Anatomical differences in the bony structure of L5 and L4: A possible classification according to the lateral tilt of the pedicles

Publication date: March 2018 Source:Journal of Orthopaedics, Volume 15, Issue 1 Author(s): Giorgio Cacciola, Giuseppe Anastasi, Salvatore Bertino, Giuseppina Rizzo, Giuseppina Cutroneo, Fabio Trimarchi, Alessandro Pisani, Pietro Cavaliere, Andrea Barbanera, Daniele Bruschetta The aim of this study is to underline the necessity of a better knowledge of pedicles anatomy in order to improve surgical treatment of spine disorders such us low back pain, spinal fractures and scholiosis. A classification of pedicles lateral tilt which could help surgeons before the application of screws during transpedicular fixation is reported. Anatomical differences in the orientiation of the pedicles of L5 and L4 have been found. For each patient that met the inclusion criteria underwent: Radiography of the lumbo-sacral region, CT examination, MRI acquisition. Patients were divided into three categories thanks to 3D direct volume rendering of CT scan. Subjects belonged to W-Type, V-Type and U-type depending on their morphometric features. The subdivision was further implemented with measurements of the distance between pedicles and adjacent nervous structures. Concerning L5, W-Type (WT) exhibited a lateral tilt of L5 larger than 36°, V-Type exhibited a lateral tilt of L5 from 30° to 36°, U-type exhibited a lateral tilt of L5 smaller than 30°. Concerning L4, WT exhibited a lateral tilt of 28.4°, VT exhibited a lateral tilt of of 25.1, UT exhibited a lateral tilt of 22.2°; ...
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research

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ConclusionSclerosis can occur in endplates with any type of MCs. However, the clinical and animal study suggests that sclerosis is greatest in endplates showing type III MCs.The translational potential of this articleThe study showed that sclerosis can occur in endplates with MCs type I, II and III. In patients with endplate sclerosis on plain radiographs or CT scans, the endplate can still represent an inflammatory process associated with chronic lower back pain.
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
This article is a case report, no outcomes.Lessons:Multifocal extensive spinal TB involving the whole spine is rarely reported in the literature, which presents with atypical presentations and imaging features. It is noticeable that the possibility of TB is considered for any skip lesions involving the spine cautiously. Meanwhile, careful physical examination, trials of anti-TB treatment, and using the whole spine MRI routinely also play an important role in the diagnosis and treatment of this disease. Rationale: Skipped multifocal extensive spinal tuberculosis (TB) involving the whole spine is very rare. So far, only ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Study Design. A prospective cohort study. Objective. The aim of this study was to identify associations of spondylotic and kinematic changes with low back pain (LBP). Summary of Background Data. The ability to characterize and differentiate the biomechanics of both the symptomatic and asymptomatic lumbar spine is crucial to alleviate the sparse literature on the association of lumbar spine biomechanics and LBP. Methods. Lumbar dynamic plain radiographs (flexion-extension), dynamic computed tomography (CT) scanning (axial rotation, disc height), and magnetic resonance imaging (MRI, disc and facet degeneration grades) wer...
Source: Spine - Category: Orthopaedics Tags: Biomechanics Source Type: research
CONCLUSIONS: This novel mini-navigation tool measured CP, LL, and OS accurately when compared with implant position measured on imaging. PMID: 28537348 [PubMed - as supplied by publisher]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Spondylolysis, Spondylolisthesis, Spondylitis &Spondylosis These four conditions affect the lumbar spine and may be confusing. What is the difference between spondylolysis, spondylolisthesis, spondylitis, and spondylosis? Spondylolysis (pars interarticularis Defect) - Used to describe the anatomic defect or break of the pars interarticularis of the vertebral arch. Spondylolysis usually occurs in the lower lumbar spine, especially the L5 vertebrae. It usually appears as a radiolucent gap on lateral X-ray. It occurs in about 5% of the population; it is not present at birth but develops over time and may run in fami...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
The FDA today released its list of the pre-market approvals it granted for medical devices in November 2015: Summary of PMA Originals &Supplements Approved Originals: 3 Supplements: 69 Summary of PMA Originals Under Review Total Under Review: 57 Total Active: 30 Total On Hold: 27 Summary of PMA Supplements Under Review Total Under Review: 583 Total Active: 433 Total On Hold: 150 Summary of All PMA Submissions Originals: 4 Supplements: 75 Summary of PMA Supplement PMA Approval/Denial Decision Times Number of Approvals: 69 Number of Denials: 0 Average Days Fr Receipt to Decision (Total Time): 193.4 FDA Time...
Source: Mass Device - Category: Medical Equipment Authors: Tags: Food & Drug Administration (FDA) Regulatory/Compliance Source Type: news
Publication date: Available online 18 January 2016 Source:Orthopaedics & Traumatology: Surgery & Research Author(s): C. Scemama, H. D’astorg, P. Guigui Sacral fracture after lumbosacral instrumentation could be a source of prolonged pain and a late autonomy recovery in old patients. Diagnosis remains difficult and usually delayed. No clear consensus for efficient treatment of this complication has been defined. Aim of this study was to determine how to manage them. Three patients who sustained sacral fracture after instrumented lumbosacral fusion performed for degenerative disease of the spine are discus...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Conclusion We hypothesize that 18F-fluoride PET/CT may be able to provide support for the diagnosis of painful pseudarthrosis and could serve as a tool to discriminate between symptomatic and asymptomatic pseudarthrosis for revision surgery, as CT defines the consolidation status and PET pinpoints the ‘stress reaction’ at the vertebral endplates which significantly correlates with Oswestry Disability Index score.
Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
Conclusion The occurrence of vascular displacement into the intervertebral disc space related to lumbar hyperextension, as a compensating mechanism, is a rare incident but can occur. Consequently, when this mechanism presents with abnormal widening of the intervertebral disc space, especially at the low lumbar level, it should raise surgeon’s concern about the probability of vascular injury when performing a disc procedure. Thorough investigation with imaging studies and selecting the optimum surgical treatment are warranted.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Conclusions: Radiographic evidence of sacroiliac joint degeneration is highly prevalent in the asymptomatic population and is associated with age. Caution must be exercised when attributing lower back or pelvic girdle pain to sacroiliac joint degeneration seen on imaging. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Source: The Journal of Bone and Joint Surgery - Category: Orthopaedics Authors: Tags: Spine Scientific Articles Source Type: research
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