scholarly journals Assessment of the Possibilities of B-Mode Ultrasonography in the Diagnosis of Lumbar Intervertebral Discs Protrusion in Adolescents

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Rizvan Ya Abdullaiev ◽  
Ilgar G Mammadov ◽  
Tatyana A Dudnik ◽  
Roman R Abdullaiev
Keyword(s):  
Lumbar Spine ◽  
Spinal Canal ◽  
Lumbar Vertebrae ◽  
Longitudinal Section ◽  
Intervertebral Discs ◽  
Spinal Nerve ◽  
Frequency Of Occurrence ◽  
Axial Section ◽  
Disc Protrusion ◽  
Canal Width

Objective: To improve the efficiency of lumbar intervertebral discs protrusion by determining the ultrasound biomarkers. Materials and Methods: The study included 68 patients with the disc protrusion and 65 healthy adolescents with normal lumbar intervertebral discs and neurologic status aged 16-18 years. Ultrasonography (USG) was performed at the level of disks L1-L2, L2-L3, L3-L4, L4-L5, L5-S1 in longitudinal and transverse projections. In longitudinal section was measured height of lumbar vertebrae and intervertebral discs, in axial section – the sagittal sizes of intervertebral discs and spinal canal, width of spinal nerve canals, thickness of the yellow ligament. Results: In 31 (45,6±6,0%) cases the protrusion was paramedian, in 16 (23,5±5,1%) – posterolateral, in 13 (19,1±4,8) – median and in 8 (11,8±3,9%) – circular types. The paramedian protrusion was significantly more frequently recorded than the posterolateral (P<0,05), median and circular (p <0.001) types. In 7 (10,3±3,7% ) cases the protrusion was localized at the level of L2-L3, in 13 (19,1 ±4,8%) – L3-L4, in 27 (39,7±5,9%) - at the level of L4-L5 and in 21 (30,9±5,6%) – at the level of L5-S1 respectively. There were no significant differences in the frequency of occurrence between L2-L3 and L3-L4, as well as L4-L5 and L5-S1. The lower located lumbar discs were significantly more affected than the upper ones (P<0,05; P<0,001).Conclusions: In adolescents in the lumbar spine, paramedian protrusion are most commonly found, which are most often localized at the level of both L4-L5 and L5-S1. The greatest  narrowing and deformation of the spinal nerve canal is observed by posterolateral and paramedian protrusion. The greatest thickness of the yellow ligament, radiculopathy  is observed at level of L5-S1 protrusion. 

Assessment of the Possibilities of B-Mode Ultrasonography in the Diagnosis of Cervical Intervertebral Discs Hernia in Adolescents

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Rizvan Ya Abdullaiev ◽  
Konul N Ibragimova ◽  
Ibragimova Tatyana A ◽  
Philipp N Gorleku ◽  
Roman R Abdullaiev
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Intervertebral Discs ◽  
Spinal Nerve ◽  
Axial Section ◽  
Disc Hernia ◽  
Neurologic Status ◽  
Space Size

Objective: To improve the efficiency of cervical intervertebral discs hernia by determining the ultrasound biomarkers. Materials and Methods: The study included 38 healthy adolescents with normal intervertebral discs and neurologic status and 21 person with the disc hernia. Ultrasonography (USG) was performed at the level of disks C2-C3, C3-C4, C4-C5, C5-C6, C6-C7, C7-Тh1 in longitudinal and transverse projections. In axial section was performed the sagittal intervertebral disc and spinal canal sizes, the anterior dural space size, the width of spinal nerve canals. Results: In 9 (42,9±10,8% ) cases, the hernia was localized at the level of C5-C6, in 7 (33,3 ±10,3%) - C4-C5, in 2 (9,5±6,4%) - at the level of C2-C3 and C6-C7 C7, in 1 (4,8±4,7%) – at the level of C3-C4 respectively. In 13 (61,9±10,6%) cases the hernia had paramedian, in 5 (23,8±9,3%) cases – median, in 3 (14,3±7,6) cases – posterolateral localization. The paramedian hernia was significantly more frequently recorded than the posterolateral (P<0,05) and median hernia (p <0.001). Conclusions: In adolescents in the cervical spine, paramedian hernia are most commonly found, which are most often localized at the level of both C5-C6 and C4-C5. The greatest narrowing and deformation of the spinal nerve canal is observed by posterolateral and paramedian hernia, dural space – by median hernia respectively.

scholarly journals Midsagittal Anatomy of Lumbar Lordosis in Adult Egyptians: MRI Study

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Abdelmonem A. Hegazy ◽  
Raafat A. Hegazy
Keyword(s):  
Lumbar Spine ◽  
Lumbar Lordosis ◽  
Lumbar Vertebrae ◽  
Clinical Importance ◽  
Diagnostic Technique ◽  
Intervertebral Discs ◽  
Mean Values ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study ◽  
Lower Lumbar

Despite the increasing recognition of the functional and clinical importance of lumbar lordosis, little is known about its description, particularly in Egypt. At the same time, magnetic resonance imaging (MRI) has been introduced as a noninvasive diagnostic technique. The aim of this study was to investigate the anatomy of the lumbar lordosis using midsagittal MRIs. Normal lumbar spine MRIs obtained from 93 individuals (46 males, 47 females; 25–57 years old) were evaluated retrospectively. The lumbar spine curvature and its segments “vertebrae and discs” were described and measured. The lumbar lordosis angle (LLA) was larger in females than in males. Its mean values increased by age. The lumbar height (LH) was longer in males than in females. At the same time, the lumbar breadth (LB) was higher in females than in males. Lumbar index (LI = LB/LH × 100) showed significant gender differences (P<0.0001). Lordosis was formed by wedging of intervertebral discs and bodies of lower lumbar vertebrae. In conclusion, MRI might clearly reveal the anatomy of the lumbar lordosis. Use of LI in association with LLA could be useful in evaluation of lumbar lordosis.

The Symptomatic Incompetent Cervical Intervertebral Disc

Neurosurgery ◽  
1989 ◽  
Vol 25 (2) ◽  
pp. 232-239 ◽  
Author(s):  
John Vassilouthis ◽  
Angelos Kalovithouris ◽  
Athinodoros Papandreou ◽  
Stergios Tegos
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Positive Contrast ◽  
Intervertebral Discs ◽  
Response To Treatment ◽  
Complete Relief ◽  
Surgical Removal ◽  
Nerve Roots ◽  
Disc Protrusion

Abstract A series of 16 patients with symptoms such as pain in the neck, occiput, shoulder and arm; numbness in the hands: and/or difficulty in walking, is described. Neurological examination of the upper extremities disclosed signs of nerve roots dysfunction in 5 patients and long tract signs in 12, whereas examination of the lower extremities disclosed long tract signs in every patient. Positive contrast cervical myelograms suggested mild posterior bulging of one or two intervertebral discs in every patient, but computed tomographic myelograms invariably demonstrated a coincident narrow cervical spinal canal, thus revealing the true compressive potential of the aforementioned mild disc protrusion on the spinal cord. All patients underwent anterior cervical microdiscectomy of the offending disc or discs, which were found to be degenerated. No case of frank rupture of the anulus was identified. Response to treatment was graded as excellent in 12 patients, who had complete relief of symptoms, and good in 4 patients, who had mild residual complaints. This study suggests that incompetence (bulging) of a cervical intervertebral disc may acquire important clinical significance in the presence of a narrow spinal canal by compressing the spinal cord and the corresponding nerve roots. Surgical removal of the diseased disc may result in restoration of neurological function.

scholarly journals A three-dimensional multibody computational model of lumbar spine

2021 ◽  
Author(s):  
Roozbeh Seradj Zadeh
Keyword(s):  
Lumbar Spine ◽  
Computational Model ◽  
Lumbar Vertebrae ◽  
Intervertebral Discs ◽  
The Body ◽  
Upper Body ◽  
Accurate Estimation ◽  
Preliminary Evaluation ◽  
Biomechanical Models ◽  
Custom Made

The lower back is the most sensitive part of the human spine and over loading and bad posture during lifting can damage this area of the body. The lumbar spine consists of five vertebrae, which are responsible for carrying the weight of the upper body and loads. Intervertebral discs allow articulation between vertebrae. These discs are primarily made of non-homogeneous soft tissue, which allows the vertebrae to move and flex in all directions. Biomechanical models have been developed in the past decades to model and to predict the behavior of the spine in response to different loads. With the advances in computer modeling technology, analytical methods have become more popular in modeling the spine. These models are more cost effective and practical compared to the early models and use of human volunteers and cadavers. Unfortunately due to the complexity of the spine, most of the models failed to offer an accurate estimation of reaction moments and forces. Most models also use proprietary and custom-made software which makes it difficult for other researchers to use and modify them. This thesis reports the development and verification of a multi-body computational model of the lumbar spine. The model comprises five lumbar vertebrae (L1 to L5) and pelvis (S1). The vertebrae are connected to each other by invertebral discs, which consist of an anatomically correct kinematic and dynamic constraints. This combination represents a six degree-of-freedom mobility and enables the model to accommodate flexion, lateral bending, and axial rotation. The model is validated by carrying out a series of case studies including experimental motion studies. It is also used for preliminary evaluation of an ergonomical device called the dynamic trunk support (DTS), developed at Ryerson, School of Occupational and Public Health, in conjunction with the Mechanical and Industrial Engineering department. The results are in good agreement with the experimental results.

scholarly journals A three-dimensional multibody computational model of lumbar spine

2021 ◽  
Author(s):  
Roozbeh Seradj Zadeh
Keyword(s):  
Lumbar Spine ◽  
Computational Model ◽  
Lumbar Vertebrae ◽  
Intervertebral Discs ◽  
The Body ◽  
Upper Body ◽  
Accurate Estimation ◽  
Preliminary Evaluation ◽  
Biomechanical Models ◽  
Custom Made

The lower back is the most sensitive part of the human spine and over loading and bad posture during lifting can damage this area of the body. The lumbar spine consists of five vertebrae, which are responsible for carrying the weight of the upper body and loads. Intervertebral discs allow articulation between vertebrae. These discs are primarily made of non-homogeneous soft tissue, which allows the vertebrae to move and flex in all directions. Biomechanical models have been developed in the past decades to model and to predict the behavior of the spine in response to different loads. With the advances in computer modeling technology, analytical methods have become more popular in modeling the spine. These models are more cost effective and practical compared to the early models and use of human volunteers and cadavers. Unfortunately due to the complexity of the spine, most of the models failed to offer an accurate estimation of reaction moments and forces. Most models also use proprietary and custom-made software which makes it difficult for other researchers to use and modify them. This thesis reports the development and verification of a multi-body computational model of the lumbar spine. The model comprises five lumbar vertebrae (L1 to L5) and pelvis (S1). The vertebrae are connected to each other by invertebral discs, which consist of an anatomically correct kinematic and dynamic constraints. This combination represents a six degree-of-freedom mobility and enables the model to accommodate flexion, lateral bending, and axial rotation. The model is validated by carrying out a series of case studies including experimental motion studies. It is also used for preliminary evaluation of an ergonomical device called the dynamic trunk support (DTS), developed at Ryerson, School of Occupational and Public Health, in conjunction with the Mechanical and Industrial Engineering department. The results are in good agreement with the experimental results.

Clinical and Radiographic Correlation (According to CT) in Patients with Degenerative Lumbar Spinal Stenosis

2017 ◽  
pp. 124-130 ◽  
Author(s):  
S. G. Mlyavykh ◽  
A. Y. Aleynik ◽  
A. E. Bokov ◽  
M. V. Rasteryaeva ◽  
M. A. Kutlaeva
Keyword(s):  
Ct Scan ◽  
Spinal Canal ◽  
Clinical Manifestations ◽  
Intervertebral Discs ◽  
Morphometric Parameters ◽  
Neurogenic Claudication ◽  
Clinical Group ◽  
Lumbar Stenosis ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

Сomputed tomography (CT) is widely used in the diagnosis of  degenerative pathology of the lumbar spine, but the relationship  between clinical manifestations of lumbar stenosis and its anatomical prerequisites has not been sufficiently studied to date.The objective: to determine the significance of the morphometric  parameters of lumbar stenosis according to CT scans and to  establish their relationship with the prevailing symptoms of the disease.Material and methods. Seventy-five consecutive patients with  clinically significant lumbar stenosis who underwent CT scan before  surgery were enrolled in this study. The average values of thirteen  different morphometric parameters were calculated at LIII–SI levels of the intervertebral discs and of the pedicels in the axial and sagittal views. The possibility of classification of clinical observations and the correlation of morphometric parameters with the clinical forms of lumbar stenosis were investigated using discriminant and logistic regression analysis. Results. CT scan with high probability allocates patients with  predominant symptoms of neurogenic claudication or bilateral  radiculopathy. The most significant morphometric predictors of this  clinical group are the depth of the lateral recesses and the cross-sectional area of the spinal canal.Conclusion. CT scan significantly expands the informative value of  magnetic resonance imaging and can be used in planning the  decompressive stage of the surgery intervention in patients with lumbar spinal canal stenosis.

scholarly journals Detection of Degenerative Changes on MR Images of the Lumbar Spine with a Convolutional Neural Network: A Feasibility Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 902
Author(s):  
Nils Christian Lehnen ◽  
Robert Haase ◽  
Jennifer Faber ◽  
Theodor Rüber ◽  
Hartmut Vatter ◽  
...  
Keyword(s):  
Neural Network ◽  
Lumbar Spine ◽  
Diagnostic Accuracy ◽  
Nerve Root ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Degenerative Changes ◽  
High Diagnostic Accuracy ◽  
Canal Stenosis ◽  
Disc Herniations

Our objective was to evaluate the diagnostic performance of a convolutional neural network (CNN) trained on multiple MR imaging features of the lumbar spine, to detect a variety of different degenerative changes of the lumbar spine. One hundred and forty-six consecutive patients underwent routine clinical MRI of the lumbar spine including T2-weighted imaging and were retrospectively analyzed using a CNN for detection and labeling of vertebrae, disc segments, as well as presence of disc herniation, disc bulging, spinal canal stenosis, nerve root compression, and spondylolisthesis. The assessment of a radiologist served as the diagnostic reference standard. We assessed the CNN’s diagnostic accuracy and consistency using confusion matrices and McNemar’s test. In our data, 77 disc herniations (thereof 46 further classified as extrusions), 133 disc bulgings, 35 spinal canal stenoses, 59 nerve root compressions, and 20 segments with spondylolisthesis were present in a total of 888 lumbar spine segments. The CNN yielded a perfect accuracy score for intervertebral disc detection and labeling (100%), and moderate to high diagnostic accuracy for the detection of disc herniations (87%; 95% CI: 0.84, 0.89), extrusions (86%; 95% CI: 0.84, 0.89), bulgings (76%; 95% CI: 0.73, 0.78), spinal canal stenoses (98%; 95% CI: 0.97, 0.99), nerve root compressions (91%; 95% CI: 0.89, 0.92), and spondylolisthesis (87.61%; 95% CI: 85.26, 89.21), respectively. Our data suggest that automatic diagnosis of multiple different degenerative changes of the lumbar spine is feasible using a single comprehensive CNN. The CNN provides high diagnostic accuracy for intervertebral disc labeling and detection of clinically relevant degenerative changes such as spinal canal stenosis and disc extrusion of the lumbar spine.

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Nian Chen ◽  
Zhenhua Hong ◽  
Yongyu Zheng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Ventral Side ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions. Methods A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7 ± 8.7 vs 68.4 ± 10.5, P < 0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P < 0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P < 0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

Percutaneous Discectomy: An Anatomical Study

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Steven L. Kanter ◽  
William A. Friedman
Keyword(s):  
Computed Tomography ◽  
Lumbar Spine ◽  
Vascular Injury ◽  
Anatomical Study ◽  
Intervertebral Discs ◽  
Viable Alternative ◽  
Percutaneous Discectomy ◽  
Computed Tomographic ◽  
Anatomical Analysis ◽  
Computed Tomographic Scan

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.

Computed Tomographic Discography in the Evaluation of Extreme Lateral Disc Herniation

Neurosurgery ◽  
1984 ◽  
Vol 14 (3) ◽  
pp. 350-352 ◽  
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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