Bone Density Distribution in the Cervical Spine

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

Given changes in bone density induced by degenerative disease, general measures of bone health (ie DEXA) are inadequate to evaluate bone density in surgical areas of interest. Regional differences in HU in the cervical spine may influence surgical strategies. The purposes of our study were to determine whether cervical Hounsfield units (HU) vary by level, examine their relationship with age, comorbidities, and alignment, and propose a technique to measure HU in the lateral masses.

METHODS

Two hundred twenty-four patients with degenerative spine pathology with a cervical computed tomography were included (2015-2019). Measurements were performed in each vertebral body (C2-T1; mid-axial, anterior-axial, posterior-axial, mid-coronal, and mid-sagittal) and 2 regions of the lateral masses (C3-C6; mid-cor, mid-sag). To evaluate reliability, 6 observers each measured 355 HU values, inter-relater reliability assessed with intraclass correlation coefficients Correlations of HU with age, BMI, comorbidities, and cervical alignment were evaluated.

RESULTS

Bone density differed by level, with the lowest HU scores in the lower cervical spine (C6-T1) (P < .001). No correlations were found between LM HU and age, BMI, CCI, or alignment (P > .05). Increased kyphosis was weakly correlated with VB HU, while age and CCI showed moderate correlations with VB HU at all levels (P<.001). ICC for HU measurements were good to excellent for the VBs, but poor to moderate for the LMs.

CONCLUSION

Bone is least dense in the lower cervical spine. HU scoring is not reliable in the lateral masses. We recommend that a level-specific approach to bone density is considered in surgical planning.

Comparison of the most odor-active compounds in fresh and dried hop cones (Humulus lupulus L. variety spalter select) based on GC-olfactometry and odor dilution techniques

Application of aroma extract dilution analysis on the volatiles obtained from dried cones of Spalter Select hops grown in the German hop-growing area of Hallertau revealed 23 odorants in the flavor dilution (FD) factor range of 16-4096, 20 of which could be identified. On the basis of high FD factors, trans-4, 5-epoxy-(E)-2-decenal, linalool, and myrcene were identified as the most potent odorants, followed by ethyl 2-methylpropanoate, methyl 2-methylbutanoate, (Z)-1,5-octadien-3-one, nonanal, (E,Z)-1,3, 5-undecatriene, 1,3(E),5(Z),9-undecatetraene, propyl 2-methylbutanoate, 4-ethenyl-2-methoxyphenol, and 1-octen-3-one. Ten of the high-impact hop aroma compounds had previously not been identified as hop constituents and, in particular, 1,3(E),5(Z), 9-undecatetraene has not yet been reported as a food odorant. In an extract obtained from fresh hops, in addition to the odorants found in dry hops, (Z)-3-hexenal was characterized as a further key odorant rendering an additional green aroma note to the fresh material.

[Angioma like dysplasia of synovial membrane with phlebectasia causing palindromic joint swelling in childhood (author's transl)]

In a five year old boy who had intermittent knee joint swelling, angioma like venous dysplasia of synovial membrane was diagnosed by arthroscopic examination. The arthroscopic diagnosis was the indication for arthrotomy. The suprapatella pouch of the knee joint contained a blue grape like tumor. Angiomalike venous dysplasia of the synovialmembrane can histologically be separated from other angiomas of the inner joint capsule and angiomalike alterations in other joint diseases. Arthroscopy should be performed if within half a year monarticular intermittent joint swelling in childhood can not be diagnosed.

[Thoracic and lumbar myelography with metrizamid (author's transl)]

With the new x-ray medium Metrizamid it is possible to perform almost complication-free lumbar and thoracic myelography. In an experience the type of complications arising were reduced to moderate headaches, mild nausea occasional dissiness. No convulsions were seen. The number of complications are less than with other watersoluble contrast medium.