scholarly journals Progressive enlargement of thoracic ossification of the ligamentum flavum in professional baseball pitchers: a report of two cases

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110594
Author(s):  
Kinshi Kato ◽  
Kenichi Otoshi ◽  
Michiyuki Hakozaki ◽  
Shin-ichi Konno
Keyword(s):  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Physical Activities ◽  
Professional Baseball ◽  
Resonance Imaging ◽  
Local Factors ◽  
Left Handed ◽  
Lower Thoracic Spine ◽  
Baseball Pitchers ◽  
Progressive Enlargement

Both systemic and local factors might influence the development of ossification of the ligamentum flavum (OLF); however, whether specific physical activities play a role in the development of OLF remains unclear. This report presents two cases of thoracic radiculopathy owing to progressive enlargement of thoracic OLF within a few years in Japanese professional baseball pitchers. Two left-handed, Japanese, professional baseball pitchers in their 20s experienced thoracic radiating pain. Mild hypesthesia of the lower thoracic vertebral levels was observed, and an increase in the size of the OLF within a few years was identified in the lower thoracic spine using computed tomography and magnetic resonance imaging. Neither patient exhibited myelopathy and were, therefore, treated conservatively. Both patients were able to return to playing in top condition within 4 months after onset. The findings in these cases suggest that thoracic OLF might increase in size and become exacerbated in certain individuals, such as professional pitchers, who experience repeated, localized, mechanical stress on the thoracic spine, irrespective of age.

scholarly journals Ultrasonic Osteotome Assisted Full-Endoscopic en Block Resection of Thoracic Ossified Ligamentum Flavum: Technical Note and 2 Years Follow-up

2021 ◽  
pp. E239-E248
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cohort Study ◽  
Back Pain ◽  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Radicular Pain ◽  
Resonance Imaging

BACKGROUND: Conventional open laminectomy is considered to be the standard procedure for the treatment of thoracic ossified ligamentum flavum, but multi-segment thoracic laminectomy extensively removes the facet joints and ligamentous tissue, destroying the thoracic spine biomechanics and stability, may lead to delayed thoracic spine kyphosis deformities, which in turn can lead to potential neurological deterioration and local intractable pain. OBJECTIVE: To introduce the technical notes and clinical outcome of ultrasonic osteotome assisted full-endoscopic en block resection of thoracic ossified ligamentum flavum. STUDY DESIGN: A prospective cohort study. SETTING: Hospital and outpatient surgery center. METHODS: From January 2017 to March 2018, 15 patients with 1 – 2 segment thoracic ossified ligamentum flavum were treated with ultrasonic osteotome assisted full-endoscopic en block resection of thoracic ossified ligamentum flavum under local anesthesia. The magnetic resonance imaging and computed tomography of the thoracic spine was reexamined after the operation to evaluate the completeness of ossified ligamentum flavum resection and spinal cord decompression. The patients were followed up on the visual analogue scale of back pain and radicular pain, Nurick score and mJOA score of neurological function, and Oswestry Disability Index at 1 week, 3 months, 6 months, one year, and 2 years after operation. RESULTS: All operations of 17 segments thoracic ossified ligamentum flavum in 15 patients were successfully completed without intraoperative conversion to open surgery. There were no intraoperative spinal cord injuries, dura tears, postoperative cerebrospinal fluid leakage, postoperative infections, and postoperative spinal cord injury aggravated symptoms. Postoperative thoracic spine magnetic resonance imaging and computed tomography examinations of all patients showed that the spinal cord was fully decompressed without any residual pressure. Back pain and radicular pain were relieved significantly, and spinal cord function (Nurick, mJOA, and Oswestry Disability Index scores) was obviously restored. The mJOA recovery rate at the 2-year follow-up was 78.3% in average. LIMITATIONS: This is an observational cohort study with relative small sample and short-term follow-up. CONCLUSIONS: Ultrasonic assisted full-endoscopic en block resection of ossified ligamentum flavum is a safe and effective minimally invasive spine surgery for thoracic myelography caused by thoracic ossified ligamentum flavum. KEY WORDS: Thoracic myelopathy, ossified ligamentum flavum, full-endoscopic decompression, ultrasonic osteotome, minimally invasive surgery

scholarly journals Case Report: Primary ganglioneuroblastoma occurrence in lower thoracic spine

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 59
Author(s):  
Masuma Islam ◽  
Muhammad Khurram Zia ◽  
Syeda Ifra asad ◽  
Syed Zawahir Hassan ◽  
Osama Salam ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Thoracic Spine ◽  
Rare Case ◽  
Ganglion Cells ◽  
Pediatric Population ◽  
Neural Tissue ◽  
Surgical Excision ◽  
Resonance Imaging ◽  
Spinal Compression ◽  
Lower Thoracic Spine

Ganglioneuroblastoma is a neural tissue neoplasm, which is derived from the neural crest cells. It is mostly seen in the pediatric population but is very rarely found in the lower thoracic spine. Here, we report a rare case of ganglioneuroblstoma occurrence in the lower thoracic spine. A 2.5-year-old boy presented with spinal compression symptoms and on magnetic resonance imaging, a mass was identified over T10 to L1. The tumor showed round blue cells and mature ganglion cells with hypermitotic activity. Immunohistochemical synaptophysin and neurofilament staining was positive, confirming the diagnosis. The patient showed significant improvement after surgical excision of the tumor. This is the first reported case of ganglioneuroblastoma in the lower thoracic spine that was successfully treated in Pakistan.

Lumbopelvic Control and the Development of Upper Extremity Injury in Professional Baseball Pitchers

2021 ◽  
pp. 036354652098812
Author(s):  
Kevin Laudner ◽  
Regan Wong ◽  
Daniel Evans ◽  
Keith Meister
Keyword(s):  
Upper Extremity ◽  
Lower Limbs ◽  
Group Differences ◽  
Professional Baseball ◽  
Extremity Injury ◽  
Level Of Evidence ◽  
Balance Task ◽  
Upper Extremity Injury ◽  
Baseball Pitchers ◽  
Extremity Injuries

Background: The baseball-throwing motion requires a sequential order of motions and forces initiating in the lower limbs and transferring through the trunk and ultimately to the upper extremity. Any disruption in this sequence can increase the forces placed on subsequent segments. No research has examined if baseball pitchers with less lumbopelvic control are more likely to develop upper extremity injury than pitchers with more control. Purpose: To determine if baseball pitchers who sustain a chronic upper extremity injury have less lumbopelvic control before their injury compared with a group of pitchers who do not sustain an injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 asymptomatic, professional baseball pitchers from a single Major League Baseball organization participated. Lumbopelvic control was measured using an iPod-based digital level secured to a Velcro belt around each player’s waist to measure anteroposterior (AP) and mediolateral (ML) deviations (degrees) during single-leg balance with movement and static bridge maneuvers. During a competitive season, 22 of these pitchers developed upper extremity injuries, while the remaining 27 sustained no injuries. Separate 2-tailed t-tests were run to determine if there were significant differences in lumbopelvic control between groups ( P < .05). Results: There were no significant between-group differences for the stride leg (nondominant) during the bridge test in either the AP ( P = .79) or the ML ( P = .42) directions, or either direction during the drive leg bridge test ( P > .68). However, the injured group had significantly less lumbopelvic control than the noninjured group during stride leg balance in both the AP ( P = .03) and the ML ( P = .001) directions and for drive leg balance in both the AP ( P = .01) and the ML ( P = .04) directions. Conclusion: These results demonstrate that baseball pitchers with diminished lumbopelvic control, particularly during stride leg and drive leg single-leg balance with movement, had more upper extremity injuries than those with more control. Clinicians should consider evaluating lumbopelvic control in injury prevention protocols and provide appropriate exercises for restoring lumbopelvic control before returning athletes to competition after injury. Specific attention should be given to testing and exercises that mimic a single-limb balance task.

scholarly journals The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 759
Author(s):  
Byung Gon Kim ◽  
Seung Kil Lim ◽  
Sunga Kong
Keyword(s):  
External Rotation ◽  
Professional Baseball ◽  
Isokinetic Strength ◽  
Strength Ratio ◽  
Shoulder Injury ◽  
Isokinetic Dynamometer ◽  
Normal Range ◽  
History Of ◽  
Baseball Pitchers ◽  
The Relationship

This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.

Development and internal validation of a humeral torsion prediction model in professional baseball pitchers

2021 ◽  
Author(s):  
Garrett S. Bullock ◽  
Ellen Shanley ◽  
Gary S. Collins ◽  
Nigel K. Arden ◽  
Thomas K. Noonan ◽  
...  
Keyword(s):  
Prediction Model ◽  
Professional Baseball ◽  
Internal Validation ◽  
Humeral Torsion ◽  
Baseball Pitchers
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