scholarly journals Clinical Implication of Mid-Range Dynamic Instability in Lumbar Degenerative Spondylolisthesis

2020 ◽  
Vol 14 (4) ◽  
pp. 507-512
Author(s):  
Chang-Yk Lee ◽  
Byeong-Mun Park ◽  
Tae-Woo Kim ◽  
Seung-Hwan Lee
Keyword(s):  
Lumbar Spine ◽  
Clinical Implication ◽  
Dynamic Instability ◽  
Degenerative Spondylolisthesis ◽  
Control Group ◽  
Significant Difference ◽  
Posterior Translation ◽  
Lumbar Degenerative Spondylolisthesis ◽  
Flexion And Extension ◽  
Anterior Posterior

Study Design: Retrospective evaluation.Purpose: To determine the prevalence of mid-range dynamic instability in patients with degenerative spondylolisthesis (DS) and to evaluate the clinical implication of mid-range instability (MI).Overview of Literature: Instability is identified by measuring vertebral body anterior–posterior translation on static end-range flexion and extension lateral radiographs. Mid-range kinematics could evince occult dynamic instability in which motion is not appreciated at the terminal-range of motion.Methods: In this study, 30 patients with DS with checked standing dynamic radiographs of the lumbar spine in Gwangmyeong Sungae Orthopedic Clinic were recruited. Standing lateral radiographs were evaluated in extension, 45° of flexion (mid-range) and 90° of flexion (terminal-range) of the lumbar spine. Instability was defined as sagittal translation greater than 3 mm from the extension position. Patients were divided into three groups: a control group, an MI group, and a terminal-range instability (TI) group. Radiographic outcome (stenosis grade) and clinical outcome were compared between the three groups.Results: The average sagittal translation of the lumbar spine was 5.2 mm in extension, 6.6 mm in mid-range, and 7.2 mm in endrange. MI was observed in eight patients (26.2%) and TI was seen in 12 patients (40%). Of eight patients with MI, three patients did not have instability at terminal-range (occult patients) and five patients had instability at terminal-range (typical patients). Body weight and body mass index (BMI) was significantly higher in the MI group as compared to the control group. BMI was positively correlated with slippage to mid-range. There was no significant difference in stenosis grade, Visual Analog Scale, and Oswestry Disability Index. In the TI group, there was no significant difference in radiographic clinical parameters as compared to the control group.Conclusions: MI was demonstrated in 25% of DS patients. Mid-range motion was increased with BMI. Mid-range lateral radiography can reveal occult instability in patients with DS, particularly in obese patients.

Incidence of Asymptomatic, Nontraumatic Unilateral Knee Hyperextension in the High School Athlete

1996 ◽  
Vol 5 (4) ◽  
pp. 287-292
Author(s):  
George A. Arangio ◽  
Marie St. Amour-Myers ◽  
James Reed
Keyword(s):  
High School ◽  
Range Of Motion ◽  
Peak Torque ◽  
Left Knee ◽  
Control Group ◽  
Control Groups ◽  
Anterior Translation ◽  
Significant Difference ◽  
Posterior Translation ◽  
And Control

Four hundred sixty-seven high school athletes were screened in apreparticipation athletic physical. Forty-six (9.8%) of these athletes presented with asymptomatic, nontraumatic unilateral hyperextension. Twenty-three athletes were reexamined and compared to a normal control group. A 2.5-cm, statistically significant heel-to-heel difference was recorded in the hyperextension group. Between the involved hyperextended and uninvolved legs, there were differences in average range of motion (132.04° vs. 130.74°, respectively), average manual anterior translation by KT-1000 (5.39 mm vs. 5.15 mm, respectively), average posterior translation (2.07 mm vs. 2.00 mm, respectively), average peak quadriceps torque (86.25 ft-lb vs. 84.06 ft-lb, respectively), and hamstring average peak torque (53.89 ft-lb vs. 52.93 ft-lb, respectively), though these differences were not statistically significant. In the control group, there was no heel-to-heel difference in the right versus the left knee. Heel-to-heel difference between the experimental and control groups was statistically significant. There was no statistically significant difference between range of motion, anterior translation, or posterior translation between the experimental and control groups.

scholarly journals Hypodontia Patterns and Variations in Craniofacial Morphology in Japanese Orthodontic Patients

2006 ◽  
Vol 76 (6) ◽  
pp. 996-1003 ◽  
Author(s):  
Toshiya Endo ◽  
Rieko Ozoe ◽  
Sugako Yoshino ◽  
Shohachi Shimooka
Keyword(s):  
Craniofacial Morphology ◽  
Occlusal Plane ◽  
Control Group ◽  
Missing Teeth ◽  
Linear Measurements ◽  
Posterior Group ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Orthodontic Patients ◽  
Anterior Posterior

Abstract Objective: The purpose of this study was to explore the association of hypodontia patterns and variations in craniofacial morphology in Japanese orthodontic patients. Materials and Methods: A total of 50 girls with hypodontia (the total group) were selected and categorized into anterior, posterior, and anterior-posterior groups according to the location of the congenitally missing teeth. By using the lateral cephalograms of each subject, 28 angular and 37 linear measurements were made. The cephalometric data were statistically analyzed and compared among the groups and with the Japanese cephalometric standards from 36 age-matched female subjects without hypodontia or malocclusion (the control group). Results: Every hypodontia group showed shorter anterior and overall cranial base lengths, shorter maxillary length, greater retroclination and elongation of mandibular incisors, and a larger interincisal angle than the control group. The total and anterior-posterior groups especially exhibited a significantly more prognathic mandible, larger retroclination of maxillary incisors, and a more counterclockwise-rotated occlusal plane. Furthermore, these skeletal and dental deviations were more remarkable in the anterior-posterior group than in either the anterior or the posterior group. Anterior hypodontia exerted as much influence on craniofacial morphology as posterior hypodontia. Conclusions: When orthodontic treatment is performed on patients with hypodontia, not only the number but also the distribution of missing teeth should be taken into consideration, though there was no significant difference in craniofacial morphology between anterior hypodontia and posterior hypodontia.

scholarly journals Peculiarities of the chest’s size in female volleyball players of different constitutional types

2018 ◽  
pp. 47-52
Author(s):  
L. A. Sarafyniuk ◽  
V. I. Pivtorak ◽  
V. O. Khavtur ◽  
L. Ia. Fedoniuk ◽  
O. P. Khapitska
Keyword(s):  
Young Women ◽  
Great Influence ◽  
Control Group ◽  
Constitutional Type ◽  
Significant Difference ◽  
Volleyball Players ◽  
High Level ◽  
Medical University ◽  
Different Levels ◽  
Anterior Posterior

During qualified sport selection special attention should be paid to those features and abilities that have a great influence on the effectiveness, and those, that are mainly under the influence of genetic factor. Such morphogenetic markers of sports selection include, firstly, the constitutional features of athletes, in particular the shape of the chest. The purpose of work is to determine the differences between the anthropometric dimensions of the chest between female volleyball players of high level of athletic skill and non-sportsmen, who belonged to different constitutional types. On the base of the Scientific-Research Center of the Vinnytsya National Pirogov Memorial Medical University an anthropo-somatotypological investigation of 113 female volleyball players of high level athletic skill (from 16 to 20 years old) was done. The control group included 204 practically healthy young women, who were not engaged in sports of the corresponding age. Anthropometric research was performed according to the V. V. Bunak (1941) method, somatotypological study was based on the estimated modification of the Heath-Carter method (1990). In young women, who were not engaged in sports, more than in half of the cases were indicated constitutional types, which were characterized by good development of fatty body composition. Between female volleyball players were dominated individuals with mesomorphic somatotype (26.66%), ectomorphic somatotype (23.01%), ecto-mesomorphic somatotype (23.89%), and representatives of the intermediate somatotype (23.01%) were almost uniformly represented in the sample. The analysis of the results was carried out in the licensing program "Statistica 5.5" using nonparametric methods of estimating the parameters. We have found that the female volleyball players of the ectomorphic somatotype have the smallest anthropometric dimensions of the chest, as compared with athletes of other constitutional groups. In the mesomorphs female volleyball players all transverse and the most of overall sizes of the chest were the largest. Parameters of the athletes with the ecto-mesomorphic somatotype were slightly small to the size of the somatometric parameters of the mesomorphs, but they had the highest values of the anterior-posterior size of the chest. Female volleyball players with intermediate somatotype had larger values of the chest size than volleyball players with ectomorphic somatotype, although no significant difference was found when comparing them. It was found, that the most of the overall, transverse, and anterior-posterior dimensions of the chest in female volleyball players are statistically significantly higher than that of girls, who were not engaged in sports, and belonged to the same constitutional type as athletes. We have made a conclusion that belonging to one of the constitutional type does not provide similarity of morphometric parameters of the chest in persons with different levels of physical activity.

scholarly journals Definitions of segmental instability in the degenerative lumbar spine and validation of these definitions: a systematic review protocol article according to PRISMA-P 2015 statement

2020 ◽  
Author(s):  
Signe Forbech Elmose ◽  
Gustav Østerheden Andersen ◽  
Leah Yacat Carreon ◽  
Freyr Gauti Sigmundsson ◽  
Mikkel Østerheden Andersen
Keyword(s):  
Systematic Review ◽  
Lumbar Spine ◽  
Diagnostic Imaging ◽  
Spinal Stenosis ◽  
Systematic Reviews ◽  
Literature Search ◽  
Degenerative Spondylolisthesis ◽  
Data Synthesis ◽  
Segmental Instability ◽  
Lumbar Degenerative Spondylolisthesis

Abstract Background The concept of segmental lumbar spine instability is controversial with varying definitions. However, suspicion of instability is used as an indication for vertebral fusion surgery in patients with lumbar degenerative spondylolisthesis and spinal stenosis. The objectives of this systematic review are to describe, the definitions of segmental instability in the degenerative lumbar spine, in studies of patients with lumbar spinal stenosis and/or lumbar degenerative spondylolisthesis, involving diagnostic imaging. And to describe which of the measurable radiological variables used to define instability have been validated against dynamic flexion-extension radiographs. Method Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Systematic literature search will be conducted in MEDLINE and EMBASE databases, supplemented by search in Cochrane Library. International Clinical Trials Registry Platform Search Portal and ClinicalTrials.gov will be searched for ongoing or recently completed trials. PROSPERO (International Prospective Register of Systematic Reviews) will be searched before initiating this review. In addition, a gray literature search will be conducted. Studies eligible for inclusion are clinical and biomechanical studies on adult patients with degenerative spondylolisthesis and spinal stenosis and surgical treatment hereof, studies involving diagnostic imaging. We will include studies giving a definition or describing patho-anatomical findings of segmental instability or any synonym or antonym hereof. Two reviewers will independently screen articles, involving a third reviewer as referee. Screening process and data extraction conducted using Covidence software. Data synthesis presented in results checklist and systematic narrative synthesis. Data synthesis on secondary objective by contingency table. Discussion With this systematic review we want to contribute to evidence based treatment planning of lumbar degenerative spondylolisthesis with spinal stenosis. We also aim to present our result in a comprehensive manner, to encourage consensus regarding the definition of segmental instability. Registration This protocol was submitted to the International Prospective Register of Systematic Reviews (PROSPERO) on 29. April 2020, submission ID: 182827

scholarly journals Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 730-737
Author(s):  
Hao-Yang Ma ◽  
Shuang Chen ◽  
Ling-Ling Lu ◽  
Wei Gong ◽  
Ai-Hua Zhang
Keyword(s):  
Lumbar Spine ◽  
Renal Disease ◽  
Postmenopausal Women ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

AbstractAs a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

scholarly journals Mathematical modeling of individual parameters of the sum of the sizes intervertebral discs of the lumbar spine in juvenile males and males of the first mature age in norm

2019 ◽  
Vol 25 (1) ◽  
pp. 68-76
Author(s):  
V.P. Danylevych ◽  
Yu.Y. Guminskyi ◽  
V.O. Tykholaz ◽  
Y.O. Bezsmertnyi ◽  
S.V. Pavlov ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Lumbar Spine ◽  
Intervertebral Discs ◽  
The Body ◽  
Individual Values ◽  
Total Size ◽  
Mean Values ◽  
Significant Difference ◽  
The Individual ◽  
Anterior Posterior

In nowadays, an important area in medicine is the early preclinical identification of the parameters deviations from the norm, where mathematical modeling can help, which should be used to calculate individual linear parameters of internal structures based on external parameters of the body. The aim of the study was to calculate the individual total linear measures of the lumbar intervertebral discs in juniors and men of the first adulthood (17-28 years) in norm. The total size of the each intervertebral discs were calculated a sum of the anterior-posterior diameter, frontal diameter and vertical sizes of each lumbar intervertebral discs, which were measured by MRI. The next step was to calculate the relative proportional nonlinear somato-disc rates (based on body weight and body length) for each individual examined. Mathematical processing of the measured parameters and the relative values of the somato-disc relationships was carried out by the statistical data processing program “STATISTICA 6.1” using parametric methods. The correct distribution of the variational series indicators, mean values and their standard errors were evaluated. Based on relative values the mathematical model was created to obtain individual values of the TS of the lumbar intervertebral discs. Subsequently, we compared the measured total discs sizes of the anterior-posterior, frontal diameters and vertical sizes of the lumbar intervertebral discs with a mathematically calculated value for each lumbar intervertebral discs. The significant difference between the mathematically calculated and measured values of the total intervertebral discs’ sizes of the didn’t exceed 10%. Determination of the standard linear dimensions of the intervertebral discs of the lumbar spine using CT and MRI and comparison with theoretically calculated indices will make it possible to diagnose early manifestations of the lumbar intervertebral discs pathology.

scholarly journals The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Chengxin Li ◽  
Zhizhuo Li ◽  
Qiwei Wang ◽  
Lijun Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
External Rotation ◽  
Meta Analysis ◽  
Distal Tibia ◽  
Valgus Deformity ◽  
Cochrane Library ◽  
Control Group ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Fibular Fixation ◽  
Anterior Posterior

Objectives. The necessity of fibular fixation in distal tibia-fibula fractures remains controversial. This study aimed to assess its impact on radiographic outcomes as well as rates of nonunion and infection. Methods. A systematic search of the electronic databases of PubMed, Embase, and Cochrane library was performed to identify studies comparing the outcomes of reduction and internal fixation of the tibia with or without fibular fixation. Radiographic outcomes included malalignment and malrotation of the tibial shaft. Data regarding varus/valgus angulation, anterior/posterior angulation, internal/external rotation deformity, and the rates of nonunion and infection were extracted and then polled. A meta-analysis was performed using the random-effects model for heterogeneity. Results. Additional fibular fixation was statistically associated with a decreased rate of rotation deformity (OR = 0.13; 95% CI 0.02–0.82,p=0.03). However, there was no difference in the rate of malreduction between the trial group and the control group (OR = 0.86; 95% CI 0.27–2.74,p=0.80). There was also no difference in radiographic outcomes of varus-valgus deformity rate (OR = 0.17; 95% CI 0.03–1.00,p=0.05) or anterior-posterior deformity rate (OR = 0.76; 95% CI 0.02–36.91,p=0.89) between the two groups. Meanwhile, statistical analysis showed no significant difference in the nonunion rate (OR = 0.62; 95% CI 0.37–1.02,p=0.06) or the infection rate (OR = 0.81; 95% CI 0.18–3.67,p=0.78) between the two groups. Conclusions. Additional fibular fixation does not appear to reduce the rate of varus-valgus deformity, anterior-posterior deformity, or malreduction. Meanwhile, it does not appear to impair the union process or increase the odds of infection. However, additional fibular fixation was associated with decreased odds of rotation deformity compared to controls.

Effect of Wrist Joint Angle on the Examination of Hoffmann's Sign

2021 ◽  
Author(s):  
Guan Shi ◽  
Hai Tang ◽  
Jianlin Shan
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Joint Angle ◽  
Wrist Joint ◽  
Control Group ◽  
Wrist Flexion ◽  
Significant Difference ◽  
Palmar Flexion ◽  
Flexion And Extension

Abstract Objective To study the effect of different wrist flexion and extension angles on the results of Hoffmann’s sign.Methods Thirty-seven patients with cervical spondylotic myelopathy and fifty objectives as control group were examinated at 15° palmar flexion, 0° neutral, 30° back extension, and 60° back extension of the wrist joint to observe Hoffmann's sign.ResultsThe patients with cervical spondylotic myelopathy did not present significantly different results of Hoffmann’s sign at 0° neutral, 30° back extension, and 60° back extension, but significantly different at 15° palmar flexion (P<0.05). In control group, there is no significant difference at 15° palmar flexion, 0° neutral, 30° back extension, but significantly different at 60° back extension (p<0.05).ConclusionThe different angles of wrist flexion and extension present a significant impact on the results of Hoffmann’s sign examination. For the patients with cervical spondylotic myelopathy, it is reliable to test Hoffmann’s sign at 30° wrist back extension.

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