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Degulmadi D, Dave B, Krishnan A, Rai RR, Mayi S, Chintam CR. 'Higher the grade-smaller the pedicle': a study of pedicle dimensional variations in 100 cases of high grade lytic spondylolisthesis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:455-461. [PMID: 35767112 DOI: 10.1007/s00586-022-07277-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To measure the pedicle dimensions in high grade lytic spondylolisthesis (HGL) and to classify them, which helps the spine surgeon in proper selection of pedicle screws. METHODS A study of CT scans in 100 consecutive patients between Jan 2017 and April 2021 diagnosed as single-level HGL on standing radiographs. Pedicle height (PH), Pedicle width (PW), Differential pedicle height (DPH), Screw length (SL) and Transverse pedicle angle (TPA) were measured and analyzed. PH and PW were classified into four grades as-grade A less than 5.0 mm, grade B between 5.0 and 6.0 mm, grade C between 6.0 and 7.0 mm, and grade D above 7.0 mm. RESULTS 5 males and 95 females with mean age of 49.1 years. PH in 44% lytic vertebra were grade A, B (less than 6 mm) and the rest 56% had grade C, D (greater than 6 mm). PH averaged 6.6 mm in grade 3 HGL, 5.61 mm in grade 4 HGL. Change in PW, SL and TPA was not statistically significant with regards to grade or level of listhesis. A total of 37 cases were noted to have DPH (25 cases had a difference < 2 mm and 12 had a difference > 2 mm). CONCLUSION 44% of the PH in lytic vertebra was grade A and B (less than 6 mm) that stresses the importance of pre-op CT assessment and planning the appropriate screw dimensions. Change in PH was statistically significant with regards to the grade of listhesis (P-value < 0.01). Differential pedicle height also need to be looked for.
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Affiliation(s)
| | - Bharat Dave
- Stavya Spine Hospital and Research Institute, Ahmedabad, India
| | - Ajay Krishnan
- Stavya Spine Hospital and Research Institute, Ahmedabad, India
| | - Ravi Ranjan Rai
- Stavya Spine Hospital and Research Institute, Ahmedabad, India
| | - Shivanand Mayi
- Stavya Spine Hospital and Research Institute, Ahmedabad, India
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Jo M, Chae SW. Stress analysis of intervertebral disc during occupational activities. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 208:106298. [PMID: 34340051 DOI: 10.1016/j.cmpb.2021.106298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Manual material handling activities cause large compression of the intervertebral disc of the lumbar spine. Intradiscal pressure (IDP) has generally been employed to predict the risk of low back injury. As an alternative to in vivo measurements, either motion analysis or finite element (FE) analysis has been used to estimate IDP. The purpose of this study is to propose a new biomechanical method that integrates FE analysis with motion analysis, in order to estimate the stresses and deformations of the intervertebral disc of the lumbar spine during occupational activities. METHODS In the proposed method, motion analysis is performed first by using motion capture data, and the results are employed as input data to FE analysis at specific times of interest during motion. In this method, an in-house interface program is used to scale an initial reference FE model to the subject of experiment, and transformed to the corresponding posture at a specific time during motion. The muscle forces and GRF obtained from motion analysis are applied to FE analysis as boundary and loading conditions. For a total of eighteen occupational activities, the IDP, shear stress, and strain of the L4-L5 segment are estimated. RESULTS Under each in vivo activity, the predicted IDP was in overall agreement with the available in vivo data. For lifting activities according to lift origin position, the maximum IDP occurred in the far-knee position immediately after lifting. As the lift origin position moved away from the spine, the stresses and strains in the disc increased. CONCLUSIONS This new proposed method is expected to allow the estimation of the stresses and deformations in the intervertebral disc during various occupational activities.
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Affiliation(s)
- Minhye Jo
- Department of Mechanical Engineering, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Soo-Won Chae
- Department of Mechanical Engineering, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
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Increased sagittal diameter of the vertebral arch aids in diagnosis of lumbar spondylolysis. Skeletal Radiol 2021; 50:1125-1130. [PMID: 33112978 PMCID: PMC8035112 DOI: 10.1007/s00256-020-03658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify a diagnostic indicator of lumbar spondylolysis visible in plain X-ray films. METHODS One hundred and seventy-two patients with low back pain who received X-ray and computerized tomography (CT) examinations were identified and studied. They were divided into three groups: the spondylosis without spondylolisthesis (SWS) group, comprising 67 patients with bilateral pars interarticularis defects at L5 and without spondylolisthesis, the isthmic spondylolisthesis (IS) group, comprising 74 patients with L5/S1 spondylolisthesis and bilateral L5 pars interarticularis defects, and the control group, comprising 31 patients with low back pain but without spondylolysis. The sagittal diameters of the vertebral arch (SDVAs) of L4 and L5 were measured in lateral X-ray image, and the differences in SDVA between L4 and L5 (DSL4-5) in each case were calculated and analyzed. RESULTS There were no significant differences in demographic characteristics among the three groups. In the SWS and IS groups, the SDVA of L5 was significantly longer than the SDVA of L4 (p < 0.001), whereas no significant difference found in the control group (p > 0.05). DSL4-5, in which the SDVA of L4 was subtracted from the SDVA of L5, significantly differed among the three groups (p < 0.001), and the normal threshold was provisionally determined to be 1.55 mm. CONCLUSIONS In bilateral L5 spondylolysis, the SDVA of L5 is wider than the SDVA of L4, and this difference is greater in isthmic spondylolisthesis. This sign in lateral X-rays may provide a simple and convenient aid for the diagnosis of spondylolysis.
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Plomp KA, Dobney K, Weston DA, Strand Viðarsdóttir U, Collard M. 3D shape analyses of extant primate and fossil hominin vertebrae support the ancestral shape hypothesis for intervertebral disc herniation. BMC Evol Biol 2019; 19:226. [PMID: 31842740 PMCID: PMC6916256 DOI: 10.1186/s12862-019-1550-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/29/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Recently we proposed an evolutionary explanation for a spinal pathology that afflicts many people, intervertebral disc herniation (Plomp et al. [2015] BMC Evolutionary Biology 15, 68). Using 2D data, we found that the bodies and pedicles of lower vertebrae of pathological humans were more similar in shape to those of chimpanzees than were those of healthy humans. Based on this, we hypothesized that some individuals are more prone to intervertebral disc herniation because their vertebrae exhibit ancestral traits and therefore are less well adapted for the stresses associated with bipedalism. Here, we report a study in which we tested this "Ancestral Shape Hypothesis" with 3D data from the last two thoracic and first lumbar vertebrae of pathological Homo sapiens, healthy H. sapiens, Pan troglodytes, and several extinct hominins. RESULTS We found that the pathological and healthy H. sapiens vertebrae differed significantly in shape, and that the pathological H. sapiens vertebrae were closer in shape to the P. troglodytes vertebrae than were the healthy H. sapiens vertebrae. Additionally, we found that the pathological human vertebrae were generally more similar in shape to the vertebrae of the extinct hominins than were the healthy H. sapiens vertebrae. These results are consistent with the predictions of the Ancestral Shape Hypothesis. Several vertebral traits were associated with disc herniation, including a vertebral body that is both more circular and more ventrally wedged, relatively short pedicles and laminae, relatively long, more cranio-laterally projecting transverse processes, and relatively long, cranially-oriented spinous processes. We found that there are biomechanical and comparative anatomical reasons for suspecting that all of these traits are capable of predisposing individuals to intervertebral disc herniation. CONCLUSIONS The results of the present study add weight to the hypothesis that intervertebral disc herniation in H. sapiens is connected with vertebral shape. Specifically, they suggest that individuals whose vertebrae are towards the ancestral end of the range of shape variation within H. sapiens have a greater propensity to develop the condition than other individuals. More generally, the study shows that evolutionary thinking has the potential to shed new light on human skeletal pathologies.
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Affiliation(s)
- Kimberly A Plomp
- Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK.,Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Keith Dobney
- Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK.,Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.,Department of Archaeology, School of Geosciences, University of Aberdeen, St Mary's, Elphinstone Road, Scotland, UK, AB24 3UF, Aberdeen
| | - Darlene A Weston
- Department of Anthropology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada
| | - Una Strand Viðarsdóttir
- Biomedical Center, University of Iceland, Læknagarður, Vatnsmýrarvegi 16, 101, Reykjavík, Iceland
| | - Mark Collard
- Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.
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Shurley JP, Newman JK. Spondylolysis in American Football Players: Etiology, Symptoms, and Implications for Strength and Conditioning Specialists. Strength Cond J 2016. [DOI: 10.1519/ssc.0000000000000244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Dang L, Chen Z, Liu X, Guo Z, Qi Q, Li W, Zeng Y, Jiang L, Wei F, Sun C, Liu Z. Lumbar Disk Herniation in Children and Adolescents: The Significance of Configurations of the Lumbar Spine. Neurosurgery 2016; 77:954-9; discussion 959. [PMID: 26595346 DOI: 10.1227/neu.0000000000000983] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lumbar disk herniation in adults is thought to be caused by repetitive overloading and age-rated degenerative changes. However, these causes are absent in children and adolescent patients. We assume that structural malformations in the lumbar spine could predispose intervertebral disks to early degeneration and hence need to be surgically fused. This issue has never been raised before. OBJECTIVE To investigate the assumption that structural malformations in the lumbar spine could predispose intervertebral disks to early degeneration and hence need to be surgically fused. METHODS Lumbar spine configurations, including the height of the intercrestal line, the length of L5 transverse processes, and the presence of transitional vertebrae, were recorded from anteroposterior radiographs taken from 63 consecutive pediatric patients with lumbar disk herniation admitted to our hospital over a period of 8 years. Each configuration was compared in relation to the level of disk herniation. Diskectomy alone was performed in 36 cases; arthrodesis was added in the remaining 27 cases. Patients' back and leg pain visual analog scale scores and frequency and their Oswestry Disability Index scores were recorded before surgery and at follow-up. The results were compared for assessment of outcome. RESULTS Patients with high intercrestal lines and long L5 transverse processes had a significantly higher incidence of L4/5 disk herniation, whereas low intercrestal line and lumbarization were associated with L5/S1 disk herniation. Patients' visual analog scale scores, pain frequency, and Oswestry Disability Index score all improved significantly after surgery, but there was no significant difference with or without arthrodesis. CONCLUSION Pediatric lumbar disk herniation is significantly associated with structural malformations of the lumbar spine, but arthrodesis does not improve the clinical outcome. ABBREVIATIONS ICL, intercrestal lineLDH, lumbar disk herniationL5TP, L5 transverse processODI, Oswestry Disability IndexTV, transitional vertebraeVAS, visual analog scale.
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Affiliation(s)
- Lei Dang
- Orthopaedic Department of Peking University Third Hospital, Beijing, China
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Matthews PG, Phan K, Rao PJ, Ball JR. Pedicle length and degree of slip in lumbosacral isthmic spondylolisthesis. Orthop Surg 2016; 7:108-11. [PMID: 26033990 DOI: 10.1111/os.12173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 03/23/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The present retrospective study was performed to assess the anatomical features of the pedicle in isthmic spondylolisthesis and to correlate this with degree of slip. METHODS Twenty-six patients with isthmic spondylolytic spondylolisthesis were studied. Relevant patient variables, length, width, height of the L5 pedicle, and the product of height and angle between pedicle and vertebral midline were measured. The length of the posterior compartment of the pedicle was calculated as the product of the pedicle length and angle. RESULTS With measurements comparable to those reported in previous publications, the L5 pedicle was found to be longer, and the height and width of the body shorter, than published values for patients without spondylolysis. The difference between the length of the posterior compartment of the pedicle and height of body is significantly proportional to the degree of slip and may reflect an adaptive response for stabilizing the vertebral body with posterior elements. CONCLUSIONS The pedicle anatomy was found to be altered in patients with L5 S1 spondylolytic spondylolisthesis. These anatomical changes have implications for surgeons performing fusion operations in terms of length of screw, landmarks used and entry approach.
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Affiliation(s)
- Phoebe G Matthews
- Westmead Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Kevin Phan
- Westmead Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Prashanth J Rao
- Westmead Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan R Ball
- Royal North Shore Hospital, Sydney, New South Wales, Australia
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Kim YE, Choi HW. Effect of disc degeneration on the muscle recruitment pattern in upright posture: a computational analysis. Comput Methods Biomech Biomed Engin 2014; 18:1622-31. [PMID: 25025614 DOI: 10.1080/10255842.2014.936858] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Based on the sensor driving control mechanism model, the effect of disc degeneration on the trunk muscle recruitment (TMR) pattern was analysed in erect standing posture. A previously developed computational model was used for this analysis, with modifications incorporating the T12-L1 motion segment and additional muscle fascicles. To generate disc degeneration at three different levels (L3-L4, L4-L5, or L5-S1), the material properties of the ground matrix of the annulus and bulk modulus of the nucleus were reduced. The finite element method combined with an optimization technique was applied to calculate the muscle forces. Minimization of deviations in the averaged tensile stress in the annulus fibres at the outermost layer in the five discs was selected for muscle force calculations. The results indicated that the disc degeneration noticeably increased the activation of the superficial muscle (IT and R) even though there was no clear change in the longissimus thoracis. Unlike some of the superficial muscles, activation in the deep muscles (multifidus (ML, MS, MT), LL and Q) was decreased. The change in TMR pattern generated an intervertebral disc angle difference and nucleus pressure increased in the upper level. These differences are expected to be functional in that they reduce the stress at the degenerated disc by changing the muscle activation, which slows down the progress of disc degeneration.
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Affiliation(s)
- Young Eun Kim
- a Department of Mechanical Engineering , Dankook University , 126, Jukjeon-dong, Suji-gu, Yongin-si , Gyeonggi-do 448-701 , Republic of Korea
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Choi HJ, Park JY, Chin DK, Kim KS, Cho YE, Kuh SU. Anatomical parameters of fifth lumbar vertebra in L5-S1 spondylolytic spondylolisthesis from a surgical point of view. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23:1896-902. [PMID: 24275826 DOI: 10.1007/s00586-013-3111-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 11/09/2013] [Accepted: 11/09/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE We measured the length, width, height, and angles related to both Meyerding grading system and Marchetti-Bartolozzi classification in L5-S1 spondylolytic spondylolisthesis patients to investigate the anatomical characteristics of fifth lumbar pedicles. METHODS Seventy patients with L5-S1 spondylolytic spondylolisthesis and general spinal disease were included. Patient attributes, Meyerding grading system and Marchetti-Bartolozzi classification of spondylolisthesis, length, width, height of L4 and L5 pedicle, and the angle between pedicle and vertebral midline were measured. The heights of L5 vertebral body, divided as anterior, mid, and posterior were also measured. RESULTS The pedicle is elongated and the angle of the pedicle is wider in cases of L5-S1 spondylolysis. Vertebral body shape was more posteriorly wedged in L5-S1 spondylolysis. Pedicles were more narrow and shorter in L5-S1 spondylolysis. CONCLUSIONS In L5-S1 spondylolytic spondylolisthesis, a longer screw is suitable for insertion of L5 pedicle and the screw should be inserted more medially compared to patients without spondylolysis.
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Affiliation(s)
- Hong-June Choi
- Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, 712, Eonjuro Gangnam-gu, Seoul, 135-720, Korea
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L5 pedicle length is increased in subjects with spondylolysis: an anatomic study of 1072 cadavers. Clin Orthop Relat Res 2012; 470:3202-6. [PMID: 22733185 PMCID: PMC3462855 DOI: 10.1007/s11999-012-2439-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 06/07/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND In spondylolisthesis, it is believed that as L5 slips on S1, the pedicle may become elongated in response to the instability in an attempt to bridge the defect. Whether patients with spondylolysis, which is largely developmental, also develop elongation of the pedicles is unknown. QUESTIONS/PURPOSES The purpose of this study is to evaluate and quantify the increase in L5 pedicle length in subjects with spondylolysis as compared with normal healthy subjects. METHODS Nine hundred fifty-two human cadaveric specimens without spondylolysis and 120 specimens with spondylolysis from the Hamann-Todd Osteological Collection were examined by a single examiner. Baseline data, including age, sex, and race of specimens, were collected. Digital calipers were used to measure the pedicle lengths at the L5 level. Linear regression analysis was performed to compare the L5 pedicle lengths in healthy patients and patients with spondylolysis. RESULTS Linear regression showed a significant association of increased L5 pedicle length in subjects with spondylolysis. The average L5 pedicle length in subjects with spondylolysis was greater compared with subjects without spondylolysis. In spondylolytic specimens, pedicles start to elongate after the age of 40 years. The pedicle lengths increase progressively from 5.6 mm at 40 years to 6.7 mm at 80 years with a 1% to 3% increment every decade. The pedicle lengths showed little variation in specimens from healthy subjects. CONCLUSIONS In spondylolytic specimens, there is progressive elongation of L5 pedicle length after the third decade. An increase in L5 pedicle length in all age groups compared with the specimens from healthy subjects suggests that pathologic changes occur in bony anatomy of L5 vertebrae as early as adolescence when the condition develops.
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Plomp KA, Roberts CA, Viðarsdóttir US. Vertebral morphology influences the development of Schmorl's nodes in the lower thoracic vertebrae. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2012; 149:572-82. [PMID: 23097159 DOI: 10.1002/ajpa.22168] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 09/08/2012] [Indexed: 11/09/2022]
Abstract
Schmorl's nodes are the result of herniations of the nucleus pulposus into the adjacent vertebral body and are commonly identified in both clinical and archaeological contexts. The current study aims to identify aspects of vertebral shape that correlate with Schmorl's nodes. Two-dimensional statistical shape analysis was performed on digital images of the lower thoracic spine (T10-T12) of adult skeletons from the late medieval skeletal assemblages from Fishergate House, York, St. Mary Graces and East Smithfield Black Death cemeteries, London, and postmedieval Chelsea Old Church, London. Schmorl's nodes were scored on the basis of their location, depth, and size. Results indicate that there is a correlation between the shape of the posterior margin of the vertebral body and pedicles and the presence of Schmorl's nodes in the lower thoracic spine. The size of the vertebral body in males was also found to correlate with the lesions. Vertebral shape differences associated with the macroscopic characteristics of Schmorl's nodes, indicating severity of the lesion, were also analyzed. The shape of the pedicles and the posterior margin of the vertebral body, along with a larger vertebral body size in males, have a strong association with both the presence and severity of Schmorl's nodes. This suggests that shape and/or size of these vertebral components are predisposing to, or resulting in, vertically directed disc herniation.
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Affiliation(s)
- Kimberly A Plomp
- Department of Anthropology, Evolutionary Anthropology Research Group, Durham University, Durham DH1 3LE, UK.
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Chung SB, Lee S, Kim H, Lee SH, Kim ES, Eoh W. Significance of interfacet distance, facet joint orientation, and lumbar lordosis in spondylolysis. Clin Anat 2011; 25:391-7. [PMID: 21815218 DOI: 10.1002/ca.21222] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 05/17/2011] [Accepted: 05/23/2011] [Indexed: 11/12/2022]
Abstract
The aim of this study is to reveal the association between lumbar spondylolysis and several radiologic parameters, which had been suggested to be significant. The authors examine interfacet distance (IFD), facet joint orientation (FJO), and lumbar segmental lordosis (LSL) all together on the basis of lumbar computed tomography (CT) scan of 35 patients with L5 spondylolysis and 36 unaffected control groups. Thirty-five Korean military recruits, aged 19-23 (mean 20.9 years), were diagnosed as L5 spondylolysis by lumber CT scans. As a control group, 36 male Korean military recruits, aged 18-25 (mean 21.3 years), were reconfirmed as not affected by lumbar spondylolysis by CT scan when they visited our hospital complaining of back pain. This study compares IFD, FJO, and LSL for each lumbar segment between the spondylolytic and unaffected groups. We also propose the use of normal mean data of IFD, FJO, and LSL of lumbar vertebrae from 36 Korean young military recruits because each measurement has power as an absolute value, like data from an osteologic collection in other studies. Comparison of IFD between spondylolytic and unaffected individuals reveals significant differences at the L3, L4, and L5 level (P = 0.0384, P = 0.0219, and P < 0.0001, respectively). In the group of spondylolysis, the increase of IFD from L4 to S1 was less pronounced (P < 0.0001) and the LSL at L5-S1 was more lordotic (P = 0.0203). Interfacet distance and lumbar lordosis were significantly different between patients with L5 spondylolysis and individuals without pars defect on L5. In the spondylolysis group, and the increase of IFD from L4 to S1 was less pronounced and the LSL at L5-S1 was more lordotic.
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Affiliation(s)
- Sang-Bong Chung
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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