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Kagami Y, Nakashima H, Ito K, Satake K, Tsushima M, Ouchida J, Morita Y, Ode Y, Segi N, Imagama S, Kanemura T. The anatomical relationship between the celiac artery and the median arch ligament in degenerative spinal surgery. J Orthop Sci 2024; 29:502-507. [PMID: 36914482 DOI: 10.1016/j.jos.2023.02.015] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND This study aimed to characterize the anatomical relationship between the spine, the celiac artery (CA), and the median arcuate ligament using preoperative contrast-enhanced computed tomography (CT) images of patients with spinal deformity who underwent surgical correction. METHODS This retrospective study included 81 consecutive patients (34 males, 47 females; average age: 70.2 years). The spinal level at which the CA originated, the diameter, extent of stenosis, and calcification were determined using CT sagittal images. Patients were divided into two groups: CA stenosis group and non-stenosis group. Factors associated with stenosis were examined. RESULTS CA stenosis was observed in 17 (21%) patients. CA stenosis group had significantly higher body mass index (24.9 ± 3.9 vs. 22.7 ± 3.7, p = 0.03). In the CA stenosis group, J-type CA (upward angling of the course by more than 90° immediately after descending) was more frequently observed (64.7% vs. 18.8%, p < 0.001). The CA stenosis group had lower pelvic tilt (18.6 ± 6.7 vs. 25.1 ± 9.9, p = 0.02) than non-stenosis group. CONCLUSIONS High BMI, J-type, and shorter distance between CA and MAL were risk factors for CA stenosis in this study. Patients with high BMI undergoing fixation of multiple intervertebral corrective fusions at the thoracolumbar junction should undergo preoperative CT evaluation of the anatomy of CA to assess the poteitial risk of celiac artery compression syndrome.
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Affiliation(s)
- Yujiro Kagami
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Anjo Kosei Hospital, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan.
| | - Kenyu Ito
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Kotaro Satake
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Mikito Tsushima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Jun Ouchida
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Yoshinori Morita
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Yukihito Ode
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Naoki Segi
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Tokumi Kanemura
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
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Şener U, Tellioğlu AM, Polat YD. A reappraisal of pediatric thoracic surface anatomy. Clin Anat 2023; 36:178-189. [PMID: 36088577 DOI: 10.1002/ca.23950] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/29/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022]
Abstract
Accurate knowledge of surface anatomy is essential for physical examination, invasive procedures, and anatomy education. Individual factors such as age make surface landmarks variable so accurate descriptions are needed. The aim of this study is to describe age-related surface landmarks for intrathoracic structures in children. A total of 156 thoracic computed tomography scans of children aged 0-18 years were categorized into six groups, and the associations between major intrathoracic structures and surface landmarks were analyzed. Sternal angle is an accurate surface landmark for the azygos vein-superior vena cava junction in all age groups. However, the aortic arch (except in the 0-1 year group), the bifurcation of the pulmonary trunk and the tracheal bifurcation in those aged 15-18 years were not within this plane. The left brachiocephalic vein was located behind the ipsilateral sternoclavicular joint except in the 1-3 years group, and the right was behind it in children older than 6 years. The apex of heart was at the 5th intercostal space level in the 0-1 and 12-18 years groups; however, it was higher in the other groups. The lower borders of the lungs were at the sixth costal cartilage level in the midclavicular line, eighth intercostal space level in the midaxillary line, and T12 adjacent to the vertebral column in the 15-18 years group; the lower borders were at higher levels in younger children. Defining the variations in surface anatomy by in vivo studies will increase its clinical and pedagogical value.
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Affiliation(s)
- Umut Şener
- Department of Anatomy, Faculty of Medicine, Ağrı İbrahim Çeçen University, Ağrı, Turkey
| | - Ayfer Metin Tellioğlu
- Department of Anatomy, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Yasemin Durum Polat
- Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
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Khuntikeo N, Pugkhem A, Srisuk T, Luvira V, Titapun A, Tipwaratorn T, Thanasukarn V, Klungboonkrong V, Wongwiwatchai J. Surgery. Recent Results Cancer Res 2023; 219:147-222. [PMID: 37660334 DOI: 10.1007/978-3-031-35166-2_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
This chapter provides a comprehensive background from basic to applied knowledge of surgical anatomy which is necessary for the surgical treatment of cholangiocarcinoma (CCA) patients. Significant advances that have been made in the surgical treatment of CCA were examined. For instance, in-depth details are provided for appropriate preoperative assessment and treatment to optimize patient status and to improve the outcome of surgical treatment(s). Comprehensive details are provided for the surgical techniques and outcomes of treatments for each type of CCA with clear illustrations and images. This chapter also describes the role of minimally invasive surgery and liver transplantation in CCA treatment.
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Affiliation(s)
- Narong Khuntikeo
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Ake Pugkhem
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Tharatip Srisuk
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Vor Luvira
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Attapol Titapun
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Theerawee Tipwaratorn
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Vasin Thanasukarn
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Vivian Klungboonkrong
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Jitraporn Wongwiwatchai
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
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Şener U, Tellioğlu AM, Polat YD. A reappraisal of pediatric abdominal surface anatomy. Clin Anat 2021; 35:103-115. [PMID: 34658073 DOI: 10.1002/ca.23802] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/17/2021] [Accepted: 10/08/2021] [Indexed: 11/12/2022]
Abstract
Surface anatomy is fundamental to clinical and surgical practices. As the surface anatomy varies with age, the purpose of this study is to provide age-standardized surface markings for the abdomen in children. A total of 155 abdominal computed tomography scans of healthy children aged 0-18 years were categorized into six groups, and the surface anatomy of the major vascular structures, solid viscera, and anatomical planes in the abdomen was analyzed. The vertebral levels of the celiac trunk, superior mesenteric artery, and hepatic portal vein formation were higher in the youngest age group, whereas the levels of the inferior mesenteric artery, formation of the inferior vena cava, and renal arteries did not differ with age. The right kidney lay between T12 and L3 and the left at T11-L3; however, both kidneys were in lower positions in younger children. The spleen was most commonly located between the 8th and 11th ribs except in toddlers. In all age groups, the hepatic portal vein formation was within the transpyloric plane and the aortic bifurcation was above the supracristal plane. In vivo reassessment of the surface anatomy enables the substantial variability of surface landmarks to be highlighted. This study demonstrates that taking account of age-related variations will increase the accuracy and therefore the clinical relevance of surface anatomy.
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Affiliation(s)
- Umut Şener
- Department of Anatomy, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Ayfer Metin Tellioğlu
- Department of Anatomy, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Yasemin Durum Polat
- Department of Radiology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
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