Computed Tomography- and Radiography-Based Morphometric Analysis of the Lateral Mass of the Subaxial Cervical Spine in the Indian Population

<sec><title>Study Design</title>This was a double-blinded cross-sectional study, which obtained no financial support for the research.</sec><sec><title>Purpose</title>To obtain a detailed morphometry of the lateral mass of the subaxial cervical spine.</sec><sec><title>Overview of Literature</title>The literature offers little data on the dimensions of the lateral mass of the subaxial cervical spine.</sec><sec><title>Methods</title>We assessed axial, sagittal, and coronal computed tomography (CT) cuts and anteroposterior and lateral X-rays of the lateral mass of the subaxial cervical spine of 104 patients (2,080 lateral masses) who presented to a tertiary care public hospital (King Edward Memorial Hospital, Mumbai) in a metropolitan city in India.</sec><sec><title>Results</title>For a majority of the parameters, males and females significantly differed at all levels (<italic>p</italic><0.05). Females consistently required higher (<italic>p</italic><0.05) minimum lateral angulation and lateral angulation. While the minimum lateral angulation followed the order of C5<C4<C6<C3, the lateral angulation followed the order of C3<C5<C4<C6. The lateral mass becomes longer and narrower from C3 to C7. In axial cuts, the dimensions increased from C3 to C6. The sagittal cut thickness and diagonal length increased and the sagittal cut height decreased from C3 to C7. The sagittal cut height was consistently lower in the Indian population at all levels, especially at the C7 level, as compared with the Western population, thereby questioning the acceptance of a 3.5-mm lateral mass screw. A good correlation exists between X-ray- and CT-based assessments of the lateral mass.</sec><sec><title>Conclusions</title>Larger lateral angulation is required for Indian patients, especially females. The screw length can be effectively calculated by analyzing the lateral X-ray. A CT scan should be reserved for specific indications, and a caution must be exercised while inserting C7 lateral mass screws.</sec>

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The V2 segment of the vertebral artery: anatomical considerations and surgical implications

Journal of Neurosurgery Spine ◽

10.3171/2011.7.spine1132 ◽

2011 ◽

Vol 15 (6) ◽

pp. 610-619 ◽

Cited By ~ 14

Author(s):

Vittorio M. Russo ◽

Francesca Graziano ◽

Maria Peris-Celda ◽

Antonino Russo ◽

Arthur J. Ulm

Keyword(s):

Cervical Spine ◽

Vertebral Artery ◽

Preoperative Imaging ◽

Neurosurgical Procedures ◽

Lateral Mass ◽

Modified Technique ◽

Intervertebral Disc Space ◽

Disc Space ◽

Subaxial Cervical Spine ◽

Screw Length

Object Iatrogenic injury of the V2 segment of the vertebral artery (VA) is a rare but serious complication and can be catastrophic. The purpose of this study was to characterize the relationship of the V2 segment of the VA to the surrounding anatomical structures and to highlight the potential site and mechanisms of injury that can occur during common neurosurgical procedures involving the subaxial cervical spine. Methods Ten adult cadaveric specimens (20 sides) were included in this study. Quantitative anatomical measurements between selected landmarks and the VA were obtained. In addition, lateral mass screws were placed bilaterally, from C-3 to C-7, reproducing either the Magerl technique or a modified technique. The safety angle, defined as the axial deviation from the screw trajectory needed to injure the VA, and the distance from the entry point to the VA were measured at each level for both techniques. Results The VA coursed closer to the midline at C3–4 and C4–5 (mean distance [SD] 14.9 ± 1.1 mm) than at C2–3 or C5–6. Within the intertransverse space it coursed closer to the uncinate processes of the vertebral bodies (1.8 ± 1.1 mm) than to the anterior tubercle of the transverse processes (3.4 ± 1.6 mm). The distance between the VA and the uncinate process was less at C3–6 (1.3 ± 0.7 mm) than at C2–3 (3.3 ± 0.8 mm). The VA coursed on average at a distance of 11.9 ± 1.7 mm from the anterior and 4.2 ± 2.6 mm from the posterior aspect of the intervertebral disc space. Lateral mass screw angles were 25° lateral and 39.1° cranial for the Magerl technique, and 36.6° lateral and 46.1° cranial for the modified technique. The safety angle was greater and screw length longer when using this modified technique. Conclusions The relation of the V2 segment of the VA to anterior procedures and lateral mass instrumentation at the subaxial cervical spine was reviewed in this study. A detailed anatomical knowledge of the V2 segment of the VA combined with careful preoperative imaging is mandatory for safe cervical spine surgery.

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Bicortical Laminar Screws for Posterior Fixation of Subaxial Cervical Spine: A Radiologic Analysis With Computed Tomography Images

Global Spine Journal ◽

10.1177/2192568220947054 ◽

2020 ◽

pp. 219256822094705

Author(s):

Eugene J. Park ◽

Woo-Kie Min ◽

Seungbo Sim

Keyword(s):

Computed Tomography ◽

Cervical Spine ◽

Small Diameter ◽

Posterior Fixation ◽

Subaxial Cervical Spine ◽

Computed Tomography Images ◽

Screw Length ◽

Translaminar Screw ◽

Fixation Techniques ◽

Feasible Alternative

Study Design: Retrospective radiological analysis. Objectives: Translaminar screw (TLS) placement is one of the fixation techniques in the subaxial cervical spine. However, it can be difficult to use in small diameter of the lamina. This study proposed a novel bicortical laminar screw (BLS) and analyzed the related parameters using computed tomography (CT). Methods: Cervical CT images taken at our institution from January 2013 to March 2017 were used for measurement. On the axial images, the maximum screw length (MSL) and trajectory angle (TA) of BLS and TLS were measured, together with the distance from the midline (DM) to the BLS entry point and the lamina width (LW). On the parasagittal images, the height of the lamina (LH) was measured. Results: MSL of BLS and TLS were 21.00 and 20.97 mm, 19.02 and 20.91 mm, 18.45 and 21.01 mm, and 20.00 and 21.01 mm in C3, C4, C5, and C6, respectively. TA of the BLS and TLS were 21.24° and 34.90°, 19.05° and 34.22°, 18.65° and 33.61°, and 18.30° and 34.51° at C3, C4, C5, and C6, respectively. DM were 6.44, 5.77, 5.68, and 6.03 at C3, C4, C5, and C6, respectively. LW and LH were 3.52 and 12.44 mm, 2.87 and 12.49 mm, 2.76 and 12.42 mm, and 3.18 and 13.30 mm at C3, C4, C5, and C6, respectively. Conclusion: We suggest that BLS fixation is a feasible alternative option for posterior fixation to the lamina of the subaxial cervical spine. It may be especially useful when pedicle screw, lateral mass screw, and TLS are not appropriate.

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The prevalence of femoroacetabular impingement in asymptomatic hips in Indian population: a radiomorphometric analysis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20213177 ◽

2021 ◽

Author(s):

Mohammed Fawas Namboodikandy ◽

Jojo Inassi ◽

Balaji Zacharia

Keyword(s):

Femoroacetabular Impingement ◽

Indian Population ◽

Tertiary Care ◽

Cross Sectional Study ◽

X Rays ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Secondary Osteoarthritis ◽

Asymptomatic Patients ◽

Asymptomatic Individuals

Background: Femoroacetabular impingement (FAI) is a common cause of secondary osteoarthritis of the hip. There are no much studies about the occurrence of FAI in asymptomatic individuals in Indian population. Our objective was to find out the radiological prevalence of FAI in asymptomatic adult Indian population.Methods: A cross sectional study was carried out in our institution, which is a tertiary care centre, between September 2016 and September 2018 in which in which we studied radiographs of 1600 hips from 800 pelvic x-rays of asymptomatic patients.Results: Out of 1600 radiographs of the hips studied 1353 were found to be normal and the remaining 247(15.4%), had features of FAI. 61 hip radiographs (3.8%) showed cam lesions and 9.2 % showed pincer type of lesion.38 hips (2.4%) showed mixed type of FAI.Conclusions: Significant number of radiographs of asymptomatic patients showed features of FAI. Further long-term studies are needed to see the proportion of these patients with FAI progressing to secondary osteoarthritis of hip.

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Computed tomography morphometric analysis for lateral mass screw placement in the pediatric subaxial cervical spine

Journal of Neurosurgery Spine ◽

10.3171/2012.8.spine12767 ◽

2012 ◽

Vol 17 (5) ◽

pp. 390-396 ◽

Cited By ~ 8

Author(s):

George Al-Shamy ◽

Jacob Cherian ◽

Javier A. Mata ◽

Akash J. Patel ◽

Steven W. Hwang ◽

...

Keyword(s):

Cervical Spine ◽

Morphometric Analysis ◽

Pediatric Patients ◽

Screw Fixation ◽

Screw Placement ◽

Lateral Mass ◽

Lateral Mass Screw ◽

Subaxial Cervical Spine ◽

Screw Length ◽

Lateral Mass Screws

Object Lateral mass screws are routinely placed throughout the subaxial cervical spine in adults, but there are few clinical or radiographic studies regarding lateral mass fixation in children. The morphology of pediatric cervical lateral masses may be associated with greater difficulty in obtaining adequate purchase. The authors examined the lateral masses of the subaxial cervical spine in pediatric patients to define morphometric differences compared with adults, establish guidelines for lateral mass instrumentation in children, and define potential limitations of this technique in the pediatric age group. Methods Morphometric analysis was performed on CT of the lateral masses of C3–7 in 56 boys and 14 girls. Measurements were obtained in the axial, coronal, and sagittal planes. Results For most levels and measurements, results in boys and girls did not differ significantly; the few values that were significantly different are not likely to be clinically significant. On the other hand, younger (< 8 years of age) and older children (≥ 8 years of age) differed significantly at every level and measurement except for facet angularity. Sagittal diagonal, a measurement that closely estimates screw length, was found to increase at each successive caudal level from C-3 to C-7, similar to the adult population. A screw acceptance analysis found that all patients ≥ 4 years of age could accept at least a 3.5 × 10 mm lateral mass screw. Conclusions Lateral mass screw fixation is feasible in the pediatric cervical spine, particularly in children age 4 years old or older. Lateral mass screw fixation is feasible even at the C-7 level, where pedicle screw placement has been advised in lieu of lateral mass screws because of the small size and steep trajectory of the C-7 lateral mass. Nonetheless, all pediatric patients should undergo high-resolution, thin-slice CT preoperatively to assess suitability for lateral mass screw fixation.

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Multifractal analysis of mercury inclusions in quartz by X-ray computed tomography

Nonlinear Processes in Geophysics Discussions ◽

10.5194/npgd-1-1365-2014 ◽

2014 ◽

Vol 1 (2) ◽

pp. 1365-1379

Author(s):

T. Shibata ◽

T. Maruoka ◽

T. Echigo

Keyword(s):

Computed Tomography ◽

Fluid Inclusions ◽

Diffusion Processes ◽

Three Dimensional ◽

Fractal Dimensions ◽

X Rays ◽

Diffusion Limited Aggregation ◽

Cross Sectional ◽

X Ray ◽

X Ray Computed

Abstract. In order to refine our understanding how fluid inclusions were trapped in the host minerals, we non-destructively observed mercury inclusions (liquid Hg0) in quartz samples using X-ray computed tomography (CT) technique. The X-ray CT apparatus can observe internal structures of the samples and give cross-sectional images from the transmission of the X-rays through the samples. From the cross-sectional images, we obtained three-dimensional spatial distributions of mercury inclusions, and quantitatively analyzed them using fractal and multifractal methods. Although the samples were from different mines, the resultant fractal dimensions were about 1.7 for the samples. The fractal dimensions were also close to those predicted by diffusion-limited aggregation models and percolation theory, which are controlled by the irreversible kinetics. Then, the mercury-bearing fluids were not primary fluid inclusions, but migrated into the pre-existing cracks of quartz crystals by diffusion processes.

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Anterior Hollow Screw Fixation Combined with Posterior Lateral Mass Screws Fixation to Treat A Huge Tear Drop Fracture of The Axis

Surgical Case Reports ◽

10.31487/j.scr.2019.03.13 ◽

2019 ◽

pp. 1-4

Author(s):

Huang Fei ◽

Yu Fengbin ◽

Cen Lian ◽

Zhu Hui ◽

Tao Degang ◽

...

Keyword(s):

Cervical Spine ◽

Clinical Symptoms ◽

Screw Fixation ◽

X Rays ◽

Lateral Mass ◽

X Ray ◽

Lateral Mass Screws ◽

Spine Degeneration ◽

Teardrop Fracture ◽

Ligament Disruption

Teardrop fracture of axis is rarely seen, especially the huge type. The surgical approach is controversial and individualized in the literature. We reported a special case to share our experience of anterior hollow screw fixation combined with posterior unilateral lateral mass screws fixation to treat a huge teardrop fracture of the axis (HTDFA). A 42-year-old male was referred to our department; he presented neck pain after a vehicle accident. Neck movement was limited with no neurological compromise. Cervical x-rays showed a huge tear drop fracture of the anterior–inferior corner of the axis，the lower cervical spine degeneration and poor cervical curvature. Cervical CT confirmed the avulsed ratio of inferior endplate of axis up to 62%. Cervical MRI showed the anterior longitudinal ligament disruption associated with disk injury and instability of C2-3. In order to save the motion segment of C2-3 and decrease the possibility of lower cervical degeneration if C2-3 fusion occurs, a surgical plan involving anterior reduction, hollow screw fixation combined with posterior unilateral mass screws fixation was performed. The 3 months postoperative x-ray and CT scan showed the tear drop fragment had completely healed. The internal fixations were removed timely for 6 months after surgery. The patient had an excellent function of cervical spine without any clinical symptoms. The 12 months postoperative X-ray showed radiographic union of the bony fragment and a good motion range without any instability. We conclude that anterior hollow screw fixation combined with posterior unilateral lateral mass screws fixation can be the treatment of choice for HTDFA

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X-ray micro tomography in the scanning electron microscope

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100107678 ◽

1978 ◽

Vol 36 (1) ◽

pp. 106-107 ◽

Cited By ~ 1

Author(s):

W. Brünger

Keyword(s):

Electron Beam ◽

Electron Microscope ◽

Scanning Electron Microscope ◽

Target Surface ◽

The Body ◽

X Rays ◽

Cross Sectional ◽

X Ray ◽

Micro Tomography ◽

Scanning Electron

Reconstructive tomography is a new technique in diagnostic radiology for imaging cross-sectional planes of the human body /1/. A collimated beam of X-rays is scanned through a thin slice of the body and the transmitted intensity is recorded by a detector giving a linear shadow graph or projection (see fig. 1). Many of these projections at different angles are used to reconstruct the body-layer, usually with the aid of a computer. The picture element size of present tomographic scanners is approximately 1.1 mm2.Micro tomography can be realized using the very fine X-ray source generated by the focused electron beam of a scanning electron microscope (see fig. 2). The translation of the X-ray source is done by a line scan of the electron beam on a polished target surface /2/. Projections at different angles are produced by rotating the object.During the registration of a single scan the electron beam is deflected in one direction only, while both deflections are operating in the display tube.

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Non-destructive characterization of additively manufactured components with x-ray computed tomography for part qualification: A study with laboratory and synchrotron x-rays

Materials Characterization ◽

10.1016/j.matchar.2021.110894 ◽

2021 ◽

Vol 173 ◽

pp. 110894

Author(s):

Ercan Cakmak ◽

Philip Bingham ◽

Ross W. Cunningham ◽

Anthony D. Rollett ◽

Xianghui Xiao ◽

...

Keyword(s):

Computed Tomography ◽

X Rays ◽

X Ray ◽

X Ray Computed ◽

Non Destructive ◽

Non Destructive Characterization

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Visualizing Fluid Flows With X-Rays

Volume 1: Symposia, Parts A and B ◽

10.1115/fedsm2007-37023 ◽

2007 ◽

Cited By ~ 4

Author(s):

Theodore J. Heindel ◽

Terrence C. Jensen ◽

Joseph N. Gray

Keyword(s):

Computed Tomography ◽

Flow Visualization ◽

Three Dimensional ◽

Fluid Flows ◽

X Rays ◽

Radiographic Images ◽

Optical Access ◽

X Ray ◽

X Ray Computed ◽

Density Map

There are several methods available to visualize fluid flows when one has optical access. However, when optical access is limited to near the boundaries or not available at all, alternative visualization methods are required. This paper will describe flow visualization using an X-ray system that is capable of digital X-ray radiography, digital X-ray stereography, and digital X-ray computed tomography (CT). The unique X-ray flow visualization facility will be briefly described, and then flow visualization of various systems will be shown. Radiographs provide a two-dimensional density map of a three dimensional process or object. Radiographic images of various multiphase flows will be presented. When two X-ray sources and detectors simultaneously acquire images of the same process or object from different orientations, stereographic imaging can be completed; this type of imaging will be demonstrated by trickling water through packed columns and by absorbing water in a porous medium. Finally, local time-averaged phase distributions can be determined from X-ray computed tomography (CT) imaging, and this will be shown by comparing CT images from two different gas-liquid sparged columns.

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