scholarly journals The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinshui Chen ◽  
Juying Wang ◽  
Xuepeng Wei ◽  
Huapeng Guan ◽  
Benhai Wang ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Regression Equation ◽  
Improvement Rate ◽  
Thoracic Inlet ◽  
T1 Slope ◽  
Asymptomatic Volunteers ◽  
Sagittal Parameters ◽  
The Mean ◽  
The Difference ◽  
Cervical Reconstruction

Abstract Background This study aimed to explore the relationship among different cervical sagittal parameters in asymptomatic volunteers and the correlation between surgical efficacy and difference of presumed and actual postoperative C2–7 Cobbs’s angle (C2–7COBB), which was calculated based on preoperative T1 slope (T1S) in patients undergoing cervical reconstruction. Methods In total, 158 inpatients with cervical spondylosis and 274 asymptomatic volunteers were retrospectively reviewed. Cervical sagittal parameters, such as C2–7COBB, T1S, thoracic inlet angle (TIA), and neck tilt (NT), were compared. Then, the correlation among these parameters was analyzed in asymptomatic volunteers, and a regression equation between T1S and C2–7COBB was established and used to analyze the correlation among the Japanese Orthopaedic Association (JOA) score improvement, the sagittal parameters, and the difference between presumed and actual postoperative C2–7COBB in patients after cervical reconstruction. Results The mean T1S, C2–7COBB, and TIA were significantly decreased in patients (P < 0.01). T1S and NT had a strong correlation with TIA (P < 0.01). T1S demonstrated a moderate correlation with C2–7COBB in asymptomatic volunteers (r = 0.569, P < 0.01). A regression equation had been established as C2–7COBB = 0.742 × T1S − 0.866. The mean C2–7COBB and JOA score improved significantly (P < 0.05) postoperatively. Moreover, the JOA improvement rate showed a significant negative correlation with the difference in the presumed and actual postoperative C2–7COBB (r = − 0.696, P < 0.01). Conclusion Our study successfully established a regression equation for calculating postsurgical C2–7COBB based on the correlation between T1S and C2–7COBB in asymptomatic volunteers. The regression equation could be used for guiding surgeons to accomplish an ideal postsurgical C2–7COBB for patients with cervical spondylosis.

scholarly journals Three-dimensional analysis of acetabular cup orientation and an evaluation of the relationship with pelvic sagittal parameters

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986122
Author(s):  
Ali Sahin ◽  
Mehmet Emin Simsek ◽  
Safa Gursoy ◽  
Mustafa Akkaya ◽  
Cetin Isik ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Statistical Correlation ◽  
Acetabular Cup ◽  
Pelvic Parameters ◽  
Sagittal Parameters ◽  
The Mean ◽  
The Difference ◽  
The Relationship

Background: This study aimed to evaluate the effect of total hip arthroplasty (THA) on sagittal pelvic parameters and to evaluate the effect of sagittal pelvic parameters on acetabular cup orientation. Methods: The study included 86 patients who underwent THA for a diagnosis of unilateral coxarthrosis between 2011 and 2015. Measurements were taken of the preoperative and postoperative acetabular cup inclination (ACI), anteversion, and sagittal pelvic parameters. The effect of THA on sagittal pelvic parameters and the effects of the sagittal pelvic parameters on acetabular cup orientation were investigated. Results: The sagittal pelvic tilt values calculated were mean 9.7° ± 6.3° (2°; 23°) preoperatively and 11.0° ± 6.1° (2°; 25°) postoperatively. The increase in postoperative pelvic incidence (PI) values was determined to be statistically significant ( p < 0.05). The preoperative PI values had no significant effect on ACI, but in cases with high preoperative PI values, a tendency to high anteversion values was determined. The mean inclination values were found to be 40.2° ± 11.0° in the low PI group, 41.7° ± 7.4° in the normal PI group, and 44.1° ± 8.3° in the high PI group. As no increase in inclination values was observed with an increase in PI values, no statistical correlation was determined ( p = 0.343). Average of anteversion values in the low PI group was 9.2° ± 13.7°, in the normal PI group 19.3° ± 10.5°, and in the high PI group 21.1° ± 12.5°. The difference between the groups was statistically significant ( p = 0.001). Conclusion: Evaluating the results of this study, it can be concluded that varying PI values do affect the acetabular cup anterversion in THA. So, preoperative assessment of PI values is important in preventing postoperative acetabular cup malposition.

scholarly journals Correlation of cervical and thoracic inlet sagittal parameters by MRI and radiography in patients with cervical spondylosis

Medicine ◽  
2019 ◽  
Vol 98 (7) ◽  
pp. e14393 ◽  
Author(s):  
Jie Cheng ◽  
Peng Liu ◽  
Dong Sun ◽  
Zikun Ma ◽  
Jingpei Liu ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Thoracic Inlet ◽  
Sagittal Parameters

Titanium Cage in Comparison with Nano-Hydroxyapatite Bone Graft Substitutes in Cervical Reconstruction

2021 ◽  
Vol 17 (7) ◽  
pp. 1448-1452
Author(s):  
Tao Zhang ◽  
Ying Guo ◽  
Dapeng Zhang ◽  
Runze Zhao ◽  
Naiwu Hu
Keyword(s):  
Cervical Spine ◽  
Bone Graft ◽  
Cervical Spondylosis ◽  
Titanium Cage ◽  
Cage Condition ◽  
Post Operation ◽  
Bone Graft Substitutes ◽  
Sagittal Parameters ◽  
One Year ◽  
Cervical Reconstruction

Cervical spondylosis is a disease that occurs with age and affects the discs and joints in the cervical spine located in the neck. The hydroxyapatite (HA) bone graft substitutes can used as a potential bone-forming agent, however, the efficacy of using HA is challenging in cervical reconstruction. In this regard, nano-based HA was used in this study to explore its sagittal parameters and clinical potency in relative to titanium (TiO2) cage in patient with cervical spondylosis. 50 patients suffering from cervical spondylosis were divided in two groups and were grafted with either TiO2 cage or nano-HA. The sagittal parameters, including cervical spine lateral radiographs (C0−2Coob and C2−7Coob) were taken pre- and post-operation (3-month, one-year and two-year). The clinical potency was also done based on the JOA scores. Angle analysis indicated that the C0−2Cobb and C2−7Cobb angles were significantly changed after the operation in both TiO2 cage and nano-HA groups, whereas no significant changes was determined in nano-HA relative to TiO2 cage condition. Also, it was shown that JOA scores were significantly higher after the operation than pre-operation, indicating a potential cervical reconstruction after surgery in both groups which slightly were higher for nano-HA groups.

Clinical and radiological results of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis

2014 ◽  
Vol 21 (6) ◽  
pp. 944-950 ◽  
Author(s):  
Lisheng Kan ◽  
Jian Kang ◽  
Rui Gao ◽  
Xiongsheng Chen ◽  
Lianshun Jia
Keyword(s):  
Scale Score ◽  
Cervical Spondylosis ◽  
Cervical Disc ◽  
Improvement Rate ◽  
Score Improvement ◽  
The Mean ◽  
Reconstructive Techniques ◽  
Anterior Cervical Corpectomy ◽  
Two Hybrid

Object To date, formulation of the optimal surgical protocol for noncontiguous multilevel cervical spondylosis remains controversial, and the corresponding clinical data continue to be limited. The purpose of this study was to compare the clinical and radiological outcomes of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis (2 contiguous disc levels and 1 “skip” disc level [nonoperated level between 2 operated levels]). The incidence of adjacent-segment degeneration (ASD) was also evaluated. Methods Sixty-three consecutive patients with noncontiguous 3-level cervical spondylosis who underwent two different hybrid methods of treatment were retrospectively reviewed. The patients were divided into 2 groups, the fusion group and the arthroplasty group. A titanium mesh cage and an anterior cervical plate were used after the anterior cervical corpectomy, and then a stand-alone cage (the fusion group) or an artificial cervical disc (the arthroplasty group) was used after the discectomy. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale score and the JOA scale score improvement rate preoperatively and during follow-up. Radiological results were assessed using global angle and global range of motion (ROM) of the cervical spine. The ASD was also evaluated. Results The JOA scores of the patients significantly improved postoperatively and were well maintained within the follow-up period, as did the JOA scale score improvement rate. The mean global angle of the cervical spine of the patients significantly increased postoperatively. At the last follow-up evaluation, the mean global ROM was retained by patients in the arthroplasty group (p > 0.05) but not by patients in the fusion group (p = 0.00). There was no significant difference in the incidence of ASD between the 2 groups (p = 0.114). However, at the skip levels, patients in the fusion group had a higher incidence of ASD than patients in the arthroplasty group (p = 0.038). Conclusions Both of the hybrid procedures (anterior cervical corpectomy and fusion [ACCF] + anterior cervical discectomy and fusion, and ACCF + cervical disc arthroplasty [CDA]) yielded favorable clinical and radiological outcomes in the treatment of noncontiguous 3-level cervical spondylosis. Moreover, the ACCF + CDA procedure may have the ability to decrease the likelihood of ASD in appropriate patients.

scholarly journals Predictive formula of cervical lordosis in asymptomatic young population

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuchen Zhu ◽  
Zhongcheng An ◽  
Yingjian Zhang ◽  
Hao Wei ◽  
Liqiang Dong
Keyword(s):  
Multiple Regression ◽  
Pearson Correlation ◽  
Reference Value ◽  
Vertical Axis ◽  
Stepwise Multiple Regression ◽  
Cervical Lordosis ◽  
Sagittal Vertical Axis ◽  
Thoracic Inlet ◽  
Sagittal Parameters ◽  
The Mean

Abstract Background Not a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet. Methods This was a prospective radiological analysis of asymptomatic subjects. The following cervical sagittal parameters were measured: CL, thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), and C2–7 sagittal vertical axis (C2–7 SVA). The Pearson correlation test was calculated, and the stepwise multiple regression analysis was conducted by using the CL (dependent variable) and the other cervical sagittal parameters (independent variables) to determine the best sets of predictors. A paired sample t test was conducted between the predicted and measured values. Results The mean age of 307 participants was 24.54 + 3.07. The mean CL, TIA, T1S, NT, and C2–C7 SVA was 17.11° ± 6.31°, 67.87° ± 7.78°, 25.84° ± 5.36°, 42.53° ± 6.68°, and 14.60 ± 8.20 mm, respectively. The formula was established as follows: CL = 0.762 × T1S − 0.392 × C2–C7 SVA + 0.25 × TIA − 13.795 (R = 0.812, R2 = 0.660) (stepwise multiple regression) and CL = 0.417 × TIA − 11.193 (R = 0.514, R2 = 0.264) (simple linear regression). There was no statistical difference between the predicted CL and the measured CL (t = 0.034, P = 0.973). Conclusions There was a significant correlation between CL and other cervical sagittal parameters, including TIA, T1S, NT, and C2–C7 SVA in asymptomatic Chinese population. The results of this study may serve as a normal reference value for the study of asymptomatic population.

scholarly journals Intelligent Three-Dimensional Reconstruction Algorithm-Based X-Ray Film for Analysis of the Changes in Sagittal Parameters and Curative Effect of Anterior Cervical Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhengyu Liu ◽  
Qingming Zhang ◽  
Juyong Wang ◽  
Shibao Lu
Keyword(s):  
Cervical Spondylosis ◽  
Three Dimensional ◽  
Three Dimensional Reconstruction ◽  
Curative Effect ◽  
Improvement Rate ◽  
X Ray ◽  
Cervical Surgery ◽  
Dimensional Reconstruction ◽  
Sagittal Parameters ◽  
Anterior Cervical Surgery

In this paper, the change characteristics of sagittal parameters of the patient’s body before and after anterior cervical surgery and rehabilitation effect were analyzed. The rotation transformation and perspective projection transformation were applied to construct a positive and lateral position (PLP) matching-based three-dimensional reconstruction (PLP-3DR) algorithm, which was compared with the marching cubes (MC) algorithm and gravity point (GP) algorithm. PLP-3DR was adopted in X-ray image diagnosis of 124 cervical spondylosis patients. Results showed that sensitivity, specificity, and accuracy of PLP-3DR were markedly higher than those of MC and GP ( P < 0.05 ). The postoperative C2-7 Cobbs’s angle (C2-7Cobb) (11.27 ± 8.41°) was smaller than that before the surgery (15.03 ± 7.39°) ( P < 0.05 ), while the postoperative cervical sagittal vertical axis (cSVA) (21.33 ± 10.38 mm) and Japanese Orthopaedic Association (JOA) scores (16.95 ± 6.07 points) were greater than those before the surgery (14.66 ± 9.68 mm and 11.39 ± 4.28 points) ( P < 0.05 ). Besides, the improvement rate of patients from the cSVA >25 mm group (68.31%) was greater than the rate of the cSVA <15 mm group (45.88%) and the cSVA within 15–25 mm group (47.29%) ( P < 0.05 ). In conclusion, PLP-3DR could effectively improve the diagnostic effect of spine X-ray film images, with high sensitivity and specificity. Anterior cervical surgery had a good curative effect for patients with cervical spondylosis and was closely related to cervical parameters (cSVA, T1 slope, and C2-7Cobb). In addition, patients with cSVA>25 mm could have the best postoperative rehabilitation effect.

scholarly journals Analysis of global spine sagittal parameters in cervical spondylotic patients and asymptomatic subjects

2020 ◽  
Author(s):  
Liang Zhu ◽  
Xiaojun Ma ◽  
Qiang Shen ◽  
Bao Sun ◽  
Qiang Fu
Keyword(s):  
Cervical Spondylosis ◽  
Lumbar Lordosis ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Normal Group ◽  
Sacral Slope ◽  
Sagittal Vertical Axis ◽  
Thoracic Inlet ◽  
Global Sagittal Alignment ◽  
Sagittal Parameters

Abstract Background: Degenerative changes associated with cervical spondylotic can result in a change of normal sagittal alignment, and this may be the initial change of kyphosis and sagittal imbalance. Few studies have analyzed the correlations between the cervical spine lordosis and global spine balance in patients with cervical spondylotic. This study is applied to investigate the characteristics and relationships of cervical and global sagittal parameters in normal adults and cervical spondylotic patients. Methods: We reviewed 46 asymptomatic control subjects (normal group, NG) and 48 cervical spondylotic patients (cervical spondylotic group, CSG), who had both cervical MRI and global radiographs obtained together, between January 2016 and September 2018. Data includes C1-2 angle, C2–7 lordosis (CL), T1 slope (T1S), thoracic inlet angle (TIA), C2–7 sagittal vertical axis (CSVA), sagittal vertical axis(SVA), thoracic-kyphosis(TK), thoracic-lumbar lordosis(TL), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). The values were presented as the mean ± standard deviation. Student t-test and Pearson’s correlation coefficient were used for statistical analysis. Probability values less than 0.05 were considered statistically significant. Results: 1.Comparison of global sagittal parameters between the normal group and cervical spondylosis group. A total of 48 cervical spondylotic patients with an average age of 57.91±9.58 and 46 healthy people with an average age of 28.00±8.09 were recruited in our study. CL in the NG was significantly lower than CSG (P<0.05), while TK and TL were significantly lower than in the CSG(P< 0.01). However, a comparison of the NG and CSG yielded no significant differences in C1-2, TIA, TIS, LL, PT, PI, SS, CSVA, and SVA. 2.The relationship between cervical and global sagittal alignment. CL positively correlated with T1S (r=0.433) and TK (r=0.335) while negatively correlated with CSVA (r=-0.309) in cervical spondylosis group. TIA has positively correlated with T1S (r=0.376 in NG and r=0.416 in CSG) and no correlated with other parameters in both groups. Conclusions Cervical spondylosis causes changes in sagittal parameters of the cervical and thoracic spine but does not affect on lumbar and pelvic parameters. TIA is a relative constant parameter, not affected by cervical spondylotic.

The Effect of Vocabulary Intervention on Text Comprehension: Who Benefits?

2019 ◽  
Vol 50 (4) ◽  
pp. 562-578 ◽  
Author(s):  
Dawna Duff
Keyword(s):  
Middle School ◽  
Reading Comprehension ◽  
Text Comprehension ◽  
Classroom Instruction ◽  
Vocabulary Instruction ◽  
Clinical Intervention ◽  
Vocabulary Knowledge ◽  
Vocabulary Intervention ◽  
The Mean ◽  
The Difference

Purpose Vocabulary intervention can improve comprehension of texts containing taught words, but it is unclear if all middle school readers get this benefit. This study tests 2 hypotheses about variables that predict response to vocabulary treatment on text comprehension: gains in vocabulary knowledge due to treatment and pretreatment reading comprehension scores. Method Students in Grade 6 ( N = 23) completed a 5-session intervention based on robust vocabulary instruction (RVI). Knowledge of the semantics of taught words was measured pre- and posttreatment. Participants then read 2 matched texts, 1 containing taught words (treated) and 1 not (untreated). Treated texts and taught word lists were counterbalanced across participants. The difference between text comprehension scores in treated and untreated conditions was taken as a measure of the effect of RVI on text comprehension. Results RVI resulted in significant gains in knowledge of taught words ( d RM = 2.26) and text comprehension ( d RM = 0.31). The extent of gains in vocabulary knowledge after vocabulary treatment did not predict the effect of RVI on comprehension of texts. However, untreated reading comprehension scores moderated the effect of the vocabulary treatment on text comprehension: Lower reading comprehension was associated with greater gains in text comprehension. Readers with comprehension scores below the mean experienced large gains in comprehension, but those with average/above average reading comprehension scores did not. Conclusion Vocabulary instruction had a larger effect on text comprehension for readers in Grade 6 who had lower untreated reading comprehension scores. In contrast, the amount that children learned about taught vocabulary did not predict the effect of vocabulary instruction on text comprehension. This has implications for the identification of 6th-grade students who would benefit from classroom instruction or clinical intervention targeting vocabulary knowledge.

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

EFFECTS OF SYNTHETIC LH/FSH-RELEASING HORMONE (LRH) ON PLASMA LH AND FSH IN AMENORRHOEIC WOMEN

1974 ◽  
Vol 75 (4) ◽  
pp. 647-652 ◽  
Author(s):  
G. Rannevik ◽  
J. Thorell
Keyword(s):  
Urinary Excretion ◽  
Initial Response ◽  
Releasing Hormone ◽  
The Mean ◽  
The Difference ◽  
Serial Measurements

ABSTRACT Eight amenorrhoeic women were given 100 μg synthetic LRH (Hoechst) iv and im, respectively, at an interval of 2 weeks. Four of the women received the iv injection first and four the im injection. The urinary excretion of oestrogens and pregnanediol was low and unaltered throughout the test weeks. The effects of LRH were compared by serial measurements of the plasma LH and FSH during 8 h. The initial response of LH for up to 25 min and that of FSH for up to 60 min were equal whether LRH was given iv or im. The difference appeared later. Four hours after the injection the mean increase of LH to iv injection was 0.5 ng/ml (N. S.), while that to im injection was 1.9 ng/ml (P < 0.01). The corresponding values for FSH were 1.3 (P < 0.05) and 3.2 (P < 0.001). The effect of LRH administration im was thus found to be larger and more prolonged.

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