Macro- and microelement content of intervertebral discs in hernias of the lumbar spine

Abstract Percutaneous discectomy is a viable alternative in the treatment of herniated intervertebral discs of the lumbar spine. Anatomical analysis of the retroperitoneal surgical path utilizing computed tomography suggests that the risk of vascular injury is negligible at the L-4, L-5 level, but substantial at the L-5, S-1 level. In addition, one-third of patients otherwise suitable for percutaneous discectomy have segments of bowel obstructing the surgical path. Obtaining an abdominal computed tomographic scan with the patient in the surgical position seems to be a valuable screening technique in the evaluation of candidates for this procedure.

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Computed Tomographic Discography in the Evaluation of Extreme Lateral Disc Herniation

Neurosurgery ◽

10.1097/00006123-198403000-00018 ◽

1984 ◽

Vol 14 (3) ◽

pp. 350-352 ◽

Cited By ~ 1

Author(s):

J. C. Angtuaco Edgardo ◽

C. Holder John ◽

C. Boop Warren ◽

F. Binet Eugene

Keyword(s):

Lumbar Spine ◽

High Resolution ◽

Contrast Enhancement ◽

Thin Section ◽

Preoperative Evaluation ◽

Intervertebral Discs ◽

Ct Scans ◽

Computed Tomographic ◽

Disc Herniations ◽

Lateral Disc Herniation

Abstract Thin section, high resolution computed tomographic (CT) scans of the lumbar spine produce images that can show herniated intervertebral discs without intravenous or intrathecal contrast enhancement. With this technique, the diagnosis of posterolateral and midline herniation has been greatly facilitated. This communication reports the use of CT discography in the preoperative evaluation of two patients who were shown at discography and proven at operation to have extreme lateral disc herniations.

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Biomechanical in Vitro and Finite Element Study On Different Sagittal Alignment Postures of the Lumbar Spine During Multiaxial Daily Motion

Journal of Biomechanical Engineering ◽

10.1115/1.4053083 ◽

2021 ◽

Author(s):

Nadja Wilmanns ◽

Agnes Beckmann ◽

Luis Fernando Nicolini ◽

Christian Herren ◽

Rolf Sobottke ◽

...

Keyword(s):

Finite Element ◽

Lumbar Spine ◽

Planning Process ◽

Axial Rotation ◽

Intervertebral Discs ◽

Fe Model ◽

Bending Moments ◽

Sagittal Spinal Alignment ◽

Biomechanical Response

Abstract Lumbar Lordotic correction (LLC), the gold standard treatment for Sagittal Spinal malalignment (SMA), and its effect on sagittal balance have been critically discussed in recent studies. This paper assesses the biomechanical response of the spinal components to LLC as an additional factor for the evaluation of LLC. Human lumbar spines (L2L5) were loaded with combined bending moments in Flexion (Flex)/Extension (Ex) or Lateral Bending (LatBend) and Axial Rotation (AxRot) in a physiological environment. We examined the dependency of AxRot range of motion (RoM) on the applied bending moment. The results were used to validate a Finite Element (FE) model of the lumbar spine. With this model, the biomechanical response of the intervertebral discs (IVD) and facet joints under daily motion was studied for different sagittal spinal alignment (SA) postures, simulated by a motion in Flex/Ex direction. Applied bending moments decreased AxRot RoM significantly (all P<0.001). A stronger decline of AxRot RoM for Ex than for Flex direction was observed (all P<0.0001). Our simulated results largely agreed with the experimental data (all R2>0.79). During daily motion, the IVD was loaded higher with increasing lumbar lordosis (LL) for all evaluated values at L2L3 and L3L4 and posterior Annulus Stress (AS) at L4L5 (all P<0.0476). The results of this study indicate that LLC with large extensions of LL may not always be advantageous regarding the biomechanical loading of the IVD. This finding may be used to improve the planning process of LLC treatments.

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