scholarly journals Spatial distribution of syndesmophytes along the vertebral rim in ankylosing spondylitis: preferential involvement of the posterolateral rim

2016 ◽  
Vol 75 (11) ◽  
pp. 1951-1957 ◽  
Author(s):  
Sovira Tan ◽  
Abhijit Dasgupta ◽  
Jianhua Yao ◽  
John A Flynn ◽  
Lawrence Yao ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Intervertebral Disc ◽  
Uniform Distribution ◽  
Thoracolumbar Spine ◽  
Ct Scans ◽  
Vertebral Endplate ◽  
Vertebral Level ◽  
Spine Ct

ObjectiveSyndesmophytes in ankylosing spondylitis (AS) can occur anywhere along the vertebral rim, but little is known about how and where they develop, and particularly if they first form in certain locations along the rim. This information might provide clues to their aetiology. We examined the spatial distribution of syndesmophytes in the thoracolumbar spine in patients with AS using CT.MethodsWe performed lumbar spine CT scans in 50 patients and used a validated computer algorithm to measure syndesmophyte heights in six intervertebral disc spaces. We measured heights every five radial degrees around the rim of each superior and inferior vertebral endplate.ResultsSyndesmophytes were observed in 208 of 296 intervertebral disc spaces. Both ascending and descending syndesmophytes were non-randomly distributed along the vertebral rim (p<0.0001 for deviation from uniform distribution). Syndesmophytes occurred most often at the posterolateral vertebral rim, and least commonly at the posterior rim and anterior rim. In disc spaces with only small isolated syndesmophytes, these were also most likely to occur at the posterolateral rim. Syndesmophyte distribution varied with the vertebral level. Localisation at the posterolateral rim was most pronounced at T10-T11, T12-T12 and T12-L1, while L2-L3 and L3-L4 exhibited little localisation.ConclusionsSyndesmophytes are not randomly distributed around the vertebral rim, as might be expected if they develop solely in response to inflammation. Rather, they preferentially occur, and likely develop first, at the posterolateral rim. Studying factors that can lead to this pattern may help elucidate how syndesmophytes develop.

Thoracic Syndesmophytes Commonly Occur in the Absence of Lumbar Syndesmophytes in Ankylosing Spondylitis: A Computed Tomography Study

2017 ◽  
Vol 44 (12) ◽  
pp. 1828-1832 ◽  
Author(s):  
Sovira Tan ◽  
Lawrence Yao ◽  
Michael M. Ward
Keyword(s):  
Computed Tomography ◽  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Intervertebral Disc ◽  
Thoracic Spine ◽  
Thoracolumbar Spine

Objective.To determine the extent of thoracic involvement with syndesmophytes in ankylosing spondylitis (AS) relative to lumbar involvement.Methods.We performed thoracolumbar spine computed tomography (CT) and lumbar radiography on 18 patients. We quantitated syndesmophytes in 11 intervertebral disc spaces and related these to the presence of syndesmophytes on lumbar radiographs.Results.Syndesmophytes were slightly more common in the thoracic than in the lumbar spine and bridging was significantly more common. Thoracic syndesmophytes were universally present in patients without visible lumbar syndesmophytes on either radiographs or CT.Conclusion.Syndesmophytes predominate in the thoracic spine. Lumbar radiographs underestimate the degree of thoracic involvement.

scholarly journals Quantitative measurement of syndesmophyte volume and height in ankylosing spondylitis using CT

2013 ◽  
Vol 73 (3) ◽  
pp. 544-550 ◽  
Author(s):  
Sovira Tan ◽  
Jianhua Yao ◽  
John A Flynn ◽  
Lawrence Yao ◽  
Michael M Ward
Keyword(s):  
Ankylosing Spondylitis ◽  
Dimensional Space ◽  
Three Dimensional ◽  
Reliability And Validity ◽  
Intervertebral Disk ◽  
Ct Scans ◽  
Developmental Study ◽  
Coefficients Of Variation ◽  
Spine Ct ◽  
Computer Based

ObjectiveSyndesmophyte growth in ankylosing spondylitis can be difficult to measure using radiographs because of poor visualisation and semiquantitative scoring methods. We developed and tested the reliability and validity of a new computer-based method that fully quantifies syndesmophyte volumes and heights on CT scans.MethodsIn this developmental study, we performed lumbar spine CT scans on 38 patients and used our algorithm to compute syndesmophyte volume and height in four intervertebral disk spaces. To assess reliability, we compared results between two scans performed on the same day in nine patients. To assess validity, we compared computed measures to visual ratings of syndesmophyte volume and height on both CT scans and radiographs by two physician readers.ResultsCoefficients of variation for syndesmophyte volume and height, based on repeat scans, were 2.05% and 2.40%, respectively. Based on Bland–Altman analysis, an increase in syndesmophyte volume of more than 4% or in height of more than 0.20 mm represented a change greater than measurement error. Computed volumes and heights were strongly associated with physician ratings of syndesmophyte volume and height on visual examination of both the CT scans (p<0.0001) and plain radiographs (p<0.002). Syndesmophyte volumes correlated with the Schober test (r=−0.48) and lateral thoracolumbar flexion (r=−0.60).ConclusionsThis new CT-based method that fully quantifies syndesmophytes in three-dimensional space had excellent reliability and face and construct validity. Given its high precision, this method shows promise for longitudinal clinical studies of syndesmophyte development and growth.

Interobserver discrepancies in distance measurements from lumbar spine CT scans

1985 ◽  
Vol 144 (2) ◽  
pp. 395-398 ◽  
Author(s):  
GJ Beers ◽  
AP Carter ◽  
BE Leiter ◽  
SP Tilak ◽  
RR Shah
Keyword(s):  
Lumbar Spine ◽  
Ct Scans ◽  
Distance Measurements ◽  
Spine Ct

scholarly journals Can Diffuse Idiopathic Skeletal Hyperostosis Be Diagnosed by Plain Lumbar Spine X-Ray Findings Alone?

2020 ◽  
pp. 219256822094803
Author(s):  
Hiroshi Misaki ◽  
Tadao Morino ◽  
Masayuki Hino ◽  
Yusuke Murakami ◽  
Hiroshi Imai ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Thoracolumbar Spine ◽  
Ct Scanning ◽  
Retrospective Case ◽  
Cutoff Value ◽  
X Ray ◽  
Ct Findings ◽  
Spine Ct ◽  
Before And After

Study Design: Retrospective case-control study Objectives: To determine whether diffuse idiopathic skeletal hyperostosis (DISH) can be diagnosed based on anterior longitudinal ligamental ossification in the lumbar spine using plain lumbar spine X-ray images. Methods: This study included 100 patients (59 men and 41 women; mean age, 64.8 ± 13.8 years; range, 27-89 years) who underwent computed tomography (CT) of the chest to the pelvis in our hospital and plain lumbar spine radiography within 6 months before and after CT scanning. DISH was diagnosed based on the thoracolumbar spine CT findings using Resnick’s diagnostic criteria. The patients were grouped according to DISH diagnosis into the DISH (+) and DISH (−) groups. On the frontal and lateral lumbar spine X-ray images, each spinal level from Th11/12 to L5/S was scored based on the Mata scoring system. The distribution of the Mata scores was compared between the 2 groups. Results: Forty (40%) patients were diagnosed with DISH based on the CT findings. A cutoff value ≥8 provided a sensitivity of 75% and specificity of 100% for diagnosing DISH, thus, indicating the validity of the cutoff value. In the DISH (−) group, no patient had ≥3 consecutive spinal levels with a Mata score ≥2, suggesting that DISH can be diagnosed on the basis of at least 3 consecutive spinal levels with a Mata score ≥2. Conclusion: On lumbar spine X-ray images of the T11/12 to L5/S levels, a Mata score ≥2 for at least 3 consecutive levels or a total score ≥8 strongly indicates the presence of DISH.

scholarly journals MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 455
Author(s):  
Nico Sollmann ◽  
Nithin Manohar Rayudu ◽  
Long Yu Yeung ◽  
Anjany Sekuboyina ◽  
Egon Burian ◽  
...  
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Fracture Risk ◽  
Thoracolumbar Spine ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Osteoporotic Vertebral Fractures ◽  
The Mean ◽  
Biomechanical Strength

Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD–L2-IVD–L3 (FSU_L1–L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1–L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1–L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.

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.

Intraspinal Cyst Communicating With the Intervertebral Disc in the Lumbar Spine

Spine ◽  
2001 ◽  
Vol 26 (19) ◽  
pp. 2112-2118 ◽  
Author(s):  
Kazuhiro Chiba ◽  
Yoshiaki Toyama ◽  
Morio Matsumoto ◽  
Hirofumi Maruiwa ◽  
Masahiko Watanabe ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Intraspinal Cyst

scholarly journals Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

CJEM ◽  
2014 ◽  
Vol 16 (02) ◽  
pp. 131-135 ◽  
Author(s):  
Hendrik P. Van Zyl ◽  
James Bilbey ◽  
Alan Vukusic ◽  
Todd Ring ◽  
Jennifer Oakes ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Clinical Skills ◽  
Ct Scans ◽  
Spine Injury ◽  
Emergency Physicians ◽  
Cervical Spine Injuries ◽  
Spine Ct ◽  
Spine Injuries ◽  
Rule Out

ABSTRACT Objective: Emergency physicians are expected to rule out clinically important cervical spine injuries using clinical skills and imaging. Our objective was to determine whether emergency physicians could accurately rule out clinically important cervical spine injuries using computed tomographic (CT) imaging of the cervical spine. Method: Fifteen emergency physicians were enrolled to interpret a sample of 50 cervical spine CT scans in a nonclinical setting. The sample contained a 30% incidence of cervical spine injury. After a 2-hour review session, the participants interpreted the CT scans and categorized them into either a suspected cervical spine injury or no cervical spine injury. Participants were asked to specify the location and type of injury. The gold standard interpretation was the combined opinion of two staff radiologists. Results: Emergency physicians correctly identified 182 of the 210 abnormal cases with cervical spine injury. The sensitivity of emergency physicians was 87% (95% confidence interval [CI] 82–91), and the specificity was 76% (95% CI 74–77). The negative likelihood ratio was 0.18 (95% CI 0.12–0.25). Conclusion: Experienced emergency physicians successfully identified a large proportion of cervical spine injuries on CT; however, they were not sufficiently sensitive to accurately exclude clinically important injuries. Emergency physicians should rely on a radiologist review of cervical spine CT scans prior to discontinuing cervical spine precautions.

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