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Journal articles on the topic 'Lumbar vertebrae treatment'
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1
Lee, Hsieh-Hsing, Shing-Sheng Wu, Shih-Youeng Chuang, Tsu-Te Yeh, and Po-Quang Chen. "BIOMECHANICAL EVALUATION OF TRANSPEDICULARLY PLACED INTRAVERTEBRAL SUPPORT FOR THE MANAGEMENT OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES." Journal of Musculoskeletal Research 11, no. 01 (March 2008): 37–43. http://dx.doi.org/10.1142/s0218957708001936.
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This in vitro biomechanical study reports on a new implant, called an intravertebral expandable pillar (IVEP). The implant is aimed at restoring the height and strength of collapsed vertebra after fracture in an osteoporotic patient. The hypothesis is that the IVEP can effectively restore the body height of the compressed vertebra and provide proper stiffness for the collapsed vertebra. Although the reported complication rate of percutaneous vertebroplasty by injection of polymethylmethacrylate (PMMA) is low, the sequelae are severe; other potential adverse effects of PMMA injection into the vertebral body include thermal necrosis of the surrounding tissue caused by a high polymerization temperature, and lack of long-term biocompatibility. We test the mechanical properties before and after fracture of 14 human cadaver lumbar vertebrae by a material testing system. The fractured vertebra was implanted with the IVEP, and its mechanical properties tested. The vertebral body height at each stage was evaluated by a digital caliper and radiographic films. After IVEP implantation, the vertebral body height restoration rate was 97.8%. The vertebral body height lost 12.7% after the same loading to create fracture. The vertebra lost half of its strength after compressed fracture, while IVEP implantation restored 86.4% of intact vertebra strength. The stiffness of intact vertebrae was significantly greater than that of untreated vertebrae after fracture and fractured vertebrae with IVEP treatment, while the stiffness of fractured vertebrae after IVEP treatment was significantly greater than that of untreated vertebrae after fracture. The bipedicularly implanted IVEP restores the initial height and strength of the vertebral body following an induced compression fracture, and could be used by a minimally invasive procedure to treat lumbar vertebra compression factures and avoid the disadvantage of using bone cement in vertebroplasty or kyphoplasty.
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Ortiz, A. Orlando. "Use and evaluation of a semi-permeable mesh implant in vertebral augmentation for the treatment of painful osteoporotic vertebral compression fractures." Journal of NeuroInterventional Surgery 8, no. 3 (January 13, 2015): 328–32. http://dx.doi.org/10.1136/neurintsurg-2014-011512.
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ObjectiveTo assess the efficacy of a semi-permeable mesh implant in the treatment of painful thoracic and lumbar osteoporotic vertebral compression fractures.MethodsPatients with painful thoracic and lumbar osteoporotic vertebral compression fractures which were refractory to conventional medical management and less than 3 months of age were considered possible candidates for this vertebral augmentation technique. Data recorded for the procedure included patient age, gender, fracture level and morphology, mesh implant size, amount of cement injected, cement extravasation, complications, and pre- and post-procedure numeric pain scores and Oswestry Disability Index (ODI) scores.Results17 patients were included in this retrospective study; 12 women and 5 men, with an average age of 78.6 years. Each patient had one level treated with the mesh implant; 4 thoracic levels and 13 lumbar levels. The 10×15 mm implant was used in 13 treated vertebrae, including the two thoracic vertebrae; the 10×20 mm implant was used to treat 3 lumbar vertebrae, and one 10×25 mm implant was used to treat an L1 vertebra. An average of 2.4 mL of acrylic bone cement was injected, and there was fluoroscopic evidence of a small amount of cement leakage in one case. No patient related complications were seen and there were no device failures. All patients, followed-up to at least 3 weeks, showed significant pain relief. The average pretreatment numeric pain score of 9 and ODI of 50 decreased to an average post-treatment score of 0.6 and 12, respectively (p<0.001).ConclusionsVertebral augmentation with a semi-permeable mesh stent implant can be used to effectively and safely treat osteoporotic vertebral compression fractures within the lower thoracic and lumbar spine.
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Hubner, André Rafael, Carlos Tobias Scortegagna, Charles Leonardo Israel, Everton Luis do Amarante Ivo, Fabiano Favretto, Marcelo Ribeiro, and Leandro de Freitas Spinelli. "NEW PROPOSAL FOR THE TREATMENT OF CORONAL SPLIT FRACTURES IN LUMBAR VERTEBRAE: THE FATIGUE CURVE." Coluna/Columna 20, no. 2 (June 2021): 127–31. http://dx.doi.org/10.1590/s1808-185120212002235745.
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ABSTRACT Objective: To evaluate a new treatment for split fractures through fatigue tests on a swine model. Methods: Thirty lumbar spine samples (L2-L3-L4) from swine models were divided into three test groups. The first was the control group (intact vertebrae). In the second group, a bone defect was created, similar to a coronal split fracture of the vertebral body. For this, a bone defect (osteotomy) was performed in the coronal axis of the middle third of the middle lumbar vertebral body (L3), keeping the disc-ligament structures intact. In the third group, the same procedure was performed to cause bone failure, but was associated with the use of synthesis material, with pedicular fixation using 3.5 mm cannulated screws with partial thread, in order to apply compression at the fracture site, giving resistance and support to the vertebra. The groups were submitted to biomechanical fatigue tests. The number of cycles required to failure in the specimen was analyzed. Results: The use of the synthesis material increased the resistance of the fractured vertebrae to levels equal to those of the intact vertebra for low cycles with loads of 40% of the failure load, possibly losing up to 20% of their resistance for higher cycles. Conclusions: In the vertebrae in which synthetic material was used, greater resistance to a greater number of cycles for a longer period of time was observed when compared with the fractured vertebrae, suggesting that this is an interesting method for the fixation of split-type spinal fractures. Level of evidence III; Experimental Study.
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Shen, Lanjuan, Cheng Ji, Jian Lin, and Hongping Yang. "Construction of Vertebral Body Tracking Algorithm Based on Dynamic Imaging Parameter Measurement and Its Application in the Treatment of Lumbar Instability." Journal of Medical Imaging and Health Informatics 11, no. 7 (July 1, 2021): 1834–44. http://dx.doi.org/10.1166/jmihi.2021.3534.
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Static imaging measurements could not truly reflect the dynamic panorama of the lumbar movement process, and the abnormal activities between the lumbar vertebrae and their dynamic balance could not be observed, resulting in difficulties in the mechanism analysis of lumbar instability and the efficacy evaluation of manipulation therapy. Therefore, this paper constructed a vertebral tracking algorithm based on dynamic imaging parameter measurement through imaging parameter measurement and calculation. According to the imaging data obtained by vertebral body tracking algorithm, the corresponding statistical methods were used to compare the functional scores before and after manipulation and the changes of imaging data, so as to evaluate the therapeutic effect of manipulation on lumbar instability. Through the clinical observation and imaging analysis of 15 patients with lumbar instability before and after manipulation treatment, it is verified that the vertebra tracking algorithm is effective in the vertebra tracking and plays a positive role in the treatment of lumbar instability.
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Nadulich, K. A., V. V. Khominets, and E. B. Nagornyi. "Tactics of surgical treatment of patients with lumbar spondylolysis." Bulletin of the Russian Military Medical Academy 22, no. 2 (June 15, 2020): 84–93. http://dx.doi.org/10.17816/brmma50052.
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The bilateral defect of the pars interarticularis (spondylolysis) is often the cause of low back pain syndrome and can lead to development of spondylolistesis. In some cases inefficiency of conservative treatment of this condition forces orthopedists to use surgical technologies. At the same time, in young patients with intact intervertebral discs, the rigid segmental fixation of the spine should be avoided. Where no neural decompression is needed, selective osteosynthesis of the pars defect is an optimal technique. The authors present the results of surgical treatment of 15 patients with single and two-level lumbar spondylolysis, 4 of which revealed minimal I degree lytic spondylolystesis of the L5 vertebrae. Localization of the pathological process in all patients was noted on both sides. In two patients spondylolysis defects of two vertebrae were detected (in one- adjacent L4 and L5, in the other - L2 and L4 vertebrae with sacralization of L5). The average period from the onset of symptoms ranged from 6 months to 2 years (an average of 14 months). All patients undergone bone autoplasty with iliac crest bone graft, and osteosynthesis of vertebral arches by a combined laminar-transpedicular system of the screw - rod - hook type. All patients had excellent and good anatomic and functional results. The used method of surgical treatment of patients of this category should be considered pathogenetically justified, as it is aimed at repair of spondylolytic defects as the main cause of segmental instability and forward displacement of vertebrae. The possibility to avoid fixation of intact segments of spine allows to categorize this operation as organ-preserving.
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Fukuda, Kentaro, Hiroyuki Katoh, Yuichiro Takahashi, Kazuya Kitamura, and Daiki Ikeda. "Minimally invasive anteroposterior combined surgery using lateral lumbar interbody fusion without corpectomy for treatment of lumbar spinal canal stenosis associated with osteoporotic vertebral collapse." Journal of Neurosurgery: Spine 35, no. 2 (August 2021): 154–62. http://dx.doi.org/10.3171/2020.10.spine201293.
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OBJECTIVE Various reconstructive surgical procedures have been described for lumbar spinal canal stenosis (LSCS) with osteoporotic vertebral collapse (OVC); however, the optimal surgery remains controversial. In this study, the authors aimed to report the clinical and radiographic outcomes of their novel, less invasive, short-segment anteroposterior combined surgery (APCS) that utilized oblique lateral interbody fusion (OLIF) and posterior fusion without corpectomy to achieve decompression and reconstruction of anterior support in patients with LSCS-OVC. METHODS In this retrospective study, 20 patients with LSCS-OVC (mean age 79.6 years) underwent APCS and received follow-up for a mean of 38.6 months. All patients were unable to walk without support owing to severe low-back and leg pain. Cleft formations in the fractured vertebrae were identified on CT. APCS was performed on the basis of a novel classification of OVC into three types. In type A fractures with a collapsed rostral endplate, combined monosegment OLIF and posterior spinal fusion (PSF) were performed between the collapsed and rostral adjacent vertebrae. In type B fractures with a collapsed caudal endplate, combined monosegment OLIF and PSF were performed between the collapsed and caudal adjacent vertebrae. In type C fractures with severe collapse of both the rostral and caudal endplates, bisegment OLIF and PSF were performed between the rostral and caudal adjacent vertebrae, and pedicle screws were also inserted into the collapsed vertebra. Preoperative and postoperative clinical and radiographical status were reviewed. RESULTS The mean number of fusion segments was 1.6. Walking ability improved in all patients, and the mean Japanese Orthopaedic Association score for recovery rate was 65.7%. At 1 year postoperatively, the mean preoperative Oswestry Disability Index of 65.6% had significantly improved to 21.1%. The mean local lordotic angle, which was −5.9° preoperatively, was corrected to 10.5° with surgery and was maintained at 7.7° at the final follow-up. The mean corrective angle was 16.4°, and the mean correction loss was 2.8°. CONCLUSIONS The authors have proposed using minimally invasive, short-segment APCS with OLIF, tailored to the morphology of the collapsed vertebra, to treat LSCS-OVC. APCS achieves neural decompression, reconstruction of anterior support, and correction of local alignment.
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Hanson, Eric H., Rahul K. Mishra, David S. Chang, Thomas G. Perkins, Daniel R. Bonifield, Richard D. Tandy, Peter E. Cartwright, Randal R. Peoples, and William W. Orrison. "Sagittal whole-spine magnetic resonance imaging in 750 consecutive outpatients: accurate determination of the number of lumbar vertebral bodies." Journal of Neurosurgery: Spine 12, no. 1 (January 2010): 47–55. http://dx.doi.org/10.3171/2009.7.spine09326.
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Object When the number of lumbar and sacral vertebrae is being assessed, variations from typical lumbosacral anatomy may confuse the practitioner, potentially leading to significant clinical errors. In this study, the authors describe the statistical variation in lumbar spine anatomy in an outpatient imaging setting, evaluate the potential implications for clinical practice based on the variation in the number of lumbar-type vertebrae identified, and recommend a method for rapidly determining the number of lumbar spine vertebral bodies (VBs) in outpatients referred for lumbar spine MR imaging. Methods A total of 762 patients (male and female) who presented with low back–related medical conditions underwent whole-spine MR imaging in an outpatient setting. Results The high-speed whole-spine evaluation was successful for determining the number of lumbar-type VBs in 750 (98%) of 762 consecutive patients. The sagittal whole-spine 3-T MR imaging system images obtained between the beginning of January 2005 and the end of February 2007 were reviewed. The VBs were counted successively from the level of C-2 inferiorly to the intervertebral disc below the most inferior lumbar-type VB. Numbers of disc herniations were also evaluated in the context of the number of VBs. Conclusions One in 5 of these outpatients did not have 5 lumbar-type vertebrae: 14.5% had 6; 5.3% had 4; and 1 (0.13%) had the rare finding of 3 lumbar-type vertebrae. Two-thirds of the individuals with 6 lumbar-type vertebrae were male and two-thirds of the individuals with 4 lumbar-type vertebrae were female. Sagittal whole-spine MR imaging can be performed rapidly and efficiently in the majority of patients (98%), and provides improved accuracy for the determination of the number of lumbar-type VBs. A supplementary coronal MR, Ferguson view radiograph or intraoperative fluoroscopic determination for the presence of lumbosacral transitional vertebrae may add additional information when indicated for clinical treatment or surgical planning.
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Hohn, Eric A., Bryant Chu, Audrey Martin, Elizabeth Yu, Connor Telles, Jeremi Leasure, Tennyson L. Lynch, and Dimitriy Kondrashov. "The Pedicles Are Not the Densest Regions of the Lumbar Vertebrae: Implications for Bone Quality Assessment and Surgical Treatment Strategy." Global Spine Journal 7, no. 6 (April 11, 2017): 567–71. http://dx.doi.org/10.1177/2192568217694141.
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Study Design: Cadaver study. Objective: To determine the bone density of lumbar vertebral anatomic subregions. Bone mineral density (BMD) is a major factor in osseous fixation construct strength. The standard region for implant fixation of the spine is the pedicle; however, other regions may be more viable options with higher bone quality. Methods: Using computed tomography images, the spine was digitally isolated by applying a filter for adult bone. The spine model was separated into 5 lumbar vertebrae, followed by segmentation of each vertebra into 7 regions and determination of average Hounsfield units (HU). HU was converted to BMD with calibration phantoms of known BMD. Results: Overall mean BMD in vertebral regions ranged from 172 to 393 mg/cm3 with the highest and lowest BMD in the lamina and vertebral body, respectively. Vertebral regions formed 3 distinct groups ( P < .03). The vertebral body and transverse processes represent one group with significantly lower BMD than other regions. Spinous process, pedicles, and superior articular processes represent a second group with moderate BMD. Finally, inferior articular process (IAP) and lamina represent a third group with significantly higher BMD than other regions. Conclusions: Standard lumbar fusion currently uses the vertebral body and pedicles as primary locations for fixation despite their relatively low BMD. Utilization of posterior elements, especially the lamina and IAP, may be advantageous as a supplement to modern constructs or the primary site for fixation, possibly mitigating construct failures due to loosening or pullout.
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Jankovic, Tanja, Jelena Zvekic-Svorcan, and Ksenija Boskovic. "Verification of osteoporotic vertebral fractures caused by glucocorticoids." Medical review 67, no. 3-4 (2014): 118–22. http://dx.doi.org/10.2298/mpns1404118j.
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Introduction. Long-term administration of glucocorticoids leads to rapid osteoporosis, and vertebral fractures are one of its most common complications. The methods used in identification are semi-quantitative ones, based on visual assessment, and quantitative ones, which use morphometric criteria. Case Report. A 79-year-old woman, who has suffered from polymyalgia rheumatica since July 2012, was treated with prednisone at a daily dose of 20 mg. Radiography of thoracic and lumbar spine verified the reduction of body height of T 12, L3 and L4 vertebrae. Densitometry findings showed a decrease in bone density at the lumbar segment of the spine and femoral neck. Dual-energy x-ray absorptiometry device was used to perform vertebral morphometry by applying Genant semi-quantitative method, which verified crush fractures of the body of T4 and L3 vertebrae, while the L2 vertebra had a biconcave shape. The spinal deformity index parameter was 8. An intense pain developed in the back after 9 months of glucocorticoids administration. The repeated radiographic findings of thoracic and lumbar spine and vertebral morphometry, which had been done by dual-energy xray absorptiometry device, revealed deterioration in the form of serial crush fractures, while fat distribution index parameter increased to 15. Dual-energy x-ray absorptiometry finding showed a decrease in T score at the femoral neck. Conclusion. Longterm administration of glucocorticoids is accompanied by a rapid loss of bone mass, and vertebral fractures are one of its most common consequences. Therefore, its prevention, early diagnosis and treatment are required. The combination of qualitative conventional radiography and semi-quantitative dual-energy xray absorptiometry vertebral morphometry plays an important role in identifying vertebral fractures.
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Jeromel, Miran, and Janez Podobnik. "Magnetic resonance spectroscopy (MRS) of vertebral column – an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesion." Radiology and Oncology 48, no. 2 (June 1, 2014): 137–41. http://dx.doi.org/10.2478/raon-2013-0013.
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Abstract Background. Most vertebral haemangioma are asymptomatic and discovered incidentally. Sometimes the symptomatic lesions present with radiological signs of aggressiveness and their appearance resemble other aggressive lesions (e.g. solitary plasmacytoma). Case report. We present a patient with large symptomatic aggressive haemangioma like lesion in 12th thoracic vertebra in which a magnetic resonance spectroscopy (MRS) was used to analyse fat content within the lesion. The lesion in affected vertebrae showed low fat content with 33% of fat fraction (%FF). The fat content in non-affected (1st lumbar) vertebra was as expected for patient’s age (68%). Based on MRS data, the lesion was characterized as an aggressive haemangioma. The diagnosis was confirmed with biopsy, performed during the treatment - percutaneous vertebroplasty. Conclusions. The presented case shows that MRS can be used as an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesions.
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Ramikh, E. A., M. T. Atamanenko, E. A. Ramikh, and M. T. Atamanenko. "Surgery in Complex Treatment of Thoracic and Lumbar Spine Fractures." N.N. Priorov Journal of Traumatology and Orthopedics 10, no. 3 (September 15, 2003): 43–47. http://dx.doi.org/10.17816/vto200310343-47.
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Between 1990 and 2001, 1540 patients with various fractures and fracture-dislocations of thoracolumbar vertebrae (type А, В, C) were operated on at the Regional Center for Spine Pathology of Novosibirsk RITO. Basing on that experience the indications and pathogenetic surgical techniques were defined for every clinical form of spine injury. Depending on the type of spine fracture and its stability the individual choice of technique for dorsal fixation, ventral spinal fusion or their combination provided the complete restoration of spine anatomy and stiff stabilization of the injured vertebral segments. Such differentiation in the treatment of various types of spine injuries permits to reduce the terms and stages of treatment thus predetermining favorable short-term and long-term outcomes.
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Zhou, Lihua, Lei Zhou, Hao Hu, Junhong Peng, Youjun Zhan, and Wei Cui. "Study on the Condition of Aging Vertebral Fracture Patients with Aging Based on Magnetic Resonance Imaging." Journal of Medical Imaging and Health Informatics 10, no. 4 (April 1, 2020): 928–33. http://dx.doi.org/10.1166/jmihi.2020.2956.
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The dissertation study was collected from 2015 to 2018 inpatients in our hospital for spinal surgery. For the 574 patients who met the inclusion criteria, they were divided into group A according to lumbar vertebrae QCT: lumbar vertebra CTQ ≤ 30 mg/cm3; group B: 30 mg/cm3 < waist QCT value ≤ 50 mg/cm3; group C: 50 mg/cm 3 < waist QCT value < 80 mg/cm3; Group D: 80 mg/cm3 ≤ waist QCT value < 120 mg/cm3. Among them, 142 patients in group A, 172 patients in group B, 177 patients in group C, and 83 patients in group D. MRI data from each group were reviewed and recorded for the presence or absence of a black linear signal on the STIR fat suppression image. The aim was to investigate whether bone density values were associated with the presence of a black linear signal of MRI STIR in osteoporotic vertebral compression fractures in order to provide a better reference for clinical treatment.
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Vissarionov, Sergey Valentinivich, Aleksandr Yuryevich Mushkin, and Eduard Vladimirovich Ulrikh. "CORRECTION AND STABILIZATION OF THE SPINE WITH NEW GENERATION IMPLANTS FOR VERTEBRAL CONGENITAL MALFORMATIONS IN CHILDREN AGED ONE TO FIVE YEARS." Hirurgiâ pozvonočnika, no. 4 (December 19, 2006): 013–17. http://dx.doi.org/10.14531/ss2006.4.13-17.
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Objectives. To analyze the results of correction and stabilization of the spine with new generation implants for congenital malformation of the vertebrae in children of 1 to 5 years old. Material and Methods. A metal construction for surgical treatment of congenital anomalies of the spine in children of 1 to 5 years old was developed, consisting of transpedicular and laminar support elements. This construction was used in 38 patients with congenital thoracic and lumbar spine deformities associated with malformations of the vertebral bodies. Six patients had an isolated lateral or posterior-lateral hemivertebra in the thoracic spine and 11 – in the thoracolumbar junction, 3 patients had wedge-shaped vertebra in the thoracolumbar spine, and 18 – multiple or combined developmental anomalies of the spine. Initial angulation of scoliotic deformity was 24° to 50° and kyphotic deformity – 20° to 46°. Surgical treatment consisted of one-moment three-staged operation according to developed technique. Results. Correction of deformity within 92–100 % was achieved in patients with isolated hemivertebra in the thoracic and lumbar spine, and posterior wedge-shaped vertebrae in the thoracolumbar junction. In patients with multiple and combined developmental anomalies of the spine the correction of scoliotic deformity was 52–76 % and of kyphotic one – 58–80 %. Conclusion. The suggested metal construction provides the possibility to perform surgery at early stages even for developmental anomalies of the spine posterior support column in patients of 1 to 5 years old with congenital spine deformities.
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Mwale, F., G. Marguier, J. A. Ouellet, A. Petit, L. M. Epure, J. Antoniou, and L. E. Chalifour. "Effect of Dexrazoxane and Amifostine on the Vertebral Bone Quality of Doxorubicin Treated Male Rats." Open Orthopaedics Journal 2, no. 1 (July 14, 2008): 115–20. http://dx.doi.org/10.2174/1874325000802010115.
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Doxorubicin (DOX) is widely used in combination cocktails for treatment of childhood hematological cancers and solid tumors. A major factor limiting DOX usage is DOX-induced cardiotoxicity. However, it is not known whether protectants like dexrazoxane (DXR) and amifostine (AMF) can prevent DOX-mediated bone damage. The present study investigated whether administration of AMF alone or in combination with DXR would prevent any DOX-mediated bone damage. Male rat pups were treated with DOX, DXR, AMF, and their combinations. On neonate day 38, the bone mineral density (BMD), bone mineral content (BMC) and the micro-architecture of the lumbar vertebrae were analyzed. We have shown that when male rats are treated with DOX, DXR, DOX+DXR, AMF, DOX+AMF or DOX+DXR+AMF, there is a decrease in lumbar vertebral BMD (p<0.05). Furthermore, the relative bone volume (BV/TV) was decreased by DXR, DOX+DXR, and DOX+AMF treatments. Interestingly, DOX+AMF significantly increased BV/TV when compared to DXR treatment (p<0.04). The trabecular number (Tb.N) decreased with DXR and DOX+DXR and increased with DOX+AMF treatments. This information will be useful in designing better cancer combination therapies that do not lead to vertebrae deterioration.
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Hadley, Mark N., Volker K. H. Sonntag, Rob M. Amos, John A. Hodak, and Lynda J. Lopez. "Three-Dimensional Computed Tomography in the Diagnosis of Vertebral Column Pathological Conditions." Neurosurgery 21, no. 2 (August 1, 1987): 186–92. http://dx.doi.org/10.1227/00006123-198708000-00009.
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Abstract Three-dimensional computed tomographic scanning is a valuable adjunct in the diagnosis and treatment of disease processes involving the spine. We present our experience with this noninvasive radiological diagnostic technique in 32 patients with vertebral column abnormalities ranging from craniovertebral junction disorders to fractures of lumbar vertebrae. The three-dimensional CT images often demonstrate pathological conditions and occult lesions that are not adequately defined by conventional radiographic means.
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Khan, Maimoona. "A Cadaveric Morphometric Study of Lumbar Vertebrae in Zimbabwean Adult Males." Journal of Islamabad Medical & Dental College 9, no. 4 (December 31, 2020): 291–97. http://dx.doi.org/10.35787/jimdc.v9i4.479.
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Background: The occurrence of vertebral fractures and spinal cord injuries in developing countries in Africa is high with an annual incidence rate of 12.1 to 57.8 per million; 82.8% of these occurring in males and the most common causes being vehicle crushes (41.4%) and falls (34.9%)1. Treatment of vertebral fractures is aimed at stabilising a segment and then restoring its mobility thereby preventing nerve damage2. Violation of the pedicle walls during transpedicular screw fixation may occur if the screw diameter is too large or there is wrong placement3. Prevalence of pedicle wall violation using the “free hand” technique was reported to be 1.4%4.
Objective: To document the dimensions of the pedicles of lumbar vertebrae in the Zimbabwean population.
Study design: A descriptive cross-sectional study.
Place and duration of study: The study was conducted in the Gross Anatomy Laboratory of the Department of Anatomy, University of Zimbabwe College of Health Sciences, Harare. The duration of study was 6 months (from June 2019 to December 2019).
Material and Methods: A total of 15 adult male cadaveric specimens were taken from the Department of Anatomy at University of Zimbabwe. The lumbar vertebrae were dissected and their Pedicle Transverse Diameter (PTD), Pedicle Vertical Diameter (PVD) and the chord length were measured using a vernier calliper. Statistical calculations were performed using SPSS version 20.
Results: There was no significant difference between the pedicle dimensions of the right and left sides (P > 0.05). PTD steadily increases from vertebral level L1 to L4 followed by an abrupt increase at L5. PVD gradually decreases from L1 to L5 level. The chord length increases from a minimum at L1 to reach a maximum at L3 and then again decreases to L5 level.
Conclusion: Pedicle dimensions for the Zimbabwean population differ from those reported in previous studies for other population groups.
Key words: Chord length, Lumbar vertebrae, Pedicle dimensions.
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Paek, Matthew, Eric Glass, Marc Kent, Craig A. Clifford, and Alexander De Lahunta. "Primary Lumbar Extradural Hemangiosarcoma in a Dog." Journal of the American Animal Hospital Association 51, no. 3 (May 1, 2015): 191–96. http://dx.doi.org/10.5326/jaaha-ms-6139.
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A 9 yr old castrated male golden retriever weighing 36 kg was presented for evaluation of progressive left pelvic limb paresis and fecal and urinary incontinence. MRI demonstrated an extradural, ovoid mass compressing the lumbar spinal cord. Surgical excision of the mass was performed. Histologically, the mass was consistent with hemangiosarcoma with no involvement of the adjacent vertebrae. The dog underwent a doxorubicin-based chemotherapy protocol with the addition of oral cyclophosphamide. After completion of chemotherapy, the dog was evaluated q 4 mo for restaging. Clinicopathological evidence of primary tumor recurrence or metastatic disease was not detected for 15 mo after initial diagnosis and treatment. To the authors' knowledge, this is the first report of a primary extradural hemangiosarcoma in the lumbar vertebral column in a dog. The clinical presentation, diagnosis, treatment, and outcome are also discussed.
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Suwanwalaikorn, Sompongse, Boonsong Ongphiphadhanakul, Lewis E. Braverman, and Daniel T. Baran. "Differential responses of femoral and vertebral bones to long-term excessive l-thyroxine administration in adult rats." European Journal of Endocrinology 134, no. 5 (May 1996): 655–59. http://dx.doi.org/10.1530/eje.0.1340655.
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Suwanwalaikorn S, Ongphiphadhanakul B, Braverman LE, Baran DT. Differential responses of femoral and vertebral bones to long-term excessive l-thyroxine administration in adult rats. Eur J Endocrinol 1996;134:655–9. ISSN 0804–4643 Recent studies suggest that thyroid-stimulating hormone suppressive doses of thyroid hormone decrease bone mass in humans and growing rats. To determine the long-term effects of excessive l-thyroxine administration on the femur and vertebrae in an adult rat model, 20 male Sprague-Dawley rats (20 weeks old) were randomized into two groups. Group 1 received l-thyroxine (20 μg/100 g body weight ip daily), and group 2 received normal saline ip daily for 20 weeks. Femoral and lumbar vertebral bone mineral density measurements were performed at 0, 6, 15, 18 and 20 weeks of treatment. After 20 weeks of treatment, total RNA was isolated from both femoral and lumbar bones. Northern hybridization was performed with 32P-labeled DNA probes for osteocalcin, osteopontin, alkaline phosphatase and tartrate-resistant acid phosphatase. Significant decreases in bone mineral density in the femur of l-thyroxine-treated rats were observed after 15 weeks (p < 0.03). Lumbar bone mineral density was not affected. Both osteoblast (osteocalcin, osteopontin, alkaline phosphatase) and osteoclast (tartrate-resistant acid phosphatase) gene expression markers were increased significantly in the femoral bone (p < 0.001), but not in the lumbar vertebrae of the l-thyroxine-treated rats. We conclude that long-term administration of excessive doses of l-thyroxine to the adult rat preferentially affects femoral but not vertebral bone. This is manifested by decreased bone mineral density as well as increased gene expression markers for osteoblast and osteoclast activity in the femur. Daniel T Baran, Department of Orthopedics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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Rocha Romero, Andrés, Berenice Carolina Hernández-Porras, Ricardo Plancarte-Sanchez, José Ramiro Espinoza-Zamora, Gabriel Carvajal, Reyna Guadalupe Ramos Natarén, Victor Alfonso De Los Reyes Pacheco, and Ivan Hamiyd Salazar Carrera. "Risk of New Fractures in Vertebroplasty for Multiple Myeloma. A Retrospective Study." Pain Medicine 21, no. 11 (March 9, 2020): 3018–23. http://dx.doi.org/10.1093/pm/pnaa018.
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Abstract Objective Vertebroplasty is a percutaneous minimally invasive procedure indicated for vertebral collapse pain treatment. Among the known complications of the procedure is the augmented risk of new vertebral fractures. There are no specific studies in this patient population describing the risk of new vertebral fractures after vertebroplasty. This study analyzed risk factors associated with new vertebral fractures after vertebroplasty in patients with multiple myeloma. Methods Observational retrospective study in patients with multiple myeloma. The data collection took place from January 1, 2010, to December 30, 2017, at the National Cancer Institute. Clinical data and procedural variables such as cement volume, cement leaks, fracture level, number of treated vertebrae, pedicular disease, and cement distribution pattern, with two years follow-up, were analyzed with the Wilcoxon test, and a logistic regression model was used to identify risk factors related to new vertebral fractures. A confidence interval of 95% was used for analysis. Results At one-year follow-up, 30% of fractures were reported after vertebroplasty, most of them at low thoracic and lumbar level (50% adjacent level). Vertebroplasty was most commonly performed at the thoracolumbar and lumbar area. We demonstrated a 70.7% median numerical rating scale reduction at one-year follow-up; a significant decrease in opioid consumption occurred only during the first month. Conclusions Pedicle involvement, disc leakage, cement volume, thoracolumbar and lumbar level, and number of treated vertebrae by intervention are important risk factors when performing vertebroplasty. Prospective randomized studies are needed to evaluate these factors in this specific population.
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Kudiashev, A. L., V. V. Khominets, A. V. Teremshonok, E. B. Nagorny, S. Yu Stadnichenko, A. V. Dol, D. V. Ivanov, I. V. Kirillova, L. Yu Kossovich, and A. L. Kovtun. "BIOMECHANICAL MODELING IN SURGICAL TREATMENT OF A PATIENT WITH TRUE LUMBAR SPONDYLOLISTHESIS." Hirurgiâ pozvonočnika 15, no. 4 (December 4, 2018): 87–94. http://dx.doi.org/10.14531/2018.4.87-94.
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Objective. To assess the results of clinical approbation of individual finite-element biomechanical model of a patient’s spino-pelvic complex with subsequent modeling of the best option of surgical treatment. Material and Methods. A biomechanical modeling of changes in the sagittal profile of a patient with degenerative disease of the lumbosacral spine, bilateral spondylolysis, and unstable grade 2 spondylolisthesis of the L4 vertebra was performed. The developed biomechanical model made it possible to assess the characteristics of the stress-strain state of the spinal motion segments aroused due to development of the disease. Within the built biomechanical model of the patient’s spino-pelvic complex, a corrective operation was further modeled that assumed a preservation of harmonious profile of sagittal spino-pelvic relationships. Post-correction characteristics of the stress-strain state of spinal motion segments were studied and compared with preoperative parameters of the biomechanical model. Results. Using methods of biomechanics and computer modeling allowed to calculate the stress-strain state of the lumbosacral spine under static load for two options of fixation and intervertebral cage implantation at the L4–L5 level: four transpedicular screws (L4–L5 vertebrae) and six transpedicular screws (L3–L4–L5 vertebrae). The simulation results showed that neither metal implants, nor elements of the lumbosacral spine experienced critical stresses and deformations that could lead to the destruction and instability of the implant. Conclusion. The developed individual biomechanical finite-element solid model of the spine and pelvis allowed for biomechanical justification of prerequisites for the formation and further progression of degenerative changes in spinal motion segments associated with violations of the sagittal profile due to grade 2 spondylolisthesis of the L4 vertebra. The model built on the results of radiological examination biomechanically substantiated the best option of corrective spine surgery allowing to minimize stresses and deformations by choosing reasonable magnitude of correction of sagittal spino-pelvic parameters and configuration of transpedicular system.
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Chinchilla-Barboza, Maripaz, Siam Chiquillo-Vergara, Valeria Delgado-Álvarez, Susan Gutiérrez-Gutiérrez, Johnny Steven Mora-Aleman, Jonathan Gerardo Páez-Padilla, Jorge Sanchez-Bermudez, and Andréia Passos-Pequeno. "An Anatomical and Radiographic Study on the Vertebral Column of the Two-Toed Sloth (Choloepus hoffmanni)." Ciencias Veterinarias 39, no. 2 (June 27, 2021): 1–18. http://dx.doi.org/10.15359/rcv.39-2.2.
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The Choloepus Hoffmani is a mammal belonging to the Xenarthra superorder; xenarthrans are distributed from North to South America. It is common for these animals to require medical attention at wildlife rescue centers after being attacked by domestic animals or run over by cars. A proper understanding of this species’ anatomy is vital in order to be able to offer them a proper level of clinical attention. This publication aims to describe the spine’s anatomical and radiographic characteristics of the Choloepus Hoffmani. Four individuals were used in this research; the spine bones were cleaned by boiling and maceration. In the results, it was possible to observe how the postcranial axial skeleton in the sloths is made up by five of distinctive vertebra types. In the spine were found: six cervical vertebrae, a variable number of thoracic vertebrae, xenarthrous lumbar vertebrae, and a fusion between the sacrum and coxal bone. Finally, four underdeveloped caudal vertebrae were also identified in a small stump-like tail. Radiographically, no pathologies were observed in the alignment or structure of the spine. In conclusion, the present study described both the osteology alongside the anatomical radiography of the vertebral column of the Choloepus hoffmani, highlighting the particularities that are not found in domestic mammals and other members of the Xenarthra superorder. Information of this kind is relevant for forensic wildlife analysis, alongside aiding the treatment of animals in this species who suffered lesions in their spine.
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Tosun, Ozgur, Muhabbet D. Koralp, Aliye Tosun, Levent Celebi, and Nail Bulakbaşi. "Avulsion Fracture and Myositis Ossificans in a Professional Teenage Dancer: A Case Report." Medical Problems of Performing Artists 30, no. 2 (June 1, 2015): 111–14. http://dx.doi.org/10.21091/mppa.2015.2019.
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Fractures of the transverse processes in the lumbar vertebrae occur as the result of major forces such as direct blunt trauma, violent lateral flexion-extension forces, avulsion of the psoas muscle, or Malgaigne fractures of the pelvis. Dancers make repeated and forceful hyperextension and flexions of the spine, which may cause fractures of the transverse processes of the lumbar vertebrae. Repeated trauma of muscles in dancers may cause avulsion fractures and myositis ossificans. Herein, we report MRI and CT findings of an avulsion from the right transverse process of the L2 and L3 vertebrae in a 16-year-old professional teenage dancer, who responded to conservative treatment.
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Tomilov, A. B., and N. L. Kuznetsova. "Guided correction of posttraumatic deformities of the vertebral column." Kazan medical journal 93, no. 1 (February 15, 2012): 44–48. http://dx.doi.org/10.17816/kmj2143.
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Aim. To improve the results of treatment of patients with post-traumatic deformity of the vertebral column. Methods. Analyzed were the results of treatment of 400 patients with fractures of the thoracic and lumbar vertebrae. Lesions of types A2, A3 and B according to the classification of the Association of osteosynthesis were seen in 70% of cases, lesions of type C - in 30%. The external transpedicular «Crab» construction was used in 100 patients. An internal transpedicular construction of the Scientific Research Institute «Syntez» was used in 300 cases. Transpedicular spondylosynthesis with intraoperative correction of the deformity with an original repositioning device was performed in all patients. Explosion fractures with the destruction of the vertebral body and stenosis of the spinal canal demanded the implementation of decompressive-stabilizing interventions in 25% of the cases. Conducted were clinical and radiological (spondylography, computed tomography, magnetic resonance imaging) studies. Results. Proposed was a technique of guided correction of posttraumatic deformities of the vertebral column. Unstable fractures and dislocation-fractures, lesions of intervertebral discs in the thoracic and lumbar segments of the vertebral column, inveterate lesions, posttraumatic deformities of the thoracic and lumbar segments of the vertebral column served as indications for using guided correction. Kyphotic deformity at the level of the damaged segment was corrected in 98% of observed cases with hypercorrection in the range of 2°. The vertical size of the vertebral body was restored up to 100% in the early posttraumatic period and up to 82.3% in the remote posttraumatic period. Subluxation was corrected in 86.9%, while dislocation of the fractured vertebra was corrected in 96.7% of cases. Conclusion. The proposed method of correction of posttraumatic deformities of the vertebral column makes it possible to provide similar treatment results of patients operated both with using the external fixation device of the vertebral column «Crab» and using the submersible transpedicular construction of the Scientific Research Institute «Syntez».
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Meyer, Carolin, Kerstin van Gaalen, Tim Leschinger, Max J. Scheyerer, Wolfram F. Neiss, Manfred Staat, Lars P. Müller, and Kilian Wegmann. "Kyphoplasty of Osteoporotic Fractured Vertebrae: A Finite Element Analysis about Two Types of Cement." BioMed Research International 2019 (April 22, 2019): 1–7. http://dx.doi.org/10.1155/2019/9232813.
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If conservative treatment of osteoporotic vertebral compression fractures fails, vertebro- or kyphoplasty is indicated. Usually, polymethylmethacrylate cement (PMMA) is applied coming along with many disadvantageous features. Aluminum-free glass-polyalkenoate cement (GPC) appears to be a benefit alternative material. This study aimed at comparing the mean stress values in human vertebrae after kyphoplasty with PMMA and GPC (IlluminOss™) at hand of a finite element analysis. Three models were created performing kyphoplasty using PMMA or IlluminOss™, respectively, at two native, human lumbar vertebrae (L4) while one remains intact. Finite element analysis was performed using CT-scans of every vertebra. Moreover the PMMA-treated vertebra was used as a model as analyses were executed using material data of PMMA and of GPC. The unimpaired, spongious bone showed potentials of 0.25 MPa maximally. After augmentation stress levels showed fivefold increase, rising from externally to internally, revealing stress peaks at the ventral border of the spinal canal. At central areas of cement 1 MPa is measured in both types of cement. Around these central areas the von Mises stress decreased about 25-50% (0.5-0.75 MPa). If workload of 500 N was applied, the stress appeared to be more centralized at the IlluminOss™-model, similar to the unimpaired. Considering the endplates the GPC model also closely resembles the unimpaired. Comparing the PMMA-treated vertebral body and the GPC-simulation, there is an obvious difference. While the PMMA-treated model showed a central stress peak of 5 MPa, the GPC-simulation of the same vertebral body presents lower stress of 1.2-2.5 MPa. Finite element analysis showed that IlluminOss™ (GPC), used in kyphoplasty of vertebral bodies, creates lower level stress and strain compared to standardly used PMMA, leading to lower stress concentrations on the cranial and caudal vertebral surface especially. GPC appears to own advantageous biological and clinical relevant features.
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CHENG, SU-CHUN, CHIH-KUN HSIAO, JUI-YI TSOU, RUEY-MO LIN, and FONG-CHIN SU. "PREDICTING THE VERTEBRAL BODY POSITION BASED ON PALPATED SPINOUS PROCESS POSITION." Journal of Mechanics in Medicine and Biology 14, no. 01 (February 2014): 1450010. http://dx.doi.org/10.1142/s0219519414500109.
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Palpation is an essential skill of manual therapy. Clinical techniques of physical therapy usually assume that the movement direction of palpating spinous process (SP) is the direction of the vertebral body center (VBC). This study investigated the distance [SP–projected VBC (PVBC)] between the surface palpation of the five SPs and the radiographically projected vertebral center locations (PVBC) on the skin of the lumbar spine in 37 patients with low back pain (LBP). The measurement of SP–PVBC was intended to describe if palpation on SPs could explain the positions of the VBC. The SP–PVBC distance was the greatest at L1 (35.9 mm) and the smallest at L4 (15.1 mm). The predictive analysis investigated the relationships between SP–PVBC and the geometric measurements of the lumbar anatomical structures. The geometric characteristics of the lumbar spine affected the SP–PVBC distance in different levels, with the R2 values from 0.66–0.89, except 0.38 in the L4 level. Increases in the SP inclination as well as vertebral inclinations, and increases in the SP height (SPH) were factors that were found to be significantly related to the SP–PVBC distance (p < 0.05). The results indicate that the orientation of the VBC and the SP may not be the same, and tilting and rotation of the vertebrae may occur when applying manual techniques through SPs. Physical therapists need to be aware that the tilting or rolling effect of vertebrae may not be avoidable once the treatment is done via palpation on SPs.
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Reznichenko, N. A., V. V. Simrok, and A. G. Adunts. "The influence of individual genetic polymorphisms on postmenopausal osteoporosis treatment effectiveness." Medical Herald of the South of Russia 11, no. 4 (December 20, 2020): 58–66. http://dx.doi.org/10.21886/2219-8075-2020-11-4-58-66.
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Objective: study of associations between VDR gene rs1544410 and rs10735810 polymorphisms, MCM6 gene rs4988235, CALCR gene rs1801197 one and ibandronate efficacy in women with postmenopausal osteoporosis.Materials and methods: 117 women with postmenopausal osteoporosis were examined for 12 months in the dynamics of treatment with ibandronate. Evaluation of therapy effectiveness was based on indicators of increase in bone mineral density in L1-L4 lumbar vertebrae, as well as left and right femurs.Results: An association of GG genotype of VDR gene rs1544410 polymorphism with low growth rates of mineral density of L1-L4 lumbar vertebrae (3,41 ± 0,60 % versus 5,51 ± 0,78 % in other women; р = 0,036) was established. The effect of other studied polymorphisms (rs10735810 of VDR gene, rs4988235 of MCM6 gene, rs1801197 of CALCR gene) on treatment effectiveness was not found.Conclusion: it is advisable to use obtained results when developing personalized regimens for antiresorptive therapy for women with postmenopausal osteoporosis.
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Mironov, S. P., G. M. Burmakova, V. G. Saltykova, and N. A. Es'kin. "DIAGNOSTIChESKIE VOZMOZhNOSTI SONOGRAFII PRI POYaSNIChNO-KRESTTsOVYKh BOLYaKh." N.N. Priorov Journal of Traumatology and Orthopedics 10, no. 1 (March 15, 2003): 24–31. http://dx.doi.org/10.17816/vto200310124-31.
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Ultrasound examination results of 83 athletes and ballet dancers with lumbar-sacral pain syndrome caused by osteochondrosis, spondylolysis of lower lumbar vertebrae, pathology of lumbar-sacral spine ligaments are presented. Technique of ultrasonography of the lumbar spine from anterior and posterior accesses is given. Pathological changes in various structures lumbar spine (intervertebral disks, ligamentous system) at overloading are described. The advantages of ultrasonography, i.e. informativeness, low invasiveness, possibility of the repeated examination during the treatment are noted.
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Jagannathan, Devimeenal, Venkatraman Indiran, Fouzal Hithaya, M. Alamelu, and S. Padmanaban. "Role of Anatomical Landmarks in Identifying Normal and Transitional Vertebra in Lumbar Spine Magnetic Resonance Imaging." Asian Spine Journal 11, no. 3 (June 30, 2017): 365–79. http://dx.doi.org/10.4184/asj.2017.11.3.365.
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<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>Identification of transitional vertebra is important in spine imaging, especially in presurgical planning. Pasted images of the whole spine obtained using high-field magnetic resonance imaging (MRI) are helpful in counting vertebrae and identifying transitional vertebrae. Counting vertebrae and identifying transitional vertebrae is challenging in isolated studies of lumbar spine and in studies conducted in low-field MRI. An incorrect evaluation may lead to wrong-level treatment. Here, we identify the location of different anatomical structures that can help in counting and identifying vertebrae.</p></sec><sec><title>Overview of Literature</title><p>Many studies have assessed the vertebral segments using various anatomical structures such as costal facets (CF), aortic bifurcation (AB), inferior vena cava confluence (IC), right renal artery (RRA), celiac trunk (CT), superior mesenteric artery root (SR), iliolumbar ligament (ILL) psoas muscle (PM) origin, and conus medullaris. However, none have yielded any consistent results.</p></sec><sec><title>Methods</title><p>We studied the locations of the anatomical structures CF, AB, IC, RRA, CT, SR, ILL, and PM in patients who underwent whole spine MRI at our department.</p></sec><sec><title>Results</title><p>In our study, 81.4% patients had normal spinal segmentation, 14.7% had sacralization, and 3.8% had lumbarization. Vascular landmarks had variable origin. There were caudal and cranial shifts with respect to lumbarization and sacralization. In 93.8% of cases in the normal group, ILL emerged from either L5 alone or the adjacent disc. In the sacralization group, ILL was commonly seen in L5. In the lumbarization group, ILL emerged from L5 and the adjacent disc (66.6%). CFs were identified at D12 in 96.9% and 91.7% of patients in the normal and lumbarization groups, respectively. The PM origin was observed from D12 or D12–L1 in most patients in the normal and sacralization groups.</p></sec><sec><title>Conclusions</title><p>CF, PM, and ILL were good identification markers for D12 and L5, but none were 100% accurate.</p></sec>
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Kokushin, Dmitry N., Sergei V. Vissarionov, Alexey G. Baindurashvili, Alla V. Ovechkina, Nikita O. Khusainov, Mahmud S. Poznovich, and Anna V. Zaletina. "The use of guide templates in the surgical treatment of preschool children with congenital scoliosis of thoracic and lumbar localization." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 8, no. 3 (October 6, 2020): 305–16. http://dx.doi.org/10.17816/ptors42000.
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Background. The use of transpedicular screws as support elements from the standpoint of biomechanics is preferable as compared to that of laminar fixation, albeit the former carries the risk of various complications (such as malposition screws, damage to the Dura mater, spinal cord, and major blood vessels) caused by structural changes in the vertebrae under the background of their defects, with small size of roots arcs vertebrae in young children. Thus, the issue of ensuring safe and correct installation of transpedicular screws in the surgical treatment of children with congenital scoliosis remains relevant.
Aim. We aimed to evaluate the correctness of the position of the transpedicular screws installed in the vertebral bodies in preschool children with congenital scoliosis of thoracic and lumbar localization using guide templates (SHN).
Materials and methods. We conducted a prospective analysis of the outcomes of surgical treatment of 30 patients with congenital scoliosis against the background of impaired formation of the vertebrae of the thoracic and lumbar spine. The patients included 12 boys and 18 girls of age: 1 year 8 months to 6 years 5 months (average: 3 years 4 months). Based on the computed tomography of the spine, performed postoperatively, the correctness of the position of the installed elements of the corrective multi-support metal structure was evaluated. The correctness of the position of the installed transpedicular support elements was evaluated based on the scale described by S.D. Gertzbein and co-authors (1990).
Results. The total number of implanted transpedicular screws sets was 96 (100% of the planned transpedicular screws set), and 48 SHN were used for transpedicular screws installation. The correct position of installed screws by degree of displacement revealed Grade 0 93.7% (90 screws), Grade I 4.2% (4 screws), Grade II 2.1% (2 screws), Grade III 0%. The number of screws with a Grade 0 + Grade I offset was 94 (97.9%).
Conclusion. The results obtained with the use of SHN among preschool children with congenital scoliosis of thoracic and lumbar localization revealed high accuracy and correctness of transpedicular screws installation (93.7%) with the use of this type of navigation in clinical practice. The use of SHN for installing transpedicular screws in the surgical treatment of congenital spinal deformities in young patients allows for the selection of the optimal size and correct position of the transpedicular support elements in the vertebrae to be instrumented.
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Nishi, Yoshinori, Keiichiro Okajima, Yasuyuki Abe, Naoya Murakami, Hirokazu Shimizu, and Kentarou Tabuchi. "Treatment of Lumbar Vertebrae Intervertebral Disc Herniation by MicroEndoscopic Discectomy (MED)." Orthopedics & Traumatology 52, no. 3 (2003): 612–15. http://dx.doi.org/10.5035/nishiseisai.52.612.
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Mudiraj, Nitin R., and Manisha R. Dhobale. "Diffuse idiopathic skeletal hyperostosis - a case report." National Journal of Clinical Anatomy 02, no. 02 (April 2013): 086–88. http://dx.doi.org/10.1055/s-0039-3401704.
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AbstractThe case reported here is an incidental finding of a specimen of lower three lumbar vertebrae with sacrum. It displayed ossification of anterolateral aspect of lower three lumbar vertebrae with sparing of intervertebral disc space. Para-articular osteophytosis was found at zygopophyseal (facet) joints, however ankylosis was absent at zygopophyseal joints as well as at interspinous sites. Based on its features we labelled it as a case of diffuse idiopathic skeletal hyperostosis (DISH). It is a common but often unrecognized disorder of unknown etiology in elderly individuals. The awareness of this entity may stimulate clinicians and researchers to focus on its pathogenesis, treatment and prevention.
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Li, Huan, Xiao-Jun Shang, and Qi-Rong Dong. "Effects of Transcutaneous Electrical Nerve Stimulation on Rats with the Third Lumbar Vertebrae Transverse Process Syndrome." Acupuncture in Medicine 33, no. 5 (October 2015): 400–405. http://dx.doi.org/10.1136/acupmed-2014-010752.
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Objective To investigate the analgesic and anti-inflammatory effects of transcutaneous electrical nerve stimulation (TENS) at local or distant acupuncture points in a rat model of the third lumbar vertebrae transverse process syndrome. Methods Forty Sprague–Dawley rats were randomly divided into control, model, model plus local acupuncture point stimulation at BL23 (model+LAS) and model plus distant acupuncture point stimulation at ST36 (model+DAS) groups. All rats except controls underwent surgical third lumbar vertebrae transverse process syndrome modelling on day 2. Thereafter, rats in the model+LAS and model+DAS groups were treated daily with TENS for a total of six treatments (2/100 Hz, 30 min/day) from day 16 to day 29. Thermal pain thresholds were measured once a week during treatment and were continued until day 57, when local muscle tissue was sampled for RT-PCR and histopathological examination after haematoxylin and eosin staining. mRNA expression of interleukin-1 β (IL-1β), tumour necrosis factor-α (TNF-α) and inducible nitric oxide synthase (iNOS) was determined. Results Thermal pain thresholds of all model rats decreased relative to the control group. Both LAS and DAS significantly increased the thermal pain threshold at all but one point during the treatment period. Histopathological assessment revealed that the local muscle tissues around the third lumbar vertebrae transverse process recovered to some degree in both the model+LAS and model+DAS groups; however, LAS appeared to have a greater effect. mRNA expression of IL-1β, TNF-α and iNOS in the local muscle tissues was increased after modelling and attenuated in both model+LAS and model+DAS groups. The beneficial effect was greater after LAS than after DAS. Conclusions TENS at both local (BL23) and distant (ST36) acupuncture points had a pain-relieving effect in rats with the third lumbar vertebrae transverse process syndrome, and LAS appeared to have greater anti-inflammatory and analgesic effects than DAS. Trial Registration Number 09073.
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Pas'kov, R. V., K. S. Sergeev, R. Sh Sagitov, V. I. Kucheryuk, I. N. Katrenko, and A. O. Farion. "Puncture Transpedicular Fixation in Surgical Treatment of Thoracic and Lumbar Vertebrae Injuries." N.N. Priorov Journal of Traumatology and Orthopedics 19, no. 2 (June 15, 2012): 12–16. http://dx.doi.org/10.17816/vto20120212-16.
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Results of transpedicular fixation (TPF) performed to 113 patients with injuries of thoracic and lumbar vertebrae are presented. In 26 patients original puncture TPF was performed, in 14 cases the reposition system was used. Analysis of treatment results showed high efficacy of puncture TPF. Duration of surgical intervention and volume of blood loss decreased reliably, cosmetic defect was less marked.
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Matsuhashi, Ako, Shota Tanaka, Masashi Nomura, Masako Ikemura, Yu Sakai, Yasuaki Karasawa, Shunsaku Takayanagi, and Nobuhito Saito. "CS-06 A CASE OF GLIOBLASTOMA METASTATIC TO THE LUMBAR VERTEBRA." Neuro-Oncology Advances 1, Supplement_2 (December 2019): ii39. http://dx.doi.org/10.1093/noajnl/vdz039.177.
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Abstract BACKGROUND Most cases of glioblastoma recur within one year even under the standard treatment of surgical resection, radiation therapy and chemotherapy. 60–70% of recurrences are local, and in rare cases of metastasis, most are within the CNS. Extradural metastasis is considered exceedingly rare. CASE REPORT We present a 21-year-old man post total resection of right parietal lobe glioblastoma, diagnosed with lumber metastasis. He originally presented with impaired consciousness and left hemiplegia at the age of 20 and underwent gross total resection of the tumor. Pathology was IDH wild type, H3F3A K34R/V wild-type glioblastoma. Radiotherapy and adjuvant temozolomide per the Stupp regimen as well as infusion of bevacizumab were conducted. 6 months after the resection of tumor, the patient presented with severe back pain. Radiographic studies showed an osteolytic mass on the first lumbar vertebrae, and needle biopsy was consistent with glioblastoma. Posterior spinal fusion, internal decompression and radiotherapy were conducted to relieve the pain. At 3 months after the diagnosis of lumbar metastasis, he is currently treated with temozolomide and bevacizumab, without the enlarging of the tumor. DISCUSSION As far as we investigated, there has been 30 cases of vertebral metastasis of glioblastoma reported in literature. Considering the biological obstacles that prevent glioblastomas from infiltrating outside of the CNS, it can be speculated that deposition of tumor cells into the blood stream or excision of the dura due to surgical interventions may attribute to extracranial metastasis. Due to the improvement of overall survival of glioblastoma, vertebral metastasis is suspected to be more common. Therefore, investigation of its risk factors and standardization of its treatment is necessary. CONCLUSION We reported a case of lumbar metastasis of glioblastoma. Extradural metastasis of glioblastoma must be included in differential diagnoses in treating patients with glioblastoma.
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Shevtsov, Vladimir Ivanovich, Aleksandr Timofeyevich Khudyaev, Sergey Vladimirovich Lyulin, and Oleg Sergeyevich Rossik. "TREATMENT OF SPONDYLOLISTHESIS WITH A DEVICE FOR EXTERNAL TRANSPEDICULAR SPINAL FIXATION." Hirurgiâ pozvonočnika, no. 3 (August 23, 2005): 097–100. http://dx.doi.org/10.14531/ss2005.3.97-100.
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Objectives. To analyze issues of surgical treatment of complicated spondylolisthesis in the lumbar spine. Materials and Methods. Forty-five patients at the age of 14 to 62 years were operated on with a device for external transpedicular fixation. All patients underwent clinical, radiological and physiologic examinations. To characterize the degree of spondylolisthesis the Meyerding classification was used. Grade I and II dislocations were treated by laminectomy of a displaced vertebra, excision of scars and mobilization of a dural sack, discectomy at a pathologic level involving both end plates of the adjacent vertebral bodies, impacting of 2 autografts (of the bone excised during laminectomy) into a disc space, and placement of a device for external transpedicular fixation. For Grade III and IV the second stage was performed after instrumentation and maximum possible reduction of dislocation. The procedure included anterior fusion of displaced and adjacent vertebrae in the achieved position either with autografts of the illiac crest or with porous nickel titanium implants through trans- or extraperitoneal approach. Results. Achieved results of application of the device for external transpedicular fixation in patients with spondylolisthesis enable to consider clinically justified a partial or total reduction of a displaced vertebra followed by neurologic status monitoring and radiological control during the post-operative period. Use of porous nickel titanium implant accelerates the formation of a bony block and decreases the time of surgery, as there is no need for autograft preparation.
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Tonchev, M. D., V. M. Muzhevska, О. M. Bezkorovainyy, V. M. Mitchenok, and V. I. Kravchenko. "Experience in treating patients with a combination of the descending aorta saccular aneurysm and spondylodiscitis." Ukrainian Interventional Neuroradiology and Surgery 35, no. 1 (June 30, 2021): 66–71. http://dx.doi.org/10.26683/2786-4855-2021-1(35)-66-71.
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The article presents a clinical case of treatment of a patient with spondylodiscitis of two levels – thoracic and lumbar spine spondylodiscitis combined with the thoracic aorta aneurysm. A 68-year-old patient was hospitalized in the Neurosurgical Department of the M.V. Sklifosovsky Poltava Regional Clinical Hospital in August 2019 with complaints of pain and discomfort in the thoracic and lumbar spine, shoulder joints, severe weakness in the lower extremities. The multislice computed tomography with intravenous contrast revealed a sac-like aneurysm of the descending thoracic aorta at the level of vertebrae Th4-Th5 with invasion into the vertebral bodies, spondylodiscitis of vertebrae Th4-Th5 and Th11-Th12 with deformation of the spinal axis, the formation of absolute stenosis of the spinal canal at the level of vertebrae Th11-Th12. At the first stage of the surgery, the thoracic aortic arthroplasty was performed using TAA Stent Graft System (Ankura, China) 34 × 34 × 160 mm at the M.M. Amosov National Institute of Cardiovascular Surgery and the exclusion of the descending aorta aneurysm from the bloodstream was maintained. At the second stage, transpedicular stabilization of the spine at the level of vertebrae Th10-Th11-L2-L3 was performed at the M.V. Sklifosovsky Poltava Regional Clinical Hospital using Legacy system (Medtronic, USA) and spinal cord compression was eliminated. The treatment of spondylodiscitis at the level of the vertebrae Th4-Th5 was conservative with the use of osteotropic antibacterial drugs. The patient was mobilized in the early post-surgical period after stabilization of the spine. Regression of pain syndrome and lower paraparesis was noted. Further observation was performed on an outpatient basis. According to the modified Rankin Scale, which allows assessing the degree of independence of the patient in everyday life, the patient was evaluated with 3 points at discharge. A follow-up examination at 3, 12, and 24 months showed that the functioning of the stent-graft and transpedicular system were satisfactory. The result of 0 points according to the modified Rankin Scale.Patients with the thoracic spine spondylodiscitis require special attention and additional diagnostic procedures. The risk of additional combined pathology in the form of thoracic and abdominal aorta aneurysms should be considered when planning surgical treatment.
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Afaunov, A. A., I. V. Basankin, K. K. Takhmazyan, M. L. Mukhanov, and N. S. Chaikin. "Spine stabilization in patients with the thoracic and lumbar vertebrae fractures in reduced bone mineral density." Innovative Medicine of Kuban, no. 3 (September 23, 2021): 31–39. http://dx.doi.org/10.35401/2500-0268-2021-23-3-31-39.
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Objective To compare the clinical effectiveness of various technical and tactical options for surgical treatment of patients with thoracic and lumbar vertebrae fractures with reduced bone mineral density.Material and Methods The study included 238 patients with the thoracic and lumbar vertebrae fractures with reduced bone mineral density (BMD). The patients were aged between 48 and 85 with T-score –1.5 to –3.5. The study did not include the patients with recurrent or multiple vertebral fractures, with absence of the clear date and fact of fracture in the case history, with neurological complications or polytrauma. The patients had fractures А1.2, А1.3, В1.2, В2.3 according to the classification of Magerl (1992). All patients underwent bisegmental transpedicular fixation (TPF). Group 1 included 68 patients who underwent non-cement augmented transpedicular screw fixation. Group 2 included 170 patients who underwent cement augmented transpedicular fixation. Both groups were divided into 2 subgroups. Subgroups 1.1 and 2.1 included patients operated in two stages. The first stage was TPF and the second stage was anterior corporodesis. Subgroups 1.2 и 2.2 included patients who underwent only TPF. Outcomes and complications were studied. The observation period lasted for not less than 2 years. Correlation analysis was performed between the technique of performing operations and surgical tactics in four subgroups and treatment outcomes.Conclusion 1. In the treatment of patients with fractures in the thoracic or lumbar spine with reduced BMD, isolated TPF with cemented screw implantation is clinically equivalent to two-stage surgical treatment - TPF with cementless or cemented implantation and anterior corprodesis of injured FPS. 2. In cementless TPF in patients with decreased BMD, anterior corprodesis of the injured VMS is necessary because its failure leads to the loss of anatomical relationship correction achieved during surgery, increase in local kyphosis, and functional maladaptation of patients.
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Saleh Y S and Al-Nimer M S M. "Proton Pump Inhibitors Adversely Induce Selective Changes in the Bone Mineral Density Detected by Dual-Energy X-ray Absorptiometry in Postmenopausal Women." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (September 26, 2020): 5453–59. http://dx.doi.org/10.26452/ijrps.v11i4.3175.
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Dual-energy X-ray absorptiometry (DEXA) is a universal tool that can detect bone loss and diagnose osteoporosis. Long term of using certain drugs contributed to the etiopathology of bone loss. Proton pump inhibitors (PPIs) users are at risk of developing osteoporosis. This study aimed to prove the selectivity of PPIs in inducing bone loss in postmenopausal women by determining the T-score of the axial spine and femur bone. A total number of 215 menopausal women were recruited from a Teaching hospital and private clinics from August 2018 to November 2019. The participants were grouped into Group I, n=150 (had no PPIs treatment) and Group II, n=65 (had treatment with PPIs). All the participants were subjected to DEXA investigation. Group II patients showed significantly lower T-score of the femur bone, while Group I patients showed a significantly lower T-score of lumbar vertebrae. The percentage of Group II patients had a T-score – 2.5 in femur ward bone is 35.4%, while the percentage of Group I patients had a T score -2.5 in the lumbar-3 vertebrae is 35.3%. Moreover, PPIs users showed an acceleration of bone loss despite the age, duration of menopause, body mass index, and waist-to-height ratio. We conclude that PPIs users are at risk of developing bone mass loss in the femur more than in the lumbar vertebrae
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Jing, Xiaowei, Zhiyuan Gong, Ning Zhang, Gang Chen, Fangcai Li, Qixin Chen, Zhengkuan Xu, and Rui Zhang. "Fracture and dislocation of lumbar vertebrae with entrapment of small bowel: A case report and literature review." Journal of International Medical Research 47, no. 2 (January 8, 2019): 1043–51. http://dx.doi.org/10.1177/0300060518816205.
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Traumatic incarceration of the small bowel accompanied by vertebral fractures and dislocation is rare and usually misdiagnosed until laparotomy. This report presents a rare case of jejunum entrapment between lumbar spine fractures. A 43-year-old man was clamped between two railway tracks on the upper abdomen and lower back. Following ineffective conservative treatment, he underwent a laparotomy due to the development of guarding and rebound tenderness. Loss of vitality of the jejunal loop, which was incarcerated between the L3 and L4 vertebrae, was observed. The necrotic bowel was removed and end-to-end anastomosis was performed. When his condition was stable, anterior and posterior lumbar fixation surgery was performed. The patient had no abdominal complications and lower limb nerve function deficiency during the follow-up period. A review of the literature since 1979 on incarceration of the bowel associated with lumbar fracture and dislocation identified 12 cases: five patients showed persistent neurological symptoms, but none of the patients died as a result of their injuries. It should be borne in mind that patients with hyperextension or flexion-distraction injury of the lumbar spine could show symptoms of intestinal obstruction and bowel incarceration. Enhanced computed tomography or magnetic resonance imaging will be helpful for diagnosis.
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He, Jiang-tao, Jian-wen Chen, and Peng Wei. "Surgical Treatment for Posterior Rim Separation of the Lumbar and Sacral Vertebrae." Orthopaedic Surgery 5, no. 3 (August 2013): 177–82. http://dx.doi.org/10.1111/os.12053.
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vom Scheidt, Annika, Haniyeh Hemmatian, Klaus Püschel, Matthias Krause, Michael Amling, and Björn Busse. "Bisphosphonate treatment changes regional distribution of trabecular microstructure in human lumbar vertebrae." Bone 127 (October 2019): 482–87. http://dx.doi.org/10.1016/j.bone.2019.07.003.
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Lee, Tao-Chen, Kang Lu, Lin-Cheng Yang, Hsuan-Ying Huang, and Cheng-Loong Liang. "Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction." Journal of Neurosurgery: Spine 91, no. 2 (October 1999): 163–69. http://dx.doi.org/10.3171/spi.1999.91.2.0163.
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Object. Because modern imaging techniques now allow for early diagnosis of spinal tuberculosis, more conservative management options are possible. The authors evaluated the effectiveness of transpedicular instrumentation for treatment of thoracolumbar and lumbar spinal tuberculosis in patients with mild bone destruction and the main symptom of “instability catch” (a sudden painful “snap” that occurs when one extends from a forward bent to an upright position). Methods. Eighteen patients (nine men and nine women, age range 49–71 years) with spinal tuberculosis were treated with transpedicular instrumentation that was supplemented with posterolateral fusion and chemotherapy. All patients were wheelchair dependent or bed-ridden due to severe instability catch, with a mean symptom duration of 2.5 months (range 1–6 months). Two contiguous vertebrae were involved in 17 patients, and a single vertebrae was involved in one. In five patients mild neurological deficits (Frankel Grade D) were present. During surgery, the screws were implanted into the two nonaffected pedicles nearest the lesion to stabilize the involved segments. No attempt at radical debridement or neural decompression was undertaken. The follow-up period ranged from 21 to 40 months. Postoperatively the instability catch was relieved within 10 days (excellent outcome) and within 1 month (good outcome) in seven and eight patients, respectively, and within 3 months (fair outcome) in two; in the remaining patient, the symptom did not resolve (poor outcome). A short duration of symptoms (generally < 3 months) and bone destruction of less than 50% in the involved vertebral bodies were observed in patients who made a good or excellent outcome. During the follow-up period, good maintenance of spinal alignment, stabilization of the involved segment, and resolution of the inflammatory process were shown; however, there was no strong evidence that fusion had occurred at the bony defect. Patients in whom a fair outcome was achieved experienced a longer duration of symptoms, and in each, one vertebral body with greater than 50% bone destruction was demonstrated. However, good maintenance of spinal alignment was also shown during the follow-up period. The patient whose outcome was poor had the longest history (6 months) of symptoms and the most extensive involvement of the spine (> 50% destruction of two adjacent lumbar vertebral bodies). Postoperatively, implant failure occurred and the patient developed a wound infection. Conclusions. Transpedicular instrumentation provides rapid relief of instability catch and prevents late angular deformity in patients with thoracolumbar and lumbar spinal tuberculosis in whom limited (< 50%) bone destruction of the involved vertebral bodies has been shown and whose main symptom is instability catch.
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Andresen, R., D. Banzer, and G. Möller. "Shape model-based semi-automatic morphometric assessment of vertebral deformities in clinical practice." Osteologie 20, no. 03 (2011): 239–47. http://dx.doi.org/10.1055/s-0037-1620000.
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SummaryThe accurate and clear reporting of vertebral fractures in routine clinical practice is essential to ensure that patients with osteoporosis receive appropriate treatment to prevent the occurrence of further fractures. A statistical shape model-based vision system for semi-automated morphometry called MorphoXpress® has been developed and needs to be tested in routine clinical practice.This multi-centre medical practice evaluation pilot study compared the degree of agreement between two methods to detect vertebral body deformities in routine clinical practice: qualitative visual evaluation of conventional lateral thoracic and lumbar spine radiographs as a “gold standard” and the MorphoXpress® semi-automatic software system for vertebral morphometry.This pilot study was performed in seven participating osteo-centers in Germany. The analysis included 223 ambulatory patients with 446 conventional lateral thoracic (n = 223) and lumbar (n = 223) spine radiographs showing 2676 vertebrae from T5 to L4. Qualitative visual radiograph evaluation was performed by clinician experts, who classified vertebral shape as fractured or not fractured. MorphoXpress® was used for quantitative assessment of vertebral height in digitized radiographs by localising all morphometric points within the set range of vertebrae based on a statistical model-based vision system. Using the interactive tools in Morpho Xpress→, clinicians could refine the positions of morphometric points to their satisfaction. Agreement between the two methods was analyzed.Using qualitative visual radiograph evaluation, clinicians recognised fractures in 92 (41.3 %) patients while quantitative evaluation with MorphoXpress®with interactive manual corrections detected fractures in 85 (38.1 %) patients. Distribution of fractures was comparable using the two methods. The Morpho Xpress→ system alone identified 76 % of the fractured vertebrae correctly. This result was improved to 98 % using additional manual corrections by the clinician once. The overall mean time needed for MorphoXpress® fracture morphometric assessment of vertebral fractures in clinical practice took 13 minutes and 36 seconds.Quantitative measurement using the current version of the MorphoXpress® software system for vertebral morphometry in combination with qualitative interactive corrections by clinicians seems to be a valuable tool for assessment and follow-up documentation of osteoporotic vertebral deformities in patients without severe scoliosis in epidemiological studies and clinical drug trials only. Currently the technique is too timeconsuming and only after significant improvement of the procedure time and following appropriate training for physicians, MorphoXpress® vertebral morphometry could be a valuable tool in daily routine clinical use for osteoporotic patients.
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Kokushin, D. N., S. V. Vissarionov, A. G. Baindurashvili, A. V. Ovechkina, and M. S. Poznovich. "Comparative Analysis of Pedicle Screw Placement in Children with Congenital Scoliosis: Freehand Technique (in vivo) and Guide Templates (in vitro)." Traumatology and Orthopedics of Russia 24, no. 4 (December 29, 2018): 53–63. http://dx.doi.org/10.21823/2311-2905-2018-24-4-53-63.
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Objective.To evaluate accuracy between pedicle screw placement in vertebral bodies achieved in vivo with freehand techniques versus their placement in vertebrae plastic models achieved in vitro with the use of guide templates, in toddlers and preschool children with congenital kyphoscoliosis of the thoracolumbar transition and lumbar spine amid the vertebral malformation.Material and Methods. The research is based on a retrospective analysis of the results of treatment of 10 patients with congenital kyphoscoliosis of the thoracolumbar transition and lumbar spine amid the vertebral malformation. Age – from 2 years 2 months to 6 years 8 months old (mean 3 years 8 months old), gender – 6 boys, 4 girls. Based on the postoperative multi-slice spiral computed tomography (MSCT) of the spine, the pedicle screws placement accuracy of the correcting multi-support metalwork was evaluated. These patients constituted the 1st research group (in vivo group). The 2nd research group (in vitro group) was formed from 27 vertebrae plastic models with pedicle screws inserted in them with the use of guide templates. The placement accuracy of the installed pedicle support elements was assessed based on the S.D. Gertzbein et al. scale (1990).Results. In the 1st group, there were 52 pedicle screws placed. The screw placement accuracy according to the rate of misplacement, as follows: 53.8% in Grade 0, 25% in Grade I, 11.6% in Grade II, 9.6% in Grade III. The number of screws with the rate of misplacement in Grade 0 + Grade I was 41 (78.8%). In the 2nd group, there were 54 screws placed and slightly larger than the 1st group. The screw placement accuracy according to the rate of misplacement was 94.4% in Grade 0, 1.9% in Grade I, 3.7% in Grade II, respectively. The number of screws with the rate of misplacement in Grade 0 + Grade I was 52 (96.3%).Conclusions.Comparative analysis showed that the number of pedicle screws successfully placed in vertebrae plastic models in children with congenital deformities of the thoracolumbar transition and lumbar spine achieved with the use of guide templates was significantly higher than the number of screws successfully placed with freehand techniques (96.3% versus 80.8%, p = 0.011). The results obtained with method of navigation templates in vitro showed high precision and accuracy of pedicle screw placement which gives the prospect for using this type of navigation in clinical practice in toddlers with congenital scoliosis.
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Kim, Mi Yeong, Kyunghee Lee, Hong-In Shin, Kyung-Jae Lee, and Daewon Jeong. "Metabolic activities affect femur and lumbar vertebrae remodeling, and anti-resorptive risedronate disturbs femoral cortical bone remodeling." Experimental & Molecular Medicine 53, no. 1 (January 2021): 103–14. http://dx.doi.org/10.1038/s12276-020-00548-w.
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AbstractMetabolic activities are closely correlated with bone remodeling and long-term anti-resorptive bisphosphonate treatment frequently causes atypical femoral fractures through unclear mechanisms. To explore whether metabolic alterations affect bone remodeling in femurs and lumbar vertebrae and whether anti-osteoporotic bisphosphonates perturb their reconstruction, we studied three mouse strains with different fat and lean body masses (BALB/c, C57BL6, and C3H mice). These mice displayed variable physical activity, food and drink intake, energy expenditure, and respiratory quotients. Following intraperitoneal calcein injection, double calcein labeling of the femoral diaphysis, as well as serum levels of the bone-formation marker procollagen type-I N-terminal propeptide and the bone-resorption marker C-terminal telopeptide of type-I collagen, revealed increased bone turnover in mice in the following order: C3H > BALB/c ≥ C57BL6 mice. In addition, bone reconstitution in femurs was distinct from that in lumbar vertebrae in both healthy control and estrogen-deficient osteoporotic mice with metabolic perturbation, particularly in terms of femoral trabecular and cortical bone remodeling in CH3 mice. Interestingly, subcutaneous administration of bisphosphonate risedronate to C3H mice with normal femoral bone density led to enlarged femoral cortical bones with a low bone mineral density, resulting in bone fragility; however, this phenomenon was not observed in mice with ovariectomy-induced femoral cortical bone loss. Together, these results suggest that diverse metabolic activities support various forms of bone remodeling and that femur remodeling differs from lumbar vertebra remodeling. Moreover, our findings imply that the adverse effect of bisphosphonate agents on femoral cortical bone remodeling should be considered when prescribing them to osteoporotic patients.
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Yan, Shuaifeng, Yunfan Zhang, Kai Wang, Yingchao Han, Kai Zhu, Fan He, and Jun Tan. "Three-Dimensional Morphological Characteristics of Lower Lumbar Intervertebral Foramen with Age." BioMed Research International 2018 (November 11, 2018): 1–8. http://dx.doi.org/10.1155/2018/8157061.
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Intervertebral foramen is the doorway of nerve root and it plays an important role of radiculopathy and surgical treatment of intervertebral foramen diseases. The purpose of the study is to obtain three-dimensional (3D) morphological characteristics of lumbar intervertebral foramen and their relationship with age. Pedicle-superior articular process (P-SAP), disc height between adjacent vertebra (DH), pedicle-inferior vertebrae (P-IV), inferior posterior vertebrae-superior articular process (IPV-SAP), and bony boundary area (BBA) were measured in entrance, middle slice, and exit of lumbar intervertebral foramen for 25 males of different age groups. Spinous process to intervertebral foramen entrance (SP-IFE) was measured for 25 males of different age groups. Overall, P-SAP and P-IV decreased and IPV-SAP increased from the entrance to the exit of intervertebral foramen for L3/4-L5S1. DH decreased at entrance slice, middle slice, and exit slice for L3/4-L5S1 with age. Significant difference with aging was found only at the middle slice of L3/4 and L4/5 for P-SAP. And the significant decrease of IPV-SAP was observed at middle slice of L3/4, entrance slice of L4/5 and L5S1, and exit slice of L5S1. SP-IFE is not consistent for all subjects. In addition, the decrease of BBA at L3/4 and L4/5 was observed earlier than at L5S1. The present study described detailed information of intervertebral foramen, which may be of benefit for better understanding of the pathology and surgical planning for intervertebral foramen diseases.
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Dąbrowska-Tkaczyk, Anna, Anna Floriańczyk, Roman Grygoruk, Konstanty Skalski, and Piotr Borkowski. "Virtual and Material Models of Human Thoracic-Lumbar Spine with Compressive Fracture Based on Patients' CT Data and the Rapid Prototyping Technique." Archive of Mechanical Engineering 58, no. 4 (January 1, 2011): 425–40. http://dx.doi.org/10.2478/v10180-011-0026-2.
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Virtual and Material Models of Human Thoracic-Lumbar Spine with Compressive Fracture Based on Patients' CT Data and the Rapid Prototyping TechniqueThe paper presents the development procedures for both virtual 3D-CAD and material models of fractured segments of human spine formulated with the use of computer tomography (CT) and rapid prototyping (RP) technique. The research is a part of the project within the framework of which a database is developed, comprising both 3D-CAD and material models of segments of thoracic-lumbar spine in which one vertebrae is subjected to compressive fracture for a selected type of clinical cases. The project is devoted to relocation and stabilisation procedures of fractured vertebrae made with the use of ligamentotaxis method. The paper presents models developed for five patients and, for comparison purposes, one for a normal spine. The RP material models have been built basing on the corresponding 3D-CAD ones with the use of fused deposition modelling (FDM) technology. 3D imaging of spine segments in terms of 3D-CAD and material models allows for the analysis of bone structures, classification of clinical cases and provides the surgeons with the data helpful in choosing the proper way of treatment. The application of the developed models to numerical and experimental simulations of relocation procedure of fractured vertebra is planned.
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Mironov, S. P., Galina Maksimovna Burmakova, S. P. Mironov, and G. M. Burmakova. "Low Back Pains in Athletes and Ballet Dancers: Apophysitis of Vertebral Bodies." N.N. Priorov Journal of Traumatology and Orthopedics 17, no. 3 (September 15, 2010): 3–11. http://dx.doi.org/10.17816/vto20101733-11.
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Experience in diagnosis and treatment of lumbar vertebrae apophysitis in 29 athletes and ballet dancers aged from 13 to 29 years is presented. In 25 patients pathology of thoracolumbar and upper lumbar spine was diagnosed. In 4 patients S1 apophysitis was detected including 3 patients with combination of S1 apophysitis and L4-L5 spondylolysis. Diagnosis consisted of clinical-neurologic, roentgenologic (standard including functional tests) and ultrasonographic examinations. In combination of apophysitis and spondylolysis radionuclide examination was performed. All patients were under conservative treatment which included individual complex of exercise therapy, massage, intramuscular, sympathetic trunk, ilipsoas muscle blockades, ozone-oxygen mixture injections into paravertebral muscles, use of vascular drugs, chondroprotectors and stimulating therapy. Analysis of the results confirmed high efficacy of the proposed methods for diagnosis and treatment of lumbar apophysitis in athletes and ballet dancers.
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Liu, Mu-Yi, Po-Liang Lai, and Ching-Lung Tai. "BIOMECHANICAL EVALUATION OF LOW-MODULUS BONE CEMENT FOR ENHANCING APPLICABILITY IN VERTEBROPLASTY — AN EXPERIMENTAL STUDY IN PORCINE MODEL." Biomedical Engineering: Applications, Basis and Communications 30, no. 01 (February 2018): 1850002. http://dx.doi.org/10.4015/s1016237218500023.
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Polymethylmethacrylate (PMMA) bone cement has been widely used in vertebroplasty to treat osteoporotic vertebral compression fracture. However, the high compression stiffness of PMMA is suspected to induce adjacent vertebral fracture following vertebroplasty. In the current study, modified low-modulus cement was prepared by combining PMMA with castor oil to solve this problem. The percentage of height recovery and compression stiffness of vertebral bodies was compared after injection of standard PMMA or low-modulus cement. This study aims to investigate whether low-modulus cement is as effective as standard PMMA for storing the initial vertebral height; while lowering the compression stiffness in treatment of osteoporotic vertebral compression fractures. A total of 20 fresh porcine lumbar vertebrae were assigned into two groups (10 per group): standard and low-modulus. All specimens received a four-week decalcification to mimic human osteoporotic vertebrae. The standard and low-modulus groups received a simulated compression fracture followed by treatment of standard and low-modulus cement augmentation, respectively. The low-modulus cement was prepared by combining standard PMMA with 15% weight fractions of castor oil. For all the 20 specimens, vertebral compression fracture was created by reducing the vertebral height of 25% using a material testing machine. The compression stiffness determined from the creation of compression fracture was defined as the intact group (20 specimens). The fractured vertebrae were then treated with standard and low-modulus cement augmentation. The vertebral height was measured pre- and post-treatment, and the percentage of vertebral height recovery was compared between two cementing groups. Following cement augmentation, axial compression test was conducted to compare compression stiffness among three groups. The results indicated that there is no significant difference in percentage of vertebral height between standard (83.42[Formula: see text][Formula: see text][Formula: see text]11.60%) and low-modulus (88.50[Formula: see text][Formula: see text][Formula: see text]6.15%) groups ([Formula: see text]). Moreover, the compression stiffnesses were 1166.49[Formula: see text][Formula: see text][Formula: see text]392.91 N/mm, 1795.85[Formula: see text][Formula: see text][Formula: see text]247.45[Formula: see text]N/mm and 1362.57[Formula: see text][Formula: see text][Formula: see text]236.92[Formula: see text]N/mm for intact, standard and low-modulus groups, respectively. There is significant difference among three groups ([Formula: see text]). We concluded that the modified low-modulus cement is as effective as standard PMMA for storing the initial vertebral height while lowering the compression stiffness in treatment of osteoporotic vertebral compression fractures. These reduce the risks of adjacent vertebral body fracture following vertebroplasty.
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Korzh, M., V. Kutsenko, A. Popov, and O. Perfiliev. "Main Types of Vertebrates in Spine Tumors (Prospective Study)." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 1 (February 26, 2021): 91–95. http://dx.doi.org/10.26693/jmbs06.01.091.
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Damage to the vertebrae as a result of neoplastic processes leads to serious health consequences for people of all ages and genders. Unsuccessfully constructed tactics for the treatment of primary and metastatic spinal lesions are the result of severe orthopedic and neurological complications, which can lead to fatal consequences. To decide what type of surgery to perform, you need to have more information than the type of tumor. To create a rational algorithm for the treatment of patients with loss of spinal support due to neoplastic lesions of the thoracic and lumbar vertebrae should consider the features of damage to the anatomical structures of the spinal motor segment and identify the main types of vertebral injuries. The purpose of the study was based on a prospective analysis of patients with spinal cord injuries, and description of the types of vertebral injuries. Material and methods. In the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. In the period from 2008 to 2017, 264 patients with pathological changes in the spine were diagnosed. The age of patients was from 18 to 81 years. There were 137 men and 131 women. 39 (14.8%) patients did not have vertebral body deformity accompanied by bone edema, 168 (63.6%) patients had vertebral body damage without destruction of other anatomical structures, 52 (19.7%) patients were diagnosed with deformation of the vertebral body with damage to the arches and joints, and 5 (1.9%) patients had damage to the posterior support complex. Results and discussion. As a result of a prospective analysis of patients with spinal tumors, 5 types of vertebral lesions were identified by cancer: 1 – without deformation, accompanied by bone edema and visualized on MRI; 2 – deformation of the vertebral body up to 30% without damage to the posterior wall or with a small defect; 3 – deformation of the vertebral body > 30%, but < 60% with damage to the posterior vertebral wall; 4 – deformation of the vertebral body> 60% with damage to the posterior vertebral wall; 5 – deformation of the vertebral body with damage to the arches and joints. Conclusion. As a result of damage to the anatomical structures of the vertebrae by the tumor process, important morphological features were identified: the degree of damage to the vertebral body; the magnitude of local kyphosis; deformation of the posterior wall of the vertebral body, on the basis of which the types of vertebral injuries are determined