scholarly journals Main Types of Vertebrates in Spine Tumors (Prospective Study)

2021 ◽  
Vol 6 (1) ◽  
pp. 91-95
Author(s):  
M. Korzh ◽  
◽  
V. Kutsenko ◽  
A. Popov ◽  
O. Perfiliev
Keyword(s):  
Vertebral Body ◽  
Spinal Cord Injuries ◽  
Lumbar Vertebrae ◽  
Posterior Wall ◽  
Neurological Complications ◽  
Spinal Tumors ◽  
Prospective Analysis ◽  
Anatomical Structures ◽  
Neoplastic Processes ◽  
Bone Edema

Damage to the vertebrae as a result of neoplastic processes leads to serious health consequences for people of all ages and genders. Unsuccessfully constructed tactics for the treatment of primary and metastatic spinal lesions are the result of severe orthopedic and neurological complications, which can lead to fatal consequences. To decide what type of surgery to perform, you need to have more information than the type of tumor. To create a rational algorithm for the treatment of patients with loss of spinal support due to neoplastic lesions of the thoracic and lumbar vertebrae should consider the features of damage to the anatomical structures of the spinal motor segment and identify the main types of vertebral injuries. The purpose of the study was based on a prospective analysis of patients with spinal cord injuries, and description of the types of vertebral injuries. Material and methods. In the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. In the period from 2008 to 2017, 264 patients with pathological changes in the spine were diagnosed. The age of patients was from 18 to 81 years. There were 137 men and 131 women. 39 (14.8%) patients did not have vertebral body deformity accompanied by bone edema, 168 (63.6%) patients had vertebral body damage without destruction of other anatomical structures, 52 (19.7%) patients were diagnosed with deformation of the vertebral body with damage to the arches and joints, and 5 (1.9%) patients had damage to the posterior support complex. Results and discussion. As a result of a prospective analysis of patients with spinal tumors, 5 types of vertebral lesions were identified by cancer: 1 – without deformation, accompanied by bone edema and visualized on MRI; 2 – deformation of the vertebral body up to 30% without damage to the posterior wall or with a small defect; 3 – deformation of the vertebral body > 30%, but < 60% with damage to the posterior vertebral wall; 4 – deformation of the vertebral body> 60% with damage to the posterior vertebral wall; 5 – deformation of the vertebral body with damage to the arches and joints. Conclusion. As a result of damage to the anatomical structures of the vertebrae by the tumor process, important morphological features were identified: the degree of damage to the vertebral body; the magnitude of local kyphosis; deformation of the posterior wall of the vertebral body, on the basis of which the types of vertebral injuries are determined

scholarly journals Endplate Deficits And Posterior Wall Injury Are Predictive Of Prolonged Back Pain After Osteoporotic Vertebral Body Fracture

2021 ◽  
Author(s):  
Masatoshi Teraguchi ◽  
Mamoru Kawakami ◽  
Yoshio Enyo ◽  
Ryohei Kagotani ◽  
Yoshimasa Mera ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Body ◽  
Posterior Wall ◽  
Vertebral Body Fracture ◽  
Body Fracture ◽  
Wall Injury

scholarly journals Functional Outcome Following Synthetic Vertebral Body Implantation in the Management of Spinal Disorders

2020 ◽  
Vol 8 (B) ◽  
pp. 76-80
Author(s):  
Moneer K. Faraj ◽  
Bassam Mahmood Flamerz  Arkawazi ◽  
Hazim Moojid Abbas ◽  
Zaid Al-Attar
Keyword(s):  
Functional Outcome ◽  
Vertebral Body ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Spinal Tuberculosis ◽  
Vertebral Body Replacement ◽  
Spinal Tumors ◽  
Karnofsky Performance Status Scale ◽  
Significant Change

OBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurological improvement in all spinal TB cases. Mortality recorded in only 4 cases with metastatic spinal tumor during the mean period of follow-up. Karnofsky performance status scale showed statistically significant change for spinal TB, and tumor cases during the follow-up period, but there was no significant change in cases of spinal type A3 fractures. CONCLUSION: The positive outcome of this surgery makes it recommended for properly selected patients, especially with spinal TB and tumors.

scholarly journals Transesophageal endoscopic ultrasound fine needle aspiration of vertebral body osteolytic tumors – a novel diagnostic approach. Case series.

2020 ◽  
Author(s):  
Romeo Ioan Chira ◽  
Alina Florea ◽  
Vlad Ichim ◽  
Liliana Rogojan ◽  
Alexandra Chira ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Traditional Approach ◽  
Case Series ◽  
Lumbar Vertebrae ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle

Aims: Vertebral lesions, either primary or more frequently metastasis, are difficult targets for percutaneous guided biopsies and surgical biopsies and are associated with greater risks of complications. We investigated the feasibility of endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsy in the assessment of vertebral osteolytic tumors as an alternative to CT guided biopsy which is the technique currently used.Material and methods: Four patients with osteolytic tumors of the vertebral bodies identified by imaging methods (CT or MRI) – 3 patients, and one with a tumor detected primarily during EUS procedure were included in order to evaluate the feasibility of the procedure. The lesions were located either at the dorsal or lumbar vertebrae. In all cases we performed EUS FNA of the osteolytic vertebral body lesions with 22G needles using the transesophageal or transgastric approach.Results: In all cases EUS FNA provided enough tissue for an accurate histopathological report, with no procedural complication. We diagnosed lung adenocarcinoma, hepatocarcinoma and a pancreatic adenocarcinoma vertebral metastasis and one case of lymphoma.Conclusions: EUS FNA is a valuable technique which should be considered in selected cases, when a “traditional approach” is not applicable or associated with a higher risk. Treatment guidelines are based on the histology of the tumor, histopathological examination being nowadays mandatory. Therefore, we propose for selected cases a feasible technique, with significantly lower procedural risks, as an alternative for open surgical biopsies or computed tomography guided biopsies

The locomotor system

2013 ◽  
Author(s):  
Martin E. Atkinson
Keyword(s):  
Vertebral Column ◽  
Cervical Vertebrae ◽  
Lumbar Vertebrae ◽  
Posterior Wall ◽  
Axial Skeleton ◽  
Intervertebral Discs ◽  
Central Canal ◽  
The Body ◽  
Thoracic Vertebrae ◽  
Locomotor System

The locomotor system comprises the skeleton, composed principally of bone and cartilage, the joints between them, and the muscles which move bones at joints. The skeleton forms a supporting framework for the body and provides the levers to which the muscles are attached to produce movement of parts of the body in relation to each other or movement of the body as a whole in relation to its environment. The skeleton also plays a crucial role in the protection of internal organs. The skeleton is shown in outline in Figure 2.1A. The skull, vertebral column, and ribs together constitute the axial skeleton. This forms, as its name implies, the axis of the body. The skull houses and protects the brain and the eyes and ears; the anatomy of the skull is absolutely fundamental to the understanding of the structure of the head and is covered in detail in Section 4. The vertebral column surrounds and protects the spinal cord which is enclosed in the spinal canal formed by a large central canal in each vertebra. The vertebral column is formed from 33 individual bones although some of these become fused together. The vertebral column and its component bones are shown from the side in Figure 2.1B. There are seven cervical vertebrae in the neck, twelve thoracic vertebrae in the posterior wall of the thorax, five lumbar vertebrae in the small of the back, five fused sacral vertebrae in the pelvis, and four coccygeal vertebrae—the vestigial remnants of a tail. Intervertebral discs separate individual vertebrae from each other and act as a cushion between the adjacent bones; the discs are absent from the fused sacral vertebrae. The cervical vertebrae are small and very mobile, allowing an extensive range of neck movements and hence changes in head position. The first two cervical vertebrae, the atlas and axis, have unusual shapes and specialized joints that allow nodding and shaking movements of the head on the neck. The thoracic vertebrae are relatively immobile. combination of thoracic vertebral column, ribs, and sternum form the thoracic cage that protects the thoracic organs, the heart, and lungs and is intimately involved in ventilation (breathing).

P0895THE RELATIONSHIP OF ARTERIAL CALCIFICATIONS IN CHRONIC KIDNEY DISEASE PATIENTS WITH INDIRECT ANTICOAGULANT INTAKE AND HEART MORBIDITY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Asen Kamenov ◽  
Stoyanka Georgieva ◽  
Dobrina Mlachkova ◽  
Daniela Valentinova Monova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vertebral Body ◽  
Vitamin K ◽  
Abdominal Aorta ◽  
Lumbar Vertebrae ◽  
Calcium Score ◽  
Arterial Calcification ◽  
Vitamin K Deficiency ◽  
K Deficiency

Abstract Background and Aims In patients with chronic kidney disease (CKD), arterial calcification (AC) is a potential mechanism for the progression of cardiovascular disease. AC is common in CKD patients and is a consequence of mineral-bone disorders. Indirect anticoagulants or vitamin K deficiency lead to matrix γ-carboxyglutamate decarboxylation, which may potentiate vascular calcification formation. The impaired renal function and indirect anticoagulants intake may lead to vitamin K deficiency and increased AC. The aim of this study is to determine if oral intake of Acenocoumarol has influence on abdominal aorta calcium score (AACS) and the AC relation with atrial fibrillation (AF) and / or ischemic heart disease (IHD) morbidity. Method We observe 129 patients with CKD (glomerular filtration rate below 44 ml/min/1,73 m2, MDRD formula calculated). X - ray of the lateral abdominal aorta is performed for the AACS assessment according to L. I. Kauppila et al. method. The assessment of calcium score is formed by the involvement grade of each segment on the anterior and posterior wall of the vessel along the first four lumbar vertebrae. Calcification affecting less than 1/3 of the anterior wall of the aorta along the lumbar vertebral body receives 1 score and calcification extending over ½ of the vertebral body length receives 3 scores (total score - 24). The patients are distributed into three groups: I group with calcium score from 0 to 7, II - from 8 to 15 and III group - from 16 to 24. The data from assessed AACS are compared with Acenocoumarol intake and the presence/absence of AF and/or IHD. The results are processed with χ2 statistical analysis. Results One hundred twenty nine patients with CKD (95 males and 34 females) are included in the study. The patients data (mean, percentages, degrees, etc.) are summarized in tabl.1 and tabl. 2. Clinically significant is the correlation between the grades of AACS and Acenocoumarol intake (p &lt; 0,05). With the calcium score increasing, the patients percentage treated with Acenocoumarol also increases (fig. 1). There is a moderate correlation (Cramer’s coefficient is 0,39) between the AACS grades and heart morbidity from AF and / or IHD (p &lt; 0,05). The data shows that the higher calcium score is related with increased patients percentage with AF and / or IHD morbidity (fig. 2). In our study, vascular calcifications are found in the abdominal aorta walls in all of the observed patients. We found that a higher AACS is associated with an Acenocoumarol intake in CKD patients and corresponds to an increased morbidity of AF and / or IHD. Acenocoumarol intake may lead to increased AACS. The higher calcium score is associated with a higher incidence of AF and / or IHD morbidity. Conclusion The study outcome supported the hypothesis that the increased AC formation and cardiovascular morbidity high risk could be a reason for the limited vitamin K antagonists (acenocoumarol) use in CKD patients. Furthermore, vitamin K2 supplementation is reasonable and may reduce the progression of AC.

scholarly journals Mechanical Cavity Creation with Curettage and Vacuum Suction (Q-VAC) in Lytic Vertebral Body Lesions with Posterior Wall Dehiscence and Epidural Mass before Cement Augmentation

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 633
Author(s):  
Piechowiak ◽  
Isalberti ◽  
Pileggi ◽  
Distefano ◽  
Hirsch ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Vertebral Body ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Cement Leakage ◽  
Cement Augmentation ◽  
Tissue Mass ◽  
Vacuum Suction ◽  
Tumor Debulking ◽  
Vertebral Body Stenting

Background and Objectives: We describe a novel technique for percutaneous tumor debulking and cavity creation in patients with extensive lytic lesions of the vertebral body including posterior wall dehiscence prior to vertebral augmentation (VA) procedures. The mechanical cavity is created with a combination of curettage and vacuum suction (Q-VAC). Balloon kyphoplasty and vertebral body stenting are used to treat neoplastic vertebral lesions and might reduce the rate of cement leakage, especially in presence of posterior wall dehiscence. However, these techniques could theoretically lead to increased intravertebral pressure during balloon inflation with possible mobilization of soft tissue tumor through the posterior wall, aggravation of spinal stenosis, and resultant complications. Creation of a void or cavity prior to balloon expansion and/or cement injection would potentially reduce these risks. Materials and Methods: A curette is coaxially inserted in the vertebral body via transpedicular access trocars. The intravertebral neoplastic soft tissue is fragmented by multiple rotational and translational movements. Subsequently, vacuum aspiration is applied via one of two 10 G cannulas that had been introduced directly into the fragmented lesion, while saline is passively flushed via the contralateral cannula, with lavage of the fragmented solid and fluid-necrotic tumor parts. Results: We applied the Q-VAC technique to 35 cases of thoracic and lumbar extreme osteolysis with epidural mass before vertebral body stenting (VBS) cement augmentation. We observed extravertebral cement leakage on postoperative CT in 34% of cases, but with no clinical consequences. No patients experienced periprocedural respiratory problems or new or worsening neurological deficit. Conclusion: The Q-VAC technique, combining mechanical curettage and vacuum suction, is a safe, inexpensive, and reliable method for percutaneous intravertebral tumor debulking and cavitation prior to VA. We propose the Q-VAC technique for cases with extensive neoplastic osteolysis, especially if cortical boundaries of the posterior wall are dehiscent and an epidural soft tissue mass is present.

scholarly journals A rare case of stiff left atrial syndrome caused by both coconut left atrium and vertebral compression: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Junichi Ooka ◽  
Kensuke Matsumoto ◽  
Morihiko Kondo ◽  
Toshiyuki Otomo
Keyword(s):  
Left Atrium ◽  
Vertebral Body ◽  
Rare Condition ◽  
Posterior Wall ◽  
Decompensated Heart Failure ◽  
Unusual Complication ◽  
Multidetector Row Computed Tomography ◽  
Pulmonary Capillary ◽  
History Of ◽  
V Wave

Abstract Background Calcification of the left atrium (LA) is a rare condition and can be the result of long-standing rheumatic mitral stenosis or an unusual complication after mitral valve replacement. Cases of massive LA calcification have sometimes been referred to as those with ‘coconut LA’ or ‘porcelain LA’. Case summary A 75-year-old woman was referred to our hospital because of chest discomfort and exertional dyspnoea. Doppler echocardiography revealed the presence of elevated filling pressure with significant LA dysfunction. A cardiac catheter examination revealed a quite impressive pulmonary capillary wedge pressure waveform with a steep up-slope and prominent v wave of 43 mmHg (mean: 15 mmHg). Multidetector row computed tomography revealed that LA was sandwiched by dense calcifications along the roof and bottom of the LA, and the posterior wall was compressed by a vertebral body. Integration of these functional and anatomical findings ultimately led to the diagnosis of ‘stiff LA syndrome’. Discussion She had a history of tuberculosis but no history of rheumatic fever or cardiac surgery. Thus, it appeared that the tuberculous pericarditis might have led to the calcified LA by long lasting inflammation. In this case, the LA was encased by a dense calcification and compressed by vertebral body from the posterior direction. Therefore, we speculated that the LA pressure could easily elevate even with a slight haemodynamic load in this special case, and thus eventually resulting in decompensated heart failure.

scholarly journals Vertebral body replacement with an expandable cage for reconstruction after spinal tumor resection

2003 ◽  
Vol 15 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Issada Thongtrangan ◽  
Raju S. V. Balabhadra ◽  
Hoang Le ◽  
Jon Park ◽  
Daniel H. Kim
Keyword(s):  
Vertebral Body ◽  
Tumor Resection ◽  
Anterior Column ◽  
Vertebral Body Replacement ◽  
Spinal Tumors ◽  
Wide Resection ◽  
Primary Tumors ◽  
Expandable Cage ◽  
Expandable Cages

Object The authors report their clinical experience with expandable cages used to stabilize the spine after verte-brectomy. The objectives of surgical treatment for spine tumors include a decrease in pain, decompression of the neural elements, mechanical stabilization of the spine, and wide resection to gain local control of certain primary tumors. Most of the lesions occur in the anterior column or vertebral body (VB). Anterior column defects following resection of VBs require surgical restoration of anterior column support. Recently, various expandable cages have been developed and used clinically for VB replacement (VBR). Methods Between January 2001 and June 2003, the authors treated 15 patients who presented with primary spinal tumors and metastatic lesions from remote sites. All patients underwent vertebrectomy, VBR with an expandable cage, and anterior instrumentation with or without posterior instrumentation, depending on the stability of the involved segment. The correction of kyphotic angle was achieved at an average of 20°. Pain scores according to the visual analog scale decreased from 8.4 to 5.2 at the last follow-up review. Patients whose Frankel neurological grade was below D attained at least a one-grade improvement after surgery. All patients achieved immediate stability postsurgery and there were no significant complications related to the expandable cage. Conclusions The advantage of the expandable cage is that it is easy to use because it permits optimal fit and correction of the deformity by in vivo expansion of the device. These results are promising, but long-term follow up is required.

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