scholarly journals In vivo 3D tomography of the lumbar spine using a twin robotic X-ray system: quantitative and qualitative evaluation of the lumbar neural foramina in supine and upright position

2020 ◽  
Author(s):  
Anna L. Falkowski ◽  
Balazs K. Kovacs ◽  
Robyn M. Benz ◽  
Patrick Tobler ◽  
Stephan Schön ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Image Quality ◽  
Intervertebral Disc ◽  
Weight Bearing ◽  
Upright Position ◽  
Disc Height ◽  
X Ray ◽  
3D Tomography ◽  
Intervertebral Disc Height ◽  
Wide Range

Abstract Objectives Supine lumbar spine examinations underestimate body weight effects on neuroforaminal size. Therefore, our purpose was to evaluate size changes of the lumbar neuroforamina using supine and upright 3D tomography and to initially assess image quality compared with computed tomography (CT). Methods The lumbar spines were prospectively scanned in 48 patients in upright (3D tomographic twin robotic X-ray) and supine (30 with 3D tomography, 18 with CT) position. Cross-sectional area (CSA), cranio-caudal (CC), and ventro-dorsal (VD) diameters of foramina were measured by two readers and additionally graded in relation to the intervertebral disc height. Visibility of bone/soft tissue structures and image quality were assessed independently on a 5-point Likert scale for the 18 patients scanned with both modalities. Descriptive statistics, Wilcoxon’s signed-rank test (p < 0.05), and interreader reliability were calculated. Results Neuroforaminal size significantly decreased at all levels for both readers from the supine (normal intervertebral disc height; CSA 1.25 ± 0.32 cm2; CC 1.84 ± 0.24 cm2; VD 0.88 ± 0.16 cm2) to upright position (CSA 1.12 ± 0.34 cm2; CC 1.78 ± 0.24 cm2; VD 0.83 ± 0.16 cm2; each p < 0.001). Decrease in intervertebral disc height correlated with decrease in foraminal size (supine: CSA 0.88 ± 0.34 cm2; CC 1.39 ± 0.33 cm2; VD 0.87 ± 0.26 cm2; upright: CSA 0.83 ± 0.37 cm2, p = 0.010; CC 1.32 ± 0.33 cm2, p = 0.015; VD 0.80 ± 0.21 cm2, p = 0.021). Interreader reliability for area was fair to excellent (0.51–0.89) with a wide range for cranio-caudal (0.32–0.74) and ventro-dorsal (0.03–0.70) distances. Image quality was superior for CT compared with that for 3D tomography (p < 0.001; κ, CT = 0.66–0.92/3D tomography = 0.51–1.00). Conclusions The size of the lumbar foramina is smaller in the upright weight-bearing position compared with that in the supine position. Image quality, especially nerve root delineation, is inferior using 3D tomography compared to CT. Key Points • Weight-bearing examination demonstrates a decrease of the neuroforaminal size. • Patients with higher decrease in intervertebral disc showed a narrower foraminal size. • Image quality is superior with CT compared to 3D tomographic twin robotic X-ray at the lumbar spine.

scholarly journals Radiographic evaluation of lumbar intervertebral disc height index: an intra and inter-rater agreement and reliability study

2021 ◽  
Author(s):  
Xiaolong Chen ◽  
Stone Sima ◽  
Harvinder Sandhu ◽  
Jeff Kuan ◽  
Ashish Diwan
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Measurement Methods ◽  
Disc Height ◽  
Radiographic Evaluation ◽  
Rater Agreement ◽  
Lumbar Intervertebral Disc ◽  
Rater Reliability ◽  
X Ray ◽  
Intervertebral Disc Height

Purpose: To evaluate intra- and inter-rater agreement and reliability of seven reported disc height index (DHI) measurement methods on standing lateral X-ray of lumbar spine. Methods: The adult patients who had standing lateral X-ray of lumbar spine were recruited. Seven methods were used to measure DHI of each lumbar intervertebral disc level. Bland and Altman Limits of Agreement (LOA) with standard difference were calculated to examine intra- and inter-rater agreements between two out of seven methods for DHI. Intra-class correlations (ICC) with 95% confidence intervals were calculated to assess intra- and inter-rater reliability. Results: The intra-rater reliability in DHI measurements for 288 participants were ICCs from 0.807 (0.794, 0.812) to 0.922 (0.913, 0.946) by rater 1 (SS) and from 0.827 (0.802, 0.841) to 0.918 (0.806, 0.823) by rater 2 (XC). Method 2, 3, and 5 on all segmental levels had bias (95% CI does not include zero) or/and out of the acceptable cut-off proportion (>50%). A total of 609 outliers in 9174 segmental levels LOA range. Inter-rater reliability was good-to-excellent in all but method 2 (0.736 (0.712, 0.759)) and method 5 (0.634 (0.598, 0.667)). ICCs of related lines to good-to-excellent reliability methods was excellent in all but only indirect line in method 1 and 4 (ICCs lie in the range from 0.8 to 0.9). Conclusion: Following structured protocol, intra- and inter-rater reliability was good-to-excellent for most DHI measurement methods on X-ray. However, in the presence of vertebral rotation, one should exercise caution in using complicated methods to define vertebral landmarks. Keywords: Lumbar disc herniation, discectomy, disc height, disc height index, agreement, reliability.

scholarly journals A Scoring System for Anterior Longitudinal Ligament Ossification of the Lumbar Spine in Diffuse Idiopathic Skeletal Hyperostosis: Relationship Between the Extent of Ligament Ossification and the Range of Motion

2021 ◽  
pp. 219256822199668
Author(s):  
Yusuke Murakami ◽  
Tadao Morino ◽  
Masayuki Hino ◽  
Hiroshi Misaki ◽  
Hiroshi Imai ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Range Of Motion ◽  
Scoring System ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Disc Height ◽  
Rater Reliability ◽  
Canal Stenosis ◽  
Intervertebral Disc Height ◽  
The Relationship

Study Design: Retrospective observational study. Objective: To investigate the relationship between the extent of ligament ossification and the range of motion (ROM) of the lumbar spine and develop a new scoring system. Methods: Forty-three patients (30 men and 13 women) with lumbar spinal canal stenosis who underwent decompression from January to December 2018. Ligament ossification at L1/2 to L5/S was assessed on plain X-ray (Xp) and computed tomography (CT) using a modified Mata scoring system (0 point: no ossification, 1 point: ossification of less than half of the intervertebral disc height, 2 points: ossification of half or more of the intervertebral disc height, 3 points: complete bridging), and the intra-rater and inter-rater reliability of the scoring was assessed. The relationship of the scores with postoperative lumbar ROM was investigated. Result: Intra-rater reliability was high (Cronbach’s α was 0.74 for L5/S on Xp but 0.8 or above for other sections), as was inter-rater reliability (Cronbach’s α was 0.8 or above for all the segments). ROM significantly decreased as the score increased (scores 1 to 2, and 2 to 3). A significant moderate negative correlation was found between the sum of the scores at L1/2-L5/S and the ROM at L1-S (ρ = − 0.4493, P = 0.025). Conclusion: Our scoring system reflects lumbar mobility and is reproducible. It is effective for assessing DISH in fractures and spinal conditions, and monitoring effects on treatment outcomes and changes over time.

scholarly journals Lumbar Spine Paraspinal Muscle and Intervertebral Disc Height Changes in Astronauts After Long-Duration Spaceflight on the International Space Station

Spine ◽  
2016 ◽  
Vol 41 (24) ◽  
pp. 1917-1924 ◽  
Author(s):  
Douglas G. Chang ◽  
Robert M. Healey ◽  
Alexander J. Snyder ◽  
Jojo V. Sayson ◽  
Brandon R. Macias ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
International Space Station ◽  
Space Station ◽  
Disc Height ◽  
Paraspinal Muscle ◽  
International Space ◽  
Long Duration ◽  
Intervertebral Disc Height

Effect of intervertebral disc height on postoperative motion and clinical outcomes after Prodisc-C cervical disc replacement

2009 ◽  
Vol 9 (7) ◽  
pp. 551-555 ◽  
Author(s):  
Chan W.B. Peng ◽  
Martin Quirnoa ◽  
John A. Bendo ◽  
Jeffrey M. Spivak ◽  
Jeffrey A. Goldstein
Keyword(s):  
Intervertebral Disc ◽  
Clinical Outcomes ◽  
Disc Height ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Intervertebral Disc Height

scholarly journals Denosumab Alleviates Intervertebral Disc Degeneration Adjacent to a Lumbar Fusion by Inhibiting Endplate Osteochondral Remodeling and Vertebral Osteoporosis in Ovariectomized Rats

2020 ◽  
Author(s):  
Qi Sun ◽  
Fa-Ming Tian ◽  
Fang Liu ◽  
Jia-Kang Fang ◽  
Yun-Peng Hu ◽  
...  
Keyword(s):  
Bone Formation ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Lumbar Fusion ◽  
Biomechanical Properties ◽  
Disc Height ◽  
X Ray ◽  
Manual Palpation ◽  
Trap Staining

Abstract Background: Although adjacent segmental intervertebral disc degeneration (ASDD) is one of the most common complications after lumbar fusion, its exact mechanism remains unclear. As an antibody to RANKL, denosumab (Dmab) effectively reduces bone resorption and stimulates bone formation, which can increase bone mineral density (BMD) and improve osteoporosis. However, it has not been confirmed whether Dmab has a reversing or retarding effect on ASDD. Methods: Three-month-old female Sprague-Dawley rats that underwent L4–L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation four weeks after OVX surgery were given Dmab four weeks after PLF surgery (OVX+PLF+Dmab group). In addition, the following control groups were defined: Sham, OVX, PLF, and OVX+PLF (n=12 each).Then, manual palpation and X-ray were used to evaluate the state of lumbar fusion. The bone microstructure in the lumbar vertebra and endplate as well as the disc height index (DHI) of the L5/6 were evaluated by microcomputed tomography (μCT). The characteristic alterations of ASDD were identified via Safranin-O green staining staining. Osteoclasts were detected using tartrate-resistant acid phosphatase (TRAP) staining and the biomechanical properties of vertebra were evaluated. Aggrecan (Agg), metalloproteinase-13 (MMP-13), a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4) expression in the intervertebral disc were detected by immunohistochemistry and real-time polymerase chain reaction (RT-PCR) analysis.Results: Manual palpation showed clear evidence of the fused segment’s immobility. Compared to the OVX+PLF group, more new bone formation was observed by X-ray examination in the OVX+PLF+Dmab group. Dmab significantly alleviated ASDD by retaining disc height index (DHI), decreasing porosity of endplate, and increasing the biomechanical properties and BMD of vertebra. TRAP staining results showed a significantly decreased number after Dmab treatment, especially in subchondral bone and cartilaginous endplate. Moreover, the results of protein and mRNA expression in intervertebral disc (IVD) showed that Dmab not only inhibited matrix degradation by decreasing MMP-13 and ADAMTS-4 but also promoted matrix synthesis by increasing Agg. Conclusions: These results suggest that Dmab may be a novel therapeutic target for the treatment of ASDD.

THE HARTSHILL HORSESHOE: THE TREATMENT OF CHRONIC PAIN PATIENTS WITH DISCOGENIC PAIN IN THE ABSENCE OF NEURAL COMPRESSION A PROSPECTIVE 2½- TO 3-YEAR REVIEW

2000 ◽  
Vol 04 (03) ◽  
pp. 209-220 ◽  
Author(s):  
W. Peckett ◽  
P. Hardcastle ◽  
J. Sheppherd ◽  
C. Sridhar
Keyword(s):  
Intervertebral Disc ◽  
Bone Graft ◽  
Spinal Fusion ◽  
Central Area ◽  
Disc Height ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Discogenic Pain ◽  
Radiological Results ◽  
Intervertebral Disc Height

Interbody fusion is a well-recognized technique to achieve spinal fusion. The advantage of using tricortical blocks as opposed to the dowel technique is that intervertebral disc height can be restored. Both techniques can be performed either by the anterior or posterior approach. The traditional tricortical block technique has advantages over using dowels as it is a more stable construct and can restore intervertebral disc height. However, autologous bone graft has an unpredictable behavior causing potential problems of disc space collapse, forward displacement of the graft and donor bone graft site morbidity. The Hartshill horseshoe was developed to overcome these autograft problems. It is an implant that is placed within the periphery of the intervertebral disc space where the vertebral end plate is strongest to resist compression forces. It has holes that allow screw fixation of the implant to bone to provide immediate stability and a central area for bone graft where the vertebral body is most vascular to allow incorporation of such a graft. Previous reports on the Hartshill horseshoe have used autograft (single tricortical graft). This prospective study reports the clinical and radiological results of 19 patients who underwent this procedure using xenograft 2½ to 3 years postoperative. The radiological results do not show any evidence of loosening of the screws or implant nor evidence of intervertebral disc space subsidence. It was not possible to assess the exact incidence of spinal fusion.

Sign in / Sign up

Export Citation Format

Share Document