scholarly journals Sagittal Profile and Flexion Restriction of the Thoracic Spine are Essential Elements in the Pathogenesis of Thoracic AIS

2021 ◽  
Vol 03 (01) ◽  
Author(s):  
Mikko Poussa
Keyword(s):  
Thoracic Spine ◽  
Essential Elements ◽  
Sagittal Profile

scholarly journals Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ang Gao ◽  
Yongqiang Wang ◽  
Miao Yu ◽  
Xiaoguang Liu
Keyword(s):  
Disc Herniation ◽  
Thoracic Spine ◽  
Normal Population ◽  
Sagittal Profile ◽  
Sacral Slope ◽  
Type I ◽  
Type Ii ◽  
Radiographic Parameters ◽  
Significant Difference ◽  
Thoracolumbar Region

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters. Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The sagittal profile was similar to that of the normal population in type I, presenting the apex of the thoracic kyphotic curve located in the middle thoracic spine. The well aligned thoracic-lumbar curve was disrupted in type II, presenting the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9 ± 24.8°, 8.2 ± 7.3° and 6.2 ± 4.9°, respectively. There was significant difference (p < 0.001) of thoracolumbar angle between type I (14.9 ± 7.9°) and type II patients (29.1 ± 13.7°). Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In type I patients, disc degeneration was accelerated by regional kyphosis in the thoracolumbar junction and eventually caused disc herniation. In type II patients, excessive mechanical stress was directly loaded at the top of the curve (thoracolumbar apex region) rather than being diverted by an arc as in a normal population or type I patients. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.

scholarly journals Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients

2020 ◽  
Author(s):  
Ang Gao ◽  
Yongqiang Wang ◽  
Miao Yu ◽  
Xiaoguang Liu
Keyword(s):  
Disc Herniation ◽  
Thoracic Spine ◽  
Normal Population ◽  
Sagittal Profile ◽  
Sacral Slope ◽  
Type I ◽  
Type Ii ◽  
Radiographic Parameters ◽  
Significant Difference ◽  
Thoracolumbar Region

Abstract Background: Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters.Methods: Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype.Results: We found two subtypes differentiated by the apex of thoracic kyphotic curves. The sagittal profile was similar to that of the normal population in type I, presenting the apex of the thoracic kyphotic curve located in the middle thoracic spine. The well aligned thoracic-lumbar curve was disrupted in type II, presenting the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions: We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In type I patients, disc degeneration was accelerated by regional kyphosis in the thoracolumbar junction and eventually caused disc herniation. In type II patients, excessive mechanical stress was directly loaded at the top of the curve (thoracolumbar apex region) rather than being diverted by an arc as in a normal population or type I patients. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.

scholarly journals Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

2020 ◽  
Author(s):  
Ang Gao ◽  
Yongqiang Wang ◽  
Miao Yu ◽  
Xiaoguang Liu
Keyword(s):  
Disc Herniation ◽  
Thoracic Spine ◽  
Lumbar Disc ◽  
Sagittal Profile ◽  
Type I ◽  
Type Ii ◽  
Sagittal Vertical Axis ◽  
Radiographic Parameters ◽  
Significant Difference ◽  
Thoracolumbar Region

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH)The aim of study is to investigate sagittal alignment in TLDH, and analyze sagittal profile with radiographic parameters.Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameters values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The apex of the thoracic kyphotic curve located in the middle thoracic spine in type I, and the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I patients (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In view of the different curvatures, different aetiologies were discovered in each subtype. Mismatch between shape and SS value was observed, and better agreement was found in Type II patients.

scholarly journals Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients

2020 ◽  
Author(s):  
Ang Gao ◽  
Miao Yu ◽  
Yongqiang Wang ◽  
Xiaoguang Liu
Keyword(s):  
Disc Herniation ◽  
Thoracic Spine ◽  
Lumbar Disc ◽  
Sagittal Profile ◽  
Sacral Slope ◽  
Type I ◽  
Type Ii ◽  
Radiographic Parameters ◽  
Significant Difference ◽  
Thoracolumbar Region

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters.Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The apex of the thoracic kyphotic curve located in the middle thoracic spine in type I, and the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In view of the different curvatures, different aetiologies were discovered in each subtype. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.

scholarly journals Non-uniform Segmental Range of Motion of the Thoracic Spine During Maximal Inspiration and Exhalation in Healthy Subjects

2021 ◽  
Vol 8 ◽  
Author(s):  
Jesús Burgos ◽  
Carlos Barrios ◽  
Gonzalo Mariscal ◽  
Alejandro Lorente ◽  
Rafael Lorente
Keyword(s):  
Range Of Motion ◽  
Thoracic Spine ◽  
Thoracic Kyphosis ◽  
Cross Sectional Study ◽  
Sagittal Profile ◽  
Deep Breathing ◽  
Cross Sectional ◽  
Wide Range ◽  
Relevant Role ◽  
Study Participants

Background and Objective: To analyse the range of motion of the thoracic spine by radiographically measuring changes in the sagittal profile of different thoracic segments during maximal inspiration and exhalation. The starting hypothesis was that forced deep breathing requires an active, but non-uniform widening of the lordotic–kyphotic range of motion of the different thoracic segments.Methods: Cross-sectional study. Participants were 40 healthy volunteers aged 21–60. Conventional anteroposterior and functional sagittal chest radiographs were performed during maximal inspiration and exhalation. The range of motion of each spinal thoracic functional segment, global T1–T12 motion, and the sagittal displacement of the thoracic column during breathing were measured. Considering the different type of ribs and their attachment the spine and sternum, thoracic segments were grouped in T1–T7, T7–T10, and T10–T12. The displacement of the thoracic spine with respect to the sternum and manubrium was also recorded.Results: The mean difference from inspiration to exhalation in the T1–T12 physiologic kyphosis was 15.9° ± 4.6°, reflecting the flexibility of the thoracic spine during deep breathing (30.2%). The range of motion was wider in the caudal hemicurve than in the cranial hemicurve, indicating more flexibility of the caudal component of the thoracic kyphosis. A wide range of motion from inspiration to exhalation was found at T7–T10, responsible for 73% of T1–T12 sagittal movement. When the sample was stratified according to age ranges (20–30, 30–45, and 45–60 yr.), none of the measurements for inspiration or exhalation showed statistically significant differences.Only changes at this level showed a positive correlation with changes in the global thoracic kyphosis (r = 0.794, p &lt;0.001).Conclusion: The range of motion of the thoracic spine plays a relevant role in respiration dynamics. Maximal inspiration appears to be highly dependent on the angular movements of the T7–T10 segment.

Effective Clinical Interviewing

1978 ◽  
Vol 9 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Pauline T. Flynn
Keyword(s):  
Family Members ◽  
Essential Elements ◽  
Speech Language Pathologist ◽  
Lay Persons ◽  
Clinical Interviewing ◽  
Client Management

Speech, language, and hearing professionals rely on many individuals to provide information about a client. Management programs, in part, are devised, modified, and evaluated according to responses obtained from the client, family members, educators, and other professional and lay persons who have contact with the client. The speech-language pathologist has the responsibility of obtaining pertinent, complete, unbiased information about clients. This article provides an overview of the essential elements of an interview.

Chronic immobilization stress induces anxiety-related behaviors and affects brain essential minerals in male rats

2020 ◽  
pp. 1-8
Author(s):  
Zafer Sahin ◽  
Alpaslan Ozkurkculer ◽  
Omer Faruk Kalkan ◽  
Ahmet Ozkaya ◽  
Aynur Koc ◽  
...  
Keyword(s):  
Immobilization Stress ◽  
Central Area ◽  
Essential Elements ◽  
Male Rats ◽  
Control Group ◽  
Male Wistar Rats ◽  
Swimming Test ◽  
The Brain ◽  
Center Area ◽  
Chronic Immobilization Stress

Abstract. Alterations of essential elements in the brain are associated with the pathophysiology of many neuropsychiatric disorders. It is known that chronic/overwhelming stress may cause some anxiety and/or depression. We aimed to investigate the effects of two different chronic immobilization stress protocols on anxiety-related behaviors and brain minerals. Adult male Wistar rats were divided into 3 groups as follows ( n = 10/group): control, immobilization stress-1 (45 minutes daily for 7-day) and immobilization stress-2 (45 minutes twice a day for 7-day). Stress-related behaviors were evaluated by open field test and forced swimming test. In the immobilization stress-1 and immobilization stress-2 groups, percentage of time spent in the central area (6.38 ± 0.41% and 6.28 ± 1.03% respectively, p < 0.05) and rearing frequency (2.75 ± 0.41 and 3.85 ± 0.46, p < 0.01 and p < 0.05, respectively) were lower, latency to center area (49.11 ± 5.87 s and 44.92 ± 8.04 s, p < 0.01 and p < 0.01, respectively), were higher than the control group (8.65 ± 0.49%, 5.37 ± 0.44 and 15.3 ± 3.32 s, respectively). In the immobilization stress-1 group, zinc (12.65 ± 0.1 ppm, p < 0.001), magnesium (170.4 ± 1.7 ppm, p < 0.005) and phosphate (2.76 ± 0.1 ppm, p < 0.05) levels were lower than the control group (13.87 ± 0.16 ppm, 179.31 ± 1.87 ppm and 3.11 ± 0.06 ppm, respectively). In the immobilization stress-2 group, magnesium (171.56 ± 1.87 ppm, p < 0.05), phosphate (2.44 ± 0.07 ppm, p < 0.001) levels were lower, and manganese (373.68 ± 5.76 ppb, p < 0.001) and copper (2.79 ± 0.15 ppm, p < 0.05) levels were higher than the control group (179.31 ± 1.87 ppm, 3.11 ± 0.06 ppm, 327.25 ± 8.35 ppb and 2.45 ± 0.05 ppm, respectively). Our results indicated that 7-day chronic immobilization stress increased anxiety-related behaviors in both stress groups. Zinc, magnesium, phosphate, copper and manganese levels were affected in the brain.

Guideline for radioimmunotherapy of rituximab relapsed or refractory CD20+ follicular B-cell nonHodgkin´s lymphoma

2004 ◽  
Vol 43 (05) ◽  
pp. 171-176 ◽  
Author(s):  
T. Behr ◽  
F. Grünwald ◽  
W. H. Knapp ◽  
L. Trümper ◽  
C. von Schilling ◽  
...  
Keyword(s):  
Quality Control ◽  
Quality Management ◽  
Medical Physics ◽  
Essential Elements ◽  
Background Information ◽  
After Care ◽  
Complete Treatment ◽  
Close Cooperation ◽  
Work Up

Summary:This guideline is a prerequisite for the quality management in the treatment of non-Hodgkin-lymphomas using radioimmunotherapy. It is based on an interdisciplinary consensus and contains background information and definitions as well as specified indications and detailed contraindications of treatment. Essential topics are the requirements for institutions performing the therapy. For instance, presence of an expert for medical physics, intense cooperation with all colleagues committed to treatment of lymphomas, and a certificate of instruction in radiochemical labelling and quality control are required. Furthermore, it is specified which patient data have to be available prior to performance of therapy and how the treatment has to be carried out technically. Here, quality control and documentation of labelling are of greatest importance. After treatment, clinical quality control is mandatory (work-up of therapy data and follow-up of patients). Essential elements of follow-up are specified in detail. The complete treatment inclusive after-care has to be realised in close cooperation with those colleagues (haematology-oncology) who propose, in general, radioimmunotherapy under consideration of the development of the disease.

Moving Beyond Inclusion to Participation: Essential Elements

2019 ◽  
pp. 54-67
Author(s):  
Toby Long
Keyword(s):  
Early Childhood ◽  
Early Childhood Education ◽  
Education System ◽  
Children With Disabilities ◽  
Essential Elements ◽  
Evidence Based ◽  
Childhood Education ◽  
Everyday Activities ◽  
Meaningful Participation ◽  
Full Participation

This paper discusses the evolution of the early childhood education system from excluding children with disabilities to fully including them in a manner emphasizing full participation.&nbsp; Evidence indicates meaningful participation in everyday activities is necessary for development to occur. The essential elements needed to bring about participation will be presented as well as specific evidence-based strategies used to promote inclusion and participation.

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