean kyphosis angle in fusional segment were 4.2 degrees and the rate of correction was 79%. Nerves functions of all patients got improvement and no internal fixation fail, kyphosis angle obviously lost, titanium mesh shifting, loosening and breakage of screw were found at final follow-up. Lateral anterior decompression, bone graft with titanic mesh, internal fixation with Ventrofix is an idea technique for severe thoracolumber burst fracture, but the method can not be used for patient with severity osteoporosis.

  10. OPEN SURGICAL VS. MINIMALLY INVASIVE TREATMENT OF THORACOLUMBAR AO FRACTURES TYPE A AND B1 IN A REFERENCE HOSPITAL

    Directory of Open Access Journals (Sweden)

    José Enrique Salcedo Oviedo

    Full Text Available ABSTRACT Objective: The thoracolumbar spine trauma represents 30% of spinal diseases. To compare the minimally invasive technique with the open technique in lumbar fractures. Method: A prospective, cross-sectional, comparative observational study, which evaluated the following variables: surgery time, length of hospital stay, transoperative bleeding, postoperative pain, analyzed by SPSS software using Student's t test with statistical significance of p ≥ 0.05, with 24 patients with single-level thoracolumbar fractures, randomly treated with percutaneous pedicle screws and by open technique with a transpedicular system. Results: The surgery time was 90 minutes for the minimally invasive technique and 60 minutes for the open technique, the bleeding was on average 50 cm3 vs. 400 cm3. The mean visual analogue scale for pain at 24 hours of surgery was 5 for the minimally invasive group vs. 8 for the open group. The number of fluoroscopic projections of pedicle screws was 220 in the minimally invasive technique vs. 100 in the traditional technique. Quantified bleeding was minimal for percutaneous access vs. 340 cm3 for the traditional system. The hospital discharge for the minimally invasive group was at 24 hours and at 72 hours for those treated with open surgery. Conclusions: It is a technique that requires longer surgical time, with reports of less bleeding, less postoperative pain and less time for hospital discharge, reasons why it is supposed to be a procedure that requires a learning curve, statistical significance with respect to bleeding, visual analogue scale for pain and showed no significant difference in the variables of surgical time.

  11. Posterior Fixation with Unilateral Same Segment Pedicle Fixation and Contralateral Hook in Surgical Treatment of Thoracolumbar Burst Fractures

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2016-06-01

    Full Text Available Background In surgical treatment of thoracolumbar burst fractures, most authors try to lower the number of vertebrae involved during the surgery. Objectives The aim of this study was to evaluate the outcome of a medium-segment posterior spinal fixation in these patients. Patients and Methods We retrospectively reviewed 27 patients (18 male, 9 female with mean age of 39.4 ± 15.0 years old in a before-and-after study. The mean follow-up period was 38.4 ± 15.6 months. We involved 2 intact above vertebrae and one intact below vertebra, inserting a pedicular screw at the fractured level and supplemented the construct with contralateral infralaminar hook. Clinical and radiologic characteristics were assessed with American spinal injury association (ASIA scale, oswestry disability index (ODI, visual analogue scale (VAS, and plain radiography. Data analysis was carried out by SPSS version 11.5 software. Results Mean post traumatic kyphosis was + 15.7° ± 3.3° that was changed to - 8.5° ± 4.3° and +1° ± 4.4° at immediate and last visit after surgery, respectively. Mean loss of correction (LOC was 9.5° ± 1.9° (P < 0.001. At the most recent follow-up visit, mean ODI and VAS were 15.0 ± 14.4 and 2.4 ± 2.5, respectively and 24 cases (88.9% declared excellent or good clinical results. At the last follow-up visit, LOC had no significant correlation neither with VAS nor ODI. Conclusions In surgical treatment of thoracolumbar burst fractures, a medium-segment posterior spinal fixation, although cannot maintain the radiologic reduction of the fractured vertebrae efficiently, is not only associated with acceptable clinical outcome but also spare one lower intact lumbar segment and therefore recommended.

  12. Innate immunity in vertebrates: an overview.

    Science.gov (United States)

    Riera Romo, Mario; Pérez-Martínez, Dayana; Castillo Ferrer, Camila

    2016-06-01

    Innate immunity is a semi-specific and widely distributed form of immunity, which represents the first line of defence against pathogens. This type of immunity is critical to maintain homeostasis and prevent microbe invasion, eliminating a great variety of pathogens and contributing with the activation of the adaptive immune response. The components of innate immunity include physical and chemical barriers, humoral and cell-mediated components, which are present in all jawed vertebrates. The understanding of innate defence mechanisms in non-mammalian vertebrates is the key to comprehend the general picture of vertebrate innate immunity and its evolutionary history. This is also essential for the identification of new molecules with applications in immunopharmacology and immunotherapy. In this review, we describe and discuss the main elements of vertebrate innate immunity, presenting core findings in this field and identifying areas that need further investigation. © 2016 John Wiley & Sons Ltd.

  13. Tetanus with multiple wedge vertebral collapses

    African Journals Online (AJOL)

    owner

    2012-07-06

    Jul 6, 2012 ... associated with traumatic injury, often a penetrating wound inflicted by dirty ... multiple vertebral collapses and the management chal- .... back pains and swelling as in our patient.9 There are usually no ... The cervical and.

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

    Directory of Open Access Journals (Sweden)

    Balasa D

    2016-08-01

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

  15. Constrained vertebrate evolution by pleiotropic genes.

    Science.gov (United States)

    Hu, Haiyang; Uesaka, Masahiro; Guo, Song; Shimai, Kotaro; Lu, Tsai-Ming; Li, Fang; Fujimoto, Satoko; Ishikawa, Masato; Liu, Shiping; Sasagawa, Yohei; Zhang, Guojie; Kuratani, Shigeru; Yu, Jr-Kai; Kusakabe, Takehiro G; Khaitovich, Philipp; Irie, Naoki

    2017-11-01

    Despite morphological diversification of chordates over 550 million years of evolution, their shared basic anatomical pattern (or 'bodyplan') remains conserved by unknown mechanisms. The developmental hourglass model attributes this to phylum-wide conserved, constrained organogenesis stages that pattern the bodyplan (the phylotype hypothesis); however, there has been no quantitative testing of this idea with a phylum-wide comparison of species. Here, based on data from early-to-late embryonic transcriptomes collected from eight chordates, we suggest that the phylotype hypothesis would be better applied to vertebrates than chordates. Furthermore, we found that vertebrates' conserved mid-embryonic developmental programmes are intensively recruited to other developmental processes, and the degree of the recruitment positively correlates with their evolutionary conservation and essentiality for normal development. Thus, we propose that the intensively recruited genetic system during vertebrates' organogenesis period imposed constraints on its diversification through pleiotropic constraints, which ultimately led to the common anatomical pattern observed in vertebrates.

  16. Handed behavior in hagfish--an ancient vertebrate lineage--and a survey of lateralized behaviors in other invertebrate chordates and elongate vertebrates.

    Science.gov (United States)

    Miyashita, Tetsuto; Palmer, A Richard

    2014-04-01

    Hagfish represent an ancient lineage of boneless and jawless vertebrates. Among several curious behaviors they exhibit, solitary individuals in one dominant genus of hagfish (Eptatretus spp.) regularly rest in a tightly coiled posture. We present the first systematic treatment of this distinctive behavior. Individual northeastern Pacific hagfish (E. stoutii) exhibited significant handedness (preferred orientation of coiling). However, right-coiling and left-coiling individuals were equally common in the population. Individual hagfish likely develop a preference for one direction by repeating the preceding coiling direction. We also revisit classical accounts of chordate natural history and compare the coiling behavior of Eptatretus with other handed or lateralized behaviors in non-vertebrate chordates, lampreys, and derived vertebrates with elongate bodies. Handed behaviors occur in many of these groups, but they likely evolved independently. In contrast to vertebrates, morphological asymmetries may bias lateralized larval behaviors toward one side in cephalochordates and tunicates. As a consequence, no known handed behavior can be inferred to have existed in the common ancestor of vertebrates.

  17. High prevalence of radiological vertebral fractures in HIV-infected males.

    Science.gov (United States)

    Torti, Carlo; Mazziotti, Gherardo; Soldini, Pier Antonio; Focà, Emanuele; Maroldi, Roberto; Gotti, Daria; Carosi, Giampiero; Giustina, Andrea

    2012-06-01

    Age-related co-morbidities including osteoporosis are relevant in patients responding to combination antiretroviral therapy (cART). Vertebral fractures are common osteoporotic fractures and their diagnosis is useful for managing at-risk individuals. However, there are few data from HIV-infected patients. Therefore, the aim of this study was to determine the prevalence of and factors associated with vertebral fractures in a population of HIV-infected males. A cross-sectional study of 160 HIV-infected patients with available chest X-rays was conducted from 1998 to 2010. One hundred and sixty-three males with comparable age and with no history of HIV infection were recruited as controls. Semi-quantitative evaluation of vertebral heights in lateral chest X-rays and quantitative morphometry assessment of centrally digitized images using dedicated morphometry software were utilized to detect prevalent vertebral fractures. The result showed that the vertebral fractures were detected in 43/160 (26.9%) HIV-infected patients and in 21/163 (12.9%) controls (P = 0.002). In HIV-infected patients with fractures, 27 had two or more fractures and ten patients had severe fractures. The prevalence of any fractures and multiple fractures in HIV-infected patients receiving cART (29.6 and 20.0%) was slightly higher than in HIV-infected patients not exposed to cART (17.1 and 5.7%), but significantly higher than control subjects (12.9 and 3.7%). At multivariable analyses, body mass index and diabetes mellitus were independently correlated with vertebral fractures in HIV-infected patients. We concluded that a significant proportion of HIV-infected males receiving cART showed vertebral fractures. Furthermore, proactive diagnosis of vertebral fragility fractures is particularly relevant in patients who are overweight or suffer from diabetes.

  18. Normal reference values for vertebral artery flow volume by color Doppler sonography in Korean adults

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Cha, Jang Gyu; Park, Seong Jin; Joh, Joon Hee; Park, Jai Soung; Kim, Dae Ho; Lee, Hae Kyung; Ahn, Hyun Cheol [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2003-09-15

    Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume. This study was to establish the reference values for the flow volume of the vertebral artery using color Doppler sonography in the normal Korea adults. Thirty five normal Korea adults without any underlying disease including hypertension, hyperlipidemia, diabetes, heart disease, obesity (body mas index>30), or carotid artery stenosis was included. There were 17 males and 18 females, age ranged from 20 to 53 years (average=32.86 years). Flow velocities and vessel diameters were recorded in the intertransverse (V2) segment, usually at C5-6 level, bilaterally. The flow volume (Q) was calculated. (Q=time averaged mean velocity x cross sectional area of vessel) A lower Flow velocity and smaller vessel diameter were measured on the right side compared to those of the left side, resulting in a lower flow volume. The calculated flow volumes using the equation were 77.0 +- 39.7 ml/min for the right side and 127.6 +- 71.0 ml/min for the left side (p=0.0001) while the net vertebral artery flow volume was 204.6 +- 81.8 ml/min. Decrease in the vertebral artery flow volume was statistically significant with advanced age. (r=-0.36, p=0.032). Vertebral artery blood flow volume was 191.20 +- 59.19 ml/min in male, and 217.28 +- 98.67 ml/min in female (p=0.6). The normal range for the net vertebral artery flow volume defined by the 5th to 95th percentiles was between 110.06 and 364.1 ml/min. The normal range for the net vertebral artery flow volume was between 110.06 and 364.1 ml/min. Vertebral artery flow volume decreased with the increase of age. However, gender did not affect the blood flow volume.

  19. Conserved form and function of the germinal epithelium through 500 million years of vertebrate evolution.

    Science.gov (United States)

    Grier, Harry J; Uribe, Mari Carmen; Lo Nostro, Fabiana L; Mims, Steven D; Parenti, Lynne R

    2016-08-01

    The germinal epithelium, i.e., the site of germ cell production in males and females, has maintained a constant form and function throughout 500 million years of vertebrate evolution. The distinguishing characteristic of germinal epithelia among all vertebrates, males, and females, is the presence of germ cells among somatic epithelial cells. The somatic epithelial cells, Sertoli cells in males or follicle (granulosa) cells in females, encompass and isolate germ cells. Morphology of all vertebrate germinal epithelia conforms to the standard definition of an epithelium: epithelial cells are interconnected, border a body surface or lumen, are avascular and are supported by a basement membrane. Variation in morphology of gonads, which develop from the germinal epithelium, is correlated with the evolution of reproductive modes. In hagfishes, lampreys, and elasmobranchs, the germinal epithelia of males produce spermatocysts. A major rearrangement of testis morphology diagnoses osteichthyans: the spermatocysts are arranged in tubules or lobules. In protogynous (female to male) sex reversal in teleost fishes, female germinal epithelial cells (prefollicle cells) and oogonia transform into the first male somatic cells (Sertoli cells) and spermatogonia in the developing testis lobules. This common origin of cell types from the germinal epithelium in fishes with protogynous sex reversal supports the homology of Sertoli cells and follicle cells. Spermatogenesis in amphibians develops within spermatocysts in testis lobules. In amniotes vertebrates, the testis is composed of seminiferous tubules wherein spermatogenesis occurs radially. Emerging research indicates that some mammals do not have lifetime determinate fecundity. The fact emerged that germinal epithelia occur in the gonads of all vertebrates examined herein of both sexes and has the same form and function across all vertebrate taxa. Continued study of the form and function of the germinal epithelium in vertebrates

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

    Science.gov (United States)

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

    2004-05-01

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

  1. Hormonally active phytochemicals and vertebrate evolution.

    Science.gov (United States)

    Lambert, Max R; Edwards, Thea M

    2017-06-01

    Living plants produce a diversity of chemicals that share structural and functional properties with vertebrate hormones. Wildlife species interact with these chemicals either through consumption of plant materials or aquatic exposure. Accumulating evidence shows that exposure to these hormonally active phytochemicals (HAPs) often has consequences for behavior, physiology, and fecundity. These fitness effects suggest there is potential for an evolutionary response by vertebrates to HAPs. Here, we explore the toxicological HAP-vertebrate relationship in an evolutionary framework and discuss the potential for vertebrates to adapt to or even co-opt the effects of plant-derived chemicals that influence fitness. We lay out several hypotheses about HAPs and provide a path forward to test whether plant-derived chemicals influence vertebrate reproduction and evolution. Studies of phytochemicals with direct impacts on vertebrate reproduction provide an obvious and compelling system for studying evolutionary toxicology. Furthermore, an understanding of whether animal populations evolve in response to HAPs could provide insightful context for the study of rapid evolution and how animals cope with chemical agents in the environment.

  2. Accuracy of densitometric vertebral fracture assessment when performed by DXA technicians-a cross-sectional, multiobserver study

    DEFF Research Database (Denmark)

    Rud, B; Vestergaard, A; Hyldstrup, L

    2016-01-01

    Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two radiolog......Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two...... radiologists. Three DXA technicians performed acceptable or better in identifying patients with fractured vertebrae. INTRODUCTION: This is the first study to evaluate the accuracy of vertebral fracture assessment (VFA) when used by DXA technicians as a triage test to select patients with deformed vertebrae...... for spinal radiographs. METHODS: Lateral single-energy scans and radiographs of the thoracolumbar spine (T4-L4) were acquired in 235 patients aged 65 years or more referred for osteoporosis assessment. Six DXA technicians evaluated lateral scans using dedicated software. The DXA technicians were trained...

  3. Kummel Disease Treatment by Unipedicular Vertebral Augmentation Using Curved Injection Cannula

    International Nuclear Information System (INIS)

    Masala, Salvatore; Nano, Giovanni; Mammucari, Matteo; Simonetti, Giovanni

    2011-01-01

    Purpose: This study was designed to evaluate the efficacy of the blunt-tipped curved injection needle (BCN) AVAflex (Care Fusion) for vertebral augmentation in cases of Kummel’s disease. Methods: We performed 25 vertebral augmentation procedures on 25 consecutive patients (11 men/14 women; mean age, 67 years) with Kummel’s disease using the blunt-tipped curved injection needle with PMMA cement. We performed all 25 procedures by unipedicular left approach with patients in prone position under local anesthesia and mild sedation. In all cases, an intravertebral cleft was evident on preprocedural imaging. We evaluated pain intensities by Visual Analogic Scale (VAS) before and at first day, 6 months, and 1 year after procedure. Results: In all cases the curved injection cannula permitted the filling of the clefts and surrounding cancellous bone without any complication. A significant reduction of kyphotic deformities of the treated vertebral bodies was evident. A significance decrease in VAS values at 1 year also was evident (mean decrease 7.2). At plain dynamic postprocedural X-rays checks, there was no sign of pathologic intravertebral motion as evidence of optimal stabilization. Conclusions: BCN AVAflex is a safe and effective device for targeted vertebral augmentation in cases of Kummel’s disease. Its distinctive characteristic is the curved injection cannula, which enables targeting the cement injection to areas far off the trajectory of the straight access cannula, thus providing excellent cement spread throughout the entire volume of vertebral body.

  4. Variability of tissue mineral density can determine physiological creep of human vertebral cancellous bone.

    Science.gov (United States)

    Kim, Do-Gyoon; Shertok, Daniel; Ching Tee, Boon; Yeni, Yener N

    2011-06-03

    Creep is a time-dependent viscoelastic deformation observed under a constant prolonged load. It has been indicated that progressive vertebral deformation due to creep may increase the risk of vertebral fracture in the long-term. The objective of this study was to examine the relationships of creep with trabecular architecture and tissue mineral density (TMD) parameters in human vertebral cancellous bone at a physiological static strain level. Architecture and TMD parameters of cancellous bone were analyzed using microcomputerized tomography (micro-CT) in specimens cored out of human vertebrae. Then, creep and residual strains of the specimens were measured after a two-hour physiological compressive constant static loading and unloading cycle. Creep developed (3877 ± 2158 με) resulting in substantial levels of non-recoverable post-creep residual strain (1797 ± 1391 με). A strong positive linear correlation was found between creep and residual strain (r = 0.94, p creep rate. The TMD variability (GL(COV)) was the strongest correlate of creep rate (r = 0.79, p < 0.001). This result suggests that TMD variability may be a useful parameter for estimating the long-term deformation of a whole vertebral body. The results further suggest that the changes in TMD variability resulting from bone remodeling are of importance and may provide an insight into the understanding of the mechanisms underlying progressive failure of vertebral bodies and development of a clinical fracture. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Inheritance of vertebral number in the three-spined stickleback (Gasterosteus aculeatus.

    Directory of Open Access Journals (Sweden)

    Jussi S Alho

    Full Text Available Intraspecific variation in the number of vertebrae is taxonomically widespread, and both genetic and environmental factors are known to contribute to this variation. However, the relative importance of genetic versus environmental influences on variation in vertebral number has seldom been investigated with study designs that minimize bias due to non-additive genetic and maternal influences. We used a paternal half-sib design and animal model analysis to estimate heritability and causal components of variance in vertebral number in three-spined sticklebacks (Gasterosteus aculeatus. We found that both the number of vertebrae (h(2 = 0.36 and body size (h(2 = 0.42 were moderately heritable, whereas the influence of maternal effects was estimated to be negligible. While the number of vertebrae had a positive effect on body size, no evidence for a genetic correlation between body size and vertebral number was detected. However, there was a significant positive environmental correlation between these two traits. Our results support the generalization--in accordance with results from a review of heritability estimates for vertebral number in fish, reptiles and mammals--that the number of vertebrae appears to be moderately to highly heritable in a wide array of species. In the case of the three-spined stickleback, independent evolution of body size and number of vertebrae should be possible given the low genetic correlation between the two traits.

  6. Inheritance of Vertebral Number in the Three-Spined Stickleback (Gasterosteus aculeatus)

    Science.gov (United States)

    Alho, Jussi S.; Leinonen, Tuomas; Merilä, Juha

    2011-01-01

    Intraspecific variation in the number of vertebrae is taxonomically widespread, and both genetic and environmental factors are known to contribute to this variation. However, the relative importance of genetic versus environmental influences on variation in vertebral number has seldom been investigated with study designs that minimize bias due to non-additive genetic and maternal influences. We used a paternal half-sib design and animal model analysis to estimate heritability and causal components of variance in vertebral number in three-spined sticklebacks (Gasterosteus aculeatus). We found that both the number of vertebrae (h2 = 0.36) and body size (h2 = 0.42) were moderately heritable, whereas the influence of maternal effects was estimated to be negligible. While the number of vertebrae had a positive effect on body size, no evidence for a genetic correlation between body size and vertebral number was detected. However, there was a significant positive environmental correlation between these two traits. Our results support the generalization-in accordance with results from a review of heritability estimates for vertebral number in fish, reptiles and mammals-that the number of vertebrae appears to be moderately to highly heritable in a wide array of species. In the case of the three-spined stickleback, independent evolution of body size and number of vertebrae should be possible given the low genetic correlation between the two traits. PMID:21603609

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  9. Unusual bone dysplasia featuring severe platyspondyly and vertebral 'coronal cleft' in infancy, and changes of metaphyseal chondrodysplasia in childhood

    International Nuclear Information System (INIS)

    Currarino, G.; Texas Univ., Dallas

    1986-01-01

    This is the report of a boy who presented at birth with severe generalized platyspondyly, a vertebral ''coronal cleft'', and an abnormal configuration of the pelvis with short and broad iliac and ischial bones and horizontal acetabular roofs. The rest of the skeleton was normal. In the ensuing years the vertebral bodies and pelvis assumed a near normal configuration, but the patient developed changes of metaphyseal chondrodysplasia in the long bones of the lower limbs with progressive shortness of stature. (orig.)

  10. Quantitative assessment of cervical vertebral maturation using cone beam computed tomography in Korean girls.

    Science.gov (United States)

    Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Son, Woo-Sung

    2015-01-01

    This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6-18 years of age). CBCT-generated cervical vertebral maturation (CVM) was used to demarcate the odontoid process and the body of the second cervical vertebra, based on the dentocentral synchondrosis. Correlation coefficient analysis and multiple linear regression analysis were used for each parameter of the cervical vertebrae (P cervical vertebral body and odontoid process, respectively, for the multiple regression models. This suggests that quantitative analysis might be used to estimate skeletal maturation status.

  11. EFFECTS OF X-RAY BEAM ANGLE AND GEOMETRIC DISTORTION ON WIDTH OF EQUINE THORACOLUMBAR INTERSPINOUS SPACES USING RADIOGRAPHY AND COMPUTED TOMOGRAPHY

    DEFF Research Database (Denmark)

    Djernaes, Julie D.; Nielsen, Jon V.; Berg, Lise C.

    2017-01-01

    The widths of spaces between the thoracolumbar processi spinosi (interspinous spaces) are frequently assessed using radiography in sports horses; however effects of varying X-ray beam angles and geometric distortion have not been previously described. The aim of this prospective, observational...... study was to determine whether X-ray beam angle has an effect on apparent widths of interspinous spaces. Thoracolumbar spine specimens were collected from six equine cadavers and left-right lateral radiographs and sagittal and dorsal reconstructed computed tomographic (CT) images were acquired...... measurements. Effect of geometric distortion was evaluated by comparing the interspinous space in radiographs with sagittal and dorsal reconstructed CT images. A total of 49 interspinous spaces were sampled, yielding 274 measurements. X-ray beam angle significantly affected measured width of interspinous...

  12. Evolution of circadian organization in vertebrates

    Directory of Open Access Journals (Sweden)

    M. Menaker

    1997-03-01

    Full Text Available Circadian organization means the way in which the entire circadian system above the cellular level is put together physically and the principles and rules that determine the interactions among its component parts which produce overt rhythms of physiology and behavior. Understanding this organization and its evolution is of practical importance as well as of basic interest. The first major problem that we face is the difficulty of making sense of the apparently great diversity that we observe in circadian organization of diverse vertebrates. Some of this diversity falls neatly into place along phylogenetic lines leading to firm generalizations: i in all vertebrates there is a "circadian axis" consisting of the retinas, the pineal gland and the suprachiasmatic nucleus (SCN, ii in many non-mammalian vertebrates of all classes (but not in any mammals the pineal gland is both a photoreceptor and a circadian oscillator, and iii in all non-mammalian vertebrates (but not in any mammals there are extraretinal (and extrapineal circadian photoreceptors. An interesting explanation of some of these facts, especially the differences between mammals and other vertebrates, can be constructed on the assumption that early in their evolution mammals passed through a "nocturnal bottleneck". On the other hand, a good deal of the diversity among the circadian systems of vertebrates does not fall neatly into place along phylogenetic lines. In the present review we will consider how we might better understand such "phylogenetically incoherent" diversity and what sorts of new information may help to further our understanding of the evolution of circadian organization in vertebrates

  13. Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging.

    Science.gov (United States)

    Vaccaro, Alexander R; Rihn, Jeffrey A; Saravanja, Davor; Anderson, David G; Hilibrand, Alan S; Albert, Todd J; Fehlings, Michael G; Morrison, William; Flanders, Adam E; France, John C; Arnold, Paul; Anderson, Paul A; Friel, Brian; Malfair, David; Street, John; Kwon, Brian; Paquette, Scott; Boyd, Michael; Dvorak, Marcel F S; Fisher, Charles

    2009-11-01

    Prospective diagnostic imaging study. To determine the accuracy of magnetic resonance imaging (MRI) in diagnosing injury of the posterior ligamentous complex (PLC) in patients with thoracolumbar trauma. Treatment decisions in thoracolumbar injury patients are currently based on the status of the PLC. It is, therefore, important to understand the accuracy of MRI in diagnosing varying degrees of PLC injury. Prior studies report that MRI is up to 100% sensitive for diagnosing PCL injury. Patients with an acute injury from T1 to L3 who required posterior surgery were prospectively studied. A musculoskeletal radiologist, based on the preoperative MRI findings, characterized each of the 6 components of the PLC as intact, incompletely disrupted, or disrupted. During the surgical procedure, the surgeon identified each component of the PLC as intact, incompletely disrupted, or disrupted. The radiologist's interpretation and surgical findings were compared. Forty-two patients with 62 levels of injury were studied. There were 33 males (78.6%) and 9 females (21.4%), and the average age was 35.7 years. According to the kappa score, there was a moderate level of agreement between the radiologist's interpretation and the intraoperative findings for all PLC components except the thoracolumbar fascia, for which there was slight agreement. The sensitivity for the various PLC components ranged from 79% (left facet capsule) to 90% (interspinous ligament). The specificity ranged from 53% (thoracolumbar fascia) to 65% (ligamentum flavum). There was less agreement between the radiologist and surgeon for the patients with less severe neurologic compromise, i.e., those patients with an AIS grade of either D or E. The sensitivity and specificity of MRI for diagnosing injury of the PLC are lower than previously reported in the literature. The integrity of the PLC as determined by MRI should not be used in isolation to determine treatment.

  14. Do adolescents with idiopathic scoliosis have body schema disorders? A cross-sectional study.

    Science.gov (United States)

    Picelli, Alessandro; Negrini, Stefano; Zenorini, Andrea; Iosa, Marco; Paolucci, Stefano; Smania, Nicola

    2016-01-01

    To date etiology of adolescent idiopathic scoliosis appears complex and still remains unclear. A distorted body schema has been proposed to be a part of a sequence of pathological events in the development of adolescent idiopathic scoliosis. To investigate the awareness of trunk misalignment in adolescents with idiopathic scoliosis. Information about 44 adolescents with idiopathic scoliosis was collected as follows: age; sex; handedness; family history of scoliosis; back pain; sport practice; shoulder and waist line symmetry; leg length; dorsal kyphosis; back hump; rehabilitation; scoliotic curve; Risser sign. We evaluated awareness of trunk misalignment with a graphic table displaying pictures of progressively increasing scoliotic curves. Patients were asked to indicate which picture corresponded to their perceived own spinal alignment. Patients with thoracolumbar scoliosis overestimated their actual thoracic spine curve. Patients with thoracic-thoracolumbar scoliosis underestimated their actual thoracolumbar spine curve and overestimated their actual lumbar spine curve. Scoliotic curve > 15°, double curve, younger age, back pain, family history of scoliosis and lower Risser score related with a misperception of trunk alignment. Our results support the hypothesis that adolescents with idiopathic scoliosis have an altered corporeal awareness of their trunk alignment.

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

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

    2014-04-15

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

  16. Quantitative Assessment of Cervical Vertebral Maturation Using Cone Beam Computed Tomography in Korean Girls

    OpenAIRE

    Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Son, Woo-Sung

    2015-01-01

    This study was aimed to examine the correlation between skeletal maturation status and parameters from the odontoid process/body of the second vertebra and the bodies of third and fourth cervical vertebrae and simultaneously build multiple regression models to be able to estimate skeletal maturation status in Korean girls. Hand-wrist radiographs and cone beam computed tomography (CBCT) images were obtained from 74 Korean girls (6?18 years of age). CBCT-generated cervical vertebral maturation ...

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

    Directory of Open Access Journals (Sweden)

    Steven De Decker

    Full Text Available Ankylosing spinal disorders can be associated with alterations in vertebral bone mineral density (BMD. There is however controversy about vertebral BMD in patients wuse idiopathic skeletal hyperostosis (DISH. DISH in Boxer dogs has been considered a natural occurring disease model for DISH in people. The purpose of this study was to compare vertebral BMD between Boxers with and without DISH. Fifty-nine Boxers with (n=30 or without (n=29 DISH that underwent computed tomography were included. Vertebral BMD was calculated for each thoracic and lumbar vertebra by using an earlier reported and validated protocol. For each vertebral body, a region of interest was drawn on the axial computed tomographic images at three separate locations: immediately inferior to the superior end plate, in the middle of the vertebral body, and superior to the inferior end plate. Values from the three axial slices were averaged to give a mean Hounsfield Unit value for each vertebral body. Univariate statistical analysis was performed to identify factors to be included in a multivariate model. The multivariate model including all dogs demonstrated that vertebral DISH status (Coefficient 24.63; 95% CI 16.07 to 33.19; p <0.001, lumbar vertebrae (Coefficient -17.25; 95% CI -23.42 to -11.09; p < 0.01, and to a lesser extent higher age (Coefficient -0.56; 95% CI -1.07 to -0.05; p = 0.03 were significant predictors for vertebral BMD. When the multivariate model was repeated using only dogs with DISH, vertebral DISH status (Coefficient 20.67; 95