Anterior lengthening in scoliosis occurs only in the disc and is similar in different types of scoliosis

2021 ◽  
Author(s):  
S de Reuver ◽  
RC Brink ◽  
JF Homans ◽  
L Vavruch ◽  
H Tropp ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Congenital Scoliosis ◽  
Intervertebral Discs ◽  
Ct Scans ◽  
Scoliotic Deformity ◽  
Different Types ◽  
Vertebral Bodies ◽  
Bony Abnormality

Relative anterior spinal overgrowth (RASO) was proposed as a generalized growth disturbance and a potential initiator of adolescent idiopathic scoliosis (AIS). However, anterior lengthening was also observed in neuromuscular (NM) scoliosis, was shown to be restricted to the apical areas and to be located in the intervertebral discs, not in the bone. In this study the goal was to determine if other scoliotic curves of known origin exhibit the similar mechanism of anterior lengthening without changes in the vertebral body. Therefore CT-scans of 18 patients in whom a short segment congenital malformation had led to a long thoracic compensatory curve without bony abnormality were included. Of each vertebral body and intervertebral disc in the compensatory curve, the anterior and posterior length was measured on CT-scans in the exact mid-sagittal plane, corrected for deformity in all three planes. The total AP% of the compensatory curve in congenital scoliosis showed a lordosis (+1.8%) that differed from the kyphosis in non-scoliotic controls (-3.0%; p<0.001), and was comparable to AIS (+1.2%) and NM scoliosis (+0.5%). This anterior lengthening was not located in the bone; the vertebral body AP% showed a kyphosis (-3.2%), similar to non-scoliotic controls (-3.4%), as well as AIS (-2.5%) and NM scoliosis (-4.5%; p=1.000). However, the disc AP% showed a lordosis (+24.3%), which sharply contrasts to the kyphotic discs of controls (-1.5%; p<0.001), but was similar to AIS (+17.5%) and NM scoliosis (+20.5%). The results demonstrate that anterior lengthening is part of the three-dimensional deformity in different types of scoliosis and is exclusively located in the intervertebral discs. The bony vertebral bodies maintain their kyphotic shape, which indicates that there is no active bony overgrowth. Anterior lengthening appears to be a passive result of any scoliotic deformity, rather than being related to the specific cause of AIS.

Intervertebral Disc Morphology in Cervical Spine Biomechanics

1999 ◽  
Author(s):  
Srirangam Kumaresan ◽  
Frank A. Pintar ◽  
Narayan Yoganandan ◽  
Phaladone J. Khouphongsy ◽  
Joseph F. Cusick
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Annulus Fibrosus ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Intervertebral Discs ◽  
Old Adult ◽  
Staining Methods ◽  
Histological Images

Abstract Although qualitative descriptions of degenerative changes in the intervertebral disc components have been reported, methods to quantify these changes are lacking. A methodology was developed in this study to quantify the three-dimensional geometrical variations of the annulus fibrosus and nucleus pulposus. Fresh isolated intervertebral discs with adjacent vertebral bodies of skeletally mature young and old adult primates were sectioned sequentially, and different staining methods were used to distinguish the annulus and nucleus. Histological images were examined using light microscopy and exported to a computer to trace the boundaries of the annulus fibrosus and nucleus pulposus. Dorsal to ventral depth, medial to lateral width, and caudal to cranial height measurements of the nucleus pulposus and its relative location to the annulus pulposus were obtained. In the young adult, the nucleus was translucent with scattered notochordal cells. In the older adult, the nucleus appeared as a dense region of amorphous, irregular collagen material. A higher geometrical variation of nucleus due to degeneration was noted in the sagittal plane compared to coronal plane. Determination of the three-dimensional geometrical variations and histology analyses will assist mathematical modelers to better define the disc to study the biomechanics of the cervical spine.

scholarly journals Exploring the Functionality of Mesh-to-Mesh Value Comparison in Pair-Matching and Its Application to Fragmentary Remains

Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1303
Author(s):  
Zoe McWhirter ◽  
Mara A. Karell ◽  
Ali Er ◽  
Mustafa Bozdag ◽  
Oguzhan Ekizoglu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Roc Analysis ◽  
Three Dimensional ◽  
Turkish Population ◽  
New Method ◽  
Ct Scans ◽  
Different Types ◽  
Pair Matching ◽  
Commingled Remains

Many cases encountered by forensic anthropologists involve commingled remains or isolated elements. Common methods for analysing these contexts are characterised by limitations such as high degrees of subjectivity, high cost of application, or low proven accuracy. This study sought to test mesh-to-mesh value comparison (MCV), a relatively new method for pair-matching skeletal elements, to validate the claims that the technique is unaffected by age, sex and pathology. The sample consisted of 160 three-dimensional clavicle models created from computed tomography (CT) scans of a contemporary Turkish population. Additionally, this research explored the application of MVC to match fragmented elements to their intact counterparts by creating a sample of 480 simulated fragments, consisting of three different types based on the region of the bone they originate from. For comparing whole clavicles, this resulted in a sensitivity value of 87.6% and specificity of 90.9% using ROC analysis comparing clavicles. For the fragment comparisons, each type was compared to the entire clavicles of the opposite side. The results included a range of sensitivity values from 81.3% to 87.6%. Overall results are promising and the MVC technique seems to be a useful technique for matching paired elements that can be accurately applied to a Modern Turkish sample.

Effects of collagenase upon the intervertebral disc in monkeys

1976 ◽  
Vol 44 (1) ◽  
pp. 32-44 ◽  
Author(s):  
W. Eugene Stern ◽  
Walter F. Coulson
Keyword(s):  
Bone Formation ◽  
Vertebral Body ◽  
Fibrous Tissue ◽  
Intervertebral Discs ◽  
Disc Disease ◽  
Content Type ◽  
Tissue Changes ◽  
Vertebral Bodies ◽  
Radiographic Changes ◽  
Limited Scope

✓ The authors studied five rhesus monkeys for the effects of annulotomy, with or without the addition of a bacterially-derived collagenase into the nuclear-evacuated centrum of lumbar intervertebral discs. The animals were sacrificed from 3 weeks to 21 months after the single or staged double procedures. The earliest radiographic changes were loss of height of the interspace at 7 days, erosion of the vertebral body margins at 3 weeks, malalignment at 6 weeks, osteophytic formation at 3½ months, sclerosis of vertebral body surfaces at 9½ months, and fusion of adjacent vertebral bodies at 13½ months. Pathological changes included early loss of disc convexity, focal new bone formation, osteophytic new growth, through-and-through bone formation, irregular cystification, and disc replacement by hyaline fibrous tissue. Changes were reminiscent of those seen in humans with naturally acquired disc disease or aging of the disc. Injuries were produced in a tissue that probably has a limited scope of variation in reaction to insult.

scholarly journals Three-dimensional assessment of unilateral subcondylar fracture using computed tomography after open reduction

2014 ◽  
Vol 47 (02) ◽  
pp. 203-209 ◽  
Author(s):  
Sathya Kumar Devireddy ◽  
R. V. Kishore Kumar ◽  
Rajasekhar Gali ◽  
Sridhar Reddy Kanubaddy ◽  
Mallikarjuna Rao Dasari ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Statistical Difference ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Mandibular Condyle ◽  
Clinical Results ◽  
Considerable Change ◽  
Ct Scans ◽  
Open Method ◽  
Condylar Fractures

ABSTRACT Objective: The aim was to assess the accuracy of three-dimensional anatomical reductions achieved by open method of treatment in cases of displaced unilateral mandibular subcondylar fractures using preoperative (pre op) and postoperative (post op) computed tomography (CT) scans. Materials and Methods: In this prospective study, 10 patients with unilateral sub condylar fractures confirmed by an orthopantomogram were included. A pre op and post op CT after 1 week of surgical procedure was taken in axial, coronal and sagittal plane along with three-dimensional reconstruction. Standard anatomical parameters, which undergo changes due to fractures of the mandibular condyle were measured in pre and post op CT scans in three planes and statistically analysed for the accuracy of the reduction comparing the following variables: (a) Pre op fractured and nonfractured side (b) post op fractured and nonfractured side (c) pre op fractured and post op fractured side. P <; 0.05 was considered as significant. Results: Three-dimensional anatomical reduction was possible in 9 out of 10 cases (90%). The statistical analysis of each parameter in three variables revealed (P <; 0.05) that there was a gross change in the dimensions of the parameters obtained in pre op fractured and nonfractured side. When these parameters were assessed in post op CT for the three variables there was no statistical difference between the post op fractured side and non fractured side. The same parameters were analysed for the three variables in pre op fractured and post op fractured side and found significant statistical difference suggesting a considerable change in the dimensions of the fractured side post operatively. Conclusion: The statistical and clinical results in our study emphasised that it is possible to fix the condyle in three-dimensional anatomical positions with open method of treatment and avoid post op degenerative joint changes. CT is the ideal imaging tool and should be used on a regular basis for cases of condylar fractures.

scholarly journals The Feasibility of Anterior Occipital Condyle Screw for the Reconstruction of Craniovertebral Junction: A Digital Anatomical and Cadaveric Study of a Novel Technique

2020 ◽  
Author(s):  
Dingli Xu ◽  
Haijiao Mao ◽  
Yang Wang ◽  
Kaifeng Gan ◽  
Weihu Ma
Keyword(s):  
Sagittal Plane ◽  
Three Dimensional ◽  
Craniovertebral Junction ◽  
Entry Point ◽  
Ct Scans ◽  
Occipital Condyle ◽  
Novel Technique ◽  
Screw Length ◽  
Mesh Cage ◽  
Technique Apply

Abstract Background: Anterior occipital condyle screw (AOCS) could be a feasible technique apply to the reconstruction of craniovertebral junction. This study was to analyze the feasibility of AOCS.Method: The craniovertebral junction computed tomography (CT) scans of 40 adults were enrolled and imported into Mimics software. Then the three-dimensional reconstruction digital model of craniovertebral junction were established to determine entry point, insertion angle and screw’s trajectory. After AOCS inserted into ten human cadaver spine specimens, CT scans were performed to verify the location between screws and important structures. Result: The optimal entry point is located caudally and medial to the ventral of occipital condyle. The optimal trajectory is in inclination angle (5.9°±3.4°) in the sagittal plane and diverge angle (26.7°±6.0°) in the axial plane with the screw length around 21.6±1.2mm. There were no screws invaded into hypoglossal canal and vertebral artery in all specimens.Conclusion: AOCS fixation is a feasible novel technique for anterior craniovertebral junction reconstruction, and it could be an effective alternative operation for anterior reconstruction with titanium mesh cage.

scholarly journals Tridimensional Study of the Vertebral Body in Osteoporotic Vertebral Fractures Treated with Percutaneous Vertebroplasty.

2021 ◽  
Author(s):  
Jesús Payo-Ollero ◽  
Rafael Llombart-Blanco ◽  
Carlos Villas ◽  
Matías Alfonso
Keyword(s):  
Vertebral Body ◽  
Sagittal Plane ◽  
Percutaneous Vertebroplasty ◽  
Body Height ◽  
Three Dimensional ◽  
Dimensional Structure ◽  
Volume Loss ◽  
Volume Percentage ◽  
Post Surgery ◽  
Osteoporotic Vertebral Fractures

Abstract Many studies analyze the increase in vertebral body height after percutaneous vertebroplasty (PVP) in the sagittal plane. However, the vertebral body is a three-dimensional structure. The aim of this study is to determine if there is a volume change in the vertebral body after PVP, and to determine possible differences according to the spine segment treated. This prospective study included 25 patients (51 vertebrae, BMI 26.4kg/m2, T-score − 2.6) treated with PVP. The volumetric study was performed with MRI pre and post-surgery. We studied the amount of injected cement, the volume of cement inside the vertebral body, the fractured vertebra volume, percentage of volume loss, percentage of volume restoration and percentage of bone filling. Thoracolumbar fractures predominated. The average volume of injected cement was 3.6ml (range, 0.9–6.5). The volume loss was 4.1±3.3ml (16.2%). In the vertebral body, there was an increase in volume after PVP (difference + 1.6±1.6ml, 95% CI 1.1–2.03). Volume restoration was 1.6±1.6ml. Percentage of bone cement filling was 13.3%±4.5. There were no differences between the spine segments treated (P > 0.05). PVP increases the volume of the fractured vertebra approximately 40% of the volume loss. The volumetric changes after PVP were similar in the different spine segments treated.

CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks

2019 ◽  
Vol 44 (4) ◽  
pp. 507-512
Author(s):  
Richard Zhu ◽  
Kathryn Dean ◽  
Neel Mehta ◽  
Ajay Gupta ◽  
Jesse Gruber ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Sagittal Plane ◽  
Vertebral Level ◽  
Posterior Portion ◽  
Ct Angiogram ◽  
Disc Injury ◽  
Axial Ct ◽  
Vertebral Bodies ◽  
Needle Trajectory ◽  
Lumbar Spinal

IntroductionDetermining safer techniques for lumbar injections is an important goal in pain medicine. This study aims to characterize the location of the T10–L5 spinal arteries using CT angiogram scans to define a safer approach for sympathetic and splanchnic blocks that minimizes intra-arterial injection.MethodsCT angiograms of 68 patients were included this study. The path of the spinal arteries from the aorta origin along the vertebral body to the neural foramina was traced on axial CT images. The sagittal plane of the vertebral body was divided into nine quadrants to map the path of a spinal artery at a vertebral level. At a given vertebral level and laterality, the presence of an artery as well as the quadrants the artery traveled in along its path were recorded.ResultsAt the anterior vertebral body, >90% of the spinal arteries were observed either at or below the pedicle level. At the middle portion of the vertebral body from T11 to L3, >80% of the spinal arteries were found at the pedicle level. For the posterior portion of the vertebral bodies at L4 and L5, the spinal arteries terminated almost universally below the pedicle level. For other levels at the posterior vertebral bodies, the spinal arteries were equivocally located at or below the pedicle level.ConclusionUsing routine anatomic landmarks visible on CT imaging, we classified the anatomic course of low thoracic and lumbar spinal arteries originating from the aorta into the neural foraminal space. A safe recommendation to avoid intra-arterial injection for a splanchnic or lumbar sympathetic is to start above the pedicle and add a slight caudal angulation to the needle trajectory to avoid disc injury at the anterolateral vertebral body.

Three-Dimensional Characterization of Torsion and Asymmetry of the Intervertebral Discs Versus Vertebral Bodies in Adolescent Idiopathic Scoliosis

Spine ◽  
2014 ◽  
Vol 39 (19) ◽  
pp. E1159-E1166 ◽  
Author(s):  
Tom P.C. Schlösser ◽  
Marijn van Stralen ◽  
Rob C. Brink ◽  
Winnie C. W. Chu ◽  
Tsz-Ping Lam ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Three Dimensional ◽  
Intervertebral Discs ◽  
Vertebral Bodies

Revisiting the rules for freehand ventriculostomy: a virtual reality analysis

2018 ◽  
Vol 128 (4) ◽  
pp. 1250-1257 ◽  
Author(s):  
Clemens Raabe ◽  
Jens Fichtner ◽  
Jürgen Beck ◽  
Jan Gralla ◽  
Andreas Raabe
Keyword(s):  
Virtual Reality ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Anterior Horn ◽  
Entry Point ◽  
Ct Scans ◽  
Medial Canthus ◽  
Hit Rate ◽  
Entry Points ◽  
Ventricular Puncture

OBJECTIVEFrontal ventriculostomy is one of the most frequent and standardized procedures in neurosurgery. However, many first and subsequent punctures miss the target, and suboptimal placement or misplacement of the catheter is common. The authors therefore reexamined the landmarks and rules to determine the entry point and trajectory with the best hit rate (HtR).METHODSThe authors randomly selected CT scans from their institution’s DICOM pool that had been obtained in 50 patients with normal ventricular and skull anatomy and without ventricular puncture. Using a 5 × 5–cm frontal grid with 25 entry points referenced to the bregma, the authors examined trajectories 1) perpendicular to the skull, 2) toward classic facial landmarks in the coronal and sagittal planes, and 3) toward an idealized target in the middle of the ipsilateral anterior horn (ILAH). Three-dimensional virtual reality ventriculostomies were simulated for these entry points; trajectories and the HtRs were recorded, resulting in an investigation of 8000 different virtual procedures.RESULTSThe best HtR for the ILAH was 86% for an ideal trajectory, 84% for a landmark trajectory, and 83% for a 90° trajectory, but only at specific entry points. The highest HtRs were found for entry points 3 or 4 cm lateral to the midline, but only in combination with a trajectory toward the contralateral canthus; and 1 or 2 cm lateral to the midline, but only paired with a trajectory toward the nasion. The same “pairing” exists for entry points and trajectories in the sagittal plane. For perpendicular (90°) trajectories, the best entry points were at 3–5 cm lateral to the midline and 3 cm anterior to the bregma, or 4 cm lateral to the midline and 2 cm anterior to the bregma.CONCLUSIONSOnly a few entry points offer a chance of a greater than 80% rate of hitting the ILAH, and then only in combination with a specific trajectory. This “pairing” between entry point and trajectory was found both for landmark targeting and for perpendicular trajectories, with very limited variability. Surprisingly, the ipsilateral medial canthus, a commonly reported landmark, had low HtRs, and should not be recommended as a trajectory target.

scholarly journals Height and Volume Restoration In Osteoporotic Vertebral Compression Fractures: A Biomechanical Comparison Of Standard Balloon Kyphoplasty Versus Tektona In A Cadaveric Fracture Model

2020 ◽  
Author(s):  
Antonio Krüger ◽  
Martin Bäumlein ◽  
Tom Knauf ◽  
Hugues Pascal-Moussellard ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Balloon Kyphoplasty ◽  
Ct Scans ◽  
Matched Pair ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Before And After ◽  
Vertebral Bodies ◽  
The Difference

Abstract Background: Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard Balloon kyphoplasty (BKP) versus Tektona (TEK)) with respect to height restoration. Methods: Four-teen vertebral bodies of two female cadavers were examined. Fractures were created using a standardized protocol. CT-scans were taken before and after fracture, as well as after treatment. Afterwards two groups were randomly assigned in a matched pair design: 7 vertebral bodies (VB) were treated with (BKP, Kyphon, Medtronic) and 7 vertebral bodies by TEK (Spineart, Switzerland) Anterior, central and posterior vertebral body heights were evaluated by CT-scans. Volumetry was performed using the CT-scans at three different timepoints. Results: Values before fracture represent 100 %. The anterior height after fracture was reduced to 75,99 (± 4,8) % for the BKP group and to 76,54 (± 9,17) % in the TEK Group. Statistically there was no difference for the groups (p = 1). After treatment the values increased to 93,06 (±5) % for the BKP Group and 87,71 (±6,2) % for the TEK Group. The difference before and after treatment was significant for both groups (BKP p =0,0006; TEK p= 0,03). Within the groups, there was no difference (p=0,13). The Volume of the vertebral body was reduced to 82,29 (±8,4) % in the BKP Group and to 76,54 (±8,6) % in the TEK Group. After treatment the volume was 89,26 (±6,9) % for the BKP Group and 88,80 (±8,7) % for the TEK Group. The difference before and after treatment was significant only for the TEK group (BKP p =0,0728 n.s.; TEK p= 0,0175). Within the groups, there was no difference (p=0,2). The average cement volume used was 6,1 (range 3,6 - 9 ml) for the BKP group and 5,3 (3 - 7,2 ml) for the TEK group respectively.Conclusions: Based on our results the new System Tektona in osteoporotic compression fractures might represent a promising alternative for the clinical setting, especially preserving bone. Further biomechanical tests and clinical studies have to proof Tektona`s capabilities.

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