Transpedicular Approach for Corpectomy and Circumferential Arthrodesis in Traumatic Lumbar Vertebral Body Burst Fractures: A Retrospective Analysis of Outcome in 35 Patients

2021 ◽  
Vol 69 (2) ◽  
pp. 399
Author(s):  
Amandeep Kumar ◽  
Mayank Garg ◽  
PankajKumar Singh ◽  
Raman Mahalangikar ◽  
GuruDutt Satyarthee ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Vertebral Body ◽  
Transpedicular Approach ◽  
Burst Fractures ◽  
Lumbar Vertebral Body

Management of Pediatric Posttraumatic Thoracolumbar Vertebral Body Burst Fractures by Use of Single-Stage Posterior Transpedicular Approach

2018 ◽  
Vol 117 ◽  
pp. e22-e33 ◽  
Author(s):  
Mohit Agrawal ◽  
Mayank Garg ◽  
Amandeep Kumar ◽  
Pankaj Kumar Singh ◽  
Guru Dutta Satyarthee ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Single Stage ◽  
Transpedicular Approach ◽  
Burst Fractures

Single-Stage Transpedicular Approach for Circumferential Arthrodesis in Traumatic Lumbar Vertebral Body Burst Fractures

2019 ◽  
Vol 16 (01) ◽  
pp. 14-20 ◽  
Author(s):  
Mayank Garg ◽  
Amandeep Kumar ◽  
Pankaj Kumar Singh ◽  
Deepak Agrawal ◽  
Guru Dutt Satyarthee ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Lumbar Region ◽  
Nerve Root Injury ◽  
Transpedicular Approach ◽  
Burst Fractures ◽  
Lumbar Vertebral Body ◽  
Cage Subsidence ◽  
Cobb’S Angle ◽  
The Mean

Abstract Background Traumatic vertebral burst fractures can be surgically approached via different approaches (anterior/posterior, or combined). Posterior transpedicular approach (PTA) is a posterior approach that has the advantage of achieving circumferential arthrodesis via single posterior-only approach. The purpose of this study was to analyze our experience with PTA in management of traumatic lumbar burst fractures (TLBFs). Methods All consecutive patients with TLBFs managed with PTA over 3 years’ duration were included in this retrospective study. Correction of kyphotic deformity and change in neurologic status were analyzed to assess outcome. Cobb’s angle and American Spinal Injury Association (ASIA) grade were used for this purpose. Results There were 12 males and 8 females. Five patients had complete (ASIA-A) while 12 had incomplete injury. The mean preoperative Cobb’s angle was 14.23 degrees that improved to–3.21 degrees postoperatively (mean kyphosis correction: 17.44 degrees). None of the patients developed iatrogenic nerve root injury. There was no perioperative mortality. The mean Cobb’s angle was 1.45 degrees at 36 months’ follow-up. Four patients developed cage subsidence but none required revision surgery. Postoperatively, 13 (65%) patients showed neurologic improvement and none deteriorated. The average ASIA score improved from 2.82 to 4.23. A fusion rate of 96% was observed at last follow-up. Conclusion The advantages of PTA including sense of familiarity with posterior approach among spine surgeons, lesser approach-related morbidity, and results comparable to anterior/combined approaches, make the PTA an attractive option for managing TLBFs. Although technically difficult, it can be successfully used for circumferential arthrodesis in the lumbar region without sacrificing nerve roots.

Effect of CT-based attenuation correction on uptake ratios in skeletal SPECT

2007 ◽  
Vol 46 (01) ◽  
pp. 38-42 ◽  
Author(s):  
V. Schulz ◽  
I. Nickel ◽  
A. Nömayr ◽  
A. H. Vija ◽  
C. Hocke ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Facet Joint ◽  
One Dimension ◽  
Patient Specific ◽  
Data Sets ◽  
Facet Joints ◽  
Lumbar Vertebral Body ◽  
Ct System ◽  
Ct Data ◽  
Attenuation Corrected

SummaryThe aim of this study was to determine the clinical relevance of compensating SPECT data for patient specific attenuation by the use of CT data simultaneously acquired with SPECT/CT when analyzing the skeletal uptake of polyphosphonates (DPD). Furthermore, the influence of misregistration between SPECT and CT data on uptake ratios was investigated. Methods: Thirty-six data sets from bone SPECTs performed on a hybrid SPECT/CT system were retrospectively analyzed. Using regions of interest (ROIs), raw counts were determined in the fifth lumbar vertebral body, its facet joints, both anterior iliacal spinae, and of the whole transversal slice. ROI measurements were performed in uncorrected (NAC) and attenuation-corrected (AC) images. Furthermore, the ROI measurements were also performed in AC scans in which SPECT and CT images had been misaligned by 1 cm in one dimension beforehand (ACX, ACY, ACZ). Results: After AC, DPD uptake ratios differed significantly from the NAC values in all regions studied ranging from 32% for the left facet joint to 39% for the vertebral body. AC using misaligned pairs of patient data sets led to a significant change of whole-slice uptake ratios whose differences ranged from 3,5 to 25%. For ACX, the average left-to-right ratio of the facet joints was by 8% and for the superior iliacal spines by 31% lower than the values determined for the matched images (p <0.05). Conclusions: AC significantly affects DPD uptake ratios. Furthermore, misalignment between SPECT and CT may introduce significant errors in quantification, potentially also affecting leftto- right ratios. Therefore, at clinical evaluation of attenuation- corrected scans special attention should be given to possible misalignments between SPECT and CT.

scholarly journals The human lumbar vertebral body as an intrinsic, functionally optimal structure

2007 ◽  
Vol 1 (1) ◽  
pp. 34-47
Author(s):  
D.N. Ghista ◽  
S.C. Fan ◽  
K. Ramakrishna ◽  
I. Sridhar
Keyword(s):  
Vertebral Body ◽  
Optimal Structure ◽  
Lumbar Vertebral Body

Anatomy of the Spinal Cord

2021 ◽  
pp. 60-67
Author(s):  
Jennifer A. Tracy
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Conus Medullaris ◽  
Lower Limbs ◽  
Cervical Cord ◽  
Filum Terminale ◽  
Upper Limbs ◽  
Descending Pathways ◽  
Lumbar Vertebral Body

The spinal cord begins as the cervical cord immediately below the medulla and extends through the spinal canal, where it becomes the thoracic, lumbar, sacral, and coccygeal parts of the cord. In most persons, the spinal cord proper ends at the lower portion of the first lumbar vertebral body, where it forms the conus medullaris and, finally, the filum terminale. A cervical enlargement contains the innervation pathways of the upper limbs; a lumbar enlargement contains the pathways of the lower limbs. This chapter reviews ascending and descending pathways in the spinal cord.

Diet-related changes in mechanical properties of rat vertebrae

1992 ◽  
Vol 262 (2) ◽  
pp. R318-R321 ◽  
Author(s):  
G. J. Salem ◽  
R. F. Zernicke ◽  
R. J. Barnard
Keyword(s):  
Mechanical Properties ◽  
Vertebral Body ◽  
Calcium Metabolism ◽  
Bone Mineralization ◽  
Maximum Load ◽  
Control Group ◽  
Buffer Solution ◽  
Cross Sectional ◽  
Lumbar Vertebral Body ◽  
Significant Difference

High fat and sucrose (HFS) diets may induce glucose intolerance, alter calcium metabolism, and lead to deficits in bone mineralization, development, and mechanical properties. To determine the mechanical and structural consequences of a HFS diet on rapidly growing vertebrae, female Sprague-Dawley rats (8 wk) were assigned randomly (2:1) either to a control group (n = 20) fed a low-fat complex-carbohydrate diet or an experimental group (n = 10) fed a HFS diet for 10-12 wk. The sixth lumbar vertebral body (L6) was isolated from the pedicles, morphological measures were taken, and compression was tested at a fast strain rate, while immersed in a warmed (37 degrees C) isotonic physiological buffer solution. No significant difference in body mass existed between HFS and control groups; nevertheless, HFS L6 cross-sectional areas, lengths, and volumes were significantly smaller than controls. The HFS L6 also had significantly lower mechanical properties, including initial maximum load, energy at initial maximum load, and strain energy density at initial maximum load. Diets high in sucrose and fat content have been associated with changes in calcium metabolism, and the results of the current study suggest that in immature vertebrae, a HFS diet may adversely affect vertebral body mechanical integrity and strength.

Circulating insulin levels are related to bone density in normal postmenopausal women

1993 ◽  
Vol 265 (4) ◽  
pp. E655-E659 ◽  
Author(s):  
I. R. Reid ◽  
M. C. Evans ◽  
G. J. Cooper ◽  
R. W. Ames ◽  
J. Stapleton
Keyword(s):  
Body Weight ◽  
Postmenopausal Women ◽  
Multiple Regression ◽  
Vertebral Body ◽  
Fat Mass ◽  
Volumetric Density ◽  
Insulin Levels ◽  
The Third ◽  
Lumbar Vertebral Body ◽  
Total Body

We recently established that the dependence of bone mineral density (BMD) on body weight in women is mainly attributable to a close relationship between total body fat mass and BMD. The present study assesses whether this latter relationship might be contributed to by the hormones insulin or amylin, both of which may influence fat mass and calcium metabolism. Fifty-three normal postmenopausal women underwent a 75-g glucose tolerance test with measurement of plasma insulin and amylin concentrations every 30 min for 2 h. Body composition and BMD/height (to provide a quantity with the dimensions of volumetric density that is independent of body size) were measured by dual-energy X-ray absorptiometry, and volumetric density of the third lumbar vertebral body was calculated. Circulating insulin concentrations correlated with BMD/height and volumetric density of the third lumbar vertebral body (r = 0.28-0.52). They also were related to body weight (r = 0.34-0.56) and fat mass (r = 0.38-0.56) but were not independently related to lean mass on multiple regression. There were no consistent relationships between amylin levels and these variables. Multiple-regression analyses with fat mass and insulin levels as independent variables indicated that BMD/height of total body and femoral trochanter were primarily related to fat mass, whereas, in femoral neck, the significant relationship was with insulin. Volumetric density of the third lumbar vertebral body was related to insulin levels alone on this analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

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