scholarly journals A hospital based plain radiographic observational study of lumbosacral transitional vertebrae in the Nepalese population

2018 ◽  
Vol 9 (4) ◽  
pp. 46-50
Author(s):  
Manoj Bhattarai
Keyword(s):  
Observational Study ◽  
Lumbosacral Spine ◽  
Type I ◽  
Cross Sectional ◽  
Transitional Vertebra ◽  
Type Iv ◽  
Wide Range ◽  
Clinical Consequences ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae

Background: Presence of lumbosacral transitional vertebra may lead to number of clinical consequences because of failure to correctly number the problematic vertebra and also has been associated with low back pain. Different studies done at different part of the world have shown wide range of prevalence of lumbosacral transitional vertebra.Aims and Objective: This hospital based cross sectional observational study was undertaken to determine the prevalence of lumbosacral transitional vertebra among the Nepalese population.Materials and Methods: Plain radiographs (anteroposterior and lateral views of lumbosacral spine and KUB radiographs) of 947 patients (646 with lumbosacral spine and 301 with KUB radiographs) done from August 2015 to July 2016 and meeting inclusion criteria were retrospectively analyzed for the presence of lumbosacral transitional vertebra.Results: The overall prevalence of lumbosacral transitional vertebra was 14.7% with prevalence of 16.3% in patients with lumbosacral radiographs and 11.3% in patients with KUB radiographs and was statistically significant. Prevalence of sacralization was higher than lumbarization (11.9% Vs 2.7%). Lumbosacral transitional vertebra was more common in females than in males with Castellvi type I being most common and type IV least common.Conclusion: The overall prevalence of lumbosacral transitional vertebra in the studied Nepalese population was 14.7% with significantly higher prevalence in patients with lumbosacral radiographs than with KUB radiographs.Asian Journal of Medical Sciences Vol.9(4) 2018 46-50

scholarly journals Prevalence of lumbosacral transitional vertebrae in dogs in the Czech Republic

2014 ◽  
Vol 83 (4) ◽  
pp. 399-403 ◽  
Author(s):  
Iva Fialová ◽  
Michaela Paninárová ◽  
Alois Nečas ◽  
Ladislav Stehlík ◽  
Pavel Proks
Keyword(s):  
Czech Republic ◽  
Cauda Equina ◽  
Lumbosacral Spine ◽  
Type I ◽  
Type Ii ◽  
German Shepherd ◽  
The Czech Republic ◽  
Transitional Vertebra ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae

Lumbosacral transitional vertebra is a common congenital anomaly of the spine in dogs. It is a predisposing factor for degeneration of the lumbosacral spine and development of cauda equina syndrome or hip dysplasia in affected dogs. The aim of the study was to determine breed predisposition, types, and prevalence of lumbosacral transitional vertebrae in the canine population in the Czech Republic. The value of laterolateral radiographs of the lumbosacral junction in the diagnosis of LTV was also evaluated. Prevalence of lumbosacral transitional vertebrae was determined by reviewing ventrodorsal radiographs of pelvis with an extended hip of 1,878 dogs. Lumbosacral transitional vertebrae were detected in 188 dogs (10%). German Shepherd, Alaskan Malamute and Bohemian Shepherd were found to be highly predisposed breeds. The most common type of lumbosacral transitional vertebra was type II with separation of the first sacral vertebra from sacrum and presence of rudimentary intervertebral space between S1 and the sacral median crest (37.8% of the lumbosacral transitional vertebrae). Type I was detected in 29.2% and the asymmetric type of the lumbosacral transitional vertebra (type III) in 33%. Laterolateral radiograph of the lumbosacral spine was evaluated in 126 dogs from 188 with lumbosacral transitional vertebrae. Rudimentary intervertebral disc space between S1 and S2 in laterolateral radiographs was detected in 100% of lumbosacral transitional vertebrae with type II and III, and was not detected in type I. The findings on lumbosacral transitional vertebrae in the Czech Republic will extend knowledge about the disease. Both ventrodorsal hip-extended and laterolateral radiographs should be recommended for routine screening and reliable differentiation among the three different types of lumbosacral transitional vertebra.

scholarly journals Surgical Treatment of a Rare Presentation of Bertolotti's Syndrome from Castellvi Type IV Lumbosacral Transitional Vertebra: Case Report and Review of the Literature

2018 ◽  
Vol 79 (03) ◽  
pp. e70-e74 ◽  
Author(s):  
Ryan Adams ◽  
Sarah Herrera-Nicol ◽  
Arthur Jenkins
Keyword(s):  
Back Pain ◽  
Surgical Treatment ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Complete Fusion ◽  
Type I ◽  
Type Iii ◽  
Transitional Vertebra ◽  
Type Iv ◽  
The Right

Background Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%,3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion.5 The most common types of LSTV that present with symptomatic Bertolotti's syndrome are the Castellvi type I and type II; type III and type IV variants rarely present with symptoms referable with confirmatory and provocative testing to the transitional vertebra itself, and therefore there is limited experience and no case reports of treatment toward this particular entity. Case Description We illustrated a case of a 37 years old female in which a computed tomography scan demonstrated type III LSTV on the left and a type I anomaly on the right. The patient presented with right-sided leg pain and left-sided sacroiliac (SI) region low back pain, worse with rotation and standing, for several years, and had been on daily narcotic pain medications for more than 2 years. The patient had temporary relief of her leg pain with a transverse/ALA injection on the right, but no improvement in her back pain, whereas a left-sided injection into the region around the type III interface on the left did transiently alleviate her SI pain without improvement in her leg pain. We proposed that this particular anomaly induced mechanical back pain on the left side by flexion of the bone bridge (a form of stress-fracture, with associated sclerotic changes in the interface in the transverse/ALA junction) with associated irritation of the right L5 nerve from the type I anomaly on the right in conjunction with her typical radiating leg pain on the right. A patent, but somewhat hypoplastic L5/S1 disk space was also present. Nonsegmental pedicle screw instrumentation with low-profile screws was implanted on the right side with fusion induced using allograft and off label use of infuse rh-BMP2 bone graft substitute, and the patient was discharged the same day. The patient noted immediate improvement in her preoperative symptoms, and by 2 weeks after her surgery noted complete resolution of the preoperative symptoms, and required no narcotic medications to control her incisional pain. Conclusion Patients who present with symptoms consistent with Bertolotti's syndrome, even if they have a type III or type IV LSTV, should be considered for surgical treatment of their LSTV. These patients can respond well, even if symptoms have been present for years. Given the prevalence of these anatomic variants in the general population (10–12% in most series), Bertolotti's syndrome should be considered in the differential diagnosis of any patient with a presentation of L5 radiculopathy and/or back pain.

scholarly journals Segmented lordotic angles to assess lumbosacral transitional vertebra on EOS

2020 ◽  
Vol 29 (10) ◽  
pp. 2470-2476 ◽  
Author(s):  
Domenico Albano ◽  
Carmelo Messina ◽  
Angelo Gambino ◽  
Martina Gurgitano ◽  
Carmelo Sciabica ◽  
...  
Keyword(s):  
Type I ◽  
Type Ii ◽  
Optimal Cutoff ◽  
Chi Square ◽  
Type Iii ◽  
Bony Fusion ◽  
Transitional Vertebra ◽  
Type Iv ◽  
Lumbar Segment ◽  
Lumbosacral Transitional Vertebra

Abstract Purpose To test the vertical posterior vertebral angles (VPVA) of the most caudal lumbar segments measured on EOS to identify and classify the lumbosacral transitional vertebra (LSTV). Methods We reviewed the EOS examinations of 906 patients to measure the VPVA at the most caudal lumbar segment (cVPVA) and at the immediately proximal segment (pVPVA), with dVPVA being the result of their difference. Mann–Whitney, Chi-square, and ROC curve statistics were used. Results 172/906 patients (19%) had LSTV (112 females, mean age: 43 ± 21 years), and 89/172 had type I LSTV (52%), 42/172 type II (24%), 33/172 type III (19%), and 8/172 type IV (5%). The cVPVA and dVPVA in non-articulated patients were significantly higher than those of patients with LSTV, patients with only accessory articulations, and patients with only bony fusion (all p < .001). The cVPVA and dVPVA in L5 sacralization were significantly higher than in S1 lumbarization (p < .001). The following optimal cutoff was found: cVPVA of 28.2° (AUC = 0.797) and dVPVA of 11.1° (AUC = 0.782) to identify LSTV; cVPVA of 28.2° (AUC = 0.665) and dVPVA of 8° (AUC = 0.718) to identify type II LSTV; cVPVA of 25.5° (AUC = 0.797) and dVPVA of − 7.5° (AUC = 0.831) to identify type III–IV LSTV; cVPVA of 20.4° (AUC = 0.693) and dVPVA of − 1.8° (AUC = 0.665) to differentiate type II from III–IV LSTV; cVPVA of 17.9° (AUC = 0.741) and dVPVA of − 4.5° (AUC = 0.774) to differentiate L5 sacralization from S1 lumbarization. Conclusion The cVPVA and dVPVA measured on EOS showed good diagnostic performance to identify LSTV, to correctly classify it, and to differentiate L5 sacralization from S1 lumbarization.

scholarly journals Patterns of use, effectiveness and safety of gadolinium contrast agents: a European prospective cross-sectional multicentre observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jarl Åsbjørn Jakobsen ◽  
Carlo Cosimo Quattrocchi ◽  
Frank H. H. Müller ◽  
Olivier Outteryck ◽  
Andrés Alcázar ◽  
...  
Keyword(s):  
Image Quality ◽  
Observational Study ◽  
Contrast Agents ◽  
Marketing Authorisation ◽  
Safety Data ◽  
Radiological Diagnosis ◽  
Routine Practice ◽  
Diagnostic Confidence ◽  
Cross Sectional ◽  
Wide Range

Abstract Background The EU gadolinium-based contrast agents (GBCA) market has changed in recent years due to the European Medicines Agency decision to suspend the marketing authorisation of linear GBCA and the marketing authorisation of new generic macrocyclic GBCA. The study aims to understand the patterns of (GBCA) use, and to study the effectiveness and safety of GBCA in routine practice across Europe. Methods Prospective, cross-sectional, multicentre, observational study in patients undergoing contrast-enhanced magnetic resonance. Reported usage patterns included indication, referral and examination details. Assessment of effectiveness included changes in radiological diagnosis, diagnostic confidence and image quality. Safety data were collected by spontaneous patient adverse event (AE) reporting. Results 2118 patients were included from 8 centres across 5 European countries between December 2018 and November 2019. Clariscan, Dotarem (gadoteric acid), Gadovist (gadobutrol) and ProHance (gadoteridol) were utilised in 1513 (71.4%), 356 (16.8%), 237 (11.2%) and 12 (0.6%) patients, respectively. Most were performed in CNS-related indications (46.2%). Mean GBCA doses were 0.10 mmol/kg body weight, except for Gadovist (mean 0.12 mmol/kg). GBCA use increased confidence in diagnosis in 96.2% of examinations and resulted in a change in radiological diagnosis in 73.9% of patients. Image quality was considered excellent or good in 96.1% of patients and across all GBCA. Four patients reported AEs (0.19%), with only 1 (0.05%) considered serious. Conclusions This European study confirmed that GBCAs are used appropriately in Europe for a wide range of indications. The study demonstrated a significant increase in diagnostic confidence after GBCA use and confirmed the good safety profile of GBCAs, with comparable results for all agents used.

scholarly journals Lumbosacral transitional vertebra in military aviation candidates: A cross-sectional study

2021 ◽  
Vol 65 ◽  
pp. 29-32
Author(s):  
R Vaidya ◽  
M Bhatia
Keyword(s):  
Armed Forces ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Small Subset ◽  
Lumbosacral Junction ◽  
Cross Sectional ◽  
Transitional Vertebra ◽  
Medical Evaluation ◽  
Study Population ◽  
Lumbosacral Transitional Vertebra

Introduction: Lumbosacral transitional vertebra (LSTV) is a common anomaly of the lumbosacral junction with a prevalence of 4–35.9% in various studies. Plain radiography of the spine in anteroposterior and lateral projections is done for the evaluation of the spine in candidates coming for medical evaluation for flying duties in the armed forces. Material and Methods: An observational study was conducted on the whole spine series of radiographs done at a medical selection establishment. The study population included candidates reporting to the establishment for medical examination to ascertain fitness for flying duties. In a small subset of this study population having LSTV, the Ferguson’s view was done to better delineate the lumbosacral junction. Results: The analysis revealed a total 148 cases of LSTV with a prevalence of 13.9%. Ferguson’s view, undertaken among 30 doubtful cases, confirmed the presence of LSTV in 27 cases. Type IIa was observed to be the most common pattern of LSTV followed by Type IIIb. As per the existing policy, 63.8% of candidates with LSTV were considered unfit for flying duties. Conclusion: Flying duties in the armed forces require the highest standard of physical fitness. LSTV is a very common finding during the evaluation of candidates and it is appropriate that the cases of LSTV be evaluated thoroughly. In doubtful cases of LSTV, the Ferguson’s view is a useful supplementary view as it clearly delineates the lumbosacral junction.

scholarly journals LUMBOSACRAL TRANSITIONAL VERTEBRA ASSOCIATED WITH SACRAL SPINA BIFIDA OCCULTA: A CASE REPORT

2013 ◽  
Vol 56 (3) ◽  
pp. 126-129
Author(s):  
George Paraskevas ◽  
Maria Tzika ◽  
Panagiotis Kitsoulis
Keyword(s):  
Case Report ◽  
Spina Bifida ◽  
Lumbar Vertebra ◽  
Spina Bifida Occulta ◽  
Sacral Vertebra ◽  
Transitional Vertebra ◽  
Fifth Lumbar Vertebra ◽  
Lumbosacral Transitional Vertebra ◽  
Incomplete Closure ◽  
Lumbosacral Transitional Vertebrae

Congenital malformations such as lumbosacral transitional vertebrae and spina bifida occulta constitute unrare anomalies and could affect the symptomatology of low back pain. A transitional vertebra is characterized by elongation of one or both transverse processes, leading to the appearance of a sacralized fifth lumbar vertebra or a lumbarized first sacral vertebra. Furthermore, sacral spina bifida occulta is a developmental anomaly that corresponds to the incomplete closure of the vertebral column. In the present case report, we describe a case of a dried sacrum presenting a partially sacralized fifth lumbar vertebra and total spina bifida, extended from first to fifth sacral vertebra. A pseudoarthrosis is formed on the left side and the specimen could be incorporated in Castellvi’s type IIa. Moreover, the incidence, morphology, clinical and surgical significance of these spinal malformations are discussed.

Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification

2016 ◽  
Vol 3 (1) ◽  
pp. 116
Author(s):  
Juhi V. Patel ◽  
Chetan M. Mehta ◽  
Nandakishore G. Patil ◽  
Shreya R. Sehgal
Keyword(s):  
Lumbar Vertebrae ◽  
Lumbar Vertebra ◽  
Transverse Process ◽  
The Body ◽  
Type I ◽  
Transitional Vertebra ◽  
Spinal Movement ◽  
Vertebral Disc ◽  
Fifth Lumbar Vertebra ◽  
Lumbosacral Transitional Vertebra

<p class="abstract"><strong>Background:</strong> Sacralization of L5 is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both. This fusion can occur in one or both sides of the body. Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter-vertebral disc between them may be narrow. Sacralization of lumbar vertebra may be asymptomatic but is not always clinically insignificant. While sacralization may not affect at all, it can cause problems in some cases. Sacralization may be at times associated with problems in biomechanics and affect the ways of movement and posture control. Sacralization may also be an important consideration in disc surgeries. This study has been carried out to find out prevalence of sacralisation of transverse process of fifth lumbar vertebrae<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> The present study of transverse sacralisation of fifth lumbar vertebra was carried out on 35 randomly selected patients. The sample consisted of patients undergoing CT scan for abdominal complains. Bone window of all patients were evaluated to look for lumbosacral transitional vertebra.<strong></strong></p><p class="abstract"><strong>Results:</strong> The prevalence of transverse sacralization of lumbar vertebra turned out to be 25.7% out of which Castellvi type IIb was found to be most common, accounting for 33.3% cases. 5.7% comprised the group of normal variant (Castellvi’s type I) and 68.6% were normal<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span>It is important to determine lumbosacral transitional vertebra as it can affect spinal movement and put excess stress on the lumbar vertebrae and in between disc. Moreover it</span> can have a bearing on counting of vertebral levels specially during planning of spinal surgey<span lang="EN-IN">.</span></p><p> </p>

Characterization of Periodontal Biofilm in Down Syndrome Patients: A Comparative Study

2013 ◽  
Vol 37 (3) ◽  
pp. 289-296 ◽  
Author(s):  
R E Martinez-Martinez ◽  
J P Loyola-Rodriguez ◽  
S E Bonilla-Garro ◽  
N Patiño-Marin ◽  
D Haubek ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Porphyromonas Gingivalis ◽  
Bacterial Species ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Wide Range ◽  
Pcr Products ◽  
Immunological Alterations

The aim of this study was to characterize the main periodontal bacterial species in Down syndrome (DS) pa-tients with and without periodontitis. Method: This cross-sectional study involved 75 DS patients, 45 with and 30 without periodontitis. Informed consent, health and dental questionnaires and periodontitis diagnosis were performed. PCR and LAMP assays were performed on subgingival dental plaque sample. Results: Tannerella forsythia was the most frequent bacteria detected in the group with and without periodontitis (95.5 and 63.3%) followed by Treponema denticola (88.8 and 50%) and Porphyromonas gingivalis (53.3 and 25% respectively). There were statistical differences between groups (p&lt;0.05). Pg fimA type I was the most frequent Porphyromonas gingivalis genotype. Two different sets o primers (Aa-F/Aa-R and ltx3/ltx4) were used to detect Aggregatibacter actinomycetemcomitans and different frequencies were obtained, (68% and 14.6% respectively), they had a weak correlation (Cohen Kappa=0.16). After sequencing of PCR products, ltx3/ltx4 showed more specificity. JP2 clone of A. actinomycetemcomitans was not detected in any sample. Conclusions: The composition of oral biofilm is fundamental for the development of periodontal disease independently of immunological alterations associated with DS. The frequency of detection of A. actinomycetemcomitans reported in the literature has a wide range, because the primers and probes applied.

scholarly journals Four-Year Prospective Evaluation of Femoral Neck Fractures: Types and Complications

2020 ◽  
Vol 7 (3) ◽  
pp. 129-134
Author(s):  
Ali Yeganeh ◽  
◽  
Mehdi Moghtadaei ◽  
Amir Sobhani ◽  
Mehdi Abbasi ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Avascular Necrosis ◽  
Cross Sectional Study ◽  
Femoral Neck Fractures ◽  
Type I ◽  
Cross Sectional ◽  
Non Union ◽  
Type Iv ◽  
The Mean ◽  
Type Of Fracture

Background: Despite the advances in the methods of treating femoral neck fractures, treating some types of these fractures is still challenging. Therefore, understanding these fractures, their treatments, and the ways to control their complications are necessary for the orthopedists.  Objectives: In this study, we evaluate patients with acute femoral neck fractures with respect to the type of fractures and complications. Methods: In a 4-year cross-sectional study, the patients with acute femoral neck fractures who were admitted to Rasoul Akram Hospital were selected. Anatomical features and the type of fracture were determined by using plain radiography and CT scan. Fractures were classified according to the Garden classification. The patients were also evaluated for any postoperative complications for at least 6 months. Results: A total of 124 patients were enrolled. The Mean±SD age of the patients was 64.9±12.7 years and 87 (74.4%) were male. Based on the Garden classification, 7 fractures (5.9%) belonged to type I, 10 fractures (8.5%) to type II, 48 fractures (41%) to type III, and 52 fractures (44.4%) to type IV. Avascular necrosis in 28 cases (23.9%), non-union in 14 cases (12%), and claudication and pain in 35 cases (29.9%) were noted. The mean age of patients was different between fracture groups (P=0.01).  Conclusion: Our results showed that most of the patients with femoral neck fractures admitted to Rasoul Akram Hospital were associated with displacement. In this study, the most common complications were pain and claudication, avascular necrosis of the femoral head, and nonunion. In sum, further displacement of the fracture will result in more complications.

scholarly journals Characteristics of pharmacist’s interventions triggered by prescribing errors related to computerised physician order entry in French hospitals: a cross-sectional observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045778
Author(s):  
Manon Videau ◽  
Bruno Charpiat ◽  
Céline Vermorel ◽  
Jean-Luc Bosson ◽  
Ornella Conort ◽  
...  
Keyword(s):  
Observational Study ◽  
Acceptance Rate ◽  
Drug Related Problems ◽  
Prescribing Errors ◽  
Order Entry ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Clinical Consequences ◽  
Physician Order Entry ◽  
Certified Software

ObjectivesComputerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals.DesignThis was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018.SettingPISREs from 319 French computerised healthcare facilities were analysed.ParticipantsAmong the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists.ResultsAmong the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p<0.001). The PISRE ratio for senior pharmacists was 9.2% and that for pharmacy residents 5.4% (p<0.001). Concerning prescriptions made by graduate prescribers and those made by residents, the PISRE ratio was 8.4% and 7.8%, respectively (p<0.001).ConclusionComputer-related prescribing errors are common. The PI acceptance rate by prescribers was higher than that observed for PIs that were not CPOE related. This suggests that physicians consider the potential clinical consequences of SREs for patients to be more frequently serious than interventions unrelated to CPOE. CPOE medication review requires continual pharmacist diligence to catch these errors. The significantly lower PISRE ratio for certified software should prompt patient safety agencies to undertake studies to identify the safest software and discard software that is potentially dangerous.

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