A novel method for measurement of occipital-cervical distance by occiput-C4 distance

2019 ◽  
Author(s):  
Chao Tang ◽  
Sheng Yang ◽  
Ye Hui Liao ◽  
Qiang Tang ◽  
Fei Ma ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Standardized Testing ◽  
Normal Population ◽  
Normal Subjects ◽  
Basilar Invagination ◽  
Shortest Distance ◽  
Novel Method ◽  
Asymptomatic Subjects ◽  
Spine Radiographs ◽  
Flexion And Extension

Abstract Background: To describe and measure the occipital-cervical distance by a novel method utilizing the occiput-C4 distance (OC4D) in normal subjects that can be used to guide the restoration of vertical dislocation of the occipitocervical region in patients with basilar invagination and to perform standardized testing of occipitocervical constructs.Methods: Neutral, flexion, and extension lateral cervical spine radiographs of 150 asymptomatic subjects (73 males and 77 females) judged to be normal were analyzed. The mean age was 48.0±8.4 years old (range 20–69 years; 48.4±10.2 years old for males and 47.6±6.4 years old for females). Analysis consisted of measurement of the OC4D. The OC4D was defined as the shortest distance from the center of the C4 vertebral body to the McGregor’s line. Two spine surgeons measured the OC4D thrice in the normal population and obtained the average values. Height, weight, and body mass index (BMI) of each subject was recorded and analyze its correlation with OC4D.Results: The values of OC4D on neutral, flexion, and extension lateral cervical spine radiographs were 69.0±6.9 mm, 68.9±6.8 mm and 68.1±6.9 mm, respectively. There was no significantly different from the values measured in neutral、flexion and extension (P> 0.05). But the OC4D of males were higher than females in neutral, flexion, and extension (P < 0.001 for all). There was a positive correlation between OC4D and height and weight in neutral、flexion and extension (P <0.001 for all). The correlation between O-C4D and BMI was weak, and no significant in neutral, flexion, and extension (P > 0.05). The ICC values of inter- and intra-observer agreements for the radiographic parameter in all of the cervical positions were more than 0.93.Conclusions: OC4D, a new measurement method for occipital-cervical distance that is not affected by the change in neutral, flexion, and extension positions, should be a valuable parameter and intra-operative tool to guide the vertical restoration during OCF for patients with altered occiput-cervical anatomy.

Motion Analysis of the Cervical Spine

2004 ◽  
Vol 9 (5) ◽  
pp. 1-11
Author(s):  
Patrick R. Luers
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disk ◽  
Radiographic Evaluation ◽  
Ligamentous Injury ◽  
Pattern Of Injury ◽  
Motion Segment ◽  
Single Pattern ◽  
Compensatory Motion ◽  
Loss Of Motion ◽  
Flexion And Extension

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

Computerized method for validating laboratory reference ranges for triiodothyronine and thyroxin immunoassays

1991 ◽  
Vol 37 (3) ◽  
pp. 438-442 ◽  
Author(s):  
Brian Luttrell ◽  
Sall Watters
Keyword(s):  
Reference Range ◽  
Normal Values ◽  
Reference Group ◽  
Normal Population ◽  
Normal Subjects ◽  
Reference Ranges ◽  
Large Samples ◽  
Laboratory Reference ◽  
Euthyroid Status ◽  
Computer Based

Abstract We used a computer-based method to help validate the reference ranges of assays for triiodothyronine (T3) and thyroxin (T4). A retrospective search of a database of laboratory results for the previous six months identified all patients with apparent euthyroid status, as defined by methods independent of the immunoassay under review. A computer-generated reference group (CGR Group) of 2001 records had a gaussian distribution of T4 values and a reference range (mean +/- 2 SD) of 56-161 nmol/L, compared with the supplier's suggested range for euthyroid subjects (58-148 nmol/L) and an in-house range of 60-144 nmol/L for a group of 97 normal subjects. A similar CGR Group of 1902 records gave a reference range for T3 of 0.7-2.1 nmol/L (manufacturer's range 0.8-2.8; normal subjects 0.8-2.2). An attempt to devise a reference range for thyrotropin failed when we found that its concentration in the population of patients with normal values for thyroid hormones was distributed differently from that in the normal population. The method is intended to be used in addition to conventionally derived ranges based on results for healthy subjects. It allows the laboratory to conveniently verify the reference ranges for T3 and T4 assays at regular intervals by using very large samples with appropriate age, sex, and weight distribution, drawn from the population of patients' samples submitted for analysis.

Morphological Evaluation of the Subaxial Cervical Spine in Patients with Basilar Invagination

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Shaoyi Lin ◽  
Minggui Bao ◽  
Zihan Wang ◽  
Xiaobao Zou ◽  
Su Ge ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Basilar Invagination ◽  
Subaxial Cervical Spine ◽  
Morphological Evaluation

scholarly journals Identification of the Disrupted Pathways Associated with Periodontitis Based on Human Pathway Network

2016 ◽  
Vol 5 (4) ◽  
pp. 93-98
Author(s):  
Wen Sun ◽  
Lin Han ◽  
Wenmao Xu ◽  
Yazhen Sun
Keyword(s):  
Protein Interactions ◽  
Threshold Value ◽  
Normal Subjects ◽  
Protein Protein Interactions ◽  
Pathway Network ◽  
Differential Expression Genes ◽  
Weight Value ◽  
Limma Package ◽  
Novel Method ◽  
Cognitively Normal Subjects

AbstractObjective: The objective of this work is to search for a novel method to explore the disrupted pathways associated with periodontitis (PD) based on the network level.Methods: Firstly, the differential expression genes (DEGs) between PD patients and cognitively normal subjects were inferred based on LIMMA package. Then, the protein-protein interactions (PPI) in each pathway were explored by Empirical Bayesian (EB) co-expression program. Specifically, we determined the 100th weight value as the threshold value of the disrupted pathways of PPI by constructing the randomly model and confirmed the weight value of each pathway. Meanwhile, we dissected the disrupted pathways under the weight value > the threshold value. Pathways enrichment analyses of DEGs were carried out based on Expression Analysis Systematic Explored (EASE) test. Finally, the better method was selected based on the more rich and significant obtained pathways by comparing the two methods.Results: After the calculation of LIMMA package, we estimated 524 DEGs in all. Then we determined 0.115222 as the threshold value of the disrupted pathways of PPI. When the weight value>0.115222, there were 258 disrupted pathways of PPI enriched in. Additionally, we observed those 524 DEGs that were enriched in 4 pathways under EASE=0.1.Conclusion: We proposed a novel network method inferring the disrupted pathway for PD. The disrupted pathways might be underlying biomarkers for treatment associated with PD.

scholarly journals Hoarseness After Shoulder Surgery in Beach-chair Position

2021 ◽  
Author(s):  
Seung-Min Youn ◽  
Sung-Min Rhee ◽  
Hwan Jin Kim ◽  
Hyun Woo Lee ◽  
Seong Cheol Moon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Vocal Cord ◽  
Recovery Time ◽  
Shoulder Surgery ◽  
Worst Case ◽  
Beach Chair Position ◽  
Cord Injury ◽  
Spine Radiographs ◽  
Beach Chair

Abstract Background Isolated vocal cord palsy resulting hoarseness after shoulder surgery in beach-chair position had not been reported in literature to date. The purpose of this study was to review its incidence in our patient cohort, and identify any risk factors that may predispose the patient to the injury.Methods There were 10215 operative shoulder cases from January 2010 to December 2017. Inclusion criteria was any post-operative patients, whose operation was performed under general anesthesia in beach-chair position, who had the related symptoms, but the diagnoses had to be confirmed by otorhinolaryngologists with laryngoscopy studies. The affected patients’ clinical notes were retrospectively reviewed with the particular interest in the operative times, and the peri-operative cervical spine radiographs. The degree of cervical spine lordosis was assessed using a method described in literature, in which ‘absolute rotation angle’ (ARA) was measured. Results There were 8 reported cases of vocal cord injury in total (0.08%). Four were male patients and four were arthroscopic cases. The mean age was 59.4 ± 11.9 years old. No particular difficulties with positioning or intubation were documented. The average duration of anesthetic times was 141 minutes. On peri-operative cervical spine radiographs, the average lordosis was 8.2° (1.5° kyphosis - 21° lordosis), and except for one patient, all had ‘non-lordotic’ type curvatures. All but one patient had recovered fully with observation and expectant management, with the average recovery time being 19 weeks (range: 2 weeks to 1 year). Only patient who had not recovered during our 2-year follow-up period, had a ‘sigmoidal’ type cervical spine and was also managed with observation only.Conclusions The incidence of vocal cord injury with beach-chair positioning at our institution was low at 0.08%. The possible risk factors include long duration of the procedure and ‘non-lordotic’ cervical spine, as demonstrated by the trend in our study. Although rare, vocal cord injury has varying duration of recovery time, in the worst-case scenario being permanent, therefore it needs to be avoided by taking utmost care during positioning of the patient in beach-chair. Level of Evidence Level IV, case series

scholarly journals C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

2020 ◽  
pp. 1-3
Author(s):  
Isabel Snee ◽  
Isabel Snee ◽  
Catherine A. Mazzola
Keyword(s):  
Cervical Spine ◽  
Head Tilt ◽  
Spine Injury ◽  
Halo Traction ◽  
Cord Injury ◽  
Magnetic Resonance Imaging Mri ◽  
Cervical Spine Alignment ◽  
Atlanto Axial Joint ◽  
Spine Radiographs ◽  
Halo Device

We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI) did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1- C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period. During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper cervical spine alignment and resolution of C1-C2 subluxation.

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