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Vijayakumar P, Mani R, Raja S, Dhas TS. Susceptibility of betanodavirus in a newly established vertebra-derived cell line from Mosquitofish (Gambusia affinis). J Fish Dis 2020; 43:263-273. [PMID: 31845349 DOI: 10.1111/jfd.13127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
In the present study, a new cell line from the vertebra of mosquitofish Gambusia affinis was successfully established and characterized. The cell line is named as bone Gambusia affinis (BGA) and subcultured for more than 55 passages in Leibovitz's/L15 medium supplemented with 15% FBS at 28°C. The cell line has a modal chromosome number of 48. Molecular characterization of the partial sequence of the coi gene confirmed the origin of the BGA cell line from mosquitofish. These cells exhibited epithelial morphology confirmed by the cytokeratin marker. The BGA cells showed mineralization of their extracellular matrix when stained with alizarin red and von Kossa stain. BGA cells were found to be susceptible to RGNNV and SJNNV strains of betanodavirus (NNV) showing cytopathic effect with multiple vacuolations in the cells. The RT-PCR confirmed the betanodavirus infections in BGA cells. The SEM micrograph showed the morphological changes observed in the cell during virus infection. The in vivo challenge experiment also showed the viral replicating efficiency in the Gambusia affinis with increasing viral titre. Thus, our present results show that the BGA cell line is a useful tool for isolating betanodavirus and could be used to investigate bone cell differentiation and extracellular matrix mineralization.
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Affiliation(s)
- Parameswaran Vijayakumar
- Centre for Ocean Research, Col. Dr Jeppiaar Research Park, Sathyabama Institute of Science and Technology, Chennai, India
| | - Ravi Mani
- Centre for Ocean Research, Col. Dr Jeppiaar Research Park, Sathyabama Institute of Science and Technology, Chennai, India
| | - Sudhakaran Raja
- Aquaculture Biotechnology Laboratory, Vellore Institute of Technology, School of BioSciences and Technology, Vellore, India
| | - Tharmathass Stalin Dhas
- Centre for Ocean Research, Col. Dr Jeppiaar Research Park, Sathyabama Institute of Science and Technology, Chennai, India
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Bagwell J, Norman J, Ellis K, Peskin B, Hwang J, Ge X, Nguyen SV, McMenamin SK, Stainier DY, Bagnat M. Notochord vacuoles absorb compressive bone growth during zebrafish spine formation. eLife 2020; 9:51221. [PMID: 31995030 PMCID: PMC7012607 DOI: 10.7554/elife.51221] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/28/2020] [Indexed: 12/27/2022] Open
Abstract
The vertebral column or spine assembles around the notochord rod which contains a core made of large vacuolated cells. Each vacuolated cell possesses a single fluid-filled vacuole, and loss or fragmentation of these vacuoles in zebrafish leads to spine kinking. Here, we identified a mutation in the kinase gene dstyk that causes fragmentation of notochord vacuoles and a severe congenital scoliosis-like phenotype in zebrafish. Live imaging revealed that Dstyk regulates fusion of membranes with the vacuole. We find that localized disruption of notochord vacuoles causes vertebral malformation and curving of the spine axis at those sites. Accordingly, in dstyk mutants the spine curves increasingly over time as vertebral bone formation compresses the notochord asymmetrically, causing vertebral malformations and kinking of the axis. Together, our data show that notochord vacuoles function as a hydrostatic scaffold that guides symmetrical growth of vertebrae and spine formation.
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Affiliation(s)
- Jennifer Bagwell
- Department of Cell Biology, Duke University, Durham, United States
| | - James Norman
- Department of Cell Biology, Duke University, Durham, United States
| | - Kathryn Ellis
- Department of Cell Biology, Duke University, Durham, United States
| | - Brianna Peskin
- Department of Cell Biology, Duke University, Durham, United States
| | - James Hwang
- Department of Cell Biology, Duke University, Durham, United States
| | - Xiaoyan Ge
- Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, United States
| | - Stacy V Nguyen
- Biology Department, Boston College, Boston, United States
| | | | - Didier Yr Stainier
- Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, United States.,Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Michel Bagnat
- Department of Cell Biology, Duke University, Durham, United States
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Chiu CK, Lisitha KA, Elias DM, Yong VW, Chan CYW, Kwan MK. Do the dynamic stress mobility radiographs predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty for osteoporotic thoracolumbar vertebral fractures with intravertebral cleft? J Orthop Surg (Hong Kong) 2019; 26:2309499018806700. [PMID: 30352524 DOI: 10.1177/2309499018806700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This prospective clinical-radiological study was conducted to determine whether the dynamic mobility stress radiographs can predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty. METHODS Patients included had the diagnosis of significant back pain caused by osteoporotic vertebral compression fracture secondary to trivial injury. All the patients underwent routine preoperative sitting lateral spine radiograph, supine stress lateral spine radiograph, and supine anteroposterior spine radiograph. The radiological parameters recorded were anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), MVH level below, wedge endplate angle (WEPA), and regional kyphotic angle (RKA). The supine stress versus sitting difference (SSD) for all the above parameters were calculated. RESULTS A total of 28 patients (4 males; 24 females) with the mean age of 75.6 ± 7.7 years were recruited into this study. The mean cement volume injected was 5.5 ± 1.8 ml. There was no difference between supine stress and postoperative radiographs for AVH ( p = 0.507), PVH ( p = 0.913) and WEPA ( p = 0.379). The MVH ( p = 0.026) and RKA ( p = 0.005) were significantly less in the supine stress radiographs compared to postoperative radiographs. There was significant correlation ( p < 0.05) between supine stress and postoperative AVH, MVH, PVH, WEPA, and RKA. The SSD for AVH, PVH, WEPA, and RKA did not have significant correlation with the cement volume ( p > 0.05). Only the SSD-MVH had significant correlation with cement volume, but the correlation was weak ( r = 0.39, p = 0.04). CONCLUSIONS Dynamic mobility stress radiographs can predict the postoperative vertebral height restoration and kyphosis correction after vertebroplasty for thoracolumbar osteoporotic fracture with intravertebral clefts. However, it did not reliably predict the amount of cement volume injected as it was affected by other factors.
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Affiliation(s)
- Chee Kidd Chiu
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Dahlia Munchar Elias
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Voon Wei Yong
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mun Keong Kwan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Sambataro S, Cervino G, Bocchieri S, La Bruna R, Cicciù M. TMJ Dysfunctions Systemic Implications and Postural Assessments: A Review of Recent Literature. J Funct Morphol Kinesiol 2019; 4. [PMID: 33467373 DOI: 10.3390/jfmk4030058] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 12/22/2022] Open
Abstract
Cases of correlations between posture and the temporomandibular joint have long been reported in the literature. In particular, occlusal anomalies, and therefore malocclusion, could have negative implications for the spine. The objective of this study was to review the literature and bring to light any correlations between temporomandibular joints (TMJ) and posturology. The literature search was conducted in the PubMed and Embase scientific search engines with the aim of obtaining the most possible results in the initial search, the number of results initially obtained was 263. Subsequently, the inclusion and exclusion criteria were reduced first to 83 and subsequently to manual analysis of the articles, those included remained only 11. The results show a correlation between anomalies of the TMJ and dysfunctions of the vertebral column. Not all the articles considered are in agreement with each other regarding epidemiological data, but surely this study can represent an important starting point for a much more careful evaluation of the dental patient and at the same time for the request for counseling by a dentist in case of postural abnormalities.
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van den Elshout-den Uyl D, Spoto CPE, de Boer M, Leiner T, Leavis HL, Leguit RJ. First Report of IgG4 Related Disease Primary Presenting as Vertebral Bone Marrow Lesions. Front Immunol 2019; 10:1910. [PMID: 31456806 PMCID: PMC6700296 DOI: 10.3389/fimmu.2019.01910] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/29/2019] [Indexed: 12/24/2022] Open
Abstract
IgG4-related disease is a fibro-inflammatory disorder characterized by swelling of tissues and affected organs accompanied by the development of scar tissue (fibrosis) and infiltration by IgG4 positive plasma cells. Almost any organ can be affected, including, but rarely, bone marrowinvolvement. Here we present a case of a 76-year-old male with IgG4-related disease presenting primarily with vertebral bone marrow lesions. Histopathology showed the typical features of storiform fibrosis, and increased IgG4 positive plasma cells. Treatment with corticosteroids significantly improved wellbeing and resolved lesion size on MRI.
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Affiliation(s)
| | - Clothaire P E Spoto
- Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mirthe de Boer
- Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Helen L Leavis
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Roos J Leguit
- Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands
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Abstract
BACKGROUND Sex-related differences of vertebral bone marrow fat in relation to varying bone densities have not yet been evaluated although some studies have reported an inverse association of bone marrow fat and bone mineral density (BMD). PURPOSE To evaluate the relationship between bone marrow fat and BMD and to demonstrate the sex-related differences of the vertebral bone marrow fat in normal adults with varying bone densities. MATERIAL AND METHODS A total of 123 normal adult volunteers were enrolled in this study. 1H-MRS of the lumbar spine was performed. The fat fraction (FF) values of vertebral bone marrow were measured. Volumetric BMD measurement was performed by quantitative computed tomography (QCT). All participants were divided into three groups according to BMD (normal, osteopenia, osteoporosis). The differences in the FF and body mass index (BMI) values of the three groups were compared, and partial correlation analysis was used to evaluate the correlation between FF values and BMD/BMI. RESULTS The FF values increased with decreasing BMD in both male and female participants. There were significant sex differences for the FF values in the normal bone density group ( P < 0.001). The FF values of the normal bone density group in male participants were significantly higher than those of the female participants ( P < 0.001). The FF values were significantly negative correlated with BMD for all participants (r = -0.820, P < 0.001). CONCLUSION The FF values of vertebral bone marrow correlated inversely with BMD. Sex-related differences of FF values was related to BMD.
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Affiliation(s)
- Jie He
- Department of Radiology, The Third Hospital, Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, Hebei Province, PR China
| | - Hao Fang
- Department of Radiology, First Affiliated Hospital, Tianjin University of Chinese Medicine, Tianjin, PR China
| | - Xiaona Li
- Department of Radiology, The Third Hospital, Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, Hebei Province, PR China
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Ucler N. Isolated enchondroma of the atlas. J Craniovertebr Junction Spine 2019; 9:283-285. [PMID: 30783356 PMCID: PMC6364371 DOI: 10.4103/jcvjs.jcvjs_101_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Periosteal enchondromas located in the spine are rare. We reported an even more infrequent occurrence of a periosteal enchondroma in the cervical spine of a 19-year-old girl. During the operation, a giant (>8 cm × 5.5 cm × 5 cm) ossified periosteal enchondroma with involvement of posterior structures and muscles of the axis was resected. The pathological examination revealed that the tumor consisted of enchondroid tissue with typical chondrocytes, confirming the diagnosis of periosteal enchondroma. Early identification of the initial lesion should be coupled with total surgical resection, as a definitive treatment, to prevent malignant transformation. Enchondromas grow in an expanding manner which makes easy total resection.
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Affiliation(s)
- Necati Ucler
- Department of Neurosurgery, Education and Research Hospital, Adiyaman University, Adiyaman, Turkey
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Kim DH, Kim CJ, Son SM. Neck Pain in Adults with Forward Head Posture: Effects of Cranio vertebral Angle and Cervical Range of Motion. Osong Public Health Res Perspect 2018; 9:309-313. [PMID: 30584494 PMCID: PMC6296804 DOI: 10.24171/j.phrp.2018.9.6.04] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives The purpose of this study was to determine whether the cranial vertebral angle (CVA) and the range of motion (ROM) was different between participants with a forward head posture (FHP), with or without pain. Methods Forty-four participants who had FHP participated in this study. The FHP was assessed digitally by measuring a lateral view the CVA for each subject. A cervical ROM device measured the cervical ROM. The volunteers were allocated to either, with pain (n = 22), or without pain (n = 22) groups, and pain was evaluated using the Numeric Pain Rating Scale. Results The FHP in the pain group showed a significant difference in the CVA, and the cervical ROM in both flexion and extension, compared with those in the FHP without pain group (p < 0.05). Logistic regression analysis indicated that the occurrence of cervical area pain was higher amongst subjects who had a decreased CVA and flexion motion. Conclusion This study suggested that decreased CVA and cervical flexion range, were predictive factors for the occurrence of pain in the cervical region.
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Affiliation(s)
- Dae-Hyun Kim
- Department of Physical Therapy, Chonbuk National Hospital, Jeonju, Korea
| | - Chang-Ju Kim
- Department of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea
| | - Sung-Min Son
- Department of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea
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Huang HC, Srinivasan R, Sun Y, Kazakia GJ, Lin PC, Yeh BM. Detection of Lumbar Spine Osseous Metastases Using Dual-Energy CT: Phantom Results and Preliminary Clinical Validation. AJR Am J Roentgenol 2019; 212:402-10. [PMID: 30667316 DOI: 10.2214/AJR.18.19933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the sensitivity, tumor conspicuity, and image quality of different material decomposition images of phantoms and patients with nearly isodense bone metastases using rapid-kilovoltage-switching dual-energy CT (DECT). MATERIALS AND METHODS Fifty-one semianthropomorphic lumbar spine phantoms embedded with 75 simulated tumors were scanned without and with outer torso-attenuating encasement under the same scan settings. Two radiologists independently reviewed the 70-keV virtual monochromatic and material decomposition images (hydroxyapatite-water, water-hydroxyapatite, cortical bone-water, water-cortical bone). The sensitivity of tumor detection, tumor conspicuity (on a 3-point scale), and image quality (on a 3-point scale) were recorded by two independent readers. McNemar and Wilcoxon signed rank tests were used to compare results between the image reconstructions. Six clinical abdominopelvic DECT scans (three men, three women; mean age, 52 years) with nine nearly isodense lumbar spine tumors missed in the clinical report but confirmed on other scans were also evaluated. RESULTS The hydroxyapatite-water material decomposition algorithm showed improved sensitivity for isodense lesion detection (without torso phantom encasement, 94% vs 82%, p = 0.031; with torso phantom encasement, 38% vs 18%, p = 0.013), and higher tumor conspicuity scores (p < 0.0001) compared with 70-keV virtual monoenergetic images. Artifacts were more prevalent with all material decomposition images than with 70-keV virtual monoenergetic images. Similar results were seen in the patient study. CONCLUSION Dual-energy CT with hydroxyapatite-water material decomposition may improve the detection of bone marrow metastases, especially for subtle isodense tumors. Further study in prospective clinical scans is warranted.
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Abstract
The lateral vertebral foramen (LVF) is an osseous feature found in thoracic and lumbar vertebrae of some artiodactyls and perissodactyls. To learn more about the distribution and characteristics of the LVF, we examined museum specimens from the Smithsonian mammal collection and teaching specimens from the Cornell University College of Veterinary Medicine. We identified five anatomically different types of LVF and noted their occurrence in 60 species. The LVF varies from a deep lateral groove at the cranial intervertebral notch, to as many as three distinct foramina located bilaterally in the caudal half of each vertebra. A nomenclature was developed to describe these five distinctly different LVF forms. The interspecific distribution of the LVF varies from examples such as the gazelle Gazella spekei, where the LVF occurs only in the thoracic region, to others such as the Siberian musk deer Moschus berezovski, where the LVF is predominant only in the lumbar region. Others, such as the Bos (cows), have large LVF along most of both the thoracic and lumbar regions of the vertebral column. Some did not have any form of LVF, such as the Giraffidae (giraffes) and Cetacea (whales). No LVF were found in 15 species representing nine families of the outgroup Carnivora, thus the LVF appears to be a characteristic specific to the artiodactyls and perissodactyls.
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Affiliation(s)
- Linda A Mizer
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Christina Wahl
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
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Yang C, Weisbrode S, Yardley J, Schroeder E, Premanandan C. Metaphyeal and Diaphyseal Dysplasia of the Third Cervical Vertebra Secondary to Physeal Necrosis in a Quarter Horse Foal. J Comp Pathol 2018; 163:38-41. [PMID: 30213373 DOI: 10.1016/j.jcpa.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/29/2018] [Accepted: 07/04/2018] [Indexed: 11/20/2022]
Abstract
Ischaemia-induced physeal injury has not been described previously in the horse. A 1-month-old Quarter horse foal was submitted for necropsy examination due to an acute onset of ataxia followed by a 4-week history of progressive decline. Focal narrowing of the spinal canal due to ventral compression by the rotation of the cranial aspect of the third cervical vertebra (C3) was observed. The metaphysis and diaphysis of C3 were markedly shortened and white-tan in colour. Microscopically, there was complete loss of the dorsal compact bone of C3 and replacement of 80% of the physis that runs parallel to the vertebral canal with fibrous tissue and thickened viable trabecular bone. Both cranial and caudal physes of C3 showed widespread bands of coagulative necrosis of the hypertrophic and calcifying zones. Marked bone marrow hypoplasia with slight fibrosis was observed in the metaphyses and diaphysis. There was no evidence of fracture or inflammation. The epiphyses were microscopically unremarkable. It was hypothesized that a regional transient incomplete and possibly multiphasic ischaemia involving the nutrient artery caused necrosis of the physes, resulting in dysplasia of the bone. Ischaemic injury to the physis should be considered in the pathogenesis of focal bone dysplasia in horses.
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Estell K, Spriet M, Phillips KL, Aleman M, Finno CJ. Current dorsal myelographic column and dural diameter reduction rules do not apply at the cervicothoracic junction in horses. Vet Radiol Ultrasound 2018; 59:662-666. [PMID: 29998490 DOI: 10.1111/vru.12662] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/13/2018] [Accepted: 04/15/2018] [Indexed: 11/30/2022] Open
Abstract
Previously published myelographic studies do not report findings at the junction between the seventh cervical (C7) and first thoracic vertebrae (T1). Modern digital radiographic equipment allows improved visualization of C7-T1. Based on clinical experience, we hypothesized that 50% reduction of the dorsal myelographic column or 20% reduction of the dural diameter, criteria commonly used as a supportive finding for spinal cord compression in the cervical vertebral column, do not apply at C7-T1. A myelographic study was performed on 12 healthy, neurologically normal horses. Our hypothesis was confirmed; using established criteria eight of 12 horses would have been classified as having evidence of spinal cord compression at C7-T1. The dorsal myelographic column reduction at C7-T1 was 48 ± 12%, while the C6-C7 dorsal myelographic column reduction was 33 ± 17% (mean ± standard deviation) (P = 0.010). The dural diameter reduction at C7-T1 (22.0 ± 6.7%) was significantly greater than the dural diameter reduction at C6-C7 (13.2 ± 9.5%) (P = 0.0007). Further measurements and comparisons suggested that the apparent greater reduction of dorsal myelographic column and dural diameter at C7-T1 was due to larger intravertebral measurements at C7 rather than smaller intervertebral values at C7-T1. Based on these findings, alternative criteria should be used at C7-T1 when assessing clinical cases for cervical stenotic myelopathy. Reduction of the dorsal myelographic column by 60% or of the dural diameter by 30% would avoid high numbers of false positive myelographic cases at C7-T1.
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Affiliation(s)
- Krista Estell
- Department of Large Animal Clinical Sciences, Marion DuPont Scott Equine Medical Center, Leesburg, VA, 20176
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, 95616
| | - Kathryn L Phillips
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, 95616
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, 95616
| | - Carrie J Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, 95616
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Abdullayev N, Neuhaus VF, Bratke G, Voss S, Große Hokamp N, Hellmich M, Krug B, Maintz D, Borggrefe J. Effects of Contrast Enhancement on In-Body Calibrated Phantomless Bone Mineral Density Measurements in Computed Tomography. J Clin Densitom 2018; 21:360-366. [PMID: 29169662 DOI: 10.1016/j.jocd.2017.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/22/2023]
Abstract
We aimed to test the potential of phantomless volumetric bone mineral density (PLvBMD) measurements for the determination of volumetric bone mineral density (vBMD) in routine contrast-enhanced computed tomography (CECT). We evaluated 56 tri-phasic abdominal computed tomography scans, including an unenhanced scan as well as defined CECT scans in the arterial and portalvenous phase. PLvBMD analysis was performed by 4 radiologists using an FDA-approved tool for phantomless evaluation of bone density (IntelliSpace, Philips, The Netherlands). Mean vBMD of the first 3 lumbar vertebrae in each contrast phase was determined and interobserver variance of vBMD independent of contrast phase was analyzed using intraclass correlation, Bland-Altman plots, and Student's t test. CECT scans were associated with a significantly higher PLvBMD compared with unenhanced scans (unenhanced computed tomography: 97.8 mg/cc; arterial CECT: 106.3 mg/cc, portalvenous CECT: 106.3 mg/cc). Overall, there was no significant difference of PLvBMD between data acquisition in arterial and portalvenous phases (increase of 8.6% each, standard deviation ratio 37.7%-38.3%). In Bland-Altman analysis, there was no evidence of a relevant reader-related bias or an increase in standard deviation of PLvBMD measurements in contrast-enhanced scans compared with unenhanced scans. The following conversion formulas for unenhanced PLvBMD were determined: unenhancedPLvBMD=0.89×arterialPLvBMD+3,74mg/cc(r2 = 0.94) and unenhancedPLvBMD=0.88×venousPLvBMD+4,56mg/cc(r2 = 0.93). Compared with the results of phantom-based quantitative computed tomography measurements reported in the literature, the PLvBMD changes associated with contrast enhancement were relatively moderate with an increase of 8.6% in average. The time-point of the contrast-enhanced PLvBMD measurements after injection of contrast media did not appear to affect the results. With the adjustment formulas provided in this study, the method can improve osteoporosis screening through detection of reduced bone mass of the vertebrae in routinely conducted CECT.
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Affiliation(s)
- Nuran Abdullayev
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | | | - Grischa Bratke
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | - Sebastian Voss
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | - Nils Große Hokamp
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | - Martin Hellmich
- Institut für Medizinische Statistik, Informatik und Epidemiologie, Universitätsklinikum Köln, Köln, Germany
| | - Barbara Krug
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | - David Maintz
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany
| | - Jan Borggrefe
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Germany.
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Iwata M, Yamamoto W, Shimomoto T, Okada Y, Oosawa S, Miura D, Hara Y. Persistence of vertebral growth plate cartilage in aged cynomolgus monkeys. J Toxicol Pathol 2018; 31:151-154. [PMID: 29750005 PMCID: PMC5938217 DOI: 10.1293/tox.2017-0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/17/2017] [Indexed: 11/19/2022] Open
Abstract
Growth plates at each end of vertebral bodies play a pivotal role in longitudinal spinal growth. Epiphyseal closures are formed in adult humans. Although monkeys are frequently employed in bone and disc research, the age of epiphyseal closure has not been well documented. In this study, histological analyses of lumbar vertebral end plates and the surrounding tissue were performed in 11 normal cynomolgus monkeys aged approximately 9 to 15 years, and unclosed growth plate cartilage was detected in all the end plates. The data from this study constitute the first documentation of persistent vertebral growth plate cartilage in cynomolgus monkeys. The persistence of growth plate cartilage in cynomolgus monkeys approximately 15 years of age or younger, which differs from the complete epiphyseal closure exhibited in adult humans, may affect the biomechanical behavior of the spine. This is an important factor to consider in extrapolating the results of spine and intervertebral disc research using cynomolgus monkeys to adult humans.
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Affiliation(s)
- Munetaka Iwata
- Veterinary Medical Center, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano-shi, Osaka 598-8531, Japan.,Division of Veterinary Surgery, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino-shi, Tokyo 180-8602, Japan
| | - Wataru Yamamoto
- Toxicology Research Department, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2 Asahigaoka, Hino-shi, Tokyo 191-8512, Japan
| | - Takasumi Shimomoto
- Toxicology Research Department, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2 Asahigaoka, Hino-shi, Tokyo 191-8512, Japan
| | - Yuki Okada
- Toxicology Research Department, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2 Asahigaoka, Hino-shi, Tokyo 191-8512, Japan
| | - Satomi Oosawa
- Toxicology Research Department, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2 Asahigaoka, Hino-shi, Tokyo 191-8512, Japan
| | - Daishiro Miura
- Toxicology Research Department, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2 Asahigaoka, Hino-shi, Tokyo 191-8512, Japan
| | - Yasushi Hara
- Division of Veterinary Surgery, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino-shi, Tokyo 180-8602, Japan
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De Blasio MJ, Lanham SA, Blache D, Oreffo ROC, Fowden AL, Forhead AJ. Sex- and bone-specific responses in bone structure to exogenous leptin and leptin receptor antagonism in the ovine fetus. Am J Physiol Regul Integr Comp Physiol 2018; 314:R781-R790. [PMID: 29443548 DOI: 10.1152/ajpregu.00351.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Widespread expression of leptin and its receptor in developing cartilage and bone suggests that leptin may regulate bone growth and development in the fetus. Using microcomputed tomography, this study investigated the effects of exogenous leptin and leptin receptor antagonism on aspects of bone structure in the sheep fetus during late gestation. From 125 to 130 days of gestation (term ~145 days), chronically catheterized singleton sheep fetuses were infused intravenously for 5 days with either saline (0.9% saline, n = 13), recombinant ovine leptin at two doses (0.6 mg·kg-1·day-1 LEP1, n = 10 or 1.4 mg·kg-1·day-1 LEP2, n = 7), or recombinant superactive ovine leptin receptor antagonist (4.6 mg·kg-1·day-1 SOLA, n = 6). No significant differences in plasma insulin-like growth factor-I, osteocalcin, calcium, inorganic phosphate, or alkaline phosphatase were observed between treatment groups. Total femur midshaft diameter and metatarsal lumen diameter were narrower in male fetuses treated with exogenous leptin. In a fixed length of femur midshaft, total and bone volumes were reduced by the higher dose of leptin; nonbone space volume was lower in both groups of leptin-treated fetuses. Leptin infusion caused increments in femur porosity and connectivity density, and vertebral trabecular thickness. Leptin receptor antagonism decreased trabecular spacing and increased trabecular number, degree of anisotrophy, and connectivity density in the lumbar vertebrae. The increase in vertebral porosity observed following leptin receptor antagonism was greater in the malecompared with female, fetuses. Therefore, leptin may have a role in the growth and development of the fetal skeleton, dependent on the concentration of leptin, sex of the fetus, and bone type examined.
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Affiliation(s)
- Miles J De Blasio
- Department of Physiology, Development, and Neuroscience, University of Cambridge , Cambridge , United Kingdom
| | - Stuart A Lanham
- Bone and Joint Research Group, Centre for Human Development, Stem Cells, and Regeneration, Institute of Developmental Sciences, University of Southampton , Southampton , United Kingdom
| | - Dominique Blache
- School of Animal Biology, University of Western Australia , Crawley , Australia
| | - Richard O C Oreffo
- Bone and Joint Research Group, Centre for Human Development, Stem Cells, and Regeneration, Institute of Developmental Sciences, University of Southampton , Southampton , United Kingdom
| | - Abigail L Fowden
- Department of Physiology, Development, and Neuroscience, University of Cambridge , Cambridge , United Kingdom
| | - Alison J Forhead
- Department of Physiology, Development, and Neuroscience, University of Cambridge , Cambridge , United Kingdom.,Department of Biological and Medical Sciences, Oxford Brookes University , Oxford , United Kingdom
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Schut PC, Ten Broek CMA, Cohen-Overbeek TE, Bugiani M, Steegers EAP, Eggink AJ, Galis F. Increased prevalence of abnormal vertebral patterning in fetuses and neonates with trisomy 21. J Matern Fetal Neonatal Med 2018; 32:2280-2286. [PMID: 29353507 DOI: 10.1080/14767058.2018.1431622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the prevalence of an abnormal number of ribs in a cohort of fetuses and neonates with trisomy 21 and compare this with a subgroup of fetuses without anomalies. MATERIALS AND METHODS Radiographs of 67 deceased fetuses, neonates, and infants that were diagnosed with trisomy 21 were reviewed. Terminations of pregnancy were included. The control group was composed of 107 deceased fetuses, neonates, and infants without known chromosomal abnormalities, structural malformations, infections or placental pathology. Cases in which the number of thoracic ribs or presence of cervical ribs could not be reliably assessed were excluded. The literature concerning vertebral patterning in trisomy 21 cases and healthy subjects was reviewed. RESULTS Absent or rudimentary 12th thoracic ribs were found in 26/54 (48.1%) cases with trisomy 21 and cervical ribs were present in 27/47 (57.4%) cases. This prevalence was significantly higher compared to controls (28/100, 28.0%, Χ2(1) = 6.252, p = .012 and 28/97, 28.9%, Χ2(1) = 10.955, p < .001, respectively). CONCLUSIONS Rudimentary or absent 12th thoracic ribs and cervical ribs are significantly more prevalent in deceased fetuses and infants with trisomy 21.
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Affiliation(s)
- Pauline C Schut
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | | | - Titia E Cohen-Overbeek
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Marianna Bugiani
- c Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands
| | - Eric A P Steegers
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Alex J Eggink
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Frietson Galis
- b Naturalis Biodiversity Center , Leiden , The Netherlands
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Held M, Castelein S, Bruins MF, Laubscher M, Dunn R, Keel M, Ahmad S, Hoppe S. Most Influential Literature in Spinal Tuberculosis: A Global Disease Without Global Evidence. Global Spine J 2018; 8:84-94. [PMID: 29456919 PMCID: PMC5810894 DOI: 10.1177/2192568217707182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
STUDY DESIGN Bibliometric review of the literature. OBJECTIVE This bibliometric analysis aims to give an overview of the most influential academic literature written on spinal tuberculosis. METHODS All databases included in the Thomson Reuters Web of Knowledge were searched for the most influential publications in spinal tuberculosis. The most cited articles published between 1950 and 2015, with the main focus on orthopedic surgery, were identified using a multistep approach, and a total of 100 articles were included. The publications were then analyzed in this bibliometric analysis. RESULTS The number of citations ranged from 243 to 36, with an average of 77.11. The articles were published in 34 different journals, and the studies were conducted in 20 different countries. The top 3 countries, India, the United States, and China, published a total of 51% (n = 51) of all articles. Low-burden countries produced 60% (n = 60) of all articles in our list. African centers produced only 4% (n = 4) of all included articles. CONCLUSIONS Indian and Chinese researchers dominate evidence in spinal tuberculosis. Other areas with high disease burden, such as Africa, do not feature. Most publications are retrospective studies with a low level of evidence.
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Affiliation(s)
- Michael Held
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa,Michael Held, Orthopaedic Research Unit, Groote Schuur Hospital, University of Cape Town, 7925 Observatory, Cape Town, South Africa.
| | - Sophie Castelein
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Marie-Fien Bruins
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Maritz Laubscher
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Robert Dunn
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Marius Keel
- Inselsspital, Universiry of Bern, Bern, Switzerland
| | - Sufian Ahmad
- Inselsspital, Universiry of Bern, Bern, Switzerland
| | - Sven Hoppe
- Inselsspital, Universiry of Bern, Bern, Switzerland
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Nguyen L, Stoter S, Baum T, Kirschke J, Ruess M, Yosibash Z, Schillinger D. Phase-field boundary conditions for the voxel finite cell method: Surface-free stress analysis of CT-based bone structures. Int J Numer Method Biomed Eng 2017; 33. [PMID: 28294574 DOI: 10.1002/cnm.2880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 06/06/2023]
Abstract
The voxel finite cell method uses unfitted finite element meshes and voxel quadrature rules to seamlessly transfer computed tomography data into patient-specific bone discretizations. The method, however, still requires the explicit parametrization of boundary surfaces to impose traction and displacement boundary conditions, which constitutes a potential roadblock to automation. We explore a phase-field-based formulation for imposing traction and displacement constraints in a diffuse sense. Its essential component is a diffuse geometry model generated from metastable phase-field solutions of the Allen-Cahn problem that assumes the imaging data as initial condition. Phase-field approximations of the boundary and its gradient are then used to transfer all boundary terms in the variational formulation into volumetric terms. We show that in the context of the voxel finite cell method, diffuse boundary conditions achieve the same accuracy as boundary conditions defined over explicit sharp surfaces, if the inherent length scales, ie, the interface width of the phase field, the voxel spacing, and the mesh size, are properly related. We demonstrate the flexibility of the new method by analyzing stresses in a human femur and a vertebral body.
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Affiliation(s)
- Lam Nguyen
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Stein Stoter
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Thomas Baum
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan Kirschke
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Martin Ruess
- School of Engineering, University of Glasgow, Glasgow, UK
| | - Zohar Yosibash
- Department of Mechanical Engineering, Ben-Gurion-University of the Negev, Beer Sheva, Israel
| | - Dominik Schillinger
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, Minneapolis, MN 55455, USA
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Pluemvitayaporn T, Piyaskulkaew C, Kunakornsawat S, Pruttikul P. Primary leiomyosarcoma of the spine treated with total en bloc spondylectomy: the first case in Thailand-a case report and literature review. J Spine Surg 2017; 3:707-714. [PMID: 29354752 DOI: 10.21037/jss.2017.10.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Leiomyosarcoma is a rare type of malignant soft tissue tumor and also one of the most aggressive soft tissue sarcomas. It commonly occurs in uterus, abdominal viscera, retroperitoneal space and soft tissue of the extremities. Primary osseous leiomyosarcoma is a rare condition. Furthermore, primary leiomyosarcoma of the spine is extremely rare. Only few cases have been reported. However, the treatment and outcomes remains controversial. Therefore, the objective of this case report is to illustrate the management of this extremely rare disease by using total en bloc spondylectomy (TES) procedure, which is one of a suitable option for surgical resection of the spinal tumors. In this study, we presented an unusual case of a 61-year-old female, who was diagnosed as primary leiomyosarcoma of the twelfth thoracic spine with liver metastasis, treated with total en bloc spondylectomy of the twelfth thoracic vertebra followed by chemotherapy. On last follow-up, 6 months after the surgery, the clinical outcome remained in good condition and no signs of local recurrence. In conclusion, primary leiomyosarcoma of the spine is an extremely rare and difficult to diagnosis. Immunohistochemistry studies are very important for confirmation of the diagnosis. Standard treatment remains controversial. However, surgical resection is still treatment of choice. One of the most effective surgical options is TES, which give the better outcome and minimize local recurrence, if indicate.
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Hur M, Gistelinck CA, Huber P, Lee J, Thompson MH, Monstad-Rios AT, Watson CJ, McMenamin SK, Willaert A, Parichy DM, Coucke P, Kwon RY. MicroCT-Based Phenomics in the Zebrafish Skeleton Reveals Virtues of Deep Phenotyping in a Distributed Organ System. Zebrafish 2017; 15:77-78. [PMID: 29173118 DOI: 10.1089/zeb.2017.1540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Matthew Hur
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | | | - Philippe Huber
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | - Jane Lee
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | - Marjorie H Thompson
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | - Adrian T Monstad-Rios
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | - Claire J Watson
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
| | | | - Andy Willaert
- 2 Center for Medical Genetics, Ghent University , Ghent, Belgium
| | - David M Parichy
- 4 Department of Biology, University of Virginia , Charlottesville, Virginia
| | - Paul Coucke
- 2 Center for Medical Genetics, Ghent University , Ghent, Belgium
| | - Ronald Y Kwon
- 1 Department of Orthopaedics and Sports Medicine, University of Washington , Seattle, Washington
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Toescu SM, Ibrahim M, O'Donovan DG, Balasubramaniam G, David KM. Complex spinal fixation of a cervical vertebra Brown tumour: report of an unusual case. Br J Neurosurg 2017; 33:684-686. [PMID: 29160114 DOI: 10.1080/02688697.2017.1406059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Brown tumours affecting the cervical spine are a rare but recognised complication of renal failure-related secondary hyperparathyroidism. We present a case of a 26 year-old female with radiculopathy who was managed successfully with 360° cervical spine fixation and parathyroidectomy.
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Affiliation(s)
| | - Maria Ibrahim
- Department of Nephrology, Southend University Hospital, Southend-on-Sea, UK
| | | | | | - Karoly M David
- Department of Neurosurgery, Essex Neurosciences Centre, Queens Hospital, Romford, UK
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Abstract
BACKGROUND Solitary myofibroma of the spine is extremely rare, particularly among adults. To the best of our knowledge, only 3 cases affecting lumbar vertebrae have been reported in the English language literature. Of them, only 1 case was an adult case of solitary myofibroma affecting the L1 vertebra. METHODS We report a case of solitary myofibroma affecting the L5 vertebra in an 18-year-old man and the postoperative imaging of solitary myofibroma for the first time. Conventional radiographs demonstrated an expansile osteolytic lesion with thinned cortex and marginal sclerosis. Computed tomography (CT) showed a purely osteolytic expansile lesion with partial disappearance of thinned cortex. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneous slightly hyperintense signal on T2-weighed images, and homogeneous avid enhancement with gadolinium. RESULTS Surgical excision was performed and the lesion was diagnosed as solitary myofibroma on pathological examination. One-year follow-up postoperative CT demonstrated decreased size of the osteolytic lesion with sclerotic change. Four-year follow-up postoperative MRI revealed complete resolution of the lesion replaced by normal fatty marrow. CONCLUSION If a benign-looking expansile osteolytic lesion reveals a homogeneously isointense signal on T1-weighted image, inhomogeneous slightly hyperintense signal on T2-weighted image, and homogeneous avid enhancement with gadolinium, solitary myofibroma should be considered in the differential diagnosis of spine bone tumors. It can be resolved completely.
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Affiliation(s)
| | | | | | - Dong Eun Shin
- Department of Orthopedics, CHA Bundang Medical Center, CHA University, College of Medicine, Gyeonggi-do, Republic of Korea
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Lu Y, Liu Y, Wu C. [Influence analysis of aging of spinal segment on the mechanical behavior of vertebral cortex]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2017; 34:371-376. [PMID: 29745502 DOI: 10.7507/1001-5515.201608050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The risk of vertebral cortical shell fracture increases with aging. However, it remains unclear how aging contributes to cortex fracture at present. The aim of this study is to make understanding of the mechanism of how the spinal aging influences the cortical shell strain. Two finite element (FE) models of spinal segments (mildly and fully aged) were created, and then were compared to the FE models of the healthy spinal segment. The FE models of the aged spinal segments were generated by modifying both the geometry of the intervertebral disc (IVD) and the material properties of the spinal components. To find out under which case the cortical shell strain was influenced more, we created two types of FE model comparison methods: one with changes only in the spinal material properties and the other with changes only in the IVD geometry. The results showed that the cortical shell strains increased with aging and that compared to the changes of IVD geometry, the changes of spinal material property have a higher influence on the cortical shell strains. This study may suggest that for the prevention and treatment of vertebral cortex fracture, the augmentation of the vertebral body is a more effective treatment.
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Affiliation(s)
- Yongtao Lu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, Liaoning 116024,
| | - Yue Liu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
| | - Chengwei Wu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, Liaoning 116024, P.R.China
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Abstract
RATIONALE Primary leiomyosarcoma of the bone was firstly reported by Evans and Sanerkin in 1965, whereas primary leiomyosarcoma of the vertebra is extremely rare. Because of the rarity of primary vertebral leiomyosarcoma, the diagnosis, treatment, and clinical outcome still remain controversial. Here we report a special case of primary leiomyosarcoma in the thoracic vertebra. PATIENT CONCERNS A 47-year-old female patient was admitted to our institution with the chief complaint of persistent back pain for 4 weeks. She had no symptoms of numbness, weakness, pain, and abnormal sensation in her extremities. DIAGNOSES Neurological examination on admission revealed no obvious abnormality. Magnetic resonance imaging showed a bone destruction of the T11 vertebral body and the right pedicle. Therefore, primary vertebral leiomyosarcoma was suspected. Pathological hematoxylin and eosin staining of the resected tumor revealed a diagnosis of polymorphic undifferentiated sarcoma. Furthermore, to identify the subtype of this sarcoma, the immunohistochemical staining of the tumor was performed with each of the various antibodies and the results are epithelial membrane antigen (-), H-caldesmon (-), desmin (+), smooth muscle actin (+), S-100 (-), myogenin (-), pan-keratin (-), and Ki-67 (positive rate: 20%). Finally, the patient was diagnosed as primary vertebral leiomyosarcoma. INTERVENTIONS the anterior corpectomy and autogenous iliac bone graft with instrumentation combined with the posterior spinal canal decompression and fusion with the pedicle screw system were performed through an anterior-posterior union approach. OUTCOMES Neither clinical symptoms nor signs of tumor recurrence were detected within the follow-up of 6 months. In addition, 11 cases of the primary vertebral leiomyosarcoma reported in the literature were reviewed and summarized. LESSONS Exclusion of metastatic leiomyosarcoma by various imaging modalities and histopathological examinations, especially the immunohistochemical staining with various antibodies against the epithelial and mesenchymal cell markers, are critical for establishing the correct diagnosis of the primary vertebral leiomyosarcoma. Surgical resection, especially the total en bloc spondylectomy, is the main treatment option with a good outcome, albeit with a limited follow-up duration.
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Saffarzadeh M, Hightower RC, Talton JW, Miller AN, Stitzel JD, Weaver AA. Multicenter analysis of CIREN occupant lumbar bone mineral density and correlation with age and fracture incidence. Traffic Inj Prev 2016; 17 Suppl 1:34-41. [PMID: 27586100 DOI: 10.1080/15389588.2016.1203429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study aimed to quantify lumbar volumetric bone mineral density (vBMD) for 873 seriously injured Crash Injury Research and Engineering Network (CIREN) motor vehicle crash occupants (372 male, 501 female) from 8 centers using phantomless computed tomography scans and to associate vBMD with age, fracture incidence, and osteopenia/osteoporosis diagnoses. The novelty of this work is that it associates vBMD with region of injury by applying an established method for vBMD measurement using phantomless computed tomography (CT). METHODS A validated phantomless CT calibration method that uses patient-specific fat and muscle measurements to calibrate vBMD measured from the L1-L5 trabeculae was applied on 873 occupants from various CIREN centers. CT-measured lumbar vBMD < 145 mg/cc is indicative of osteopenia using a published threshold. CIREN occupant lumbar vBMD in milligrams per cubic centimeter was regressed against age, osteopenia/osteoporosis comorbidities, height, weight, body mass index (BMI), and the incidence of fracture in vertebral (cervical, thoracic, lumbar) and rib/sternum regions. RESULTS Among the 873 occupants analyzed, 11% (92 occupants) were diagnosed as osteopenic in CIREN. Of these 92 occupants, 42% (39 occupants) had normal vBMD measures (≥145 mg/cc), suggesting possible misclassification in CIREN. Of the 134 occupants classified as osteopenic in vBMD analysis, 60% were not classified as osteopenic in CIREN, suggesting undiagnosed osteopenia, and 40% were correctly classified in CIREN. Age was negatively correlated with vBMD (P <.0001) and occupants with <145 mg/cc vBMD sustained a median number of 2 rib/sternum fractures compared to a median value of 0 rib/sternum fractures for the ≥145 mg/cc vBMD group (P <.0001). Vertebral fracture analysis revealed that the thoracolumbar region was the most common region of injury in the spine. Though the incidence of fracture was not significantly different in the thoracic (10% versus 6%, P =.122) and lumbar (16% versus 13%, P =.227) regions between the 2 bone quality groups, the proportion of thoracolumbar fractures was significantly higher in occupants with <145 mg/cc vBMD versus occupants with ≥145 mg/cc vBMD (24% versus 17%, P =.043). CONCLUSIONS Low lumbar vertebral bone quality is associated with an increased number of rib/sternum fractures and a greater incidence of thoracolumbar vertebral body fractures within the CIREN population analyzed.
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Affiliation(s)
- Mona Saffarzadeh
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - R Caresse Hightower
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Jennifer W Talton
- c Wake Forest School of Medicine, Public Health Sciences , Winston-Salem , North Carolina
| | - Anna N Miller
- d Wake Forest School of Medicine, Orthopaedic Surgery , Winston-Salem , North Carolina
| | - Joel D Stitzel
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Ashley A Weaver
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
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Jones DA, Gaewsky JP, Kelley ME, Weaver AA, Miller AN, Stitzel JD. Lumbar vertebrae fracture injury risk in finite element reconstruction of CIREN and NASS frontal motor vehicle crashes. Traffic Inj Prev 2016; 17 Suppl 1:109-115. [PMID: 27586111 DOI: 10.1080/15389588.2016.1195495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/25/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The objective of this study was to reconstruct 4 real-world motor vehicle crashes (MVCs), 2 with lumbar vertebral fractures and 2 without vertebral fractures in order to elucidate the MVC and/or restraint variables that increase this injury risk. METHODS A finite element (FE) simplified vehicle model (SVM) was used in conjunction with a previously developed semi-automated tuning method to arrive at 4 SVMs that were tuned to mimic frontal crash responses of a 2006 Chevrolet Cobalt, 2012 Ford Escape, 2007 Hummer H3, and 2002 Chevrolet Cavalier. Real-world crashes in the first 2 vehicles resulted in lumbar vertebrae fractures, whereas the latter 2 did not. Once each SVM was tuned to its corresponding vehicle, the Total HUman Model for Safety (THUMS) v4.01 was positioned in 120 precrash configurations in each SVM by varying 5 parameters using a Latin hypercube design (LHD) of experiments: seat track position, seatback angle, steering column angle, steering column telescoping position, and d-ring height. For each case, the event data recorder (EDR) crash pulse was used to apply kinematic boundary conditions to the model. By analyzing cross-sectional vertebral loads, vertebral bending moments, and maximum principal strain and stress in both cortical and trabecular bone, injury metric response as a function of posture and restraint parameters was computed. RESULTS Tuning the SVM to specific vehicle models produced close matches between the simulated and experimental crash test responses for head, T6, and pelvis resultant acceleration; left and right femur loads; and shoulder and lap belt loads. Though vertebral load in the THUMS simulations was highly similar between injury cases and noninjury cases, the amount of bending moment was much higher for the injury cases. Seatback angle had a large effect on the maximum compressive load and bending moment in the lumbar spine, indicating the upward tilt of the seat pan in conjunction with precrash positioning may increase the likelihood of suffering lumbar injury even in frontal, planar MVCs. CONCLUSION In conclusion, precrash positioning has a large effect on lumbar injury metrics. The lack of lumbar injury criteria in regulatory crash tests may have led to inadvertent design of seat pans that work to apply axial force to the spinal column during frontal crashes.
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Affiliation(s)
- Derek A Jones
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - James P Gaewsky
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Mireille E Kelley
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Ashley A Weaver
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Anna N Miller
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
| | - Joel D Stitzel
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina
- b Wake Forest School of Medicine , Winston-Salem , North Carolina
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77
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Akinpelu BJ, Zuckerman SL, Gannon SR, Westrick A, Shannon C, Naftel RP. Pediatric isolated thoracic and/or lumbar transverse and spinous process fractures. J Neurosurg Pediatr 2016; 17:639-44. [PMID: 26894517 DOI: 10.3171/2015.10.peds15377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Isolated transverse and spinous process fractures (TPFx and SPFx) in the thoracic and/or lumbar region have been deemed clinically insignificant in the adult population. This same rule is often applied to the pediatric population; however, little evidence exists in this younger group. The goal of this study was to describe the clinical, radiographic, and long-term data on isolated TPFx and SPFx in an exclusively pediatric population. METHODS A retrospective chart review at Monroe Carell Jr. Children's Hospital at Vanderbilt University identified 82 pediatric patients with isolated TPFx and/or SPFx following a traumatic event between January 2000 and December 2013. Patient demographic information, presenting symptoms, radiographic characteristics, and follow-up data were collected. Follow-up was used to determine the outcome (presence of neurological deficits) of such injuries via complete physical examination and, when available, radiographic evidence. RESULTS In the 82 identified patients, the mean age was 15.5 ± 3.1 years (mean is expressed ± SD throughout), with 72 injuries (87.8%) resulting from a motor vehicle, motorcycle, or all-terrain vehicle accident. There was a mean of 1.7 ± 1.0 fractured vertebral levels involved and a mean of 1.8 ± 1.1 fractures was identified per patient. Seventy-one patients (86.6%) needed bedside pain control, 7 (8.5%) were prescribed a brace, and 4 patients (4.9%) received a collar. Physical therapy was recommended for 12 patients (14.6%). A total of 84.1% had follow-up, and the mean length of follow-up was 19 ± 37 months. No patients had true neurological deficits at presentation or follow-up as a result of their isolated fractures, whereas 95.1% had other associated system injuries. CONCLUSIONS These data shows that there is no appreciable long-term complication associated with isolated thoracic and/or lumbar TPFx and/or SPFx in an exclusively pediatric population. Because these fractures are, however, associated with high-energy blunt trauma, they often result in associated soft-tissue or other skeletal injury. All pediatric patients in the cohort benefited from conservative management and aggressive treatment of their comorbidities.
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Affiliation(s)
- Babatunde J Akinpelu
- Department of General Surgery, Vanderbilt University;,Department of Medicine, Meharry Medical College; and
| | - Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Stephen R Gannon
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Ashly Westrick
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Chevis Shannon
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Robert P Naftel
- Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
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78
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Allett B, Hecht S. MAGNETIC RESONANCE IMAGING FINDINGS IN THE SPINE OF SIX DOGS DIAGNOSED WITH LYMPHOMA. Vet Radiol Ultrasound 2016; 57:154-61. [PMID: 26765833 DOI: 10.1111/vru.12340] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 10/19/2015] [Accepted: 10/27/2015] [Indexed: 12/27/2022] Open
Abstract
Lymphoma is one of the most common neoplasms in the dog. Despite its prevalence and the increasing use of advanced diagnostic imaging in veterinary patients only few reports of magnetic resonance imaging (MRI) findings in spinal lymphoma have been published to date. The purpose of this retrospective case series study was to describe the MRI findings in dogs with confirmed lymphoma affecting the spine and/or paraspinal soft tissues. Medical records were searched for patients that had MRI of the spine and a diagnosis of lymphoma during the period of 2005-2015. Data recorded from retrieved MRI studies were presence of focal or multifocal disease, structures involved, and signal characteristics on T2-W, short tau inversion recovery (STIR), and T1-W sequences prior to and following intravenous contrast medium administration. Six dogs met the inclusion criteria. Common findings included multifocal disease (4/6), vertebral involvement (5/6), spinal cord compression (4/6), and involvement of more than one spinal compartment (medullary cavity, vertebral canal, paraspinal soft tissues) (6/6). Vertebral changes were confined to the medullary cavity without evidence of cortical osteolysis. There was questionable involvement of the spinal cord in one case. All spinal and paraspinal lesions identified were T2-W isointense to hyperintense, STIR hyperintense, T1-W hypointense to isointense, and showed variable moderate to strong contrast enhancement. Additional lesions identified were enlarged intraabdominal lymph nodes, hepatomegaly, splenomegaly, and a splenic nodule. The STIR and T1-W postcontrast sequences were subjectively the most useful in identification of the spinal and paraspinal lesions.
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Affiliation(s)
- Brian Allett
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN
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Kherad M, Mellström D, Rosengren BE, Hasserius R, Nilsson JÅ, Redlund-Johnell I, Ohlsson C, Lorentzon M, Karlsson MK. The number and characteristics of prevalent vertebral fractures in elderly men are associated with low bone mass and osteoporosis. Bone Joint J 2015. [PMID: 26224829 DOI: 10.1302/0301-620x.97b8.35032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We sought to determine whether specific characteristics of vertebral fractures in elderly men are associated with low bone mineral density (BMD) and osteoporosis. Mister Osteoporosis Sweden is a population based cohort study involving 3014 men aged 69 to 81 years. Of these, 1427 had readable lateral radiographs of the thoracic and lumbar spine. Total body (TB) BMD (g/cm²) and total right hip (TH) BMD were measured by dual energy x-ray absorptiometry. The proportion of men with osteoporosis was calculated from TH BMD. There were 215 men (15.1%) with a vertebral fracture. Those with a fracture had lower TB BMD than those without (p < 0.001). Among men with a fracture, TB BMD was lower in those with more than three fractures (p = 0.02), those with biconcave fractures (p = 0.02) and those with vertebral body compression of > 42% (worst quartile) (p = 0.03). The mean odds ratio (OR) for having osteoporosis when having any type of vertebral fracture was 6.1 (95% confidence interval (CI) 3.9 to 9.5) compared with those without a fracture. A combination of more than three fractures and compression in the worst quartile had a mean OR of 114.2 (95% CI 6.7 to 1938.3) of having osteoporosis compared with those without a fracture. We recommend BMD studies to be undertaken in these subcohorts of elderly men with a vertebral fracture.
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Affiliation(s)
- M Kherad
- Skåne University Hospital, SE-20502, Malmo, Sweden
| | - D Mellström
- Sahlgrenska Hospital, SE- 431 80, Mölndal, Sweden
| | | | - R Hasserius
- Skåne University Hospital, SE-20502, Malmo, Sweden
| | - J-Å Nilsson
- Skåne University Hospital, SE-20502, Malmo, Sweden
| | | | - C Ohlsson
- Sahlgrenska University Hospital, SE- 413 45, Gothenburg, Sweden
| | - M Lorentzon
- Sahlgrenska Hospital, SE- 431 80, Mölndal, Sweden
| | - M K Karlsson
- Skåne University Hospital, SE-20502, Malmo, Sweden
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80
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Song YG, Byun JH, Hwang SY, Kim CW, Shim SG. Use of vertebral body units to locate the cavoatrial junction for optimum central venous catheter tip positioning. Br J Anaesth 2015; 115:252-7. [PMID: 26170349 DOI: 10.1093/bja/aev218] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Central venous catheter (CVC) placement plays an important role in clinical practice; however, optimal positioning of the CVC tip remains a controversial issue. The objective of this study was to evaluate the use of vertebral body unit (VBUs), to locate the cavoatrial junction (CAJ), for optimal CVC tip placement based on chest radiography (CXR) using the carina as a landmark. METHODS 524 patients who underwent coronary computed tomographic angiography (CTA) and CXR were included. The position of the CAJ was identified using VBUs, and the efficacy of VBUs for locating the CAJ with the carina as a landmark was analysed using multiple regression analysis. A VBU was defined as the distance between two adjacent vertebral bodies, including the inter-vertebral disk space. RESULTS The mean (sd) distance from the carina to the superior CAJ was 54.3 (9.7) mm on CTA; the mean distance in VBUs at the level of the carina was 21.4 (1.7) mm on CTA and 22.6 (2.1) mm on CXR. The mean CAJ position was 2.5 VBUs below the carina on CTA and 2.4 VBUs below on CXR with 95% limits of agreement between -0.6 and +0.3. CONCLUSIONS The position of the CVC tip in relation to the carina can be described using the thoracic spine as an internal ruler, and the position of the CAJ in adults was reliably estimated to be 2.4 VBUs below the carina. CLINICAL TRIAL REGISTRATION KCT0001319.
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Affiliation(s)
- Y G Song
- Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea
| | - J H Byun
- Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea
| | - S Y Hwang
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea
| | - C W Kim
- Department of Obstetrics and Gynecology, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea
| | - S G Shim
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, South Korea
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Hesarikia H, Azma K, Kousari A, Nikouei F. Magnetic resonance imaging investigations of position of conus medullaris in adolescent idiopathic scoliosis as a peripheral neuropathy. Int J Clin Exp Med 2015; 8:5918-5924. [PMID: 26131185 PMCID: PMC4483850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 03/31/2015] [Indexed: 06/04/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a structural 3-dimensional deformity the spine, which is occurring between 10 years of age and skeletal maturity and it mostly affects prepuberbal girls. The etiology of AIS remains unknown and seems should be multifactorial. According to the theories, there could be a shorter spinal cord or a higher location of the conus medullaris and disproportionate growth in neuro-osseous system. This study wants to investigate the position of the conus medullaris in AIS patients with a large curve magnitude in comparison with healthy adolescents. 94 AIS patients consisting of 25 males and 69 females between 11 and 25 years old, based on physical examination and standing posteroanterior roentgenography of the total spine with a Cobb angle more than 40 degrees was chosen. The main curve magnitude of every AIS patient was measured by the Cobb method. Apex of deformity was determined based on SRS definition. Patients' deformity were calcified based on Lenke classification. Magnetic resonance imaging examinations of the total spine were performed in the AIS group, by means of a 1.5-T magnetic resonance imaging system. The position of conus medullaris was defined according to the method by saffiudin et al and was assessed based on the age, sex, type of deformity, severity of deformity, kyphosis, lordosis, flexibility, apical vertebra, stable vertebra. The mean age of patients were 16.34 with 6.77 of conus medullaris position in mean, which was lower one-third of L1. Our study showed no significant correlation between the position of conus medullaris with age, weight, preoperative curve, flexibility, types of deformity based on Lenke classification and degree of kyphosis and lordisis. In conclusion, there is the same mean and the distribution of the conus medullaris locations for AIS patients and normal populations.
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Affiliation(s)
- Hamid Hesarikia
- Department of Orthopedics, Baqiyatallah Hospital, Baqiyatallah University of Medical SciencesTehran, Iran
| | - Kamran Azma
- Department of Physical Medicine and Rehabilitation, AJA University of Medical SciencesTehran, Iran
| | - Aliasghar Kousari
- Department of Orthopedics, Baqiyatallah Hospital, Baqiyatallah University of Medical SciencesTehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical SciencesTehran, Iran
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Omura A, Ejima K, Honda K, Anzai W, Taguchi Y, Koyabu D, Endo H. Locomotion pattern and trunk musculoskeletal architecture among Urodela. ACTA ZOOL-STOCKHOLM 2015; 96:225-235. [PMID: 25914411 PMCID: PMC4402012 DOI: 10.1111/azo.12070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2014] [Indexed: 11/28/2022]
Abstract
We comparatively examined the trunk musculature and prezygapophyseal angle of mid-trunk vertebra in eight urodele species with different locomotive modes (aquatic Siren intermedia, Amphiuma tridactylum, Necturus maculosus and Andrias japonicus; semi-aquatic Cynops pyrrhogaster, Cynops ensicauda; and terrestrial Hynobius nigrescens, Hynobius lichenatus and Ambystoma tigrinum). We found that the more terrestrial species were characterized by larger dorsal and abdominal muscle weight ratios compared with those of the more aquatic species, whereas muscle ratios of the lateral hypaxial musculature were larger in the more aquatic species. The lateral hypaxial muscles were thicker in the more aquatic species, whereas the M. rectus abdominis was more differentiated in the more terrestrial species. Our results suggest that larger lateral hypaxial muscles function for lateral bending during underwater locomotion in aquatic species. Larger dorsalis and abdominal muscles facilitate resistance against sagittal extension of the trunk, stabilization and support of the ventral contour line against gravity in terrestrial species. The more aquatic species possessed a more horizontal prezygapophyseal angle for more flexible lateral locomotion. In contrast, the more terrestrial species have an increasingly vertical prezygapophyseal angle to provide stronger column support against gravity. Thus, we conclude trunk structure in urodeles differs clearly according to their locomotive modes.
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Affiliation(s)
- Ayano Omura
- Graduate School of Agricultural and Life Sciences The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
- The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
| | - Ken‐Ichiro Ejima
- Department of Oral and Maxillofacial Radiology Nihon University School of Dentistry 1‐8‐13, Kanda‐Surugadai, Chiyoda‐ku Tokyo 101‐8310 Japan
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology Nihon University School of Dentistry 1‐8‐13, Kanda‐Surugadai, Chiyoda‐ku Tokyo 101‐8310 Japan
- Division of Systemic Biology and Oncology Dental Research Center Nihon University School of Dentistry 1‐8‐13, Kanda‐Surugadai, Chiyoda‐ku Tokyo 101‐8310 Japan
| | - Wataru Anzai
- The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
- Graduate School of Biological Sciences The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
| | - Yuki Taguchi
- Hiroshima City Asa Zoological Park Asa‐tyou Doubutsuen Asakita‐ku Hiroshima City Hiroshima 731‐3355 Japan
| | - Daisuke Koyabu
- The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
| | - Hideki Endo
- The University Museum The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐0033 Japan
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Acquaah F, Robson Brown KA, Ahmed F, Jeffery N, Abel RL. Early Trabecular Development in Human Vertebrae: Overproduction, Constructive Regression, and Refinement. Front Endocrinol (Lausanne) 2015; 6:67. [PMID: 26106365 PMCID: PMC4458883 DOI: 10.3389/fendo.2015.00067] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/14/2015] [Indexed: 01/18/2023] Open
Abstract
Early bone development may have a significant impact upon bone health in adulthood. Bone mineral density (BMD) and bone mass are important determinants of adult bone strength. However, several studies have shown that BMD and bone mass decrease after birth. If early development is important for strength, why does this reduction occur? To investigate this, more data characterizing gestational, infant, and childhood bone development are needed in order to compare with adults. The aim of this study is to document early vertebral trabecular bone development, a key fragility fracture site, and infer whether this period is important for adult bone mass and structure. A series of 120 vertebrae aged between 6 months gestation and 2.5 years were visualized using microcomputed tomography. Spherical volumes of interest were defined, thresholded, and measured using 3D bone analysis software (BoneJ, Quant3D). The findings showed that gestation was characterized by increasing bone volume fraction whilst infancy was defined by significant bone loss (≈2/3rds) and the appearance of a highly anisotropic trabecular structure with a predominantly inferior-superior direction. Childhood development progressed via selective thickening of some trabeculae and the loss of others; maintaining bone volume whilst creating a more anisotropic structure. Overall, the pattern of vertebral development is one of gestational overproduction followed by infant "sculpting" of bone tissue during the first year of life (perhaps in order to regulate mineral homeostasis or to adapt to loading environment) and then subsequent refinement during early childhood. Comparison of early bone developmental data in this study with adult bone volume values taken from the literature shows that the loss in bone mass that occurs during the first year of life is never fully recovered. Early development could therefore be important for developing bone strength, but through structural changes in trabecular microarchitecture rather than bone mass.
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Affiliation(s)
- Frank Acquaah
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- School of Medicine, King’s College London, London, UK
| | - Katharine A. Robson Brown
- Department of Archaeology and Anthropology, University of Bristol, Bristol, UK
- *Correspondence: Katharine A. Robson Brown, Department of Archaeology and Anthropology, University of Bristol, 43 Woodland Road, Bristol BS8 1UU, UK,
| | - Farah Ahmed
- Department of Mineralogy, The Natural History Museum, London, UK
| | - Nathan Jeffery
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Richard L. Abel
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Mineralogy, The Natural History Museum, London, UK
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Griffin C, Choong WY, Teh W, Buxton AJ, Bolton PS. Head and cervical spine posture in behaving rats: implications for modeling human conditions involving the head and cervical spine. Anat Rec (Hoboken) 2014; 298:455-62. [PMID: 25219425 DOI: 10.1002/ar.23049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/17/2014] [Accepted: 08/04/2014] [Indexed: 01/08/2023]
Abstract
The aim of this study was to define the temporal and spatial (postural) characteristics of the head and cervical vertebral column (spine) of behaving rats in order to better understand their suitability as a model to study human conditions involving the head and neck. Time spent in each of four behavioral postures was determined from video tape recordings of rats (n = 10) in the absence and presence of an intruder rat. Plain film radiographic examination of a subset of these rats (n = 5) in each of these postures allowed measurement of head and cervical vertebral column positions adopted by the rats. When single they were quadruped or crouched most (∼80%) of the time and bipedal either supported or free standing for only ∼10% of the time. The introduction of an intruder significantly (P < 0.0001) reduced the proportion of time rats spent quadruped (median, from 71% to 47%) and bipedal free standing (median, from 2.9% to 0.4%). The cervical spine was orientated (median, 25-75 percentile) near vertical (18.8°, 4.2°-30.9°) when quadruped, crouched (15.4°, 7.6°-69.3°) and bipedal supported (10.5°, 4.8°-22.6°) but tended to be less vertical oriented when bipedal free standing (25.9°, 7.7°-39.3°). The range of head positions relative to the cervical spine was largest when crouched (73.4°) and smallest when erect free standing (17.7°). This study indicates that, like humans, rats have near vertical orientated cervical vertebral columns but, in contrast to humans, they displace their head in space by movements at both the cervico-thoracic junction and the cranio-cervical regions.
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Affiliation(s)
- C Griffin
- School of Biomedical Sciences & Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW, Australia
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Robson Brown K, Tarsuslugil S, Wijayathunga VN, Wilcox RK. Comparative finite-element analysis: a single computational modelling method can estimate the mechanical properties of porcine and human vertebrae. J R Soc Interface 2014; 11:20140186. [PMID: 24718451 PMCID: PMC4006260 DOI: 10.1098/rsif.2014.0186] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Significant advances in the functional analysis of musculoskeletal systems require the development of modelling techniques with improved focus, accuracy and validity. This need is particularly visible in the fields, such as palaeontology, where unobservable parameters may lie at the heart of the most interesting research questions, and where models and simulations may provide some of the most innovative solutions. Here, we report on the development of a computational modelling method to generate estimates of the mechanical properties of vertebral bone across two living species, using elderly human and juvenile porcine specimens as cases with very different levels of bone volume fraction and mineralization. This study is presented in two parts; part I presents the computational model development and validation, and part II the virtual loading regime and results. This work paves the way for the future estimation of mechanical properties in fossil mammalian bone.
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Affiliation(s)
- K Robson Brown
- Imaging Laboratory, Department of Archaeology and Anthropology, University of Bristol, , 43 Woodland Road, Bristol BS8 1UU, UK
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Martin-Vaquero P, da Costa RC. Evaluation of traditional and novel radiographic vertebral ratios in Great Danes with versus without cervical spondylomyelopathy. Vet Radiol Ultrasound 2014; 55:488-95. [PMID: 24698393 DOI: 10.1111/vru.12159] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/07/2014] [Indexed: 11/30/2022] Open
Abstract
Great Danes are predisposed to osseous-associated cervical spondylomyelopathy (Wobbler syndrome). The first aim of this prospective study was to compare values measured using previously published intravertebral and intervertebral ratio methods and a novel ventrodorsal ratio method in radiographs of clinically normal and affected Great Danes. The second aim was to determine whether these ratios could be used as predictors of sites of spinal cord compression based on magnetic resonance imaging (MRI). Thirty dogs (15 normal, 15 affected) were prospectively enrolled. Lateral and ventrodorsal radiographs were obtained and six measurements were recorded from C3-T1. For each vertebral location, intravertebral ratios and intervertebral ratios were calculated from lateral views, and the ratio of the distance between the articular process joints vs. vertebral body width (novel ventrodorsal ratio) was calculated from ventrodorsal views. Values for these three ratios were compared, by vertebral location and dog group. Intravertebral and intervertebral ratios did not differ between dog groups. The ventrodorsal ratio was significantly smaller in affected Great Danes at C5-6 (P = 0.005) and C6-7 (P < 0.001). The ventrodorsal ratio was significantly associated with MRI presence of spinal cord compression. For each 0.1 unit increase in this ratio value, there was a 65% decrease in the odds of spinal cord compression being present at that site, independent of vertebral location (P = 0.002). Findings from this study supported use of the novel ventrodorsal ratio as an initial radiographic screening method for Great Danes with suspected cervical spondylomyelopathy.
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Affiliation(s)
- Paula Martin-Vaquero
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210
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Hussein AI, Jackman TM, Morgan SR, Barest GD, Morgan EF. The intra vertebral distribution of bone density: correspondence to intervertebral disc health and implications for vertebral strength. Osteoporos Int 2013; 24:3021-30. [PMID: 23863990 PMCID: PMC4465501 DOI: 10.1007/s00198-013-2417-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 05/20/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED This study's goal was to determine associations among the intravertebral heterogeneity in bone density, bone strength, and intervertebral disc (IVD) health. Results indicated that predictions of vertebral strength can benefit from considering the magnitude of the density heterogeneity and the congruence between the spatial distribution of density and IVD health. INTRODUCTION This study aims to determine associations among the intravertebral heterogeneity in bone density, bone strength, and IVD health METHODS Regional measurements of bone density were performed throughout 30 L1 vertebral bodies using micro-computed tomography (μCT) and quantitative computed tomography (QCT). The magnitude of the intravertebral heterogeneity in density was defined as the interquartile range and quartile coefficient of variation in regional densities. The spatial distribution of density was quantified using ratios of regional densities representing different anatomical zones (e.g., anterior to posterior regional densities). Cluster analysis was used to identify groups of vertebrae with similar spatial distributions of density. Vertebral strength was measured in compression. IVD health was assessed using two scoring systems. RESULTS QCT- and μCT-based measures of the magnitude of the intravertebral heterogeneity in density were strongly correlated with each other (p < 0.005). Accounting for the interquartile range in regional densities improved predictions of vertebral strength as compared to predictions based only on mean density (R (2) = 0.59 vs. 0.43; F-test p-value = 0.018). Specifically, after adjustment for mean density, vertebral bodies with greater heterogeneity in density exhibited higher strength. No single spatial distribution of density was associated with high vertebral strength. Analyses of IVD scores suggested that the health of the adjacent IVDs may modulate the effect of a particular spatial distribution of density on vertebral strength. CONCLUSIONS Noninvasive measurements of the intravertebral distribution of bone density, in conjunction with assessments of IVD health, can aid in predictions of bone strength and in elucidating biomechanical mechanisms of vertebral fracture.
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Affiliation(s)
- A I Hussein
- Department of Mechanical Engineering, Boston University, 110 Cummington Mall, Boston, MA, 02215, USA,
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88
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Granatosky MC, Lemelin P, Chester SGB, Pampush JD, Schmitt D. Functional and evolutionary aspects of axial stability in euarchontans and other mammals. J Morphol 2013; 275:313-27. [PMID: 24288155 DOI: 10.1002/jmor.20216] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 06/21/2013] [Accepted: 08/13/2013] [Indexed: 11/08/2022]
Abstract
The presence of a stable thoracolumbar region, found in many arboreal mammals, is considered advantageous for bridging and cantilevering between discontinuous branches. However, no study has directly explored the link between osteological features cited as enhancing axial stability and the frequency of cantilevering and bridging behaviors in a terminal branch environment. To fill this gap, we collected metric data on costal and vertebral morphology of primate and nonprimate mammals known to cantilever and bridge frequently and those that do not. We also quantified the frequency and duration of cantilevering and bridging behaviors using experimental setups for species that have been reported to show differences in use of small branches and back anatomy (Caluromys philander, Loris tardigradus, Monodelphis domestica, and Cheirogaleus medius). Phylogenetically corrected principal component analysis reveals that taxa employing frequent bridging and cantilevering (C. philander and lorises) also exhibit reduced intervertebral and intercostal spaces, which can serve to increase thoracolumbar stability, when compared to closely related species (M. domestica and C. medius). We observed C. philander cantilevering and bridging significantly more often than M. domestica, which never cantilevered or crossed any arboreal gaps. Although no difference in the frequency of cantilevering was observed between L. tardigradus and C. medius, the duration of cantilevering bouts was significantly greater in L. tardigradus. These data suggest that osteological features promoting axial rigidity may be part of a morpho-behavioral complex that increases stability in mammals moving and foraging in a terminal branch environment.
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Affiliation(s)
- Michael C Granatosky
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina
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Albert MA, Maier CA. Epiphyseal union of the cervical vertebral centra: its relationship to skeletal age and maturation of thoracic vertebral centra. J Forensic Sci 2013; 58:1568-74. [PMID: 23866072 DOI: 10.1111/1556-4029.12232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 09/21/2012] [Accepted: 10/06/2012] [Indexed: 11/28/2022]
Abstract
Epiphyseal union stages for cervical vertebral centra (ring epiphyses) were documented for 55 individuals (females and males, ages 14-27 years) from the Terry Collection, using the Albert and Maples method 1, to examine both its relationship to age at death and to thoracic data collected from the same individuals using the same method. Results showed a moderate correlation between cervical ring union and age (r = 0.63, p = 0.000), and a fairly low correlation between cervical and thoracic ring union (r = 0.41, p = 0.002). Paired samples t-tests yielded a statistically significant difference between cervical and thoracic union mean values (p = 0.01). Union progressed earlier in cervical vertebrae and in females. Results indicated fairly substantial variation in both sexes. Findings may serve as a basic guideline for estimating a general age range at death for unknown skeletal remains and to corroborate findings from other skeletal age indicators.
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Affiliation(s)
- Midori A Albert
- Department of Anthropology, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403-5907
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Dutoit JC, Vanderkerken MA, Verstraete KL. Value of whole body MRI and dynamic contrast enhanced MRI in the diagnosis, follow-up and evaluation of disease activity and extent in multiple myeloma. Eur J Radiol 2013; 82:1444-52. [PMID: 23726124 DOI: 10.1016/j.ejrad.2013.04.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/16/2013] [Accepted: 04/17/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the significance of dynamic contrast enhanced MRI (DCE-MRI) and whole body MRI (WB-MRI) in the diagnosis, prognosis and assessment of therapy for patients with monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM). MATERIALS AND METHODS The retrospective study includes 219 patients providing 463 WB-MRI and DCE-MRI investigations for the subgroups MGUS (n=70), MM active disease (n=126; this includes 70 patients with new diagnosis of MM, according to the International Staging System (ISS): 41.4% ISS stage I, 20.0% ISS stage II, 7.1% ISS stage III, 31.4% insufficient for staging; and 56 patients with '(re-)active disease': 16.07% relapse, 32.14% progressive disease and 51.79% stable disease) and MM remission (n=23; 60.87% complete remission, 17.39% very good partial remission and 21.74% partial remission). Investigations of patients with hereditary multiple exostoses (n=5), neurofibromatosis (n=7) and healthy persons (n=9) were added as control subjects (n=21). WB-MRI evaluation was done by evaluating thirteen skeletal regions, providing a 'skeletal score'. DCE-MRI images of the spine, were analyzed with regions-of-interest and time-intensity-curves (TIC). RESULTS All TIC parameters can significantly differentiate between the predefined subgroups (p<0.001). One hundred days after autologous stem cell transplantation a 75% decrease of the slope wash-in value (p<0.001) can be seen. A cubic regression trend between 'skeletal score' and slope wash-in (adj.R(2)=0.412) could demonstrate a significant increase bone marrow perfusion if MM affects more than 10 skeletal regions (p<0.001), associated with a poorer prognosis (p<0.001). CONCLUSION DCE-MRI evaluation of the spine is useful for diagnosis of MM, follow-up after stem cell transplantation and evaluation of disease activity. A combined evaluation with WB-MRI and DCE-MRI provides additional micro-vascular information on the morphologic lesions and could help categorize patients with MM in two different groups to offer useful therapeutic and prognostic advise.
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Affiliation(s)
- Julie C Dutoit
- Department of Radiology, MR-1K12, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium.
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Akhaddar A, Mandour C. Multiple contiguous cervicothoracic Clay-shoveler's fractures (from C6 to T9 spinal vertebrae). Pan Afr Med J 2013; 16:128. [PMID: 24839536 PMCID: PMC4021981 DOI: 10.11604/pamj.2013.16.128.3531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 12/01/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Avicenne Military Hospital, Marrakech, Morocco ; Department of Neurosurgery, Mohammed V Military Teaching Hospital, University of Mohammed V Souissi, Rabat, Morocco
| | - Cherkaoui Mandour
- Department of Neurosurgery, Mohammed V Military Teaching Hospital, University of Mohammed V Souissi, Rabat, Morocco
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Abstract
BACKGROUND The objective of this cadaveric study was to analyze the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of lower thoracic and lumbar pedicle screws. We also investigated the effect of bone mineral density (BMD), diameter of pedicle screws, and the region of spine on the pullout strength of pedicle screws. MATERIALS AND METHODS Sixty fresh human cadaveric vertebrae (D10-L2) were harvested. Dual-energy X-ray absorptiometry (DEXA) scan of vertebrae was done for BMD. Titanium pedicle screws of different diameters (5.2 and 6.2 mm) were inserted in the thoracic and lumbar segments after dividing the specimens into three groups: a) standard pedicle screw (no cortical perforation); b) screw with medial cortical perforation; and c) screw with lateral cortical perforation. Finally, pullout load of pedicle screws was recorded using INSTRON Universal Testing Machine. RESULTS Compared with standard placement, medially misplaced screws had 9.4% greater mean pullout strength and laterally misplaced screws had 47.3% lesser mean pullout strength. The pullout strength of the 6.2 mm pedicle screws was 33% greater than that of the 5.2 mm pedicle screws. The pullout load of pedicle screws in lumbar vertebra was 13.9% greater than that in the thoracic vertebra (P = 0.105), but it was not statistically significant. There was no significant difference between pullout loads of vertebra with different BMD (P = 0.901). CONCLUSION The mean pullout strength was less with lateral misplaced pedicle screws while medial misplaced pedicle screw had more pullout strength. The pullout load of 6.2 mm screws was greater than that of 5.2 mm pedicle screws. No significant correlation was found between bone mineral densities and the pullout strength of vertebra. Similarly, the pullout load of screw placed in thoracic and lumbar vertebrae was not significantly different.
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Affiliation(s)
- Shyam K Saraf
- Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India,Address for correspondence: Dr. Shyam K Saraf, Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, India. E-mail:
| | - Ravindra P Singh
- Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Vakil Singh
- Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Ashish Varma
- Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Abstract
The mechanisms of age-related vertebral fragility remain unclear, but may be related to the degree of "structural redundancy" of the vertebra; ie, its ability to safely redistribute stress internally after local trabecular failure from an isolated mechanical overload. To better understand this issue, we performed biomechanical testing and nonlinear micro-CT-based finite element analysis on 12 elderly human thoracic ninth vertebral bodies (age 76.9 ± 10.8 years). After experimentally overloading the vertebrae to measure strength, we used nonlinear finite element analysis to estimate the amount of failed tissue and understand the failure mechanisms. We found that the amount of failed tissue per unit bone mass decreased with decreasing bone volume fraction (r(2) = 0.66, p < 0.01). Thus, for the weak vertebrae with low bone volume fraction, overall failure of the vertebra occurred after failure of just a tiny proportion of the bone tissue (<5%). This small proportion of failed tissue had two sources: the existence of fewer vertically oriented load paths to which load could be redistributed from failed trabeculae; and the vulnerability of the trabeculae in these few load paths to undergo bending-type failure mechanisms, which further weaken the bone. Taken together, these characteristics suggest that diminished structural redundancy may be an important aspect of age-related vertebral fragility: vertebrae with low bone volume fraction are highly susceptible to collapse because so few trabeculae are available for load redistribution if the external loads cause any trabeculae to fail.
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Affiliation(s)
- Aaron J Fields
- Orthopaedic Biomechanics Laboratory, Department of Mechanical Engineering, University of California, Berkeley, CA, USA
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Abstract
Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was the development of distal junctional kyphosis (DJK). Summary of Background Data Prior research has pointed to selection of the FLV for the distal instrumentation level in fusion for thoracic hyperkyphosis. In 2009, Cho et al introduced the concept of the SSV after recognizing the development of DJK despite fusion to the FLV. Methods Patients were reviewed who had undergone spinal fusion for thoracic hyperkyphosis. Preoperative radiographs were reviewed to assess thoracic kyphosis, lumbar lordosis, SSV, and FLV. Postoperative radiographs were reviewed to assess curve correction and whether patients developed DJK or implant failure. Results We reviewed 22 patients with a mean age at surgery of 18 (range 14 to 22). Mean preoperative kyphosis was 85 ± 14 degrees, and mean postoperative kyphosis at final follow-up was 59 ± 12 degrees for a mean correction of 26 ± 12 degrees. Eleven patients developed DJK and four patients experienced hardware failure. In 12 patients, the SSV was inferior to the FLV. Rates of DJK when the instrumentation included the SSV or FLV were 13 and 38%, respectively. Conclusions Fusion to the SSV is superior at preventing DJK when compared with fusion to the FLV.
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95
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Abstract
It is presumed that poor intervertebral disc cell nutrition is a contributing factor in degeneration, and is exacerbated by vertebral endplate sclerosis. Yet, quantitative relationships between endplate morphology and degeneration are unavailable. We investigated how endplate bone microstructure relates to indices of disc degeneration, such as morphologic grade, proteoglycan content, and cell density. Intervertebral core samples [n = 96, 14 subjects, L1-L5 level, ages 35-85 (64 ± 16 years), degeneration grade 1 (n = 4), grade 2 (n = 32), grade 3 (n = 44), grade 4 (n = 10), grade 5 (n = 6)] that included subchondral bone, cartilage endplate, and adjacent nucleus were harvested from human cadaveric lumbar spines. The morphology of the vertebral endplate was analyzed using µCT and the adjacent nucleus tissue was collected for biochemical and cellular analyses. Relationships between vertebral endplate morphology and adjacent disc degeneration were analyzed. Contrary to the prevailing notion, vertebral endplate porosity increased between 50% and 130% and trabecular thickness decreased by between 20% and 50% with advancing disc degeneration (p < 0.05). We also observed that nucleus cell density increased (R(2) = 0.33, p < 0.05) and proteoglycan content decreased (R(2) = 0.47, p < 0.05) as the endplate became more porous. Our data suggest that endplate sclerosis is not a fundamental factor contributing to disc degeneration. Rather, the opposite was observed in our samples, as the endplate became progressively more porous with age and degeneration. Since ischemic disc cell behavior is commonly associated with degenerative change, this may be related to other factors such as the quality of vertebral capillaries, as opposed to decreased permeability of intervening tissues.
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Affiliation(s)
- Azucena G. Rodriguez
- Department of Orthopaedic Surgery, University of California, San Francisco CA 94143, USA
| | | | - Andrew J. Burghardt
- Department of Radiology, University of California, San Francisco, CA 94143 USA
| | - Sigurd Berven
- Department of Orthopaedic Surgery, University of California, San Francisco CA 94143, USA
| | - Sharmila Majumdar
- Department of Radiology, University of California, San Francisco, CA 94143 USA
| | - Jeffrey C. Lotz
- Department of Orthopaedic Surgery, University of California, San Francisco CA 94143, USA
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96
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Piscitelli P, Tarantino U, Chitano G, Argentiero A, Neglia C, Agnello N, Saturnino L, Feola M, Celi M, Raho C, Distante A, Brandi ML. Updated incidence rates of fragility fractures in Italy: extension study 2002-2008. Clin Cases Miner Bone Metab 2011; 8:54-61. [PMID: 22461831 PMCID: PMC3279067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES We aimed to update the incidence rates of major fragility fractures in Italy, including those which do not result systematically in hospital admissions, on the basis of hospitalization rates provided in our previous researches. METHODS We analyzed italian national hospital discharge data from year 2002 to 2008 in order to determine age- and sex-specific incidence rates of hip, vertebral, humeral, and forearm fractures occurred in people aged 40 to 100 years of age. Re-hospitalizations of the same patients have been excluded from the analysis. Hospital discharge data have been adjusted taking into account recently published information concerning fracture-specific hospitalization rates. RESULTS We estimated a total of 91,494 hip fractures in year 2008 among people aged 40 to 100 years old, with a +18.1% increase across the seven-year period. Women aged >75 years old (n=55,950) accounted for about 60% of total fractures observed both in males and females. Concerning males, the highest incidence was observed between 80 and 84 years old (about 5,000 hip fractures). Overall incidence rate per 100,000 inhabitants computed for hip fractures was 283.5, with marked age- and sex-specific differences. Clinical vertebral fractures were estimated to be almost 61,000 in 2008, with a +6.3% increase over seven years. Overall incidence rate per 100,000 inhabitants computed for clinical vertebral fractures was 189.0, but this value doubled between 75 and 95 years of age. For the same year 2008, we estimated a total of 57,400 humeral and 94,000 forearm/wrist fractures, with a +13.2% and +0.7% increase over the seven-year period, respectively. Overall humeral fractures incidence per 100,000 was estimated in 178.0, with highest rates (up to 600 and over) observed in women between 75 and 95 years of age, while incidence per 100,000 for wrist fractures was computed in 298.0, with top values observed in women between aged 55 years old and over. CONCLUSION The burden of major osteoporotic fractures in Italy is still increasing. Preventive strategies aimed to reduce fractures incidence should be carried out at regional level.
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97
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Piscitelli P, Brandi ML, Chitano G, Argentiero A, Neglia C, Distante A, Saturnino L, Tarantino U. Epidemiology of fragility fractures in Italy. Clin Cases Miner Bone Metab 2011; 8:29-34. [PMID: 22461813 PMCID: PMC3279081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES We aimed to calculate the incidence of major fragility fractures in Italy, including those which do not result systematically in hospital admissions, on the basis of hospitalization rates provided in our previous researches. METHODS We analyzed Italian national hospital discharge data from year 2004 to 2006 in order to determine age- and sex-specific incidence rates of hip, vertebral, humeral, and forearm fractures occurred in people aged 40 to 100 years of age. Re-hospitalizations of the same patients have been excluded from the analysis. Hospital discharge data have been adjusted taking into account recently published information concerning fracture-specific hospitalization rates. RESULTS We estimated a total of 88,647 hip fractures in year 2006 among people aged 40 to 100 years old, with a +5.9% increase across the three examined years. Women aged >75 years old (n=53,259) accounted for 60% of total fractures observed both in males and females from 40 to 100 years of age. Concerning males, the highest incidence was observed between 80 and 84 years old (about 5,000 hip fractures). Overall incidence rate per 100,000 inhabitants computed for hip fractures was 284.28, with marked age- and sex-specific differences. Clinical vertebral fractures were estimated to be almost 61,000 in 2006, with a +3.1% increase across the three examined years. Overall incidence rate per 100,000 inhabitants computed for clinical vertebral fractures was 195.23, but this value doubled between 75 and 95 years of age. In the same year 2006, a total of 56,129 humeral and 97038 forearm/wrist fractures, with a +5.5% and +3.9% increase across three years, respectively. Overall humeral fractures incidence per 100,000 was 180, with highest rates (up to 600 and over) observed in women between 75 and 95 years of age, while incidence per 100,000 computed for wrist fractures was 311, with top values observed in women between aged 55-85 years old - thus including early post-menopausal age group - and a peak in those between 75 and 79 years of age. CONCLUSIONS The burden of major osteoporotic fractures in Italy is very high. Preventive strategies aimed to reduce fractures incidence should be carried out at regional level.
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Wegrzyn J, Roux JP, Arlot ME, Boutroy S, Vilayphiou N, Guyen O, Delmas PD, Chapurlat R, Bouxsein ML. Role of trabecular microarchitecture and its heterogeneity parameters in the mechanical behavior of ex vivo human L3 vertebrae. J Bone Miner Res 2010; 25:2324-31. [PMID: 20564249 PMCID: PMC3179283 DOI: 10.1002/jbmr.164] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Revised: 04/16/2010] [Accepted: 06/09/2010] [Indexed: 01/23/2023]
Abstract
Low bone mineral density (BMD) is a strong risk factor for vertebral fracture risk in osteoporosis. However, many fractures occur in people with moderately decreased or normal BMD. Our aim was to assess the contributions of trabecular microarchitecture and its heterogeneity to the mechanical behavior of human lumbar vertebrae. Twenty-one human L(3) vertebrae were analyzed for BMD by dual-energy X-ray absorptiometry (DXA) and microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) and then tested in axial compression. Microarchitecture heterogeneity was assessed using two vertically oriented virtual biopsies--one anterior (Ant) and one posterior (Post)--each divided into three zones (superior, middle, and inferior) and using the whole vertebral trabecular volume for the intraindividual distribution of trabecular separation (Tb.Sp*SD). Heterogeneity parameters were defined as (1) ratios of anterior to posterior microarchitectural parameters and (2) the coefficient of variation of microarchitectural parameters from the superior, middle, and inferior zones. BMD alone explained up to 44% of the variability in vertebral mechanical behavior, bone volume fraction (BV/TV) up to 53%, and trabecular architecture up to 66%. Importantly, bone mass (BMD or BV/TV) in combination with microarchitecture and its heterogeneity improved the prediction of vertebral mechanical behavior, together explaining up to 86% of the variability in vertebral failure load. In conclusion, our data indicate that regional variation of microarchitecture assessment expressed by heterogeneity parameters may enhance prediction of vertebral fracture risk.
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Affiliation(s)
- Julien Wegrzyn
- INSERM Research Unit 831, Université de Lyon, Lyon, France.
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Garra BS, Locher M, Felker S, Wear KA. Measurements of ultrasonic backscattered spectral centroid shift from spine in vivo: methodology and preliminary results. Ultrasound Med Biol 2009; 35:165-8. [PMID: 18723270 PMCID: PMC8243223 DOI: 10.1016/j.ultrasmedbio.2008.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Revised: 04/25/2008] [Accepted: 06/13/2008] [Indexed: 05/25/2023]
Abstract
Ultrasonic backscatter measurements from vertebral bodies (L3 and L4) in nine women were performed using a clinical ultrasonic imaging system. Measurements were made through the abdomen. The location of a vertebra was identified from the bright specular reflection from the vertebral anterior surface. Backscattered signals were gated to isolate signal emanating from the cancellous interiors of vertebrae. The spectral centroid shift of the backscattered signal, which has previously been shown to correlate highly with bone mineral density (BMD) in human calcaneus in vitro, was measured. BMD was also measured in the nine subjects' vertebrae using a clinical bone densitometer. The correlation coefficient between centroid shift and BMD was r = -0.61. The slope of the linear fit was -160 kHz / (g/cm(2)). The negative slope was expected because the attenuation coefficient (and therefore magnitude of the centroid downshift) is known from previous studies to increase with BMD. The centroid shift may be a useful parameter for characterizing bone in vivo.
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Affiliation(s)
| | | | | | - Keith A. Wear
- US Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA
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Yamaguchi T, Iwata J, Sugihara S, McCarthy EF Jr, Karita M, Murakami H, Kawahara N, Tsuchiya H, Tomita K. Distinguishing benign notochordal cell tumors from vertebral chordoma. Skeletal Radiol 2008; 37:291-9. [PMID: 18188556 DOI: 10.1007/s00256-007-0435-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 11/08/2007] [Accepted: 12/05/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective was to characterize imaging findings of benign notochordal cell tumors (BNCTs). DESIGN AND PATIENTS Clinical and imaging data for 9 benign notochordal cell tumors in 7 patients were reviewed retrospectively. Conventional radiographs (n = 9), bone scintigrams (n = 2), computed tomographic images (n = 7), and magnetic resonance images (n = 8) were reviewed. Eight of the 9 lesions were stained with hematoxylin-eosin and microscopically examined. RESULTS There were 3 male and 4 female patients with an age range of 22 to 55 years (average age, 44 years). Two patients had two lesions at different sites. The lesions involved the cervical spine in 4 patients, the lumbar spine in 2, the sacrum in 2, and the coccyx in 1. The most common symptom was mild pain. The lesions of 2 patients were found incidentally during imaging studies for unrelated conditions. Five patients underwent surgical procedures. One patient died of surgical complications. All other patients have been well without recurrent or progressive disease for 13 to 84 months. Radiographs usually did not reveal significant abnormality. Five lesions exhibited subtle sclerosis and 1 showed intense sclerosis. Technetium bone scan did not reveal any abnormal uptake. Computed tomography images had increased density within the vertebral bodies. The lesions had a homogeneous low signal intensity on T1-weighted magnetic resonance images and a high intensity on T2-weighted images without soft-tissue mass. Microscopically, lesions contained sheets of adipocyte-like vacuolated chordoid cells without a myxoid matrix. CONCLUSIONS Benign notochordal cell tumors may be found during routine clinical examinations and do not require surgical management unless they show extraosseous disease. These tumors should be recognized by radiologists, pathologists, and orthopedic surgeons to prevent operations, which usually are extensive.
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