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Sample records for cervical vertebrae

  1. [Whiplash injury analysis of cervical vertebra by finite element method].

    PubMed

    Wang, Tao; Li, Zheng-Dong; Shao, Yu; Chen, Yi-Jiu

    2015-02-01

    Finite element method (FEM) is an effective mathematical method for stress analysis, and has been gradually applied in the study of biomechanics of human body structures. This paper reviews the construction, development, materials assignment and verification of FEM model of cervical vertebra, and it also states the research results of injury mechanism of whiplash injury and biomechanical response analysis of the cervical vertebra using FEM by researchers at home and abroad. PMID:26058135

  2. New approach to evaluate rotation of cervical vertebrae

    NASA Astrophysics Data System (ADS)

    Hahn, Matthias

    2001-07-01

    Functional deficits after whiplash injury can be analyzed with a quite novel radiologic method by examination of joint-blocks in C0/1 and C1/2. Thereto the movability of C0, C1 and C2 is determined with three spiral CT-scans of the patient's cervical spine. One series in neutral and one in maximal active lateral right and left rotation each. Previous methods were slice based and time consuming when manually evaluated. We propose a new approach to a computation of these angles in 3D. After a threshold segmentation of bone tissue, a rough 2D classification takes place for C0, C1 and C2 in each rotation series. The center of an axial rotation for each vertebra is gained from the approximation of its center of gravity. The rotation itself is estimated by a cross-correlation of the radial distance functions. From the previous rotation the results are taken to initialize a 3D matching algorithm based on the sum of squared differences in intensity. The optimal match of the vertebrae is computed by means of the multidimensional Powell minimization algorithm. The three translational and three rotational components build a six-dimensional search-space. The vertebrae detection and rotation computation is done fully automatic.

  3. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation.

    PubMed

    Fernández-Pérez, María José; Alarcón, José Antonio; McNamara, James A; Velasco-Torres, Miguel; Benavides, Erika; Galindo-Moreno, Pablo; Catena, Andrés

    2016-01-01

    The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation. PMID:27513752

  4. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation

    PubMed Central

    Fernández-Pérez, María José; McNamara, James A.; Velasco-Torres, Miguel; Benavides, Erika; Galindo-Moreno, Pablo; Catena, Andrés

    2016-01-01

    The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation. PMID:27513752

  5. Population-Stratified Analysis of Bone Mineral Density Distribution in Cervical and Lumbar Vertebrae of Chinese from Quantitative Computed Tomography

    PubMed Central

    Zhang, Yong; Zhou, Zhuang; Wu, Cheng'ai; Zhao, Danhui; Wang, Chao; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chenxin; Tian, Wei

    2016-01-01

    Objective To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Materials and Methods Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. Results The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. Conclusion The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan. PMID:27587947

  6. Functional morphology of the first cervical vertebra in humans and nonhuman primates.

    PubMed

    Manfreda, Evelyn; Mitteroecker, Philipp; Bookstein, Fred L; Schaefer, Katrin

    2006-09-01

    The cervical vertebral column bears or balances the weight of the head supported by the nuchal muscles that partly originate from the cervical vertebrae. The position of the head relative to the vertebral column, and consequently locomotion and posture behavior, could thus be associated with the form of the cervical vertebrae. In spite of this assumption and some empirical indications along these lines, primate vertebral morphologies have been reported to be very similar and not clearly related to locomotion. We therefore study the relationship between the morphology of the first cervical vertebra, the atlas, and the locomotion pattern within primates using a geometric morphometric approach. Our analysis is based on a total of 116 vertebrae of adult Homo sapiens, Gorilla gorilla, Pan troglodytes, Pongo pygmaeus, Hylobates lar, Macaca mulatta, Papio hamadryas, Ateles geoffroyi, and Alouatta palliata. On each atlas, 56 landmarks were digitized and superimposed by Procrustes registration. The resulting shape variables were analyzed by principal component analysis, multivariate regression, and partial least-squares analysis. We found that the nine primate species differ clearly in their atlas morphology and that allometric shape change is distinct between the nonhuman primates and Homo sapiens. We could further identify morphological features that relate to the species' locomotion pattern. Human atlas shape, however, cannot be predicted by an extrapolation of the nonhuman primate model. This implies that either the primate atlas is generalized enough to allow bipedal locomotion or else the human atlas morphology is a unique adaptation different from that in the more orthograde nonhuman primates. PMID:16955497

  7. Osteolytic mass bridging two cervical vertebrae: Unusual presentation of a vertebral body hemangioma

    PubMed Central

    Miller, Dane; Sag, Alan Alper; Krishnan, Anant; Silbergleit, Richard; Roy, Anindya; Dulai, Mohanpal

    2015-01-01

    Vertebral hemangioma is the most common spinal axis tumor. This rare presentation of a vertebral hemangioma extended contiguously from one cervical vertebra to another, encasing the vertebral artery, and thereby mimicking other tumors of the spine. We discuss the differential diagnosis of bridging vertebral masses. PMID:27190555

  8. The Mammalian Cervical Vertebrae Blueprint Depends on the T (brachyury) Gene

    PubMed Central

    Kromik, Andreas; Ulrich, Reiner; Kusenda, Marian; Tipold, Andrea; Stein, Veronika M.; Hellige, Maren; Dziallas, Peter; Hadlich, Frieder; Widmann, Philipp; Goldammer, Tom; Baumgärtner, Wolfgang; Rehage, Jürgen; Segelke, Dierck; Weikard, Rosemarie; Kühn, Christa

    2015-01-01

    A key common feature of all but three known mammalian genera is the strict seven cervical vertebrae blueprint, suggesting the involvement of strong conserving selection forces during mammalian radiation. This is further supported by reports indicating that children with cervical ribs die before they reach reproductive age. Hypotheses were put up, associating cervical ribs (homeotic transformations) to embryonal cancer (e.g., neuroblastoma) or ascribing the constraint in cervical vertebral count to the development of the mammalian diaphragm. Here, we describe a spontaneous mutation c.196A > G in the Bos taurus T gene (also known as brachyury) associated with a cervical vertebral homeotic transformation that violates the fundamental mammalian cervical blueprint, but does not preclude reproduction of the affected individual. Genome-wide mapping, haplotype tracking within a large pedigree, resequencing of target genome regions, and bioinformatic analyses unambiguously confirmed the mutant c.196G allele as causal for this previously unknown defect termed vertebral and spinal dysplasia (VSD) by providing evidence for the mutation event. The nonsynonymous VSD mutation is located within the highly conserved T box of the T gene, which plays a fundamental role in eumetazoan body organization and vertebral development. To our knowledge, VSD is the first unequivocally approved spontaneous mutation decreasing cervical vertebrae number in a large mammal. The spontaneous VSD mutation in the bovine T gene is the first in vivo evidence for the hypothesis that the T protein is directly involved in the maintenance of the mammalian seven-cervical vertebra blueprint. It therefore furthers our knowledge of the T-protein function and early mammalian notochord development. PMID:25614605

  9. Cervical canal stenosis caused by progressive fusion and enlargement of cervical vertebrae with features of Proteus syndrome and Klippel-Feil syndrome.

    PubMed

    Sugita, Shurei; Chikuda, Hirotaka; Ohya, Junichi; Taniguchi, Yuki; Takeshita, Katsushi; Haga, Nobuhiko; Ushiku, Tetsuo; Tanaka, Sakae

    2013-12-01

    We report the case of a female who presented with progressive fusion and an enlargement of the cervical vertebrae. Her cervical deformity gradually progressed with age, and the abnormal bony protrusion into the spinal canal caused myelopathy. We resected the affected vertebrae to decompress the spinal cord and performed combined anterior-posterior spinal fusion. The progression of the spinal deformity and enlargement of vertebrae stopped after surgery. The enlargement of vertebrae in the present case resembled that observed in Proteus syndrome; however, autonomous vertebral fusion has not been reported previously in patients with this condition. Our report may help expand the knowledge on developmental spine disorders. PMID:23760594

  10. Morphometric Analysis of Sub-axial Cervical Vertebrae and Its Surgical Implications

    PubMed Central

    Patil, Sachin; Vasudeva, Neelam

    2015-01-01

    Background The predilection of the cervical spine to a wide array of traumatic, degenerative and neoplastic diseases necessitates frequent surgical interventions. For successful surgical management of these conditions, a detailed anatomical knowledge of the cervical spine is required but variability in vertebral dimensions exists amongst different races and prevents the standardization of measurements. Aim The aim of this study was to present a morphometric reference database for cervical vertebrae of the Indian population and enable comparisons with other populations. Materials and Methods The study was conducted on 203 typical (C3-C6) cervical vertebrae. Linear measurements of the vertebrae were taken with the help of digital Vernier caliper and angular measurements were determined with software Image J. Statistical Analysis Mean and standard deviation of the morphometric parameters taken into account were analysed. The comparison of morphometric dimensions of the right and left sides was performed using Student’s t-test and p-value was calculated. Results The morphometric analysis of the cervical vertebrae demonstrated that when compared with other races, the mean height (11.39 ± 1.08 mm) and transverse diameters (22.18 ± 2.52 mm) of the vertebral body were larger but antero-posterior diameter was less, making the vertebral bodies in Indians transversely longer. The dimensions of the pedicle, laminae, articular processes and spinous process were smaller when compared to other populations. There existed a highly significant difference (p=0.002) between the widths of the right and left superior & inferior articular processes. A great disparity of the pedicle transverse angle was noted in different populations but in Indians the angle was 44.47 ± 2.81. Conclusion The present morphometric study in Indian population would be valuable for the successful instrumentation of the cervical spine as smaller dimensions of the cervical vertebrae pose a challenge to the

  11. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study

    PubMed Central

    Datana, Sanjeev; Kumar, Prasanna; Kumar Roy, Supriya; Londhe, Sanjay

    2014-01-01

    ABSTRACT% Purpose: The patients with cleft lip and palate have a higher risk of cervical vertebrae anomalies than do patients in general population. The aim of present study was to determine the prevalence of various upper cervical spine anomalies in different type of clefts. Procedures: Lateral cephalograms of 128 patients (66 males, 62 females) with cleft lip and palate, and 125 (60 males, 65 females) non syndromic patients without cleft lip and palate were selected at random from archive. Cephalograms of the patients were traced and the diagnosis of any cervical vertebrae anomaly was noted. Anomalies were categorized as either: posterior arch deficiency or fusions. Main findings: Prevalence of cervical vertebrae anomalies in the c lef t group was 20. 3% while it was 6.4% in the control group. Further cervical vertebrae anomalies were 16.6% in the CPO group, 19.1% in the BCLP group, and 22.2% in the UCLP group. Conclusion: A higher prevalence of cervical vertebrae anomalies was observed in cleft lip and palate patients. The prevalenc e obser ved is 3 times more in clef t group than c ontrol group. How to cite this article: Datana S, Bhalla A, Kumar P, Roy SK, Londhe S. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study. Int J Clin Pediatr Dent 2014;7(3):168-171. PMID:25709295

  12. A thorny question: the taxonomic identity of the Pirro Nord cervical vertebrae revisited.

    PubMed

    Alba, David M; Colombero, Simone; Delfino, Massimo; Martínez-Navarro, Bienvenido; Pavia, Marco; Rook, Lorenzo

    2014-11-01

    The past geographic distribution of the genus Theropithecus (Primates: Cercopithecidae) is mainly restricted to Africa. Outside that continent, the earliest reported records of this genus consist of a calcaneus of cf. Theropithecus sp. from 'Ubeidiya (Israel, 1.6-1.2 Ma [millions of years ago]), as well as three associated cervical vertebrae from Pirro Nord (Italy, 1.7-1.3 Ma) attributed to Theropithecus sp. The attribution of the Pirro Nord vertebrae to this genus has been disputed on morphometric grounds, although their assignment to a large-bodied cercopithecid has remained undisputed. Here we report unpublished cervical vertebral specimens with a similar morphology and, given their significance for the paleobiogeography of Theropithecus (purportedly representing its earliest European record), we re-evaluate their taxonomic attribution. In particular, we reconsider the possibility that they belong to another non-primate mammal recorded at this site. Based on both qualitative and metric morphological comparisons, we strongly favor an alternative attribution of the cervical vertebrae from Pirro Nord to the large porcupine Hystrix refossa, which is widely documented at the site by both dentognathic and other postcranial remains. We therefore conclude that the dispersal of Theropithecus out of Africa before ca. 1 Ma (when it is recorded by dental remains from Cueva Victoria, Spain) is currently based only on the calcaneus from 'Ubeidiya tentatively attributed to this genus. PMID:25042286

  13. A child presenting with tuberculous spondylitis in a single third cervical vertebra: a case report

    PubMed Central

    2014-01-01

    Introduction Despite a global reduction in tuberculosis, extrapulmonary tuberculosis is increasing. Spinal tuberculosis remains the commonest form of skeletal tuberculosis. Cervical spine involvement is rare but is the most dangerous form because of diagnostic difficulties and serious residual disability. We report a child who had single vertebral involvement of her third cervical vertebra which is extremely rare. To the best of our knowledge isolated third cervical vertebra involvement in a child by tuberculosis has not been reported previously. Difficulties in obtaining material for histology and bacterial culture from this critical location and how the diagnosis was reached despite these challenges are highlighted. Case presentation A 10-year-old Sinhalese girl developed painful torticollis and ‘cries during sleep’. She had received Bacillus Calmette–Guérin vaccine at birth, was well nourished, and had no loss of weight, anorexia or contact with tuberculosis. A plain radiograph of her neck showed a collapsed third cervical vertebra with no disc involvement. Magnetic resonance imaging confirmed isolated destruction of third cervical vertebra associated with prevertebral soft tissue swelling indenting the thecal sac without cord compression. Her chest radiograph was normal. There was peripheral lymphocytosis, elevated erythrocyte sedimentation rate, negative tuberculin (Mantoux) test, and negative QuantiFERON®-TB GoldIn-Tube assay. Invasive procedures to obtain tissue for histology, smear or culture were perceived by parents as dangerous due to surrounding critical structures and consent was denied. The differential diagnosis included spinal tuberculosis and unifocal Langerhan cell histiocytosis. Nocturnal symptoms and the prevertebral collection of soft tissue (‘cold abscess’) were characteristic of tuberculosis, and nonspecific findings of elevated erythrocyte sedimentation rate and lymphocytosis supported this diagnosis. An incidental finding of a

  14. EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE.

    PubMed

    Veraa, Stefanie; Bergmann, Wilhelmina; van den Belt, Antoon-Jan; Wijnberg, Inge; Back, Willem

    2016-09-01

    Diagnostic imaging is one of the pillars in the clinical workup of horses with clinical signs of cervical spinal disease. An improved awareness of morphologic variations in equine cervical vertebrae would be helpful for interpreting findings. The aim of this anatomic study was to describe CT variations in left-right symmetry and morphology of the cervical and cervicothoracic vertebrae in a sample of horses. Postmortem CT examinations of the cervical spine for horses without congenital growth disorders were prospectively and retrospectively recruited. A total of 78 horses (27 foals, 51 mature horses) were evaluated. Twenty-six horses (33.3%) had homologous changes in which a transposition of the caudal part of the transverse process (caudal ventral tubercle) of C6 toward the ventral aspect of the transverse process of C7 was present (n = 10 bilateral, n = 12 unilateral left-sided, n = 4 unilateral right-sided). There was one horse with occipito-atlantal malformation, two horses with rudimentary first ribs bilaterally, and one horse with bilateral transverse processes at Th1, representing homeotic (transitional) vertebral changes. Chi-square tests identified no significant differences in the number of conformational variations between the group of mature horses with or without clinical signs (P = 0.81) or between the group of mature horses and the group of foals (P = 0.72). Findings indicated that, in this sample of horses, the most frequently identified variations were homologous variations (transposition of the caudal part of the transverse process of C6-C7) in the caudal equine cervical vertebral column. Homeotic (transitional) variations at the cervicothoracic vertebral column were less common. PMID:27438135

  15. Morphological comparison of cervical vertebrae in adult females with different sagittal craniofacial patterns: A cross-sectional study

    PubMed Central

    Alkan, Özer; Aydoğan, Cihan; Akkaya, Sevil

    2016-01-01

    Introduction: Cervical vertebral maturation (CVM) methods have gained popularity to assess growth and development status for orthodontic patients. Although craniofacial and craniocervical structures are known to be associated, there is no evidence in the literature if this relation might negatively affect the accuracy of CVM assessments. Therefore, this study aimed to comparatively investigate the sizes of the 2nd, 3rd, and 4th cervical vertebrae in adult females (radius union stage of skeletal maturity) who have different sagittal skeletal patterns. Materials and Methods: A cross-sectional study was conducted, and 151 lateral cephalometric radiographs of adult female patients were assessed in the study. Patients were assigned to three groups according to ANB angle. Parameters including concavity depth at the lower border of the 2nd, 3rd, and 4th cervical vertebrae and base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae bodies were measured. One-way analysis of variance was used for between-group comparisons. Results: No statistically significant differences were found between groups in terms of concavity depth at the lower borders of the 2nd, 3rd, and 4th cervical vertebrae (P > 0.05). Base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae were also similar between groups (P > 0.05). Conclusions: The results of this study supports that sagittal craniofacial pattern has no effect on the accuracy of using the methods assessing CVM and calculating cervical vertebral age.

  16. Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis

    PubMed Central

    Bittencourt, M A V; Paranhos, L R

    2015-01-01

    Objectives: To perform a systematic review with meta-analysis to answer the question: is the cervical vertebrae maturation index (CVMI) effective to replace hand–wrist radiograph (gold standard) in determining the pubertal growth spurt in patients undergoing bone growth? Methods: A search in three databases was performed, in which studies were selected that compared one of the two main assessment methods for cervical vertebrae (Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995; 107: 58–66, or Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002; 72: 316–23) to a carpal assessment method. The main methodological data from each of the texts were collected and tabulated after. Later, the meta-analysis of the correlation coefficients obtained was performed. Results: 19 articles were selected from an initial 206 articles collected. Regardless of the method used, the results of the meta-analysis showed that every article selected presented a positive correlation between skeletal maturation assessment performed by cervical vertebrae and carpal methods, with discrepancy of values between genders indicating higher correlation for the female gender (0.925; 0.878) than for the male (0.879; 0.842). When the assessment was performed without gender separation, correlation was significant (0.592; 0.688) but lower in the cases when genders were separated. Conclusions: With the results of this meta-analysis, it is safe to affirm that both CVMIs used in the present study are reliable to replace the hand–wrist radiograph in predicting the pubertal growth spurt, considering that the highest values were found in female samples, especially in the method by Hassel and Farman. PMID:25521202

  17. Skeletal maturation in individuals with Down's syndrome: Comparison between PGS curve, cervical vertebrae and bones of the hand and wrist

    PubMed Central

    Carinhena, Glauber; Siqueira, Danilo Furquim; Sannomiya, Eduardo Kazuo

    2014-01-01

    Introduction This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS) curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. Methods The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS), 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. Results and Conclusions Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the curve of PGS is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance. PMID:25279522

  18. Trabecular trajectory in the articular processes of the human fourth cervical vertebra

    PubMed Central

    HERRERA, M.; PANCHÓN, A.; PEREZ-BACETE, M.

    2001-01-01

    The articular processes (AP) of the neural arch have been implicated in weight transmission through the cervical spine. To analyse the mechanism of weight transmission in the AP, we studied the direction of forces within it, in particular, the pattern of trabecular trajectories. Twenty-two AP from C4 vertebrae were studied in anatomical sections, and corresponding photoelastic models from selected sections were constructed and analysed. Anatomical and photoelastic findings show the subarticular spongiosa of the superior articular process (SAP) to be orthogonally arranged with vertical and oblique trabeculae in the direction of compressive forces and additional trabeculae always oriented perpendicular to the former. Vertical and oblique trabeculae are divided into rostral, middle and posterior groups. Rostral and middle trabeculae end in the anterior wall of the SAP and the transitional zone with the pedicle. Posterior trabeculae end in the subarticular spongiosa of the inferior articular process (IAP). The findings relating to trabecular trajectories in the SAP differ from previous descriptions and instead suggest that a part of the weight forces distributed within the AP transmit to the subchondral zone of the IAP. Knowledge of the trajectorial architecture of the AP may contribute to refining finite element analytical models for investigating its weight-bearing function. PMID:11554512

  19. A comparison between cervical vertebrae and modified MP3 stages for the assessment of skeletal maturity

    PubMed Central

    Prasad, Mandava; Ganji, Venkata Suresh Kumar; George, Suja Ani; Talapaneni, Ashok Kumar; Shetty, Sharath Kumar

    2013-01-01

    Objective: Evaluation of skeletal maturity in human individuals is an important aspect in orthodontics and dentofacial orthopedics because, growth guidance and fundamental structural changes are essential for treatment of skeletal discrepancies in all the three planes. Among various growth assessment methods, cervical vertebra maturation stages and hand wrist have been correlated with the individual growth changes during puberty. The purpose of this study is to determine correlation of the CVM index with the modified median phalanx index (MP3) as described by Rajagopal and Kansal. Materials and Methods: 200 subjects (100 males and 100 females) of Nellore, Indian origin boys aged between 10 to 19 years and girls of 8 to 16 years were selected for the study. The subjects are selected randomly from patients visiting the Departments of Orthodontics and Dentofacial Orthopedics, Pediatric dentistry and Oral medicine and Radiology at Narayana Dental College and Hospital. Nellore. Radiographs of left hand MP3 and lateral cephalogram were taken. Results: Cohen's kappa statistic was used to assess the agreement between the two measurements based on categorical variables. Conclusions: There was a good concordance between 6 stages of CVMI (Hassel and Farman) and the 6 stages of MP3 (Rajagopal and Kansal). Physiological maturity was earlier in females than in males when compared to the individuals of opposite sex of same chronological age. Chronological age was not a valid predictor of assessing the skeletal maturity because of significant variations in the distribution of CVMI and MP3 stages with respect to individual chronological age distribution. PMID:23633839

  20. Giant prolactinoma presenting as a skull base tumor with erosion of the cervical vertebrae: pronounced responsiveness to dopamine agonist treatment.

    PubMed

    Bjerg, Mia L; Rosendal, Frederikke; Nielsen, Edith; Ulhøi, Benedikte Palm; Jørgensen, Jens O L

    2014-08-27

    Giant prolactinomas are rare and usually associated with symptoms attributable to hypopituitarism and compression of juxtasellar structures such as the cranial nerves of the cavernous sinus and the optic chiasm. Occasionally, they masquerade as skull base tumors with atypical symptoms. We describe a patient who presented with a low-energy trauma in the neck region that led to the initial diagnosis of a large skull base tumor eroding the cervical vertebrae. After stabilizing surgery, the patient responded to dopamine agonist therapy with normalization of serum prolactin levels and pronounced reduction in tumor volume. PMID:25162753

  1. [Characteristic of the fractures of the cervical, thoracic and lumbar vertebrae in the victims of a traffic accident found in the passenger compartment of a modern motor vehicle].

    PubMed

    Pigolkin, Yu I; Dubrovin, I A; Sedykh, E P; Mosoyan, A S

    2016-01-01

    The objective of the present work was to study peculiar features of the injuries to three spinal regions in the victims of a head-on car collision found in the passenger compartments of modern motor vehicles equipped with seat belts and other safety means. It was shown that most frequent fatal injuries to the driver include the fractures of the cervical, thoracic, and lumbar vertebrae. These injuries are much less frequent in the passengers occupying the front and the right back seats. The multilayer and multiple character of the fractures in different parts of the spinal column in the car drivers is attributable to more pronounced spine flexion and extension associated with injuries of this kind. The fractures of the lower cervical vertebrae in the front seat passengers occur more frequently than injuries of a different type whereas the passengers of the back seats most frequently experience fractures of the upper cervical vertebrae. The passengers of the left back seat less frequently suffer from injuries to the thoracic spine than from the fractures of the cervical and lumbar vertebrae. The passengers of the central back seat most frequently experience fractures of the thoracic part of the vertebral column and the passengers occupying the right back seat fractures of the lumbar vertebrae. PMID:27030091

  2. Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

    PubMed Central

    Dong, Jun; Lu, Meng; Lu, Teng; Liang, Baobao; Xu, Junkui; Qin, Jie; Cai, Xuan; Huang, Sihua; Wang, Dong; Li, Haopeng; He, Xijing

    2015-01-01

    OBJECTIVE: To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group. METHODS: Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group. RESULTS: In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM) of C3–7 in all directions in the non-fusion group compared with the intact group (p>0.05), but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05). The ROM of adjacent segments (C3−4, C6−7) of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05). Significant differences in the C4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C4−6 ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01). The stability index ROM (SI-ROM) of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C4−6 segment of the non-fusion group compared with the fusion group. CONCLUSION: An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be considered

  3. DEFECTS IN CERVICAL VERTEBRAE IN BORIC ACID-EXPOSED RAT EMBRYOS ARE ASSOCIATED WITH ANTERIOR SHIFTS OF HOX GENE EXPRESSION DOMAINS

    EPA Science Inventory

    Defects in cervical vertebrae in boric acid-exposed rat embryos are associated with anterior shifts of hox gene expression domains

    Nathalie Wery,1 Michael G. Narotsky,2 Nathalie Pacico,1 Robert J. Kavlock,2 Jacques J. Picard,1 AND Francoise Gofflot,1*
    1Unit of Developme...

  4. The Cervical Spine of the American Barn Owl (Tyto furcata pratincola): I. Anatomy of the Vertebrae and Regionalization in Their S-Shaped Arrangement

    PubMed Central

    Krings, Markus; Nyakatura, John A.; Fischer, Martin S.; Wagner, Hermann

    2014-01-01

    Background Owls possess an extraordinary neck and head mobility. To understand this mobility it is necessary to have an anatomical description of cervical vertebrae with an emphasis on those criteria that are relevant for head positioning. No functional description specific to owls is available. Methodology/Principal findings X-ray films and micro-CT scans were recorded from American barn owls (Tyto furcata pratincola) and used to obtain three-dimensional head movements and three-dimensional models of the 14 cervical vertebrae (C1−C14). The diameter of the vertebral canal, the zygapophyseal protrusion, the distance between joint centers, and the pitching angle were quantified. Whereas the first two variables are purely osteological characteristics of single vertebrae, the latter two take into account interactions between vertebrae. These variables change in characteristic ways from cranial to caudal. The vertebral canal is wide in the cranial and caudal neck regions, but narrow in the middle, where both the zygapophyseal protrusion and the distance between joint centers are large. Pitching angles are more negative in the cranial and caudal neck regions than in the middle region. Cluster analysis suggested a complex regionalization. Whereas the borders (C1 and C13/C14) formed stable clusters, the other cervical vertebrae were sorted into 4 or 5 additional clusters. The borders of the clusters were influenced by the variables analyzed. Conclusions/Significance A statistical analysis was used to evaluate the regionalization of the cervical spine in the barn owl. While earlier measurements have shown that there appear to be three regions of flexibility of the neck, our indicators suggest 3–7 regions. These many regions allow a high degree of flexibility, potentially facilitating the large head turns that barn owls are able to make. The cervical vertebral series of other species should also be investigated using statistical criteria to further characterize

  5. Locally aggressive aneurysmal bone cyst of C4 vertebra treated by total en bloc excision and anterior plus posterior cervical instrumentation

    PubMed Central

    Parmar, Himanshu N.; Agrawal, Vinod A.; Shah, Munjal S.; Nanda, Saurav N.

    2015-01-01

    We are presenting a case of cervical (C4) aneurysmal bone cyst in a 13-year-old girl, came to the outpatient department with neck pain and stiffness since 6 months and normal neurology. We did an en bloc excision of locally aggressive tumor through anterior plus posterior approach and stabilization by lateral mass screw fixation and anterior cervical instrumentation. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumor and instrumentation in a single stage to avoid instability. PMID:26288549

  6. Corpectomy with Adjacent-Level Kyphoplasty to Treat Metastatic Lung Cancer in Three Contiguous Cervical Vertebrae Causing Focal Neurologic Compromise

    PubMed Central

    Bateman, Antony H.; Way, Adam C.

    2014-01-01

    Study Design Case report. Objectives Decompression of metastatic spinal cord compression has been shown to improve quality of life and prolong ambulation in patients undergoing palliative treatment. We report a case of metastatic cervical myelopathy treated with a combined approach using corpectomy and stabilization together with balloon kyphoplasty to allow adequate decompression and immediate stability in a patient with significant destruction of adjacent vertebral bodies. Methods The cervical spine was approached anteriorly and decompressed with a C7 corpectomy. Subsequent stability was achieved with insertion of a trabecular metal cage. Balloon kyphoplasty was used to treat lytic lesions within the posterior body of the adjacent vertebrae for pain relief and increased stability. Additional stability was achieved through the application of an anterior plate. Results Full limited decompression and stabilization were successfully achieved. The patient had no further neurologic deterioration and made modest improvements that allowed a return to independent ambulation. Conclusion This limited approach may be an option for patients with metastatic spinal cord compression, lytic destruction of adjacent vertebral bodies, and limited life expectancy. PMID:25844288

  7. PREVALENCE OF ANATOMICAL VARIATION OF THE SIXTH CERVICAL VERTEBRA AND ASSOCIATION WITH VERTEBRAL CANAL STENOSIS AND ARTICULAR PROCESS OSTEOARTHRITIS IN THE HORSE.

    PubMed

    DeRouen, Anthony; Spriet, Mathieu; Aleman, Monica

    2016-05-01

    The sixth cervical vertebra (C6) has unique morphology due to a ventral extension from the transverse process known as the ventral lamina. Little information was found regarding the prevalence and clinical relevance of morphologic variations. Aims of this observational, retrospective study were to characterize C6 morphologic variations in a large sample of horses. Cervical radiographic studies of 100 horses were retrieved. Data recorded were signalment, clinical history, morphology of the C6 ventral lamina, presence of articular process osteoarthritis, and presence of static vertebral canal stenosis. Morphologic variations were found in C6 vertebrae for 24/100 horses, with symmetric absence of the ventral lamina in nine horses and asymmetric absence in 15. Anomalous C6 vertebrae were more common in Warmbloods, with 19/55 Warmbloods in the population being affected (P = 0.006). No association was found with sex. There was no significant difference in the mean of the intravertebral sagittal ratios between horses with normal or anomalous C6 vertebrae; however there was a significantly greater proportion of horses with anomalous C6 vertebrae that had an intravertebral sagittal ratio of less than 0.5 at C6 (P = 0.047). There was no association between the morphology of C6 and articular process osteoarthritis. Anomalous C6 vertebrae in our population were associated with a higher likelihood of cervical pain (P = 0.013). Authors propose that morphologic variations in the C6 ventral laminae could be linked to other developmental abnormalities such as vertebral canal stenosis, might affect regional biomechanics and should therefore be considered clinically relevant in horses. Future, controlled prospective studies are needed to test this theory. PMID:26915973

  8. Brief communication: a proposed method for the assessment of pubertal stage in human skeletal remains using cervical vertebrae maturation.

    PubMed

    Shapland, Fiona; Lewis, Mary E

    2014-01-01

    The assessment of age-at-death in non-adult skeletal remains is under constant review. However, in many past societies an individual's physical maturation may have been more important in social terms than their exact age, particularly during the period of adolescence. In a recent article (Shapland and Lewis: Am J Phys Anthropol 151 (2013) 302-310) highlighted a set of dental and skeletal indicators that may be useful in mapping the progress of the pubertal growth spurt. This article presents a further skeletal indicator of adolescent development commonly used by modern clinicians: cervical vertebrae maturation (CVM). This method is applied to a collection of 594 adolescents from the medieval cemetery of St. Mary Spital, London. Analysis reveals a potential delay in ages of attainment of the later CVM stages compared with modern adolescents, presumably reflecting negative environmental conditions for growth and development. The data gathered on CVM is compared to other skeletal indicators of pubertal maturity and long bone growth from this site to ascertain the usefulness of this method on archaeological collections. PMID:24318949

  9. Age estimation in children and young adolescents for forensic purposes using fourth cervical vertebra (C4).

    PubMed

    Cameriere, R; Giuliodori, A; Zampi, M; Galić, I; Cingolani, M; Pagliara, F; Ferrante, L

    2015-03-01

    The aim of this study was to evaluate the applicability of using the growth of the body of C4 vertebra for the estimation of age in children and young adolescents. We used the fact that the proportions between the radiologic projections of the posterior and anterior sides of the C4 vertebral body, which forms a trapezoidal shape, differ with age: in younger individuals, the posterior side is higher, whereas in older individuals, the projections of the sides of the vertebral body form a rectangular shape with the two sides equal or with the anterior side slightly higher. Cephalograms of 444 Italian subjects (214 female and 230 male individuals) aged between 5 and 15 years and with no obvious development abnormalities were analyzed. The projections of the anterior side (a) and of the posterior side (b) of each C4 body were measured, and their ratio (Vba), as a value of the C4 body development, was used for age estimation. Distribution of the Vba suggested that it does not change after 13 years in female and 14 years in male subjects. Consequently, we restricted our analysis of the Vba growing model until 14 years in both sexes. We used a Bayesian calibration method to estimate chronological age as function of Vba as a predicting variable. The intra- and inter-observer agreement was satisfactory, using intra-class correlation coefficient of Vba on 30 randomly selected cephalograms. The mean absolute errors were 1.34 years (standard deviation 0.95) and 1.01 years (standard deviation 0.71), and the mean inter-quartile ranges of the calibrating distribution were 2.32 years (standard deviation 0.25) in male and 1.72 years (standard deviation 0.39) in female individuals, respectively. The slopes of the regression of the estimated age error to chronological age were 0.02 in male and 0.06 in female individuals, where both values did not result significantly different from 0 (p > 0.12). In conclusion, although our Bayesian calibration method might not really

  10. Comparison of three methods of calculation, experimental and monte carlo simulation in investigation of organ doses (thyroid, sternum, cervical vertebra) in radioiodine therapy.

    PubMed

    Shahbazi-Gahrouei, Daryoush; Ayat, Saba

    2012-07-01

    Radioiodine therapy is an effective method for treating thyroid cancer carcinoma, but it has some affects on normal tissues, hence dosimetry of vital organs is important to weigh the risks and benefits of this method. The aim of this study is to measure the absorbed doses of important organs by Monte Carlo N Particle (MCNP) simulation and comparing the results of different methods of dosimetry by performing a t-paired test. To calculate the absorbed dose of thyroid, sternum, and cervical vertebra using the MCNP code, *F8 tally was used. Organs were simulated by using a neck phantom and Medical Internal Radiation Dosimetry (MIRD) method. Finally, the results of MCNP, MIRD, and Thermoluminescent dosimeter (TLD) measurements were compared by SPSS software. The absorbed dose obtained by Monte Carlo simulations for 100, 150, and 175 mCi administered (131)I was found to be 388.0, 427.9, and 444.8 cGy for thyroid, 208.7, 230.1, and 239.3 cGy for sternum and 272.1, 299.9, and 312.1 cGy for cervical vertebra. The results of paired t-test were 0.24 for comparing TLD dosimetry and MIRD calculation, 0.80 for MCNP simulation and MIRD, and 0.19 for TLD and MCNP. The results showed no significant differences among three methods of Monte Carlo simulations, MIRD calculation and direct experimental dosimetry using TLD. PMID:23717806

  11. Comparison of Three Methods of Calculation, Experimental and Monte Carlo Simulation in Investigation of Organ Doses (Thyroid, Sternum, Cervical Vertebra) in Radioiodine Therapy

    PubMed Central

    Shahbazi-Gahrouei, Daryoush; Ayat, Saba

    2012-01-01

    Radioiodine therapy is an effective method for treating thyroid cancer carcinoma, but it has some affects on normal tissues, hence dosimetry of vital organs is important to weigh the risks and benefits of this method. The aim of this study is to measure the absorbed doses of important organs by Monte Carlo N Particle (MCNP) simulation and comparing the results of different methods of dosimetry by performing a t-paired test. To calculate the absorbed dose of thyroid, sternum, and cervical vertebra using the MCNP code, *F8 tally was used. Organs were simulated by using a neck phantom and Medical Internal Radiation Dosimetry (MIRD) method. Finally, the results of MCNP, MIRD, and Thermoluminescent dosimeter (TLD) measurements were compared by SPSS software. The absorbed dose obtained by Monte Carlo simulations for 100, 150, and 175 mCi administered 131I was found to be 388.0, 427.9, and 444.8 cGy for thyroid, 208.7, 230.1, and 239.3 cGy for sternum and 272.1, 299.9, and 312.1 cGy for cervical vertebra. The results of paired t-test were 0.24 for comparing TLD dosimetry and MIRD calculation, 0.80 for MCNP simulation and MIRD, and 0.19 for TLD and MCNP. The results showed no significant differences among three methods of Monte Carlo simulations, MIRD calculation and direct experimental dosimetry using TLD. PMID:23717806

  12. Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model

    PubMed Central

    Qin, Jie; He, Xijing; Wang, Dong; Qi, Peng; Guo, Lei; Huang, Sihua; Cai, Xuan; Li, Haopeng; Wang, Rui

    2012-01-01

    This was an in vitro and in vivo study to develop a novel artificial cervical vertebra and intervertebral complex (ACVC) joint in a goat model to provide a new method for treating degenerative disc disease in the cervical spine. The objectives of this study were to test the safety, validity, and effectiveness of ACVC by goat model and to provide preclinical data for a clinical trial in humans in future. We designed the ACVC based on the radiological and anatomical data on goat and human cervical spines, established an animal model by implanting the ACVC into goat cervical spines in vitro prior to in vivo implantation through the anterior approach, and evaluated clinical, radiological, biomechanical parameters after implantation. The X-ray radiological data revealed similarities between goat and human intervertebral angles at the levels of C2-3, C3-4, and C4-5, and between goat and human lordosis angles at the levels of C3-4 and C4-5. In the in vivo implantation, the goats successfully endured the entire experimental procedure and recovered well after the surgery. The radiological results showed that there was no dislocation of the ACVC and that the ACVC successfully restored the intervertebral disc height after the surgery. The biomechanical data showed that there was no significant difference in range of motion (ROM) or neural zone (NZ) between the control group and the ACVC group in flexion-extension and lateral bending before or after the fatigue test. The ROM and NZ of the ACVC group were greater than those of the control group for rotation. In conclusion, the goat provides an excellent animal model for the biomechanical study of the cervical spine. The ACVC is able to provide instant stability after surgery and to preserve normal motion in the cervical spine. PMID:23300816

  13. CT Morphometric Analysis to Determine the Anatomical Basis for the Use of Transpedicular Screws during Reconstruction and Fixations of Anterior Cervical Vertebrae

    PubMed Central

    Chen, Chun; Ruan, Dike; Wu, Changfu; Wu, Weidong; Sun, Peidong; Zhang, Yuanzhi; Wu, Jigong; Lu, Sheng; Ouyang, Jun

    2013-01-01

    Background Accurate placement of pedicle screw during Anterior Transpedicular Screw fixation (ATPS) in cervical spine depends on accurate anatomical knowledge of the vertebrae. However, little is known of the morphometric characteristics of cervical vertebrae in Chinese population. Methods Three-dimensional reconstructions of CT images were performed for 80 cases. The anatomic data and screw fixation parameters for ATPS fixation were measured using the Mimics software. Findings The overall mean OPW, OPH and PAL ranged from 5.81 to 7.49 mm, 7.77 to 8.69 mm, and 33.40 to 31.13 mm separately, and SPA was 93.54 to 109.36 degrees from C3 to C6, 104.99 degrees at C7, whereas, 49.00 to 32.26 degrees from C4 to C7, 46.79 degrees at C3 (TPA). Dl/rSIP had an increasing trend away from upper endplate with mean value from 1.87 to 5.83 mm. Dl/rTIP was located at the lateral portion of the anterior cortex of vertebrae for C3 to C5 and ipsilateral for C6 to C7 with mean value from −2.70 to −3.00 mm, and 0.17 to 3.18 mm. The entrance points for pedicular screw insertion for C3 to C5 and C6 to C7 were recommended −2∼−3 mm and 0–4 mm from the median sagittal plane, respectively, 1–4 mm and 5–6 mm from the upper endplate, with TPA being 46.79–49.00 degrees and 40.89–32.26 degrees, respectively, and SPA being 93.54–106.69 degrees and 109.36–104.99 degrees, respectively. The pedicle screw insertion diameter was recommended 3.5 mm (C3 and C4), 4.0 mm (C5 to C7), and the pedicle axial length was 21–24 mm for C3 to C7 for both genders. However, the ATPS insertion in C3 should be individualized given its relatively small anatomical dimensions. Conclusions The data provided a morphometric basis for the ATPS fixation technique in lower cervical fixation. It will help in preoperative planning and execution of this surgery. PMID:24349038

  14. [Apical petrositis, osteomyelitis of the base of the skull bones and of the first cervical vertebra in a 5 year-old children following chicken pox].

    PubMed

    Bogomil'sky, M R; Polunin, M M; Zelikovich, E I; Soldatsky, Yu L; Burova, O V

    2016-01-01

    This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid. However, this approach is associated with the high risk of disability arising from the potential injury to the craniocerebral nerves. PMID:26977573

  15. Bipartite Atlas with Os Odontoideum with Block Cervical Vertebrae: A Case Report with Emphasis on the "Overlooked" C1 Lateral Masses.

    PubMed

    Salunke, Pravin; Sahoo, Sushanta K; Mahajan, Anshu

    2015-01-01

    Though rare, a variety of bipartite atlas has been described. However, little has been mentioned about the hypoplastic C1 lateral masses in these cases. An unusual case of bipartite atlas, with hypoplastic lateral masses, os odontoideum and block vertebrae has been described with the surgical challenges encountered. The emphasis here is to study the C1 lateral masses and attempting C1-2 fusion before resorting to occipito-cervical fusion. A 42-year-old lady presented with progressive spastic quadriparesis. Radiology revealed blocked C2-5 vertebrae with os odontoideum with atlanto-axial dislocation with bifid anterior arch of atlas, hypoplastic C1 lateral masses (ill formed postero-inferior part) and posterior arch. Magnetic resonance imaging showed cervicomedullary compression. Reduction was achieved by opening the C1-2 joints posteriorly. Though bilateral C1-2 lateral mass fusion was attempted, we succeeded only on one side necessitating O-C2 fusion on the other. Patient improved neurologically, though neck movements were restricted. Partially formed (peg shaped) lateral mass of C1 suggests its development from more than one sclerotome. With normal superior facets of C1 lateral mass, an attempt should always be made at fusing the C1-2 joint rather than O-C2 in such cases to preserve some neck movements. PMID:26442555

  16. Correlation Analysis of the Hyoid Bone Position in Relation to the Cranial Base, Mandible and Cervical Part of Vertebra with Particular Reference to Bimaxillary Relations / Teleroentgenogram Analysis

    PubMed Central

    Deljo, Emsudina; Filipovic, Mediha; Babacic, Rafeta; Grabus, Jasmina

    2012-01-01

    Introduction: The relationship among the orofacial system and the rest of the body ,both in functional and anatomical terms was the subject of numerous scientific studies. The optimum position of the bone structures of orofacial system provides performance of intact vital functions, such as breathing or swallowing. Hyoid bone represents a link between the head and neck. Although located in the neck, hyoid bone due to its brachial origin belongs to the visceral skeleton. The purpose of the research: a) To determine the position of the hyoid bone, in relation to the cranial base, mandible and cervical part of the vertebra; b) To determine the linear measures of hyoid bone and its constituents and c) to Identify on the profile teleroengen image, whether there are differences in the position of hyoid bone depending on the saggital maxillo-mandibular relationship. The examinees and methods: 30 profile teleroengen images of patients aged 17-18 years of both sexes were used for this study. To study the position of hyoid bone depending on the saggital maxillo-mandibular relationship respondents were divided into groups based on the ANB-angle values. The first group is ortognat patients with ANBangle values, from 1 to 4°. The second group included patients with distal jaw relationship, that is, whose values of ANB-angle were greater than / or 5°. The third group consists of patients with ANB-angle value of 0 or negative. Results and Conclusion: The position of hyoid bone is not constant, but depends on the maxillo-mandibular anterior posterior relationships. Length of hyoid bones and greater horns of hyoid bone differs with respect to the sagittal malocclusion. In relation to the cranial base and maxillary bones flat position of the hyoid bone is highly correlated. A positive correlation was found with relation to the cervical vertebra, while the dependence is determined in relation to the steep mandibular plane. PMID:23322951

  17. Rupture of Cervical Esophagus From Blunt Trauma With Concomitant Fracture Dislocation of C4-C5 Vertebrae

    PubMed Central

    Makoyo, P. Ziki

    1979-01-01

    A patient is presented who had sustained a high posterior cervical esophageal laceration (secondary to an automobile accident) with concomitant fracture of the C4 - C5 spine. It was treated by Gulbrandson conversional method. To the author's knowledge, this represents the first recorded rupture of the cervical esophagus associated with high cord lesions as a result of blunt trauma to the neck. PMID:448756

  18. The Effect of Saline Coolant on Temperature Levels during Decortication with a Midas Rex: An in Vitro Model Using Sheep Cervical Vertebrae.

    PubMed

    Livingston, Asher; Wang, Tian; Christou, Chris; Pelletier, Matthew H; Walsh, William R

    2015-01-01

    Decortication of bone with a high-speed burr in the absence of coolant may lead to local thermal necrosis and decreased healing ability, which may negatively impact clinical outcome. Little data are available on the impact of applying a coolant during the burring process. This study aims to establish an in vitro model to quantitatively assess peak temperatures during endplate preparation with a high-speed burr. Six sheep cervical vertebrae were dissected and mounted. Both end plates were used to give a total of 12 sites. Two thermocouples were inserted into each vertebra, 2 mm below the end plate surface and a thermal camera set up to measure surface temperature. A 3 mm high-pneumatic speed burr (Midas Rex, Medtronic, Fort Worth, TX, USA) was used to decorticate the bone in a side to side sweeping pattern, using a matchstick burr (M-8/9MH30) with light pressure. This procedure was repeated while dripping saline onto the burr and bone. Data were compared between groups using a Student's t-test. Application of coolant at the bone-burr interface during decortication resulted in a significant decrease in final temperature. Without coolant, maximum temperatures 2 mm from the surface were not sufficient to cause thermal osteonecrosis, although peak surface temperatures would cause local damage. The use of a high-speed burr provides a quick and an effective method of vertebral end plate preparation. Thermal damage to the bone can be minimized through the use of light pressure and saline coolant. This has implications for any bone preparation performed with a high-speed burr. PMID:26284253

  19. The Effect of Saline Coolant on Temperature Levels during Decortication with a Midas Rex: An in Vitro Model Using Sheep Cervical Vertebrae

    PubMed Central

    Livingston, Asher; Wang, Tian; Christou, Chris; Pelletier, Matthew H.; Walsh, William R.

    2015-01-01

    Decortication of bone with a high-speed burr in the absence of coolant may lead to local thermal necrosis and decreased healing ability, which may negatively impact clinical outcome. Little data are available on the impact of applying a coolant during the burring process. This study aims to establish an in vitro model to quantitatively assess peak temperatures during endplate preparation with a high-speed burr. Six sheep cervical vertebrae were dissected and mounted. Both end plates were used to give a total of 12 sites. Two thermocouples were inserted into each vertebra, 2 mm below the end plate surface and a thermal camera set up to measure surface temperature. A 3 mm high-pneumatic speed burr (Midas Rex, Medtronic, Fort Worth, TX, USA) was used to decorticate the bone in a side to side sweeping pattern, using a matchstick burr (M-8/9MH30) with light pressure. This procedure was repeated while dripping saline onto the burr and bone. Data were compared between groups using a Student’s t-test. Application of coolant at the bone–burr interface during decortication resulted in a significant decrease in final temperature. Without coolant, maximum temperatures 2 mm from the surface were not sufficient to cause thermal osteonecrosis, although peak surface temperatures would cause local damage. The use of a high-speed burr provides a quick and an effective method of vertebral end plate preparation. Thermal damage to the bone can be minimized through the use of light pressure and saline coolant. This has implications for any bone preparation performed with a high-speed burr. PMID:26284253

  20. Cervical spondylosis

    MedlinePlus

    ... cartilage (disks) and bones of the neck (cervical vertebrae). It is a common cause of chronic neck ... by aging and chronic wear on the cervical spine. This includes the disks or cushions between the ...

  1. Sagittal evaluation of elemental geometrical dimensions of human vertebrae.

    PubMed Central

    Gilad, I; Nissan, M

    1985-01-01

    Geometrical configuration and dimensions of the human vertebra were investigated using radiographs of 157 normal healthy adult men. Measurements were based on five bony reference points, which can be defined in radiographs. The measurements permit the determination of nine dimensions that can be used for anthropometrical evaluation of the cervical and lumbar vertebrae. A simplified model of the vertebra in the sagittal plane is presented and serves as a basis for the geometrical measurements. In the cervical region, average width exceeded average height of vertebral bodies C3 to C7, while in C2 the average width was smaller than the average height; C7 was the longest and C3 the shortest cervical vertebra. In the lumbar region, average width exceeded average height of the vertebral bodies. Values for width and height did not differ significantly from L1 to L5; L3 was the longest and L5 the shortest lumbar vertebra. Images Fig. 1 PMID:3870717

  2. Cervical Stenosis, Myelopathy and Radiculopathy

    MedlinePlus

    ... between the vertebrae results in narrowing of the space for the spinal cord and its branches, known ... and cervical stenosis refers to narrowing of the space for the spinal cord or nerve branches in ...

  3. Automated localization of vertebra landmarks in MRI images

    NASA Astrophysics Data System (ADS)

    Pai, Akshay; Narasimhamurthy, Anand; Rao, V. S. Veeravasarapu; Vaidya, Vivek

    2011-03-01

    The identification of key landmark points in an MR spine image is an important step for tasks such as vertebra counting. In this paper, we propose a template matching based approach for automatic detection of two key landmark points, namely the second cervical vertebra (C2) and the sacrum from sagittal MR images. The approach is comprised of an approximate localization of vertebral column followed by matching with appropriate templates in order to detect/localize the landmarks. A straightforward extension of the work described here is an automated classification of spine section(s). It also serves as a useful building block for further automatic processing such as extraction of regions of interest for subsequent image processing and also in aiding the counting of vertebra.

  4. Langerhans cell histiocytosis of the cervical spine: case report of an unusual location.

    PubMed

    Geusens, E; Brys, P; Ghekiere, J; Samson, I; Sciot, R; Brock, P; Baert, A L

    1998-01-01

    An unusual location for Langerhans cell histiocytosis of the cervical spine is presented. The osteolytic lesion, instead of being located in the vertebral body, was visualised in the left lateral mass of the fifth cervical vertebra, extending into the vertebral body and through the interapophyseal joint into the lateral mass of the fourth cervical vertebra. PMID:9724427

  5. Some borderlands of the cervical spine. Pt. 1

    SciTech Connect

    Kattan, K.R.; Pais, M.J.

    1982-03-01

    The normal cervical spine may appear abnormal due to several factors, namely: The complexity of the cervical vertebra, the normal variation, the superimposition of the adjacent vertebrae, and the superimposition of structures outside the spine such as the craniofacial and laryngeal structures.

  6. Posterolateral tunnels and ponticuli in human atlas vertebrae

    PubMed Central

    HASAN, MAHDI; SHUKLA, SANJEEV; SHAKIL SIDDIQUI, M.; SINGH, DHANRAJ

    2001-01-01

    The posterolateral tunnel on the superior surface of the first cervical (atlas) vertebra is of normal occurrence in monkeys and other lower animals, but its presence in the form of a tunnel-like canal, for the passage of the third part of the vertebral artery over the posterior arch of the human atlas vertebra is not reported. The aim of the present study was to detect the presence of such a canal, in addition to other types of ponticuli (little bridges) reported by earlier investigators, in macerated atlas vertebrae and routine cadaveric dissections. The posterolateral tunnel was detected in 1.14%, and the posterior and lateral ponticuli in 6.57 and 2% of vertebrae. Probably the bony roof of the posterolateral tunnel serves the purpose of additional lateral extension for the attachment of the posterior atlanto-occipital membrane in quadrupeds, where the load of the head is supported by the extensor muscles of the neck, ligaments and posterior atlanto-occipital membrane. In man, where the weight of the head is borne by the vertical loading of the superior articular process of the atlas, the roof of the tunnel has disappeared. PMID:11554511

  7. Posterolateral tunnels and ponticuli in human atlas vertebrae.

    PubMed

    Hasan, M; Shukla, S; Siddiqui, M S; Singh, D

    2001-09-01

    The posterolateral tunnel on the superior surface of the first cervical (atlas) vertebra is of normal occurrence in monkeys and other lower animals, but its presence in the form of a tunnel-like canal, for the passage of the third part of the vertebral artery over the posterior arch of the human atlas vertebra is not reported. The aim of the present study was to detect the presence of such a canal, in addition to other types of ponticuli (little bridges) reported by earlier investigators, in macerated atlas vertebrae and routine cadaveric dissections. The posterolateral tunnel was detected in 1.14%, and the posterior and lateral ponticuli in 6.57 and 2% of vertebrae. Probably the bony roof of the posterolateral tunnel serves the purpose of additional lateral extension for the attachment of the posterior atlanto-occipital membrane in quadrupeds, where the load of the head is supported by the extensor muscles of the neck, ligaments and posterior atlanto-occipital membrane. In man, where the weight of the head is borne by the vertical loading of the superior articular process of the atlas, the roof of the tunnel has disappeared. PMID:11554511

  8. [Pediatric orthopedic cervical spine problems].

    PubMed

    Helenius, Ilkka

    2016-01-01

    Treatment-requiring diseases of the cervical spine in children are rare. The most common cases requiring medical assessment and treatment are acute torticollis and various accidents. A torticollis having lasted for more than a week should be recognized, because it can be treated by skull traction. Cervical spine fractures in children under school age are very rare, the most common being a fracture of the base of the dens of the second cervical vertebra. Cervical spine instability is almost always associated with an underlying disease. PMID:27400588

  9. Fully automatic vertebra detection in x-ray images based on multi-class SVM

    NASA Astrophysics Data System (ADS)

    Lecron, Fabian; Benjelloun, Mohammed; Mahmoudi, Saïd

    2012-02-01

    Automatically detecting vertebral bodies in X-Ray images is a very complex task, especially because of the noise and the low contrast resulting in that kind of medical imagery modality. Therefore, the contributions in the literature are mainly interested in only 2 medical imagery modalities: Computed Tomography (CT) and Magnetic Resonance (MR). Few works are dedicated to the conventional X-Ray radiography and propose mostly semi-automatic methods. However, vertebra detection is a key step in many medical applications such as vertebra segmentation, vertebral morphometry, etc. In this work, we develop a fully automatic approach for the vertebra detection, based on a learning method. The idea is to detect a vertebra by its anterior corners without human intervention. To this end, the points of interest in the radiograph are firstly detected by an edge polygonal approximation. Then, a SIFT descriptor is used to train an SVM-model. Therefore, each point of interest can be classified in order to detect if it belongs to a vertebra or not. Our approach has been assessed by the detection of 250 cervical vertebræ on radiographs. The results show a very high precision with a corner detection rate of 90.4% and a vertebra detection rate from 81.6% to 86.5%.

  10. Age estimation from stages of epiphyseal union in the presacral vertebrae.

    PubMed

    Cardoso, Hugo F V; Ríos, Luis

    2011-02-01

    The presacral vertebrae have various secondary centers of ossification, whose timing of fusion can be used for age estimation of human skeletal remains up to the middle to the latter third decade. However, detailed information about the age at which these secondary centers of ossification fuse has been lacking. In this study, the timing of epiphyseal union in presacral vertebrae was studied in a sample of modern Portuguese skeletons (57 females and 47 males) between the ages of 9 and 30, taken from the Lisbon documented skeletal collection. A detailed photographic record of these epiphyses and the age ranges for the different stages of epiphyseal union are provided. Partial union of epiphyses was observed from 11 to 27 years of age. In general, centers of ossification begin to fuse first in the cervical and lumbar vertebrae, followed by centers of ossification in the thoracic region. The first center of ossification to complete fusion is usually that of the mammillary process in lumbar vertebrae. This is usually followed by that of the transverse process, spinous transverse process, and annular ring, regardless of vertebra type. There were no statistically significant sex differences in timing of fusion, but there was a trend toward early maturation in females for some vertebra or epiphyses. Bilateral epiphyses did not show statistically significant differences in timing of fusion. This study offers information on timing of fusion of diverse epiphyseal locations useful for age estimation of complete or fragmented human skeletal remains. PMID:20872802

  11. Strontium mineralization of shark vertebrae.

    PubMed

    Raoult, Vincent; Peddemors, Victor M; Zahra, David; Howell, Nicholas; Howard, Daryl L; de Jonge, Martin D; Williamson, Jane E

    2016-01-01

    Determining the age of sharks using vertebral banding is a vital component of management, but the causes of banding are not fully understood. Traditional shark ageing is based on fish otolith ageing methods where growth bands are assumed to result from varied seasonal calcification rates. Here we investigate these assumptions by mapping elemental distribution within the growth bands of vertebrae from six species of sharks representing four different taxonomic orders using scanning x-ray fluorescence microscopy. Traditional visual growth bands, determined with light microscopy, were more closely correlated to strontium than calcium in all species tested. Elemental distributions suggest that vertebral strontium bands may be related to environmental variations in salinity. These results highlight the requirement for a better understanding of shark movements, and their influence on vertebral development, if confidence in age estimates is to be improved. Analysis of shark vertebrae using similar strontium-focused elemental techniques, once validated for a given species, may allow more successful estimations of age on individuals with few or no visible vertebral bands. PMID:27424768

  12. Strontium mineralization of shark vertebrae

    PubMed Central

    Raoult, Vincent; Peddemors, Victor M.; Zahra, David; Howell, Nicholas; Howard, Daryl L.; de Jonge, Martin D.; Williamson, Jane E.

    2016-01-01

    Determining the age of sharks using vertebral banding is a vital component of management, but the causes of banding are not fully understood. Traditional shark ageing is based on fish otolith ageing methods where growth bands are assumed to result from varied seasonal calcification rates. Here we investigate these assumptions by mapping elemental distribution within the growth bands of vertebrae from six species of sharks representing four different taxonomic orders using scanning x-ray fluorescence microscopy. Traditional visual growth bands, determined with light microscopy, were more closely correlated to strontium than calcium in all species tested. Elemental distributions suggest that vertebral strontium bands may be related to environmental variations in salinity. These results highlight the requirement for a better understanding of shark movements, and their influence on vertebral development, if confidence in age estimates is to be improved. Analysis of shark vertebrae using similar strontium-focused elemental techniques, once validated for a given species, may allow more successful estimations of age on individuals with few or no visible vertebral bands. PMID:27424768

  13. Regional changes in vertebra morphology during ontogeny reflect the life history of Atlantic cod (Gadus morhua L.)

    PubMed Central

    Fjelldal, Per G; Totland, Geir K; Hansen, Tom; Kryvi, Harald; Wang, Xiyuan; Søndergaard, Jens L; Grotmol, Sindre

    2013-01-01

    This study examined vertebra formation, morphology, regional characters, and bending properties of the vertebral column of Atlantic cod throughout its life cycle (0–6 years). The first structure to form was the foremost neural arch, 21 days post hatching (dph), and the first vertebra centrum to form – as a chordacentrum – was the 3rd centrum at 28 dph. Thereafter, the notochord centra developed in a regular sequence towards the head and caudal fin. All vertebrae were formed within 50 dph. The vertebral column consisted of 52 (± 2) vertebrae (V) and could be divided into four distinct regions: (i) the cervical region (neck) (V1 and V2), characterized by short vertebra centra, prominent neural spines and absence of articulations with ribs; (ii) the abdominal region (trunk) (V3–V19), characterized by vertebrae with wing-shaped transverse processes (parapophyses) that all articulate with a rib; (iii) the caudal region (tail) (V20–V40), where the vertebra centra have haemal arches with prominent haemal spines; (iv) the ural region (V41 to the last vertebra), characterized by broad neural and haemal spines, providing sites of origin for muscles inserting on the fin rays – lepidotrichs – of the tail fin. The number of vertebrae in the cervical, abdominal and caudal regions was found to be constant, whereas in the ural region, numbers varied from 12 to 15. Geometric modelling based on combination of vertebra lengths, diameters and intervertebral distances showed an even flexibility throughout the column, except in the ural region, where flexibility increased. Throughout ontogeny, the vertebra centra of the different regions followed distinct patterns of growth; the relative length of the vertebrae increased in the cervical and abdominal regions, and decreased in the caudal and ural regions with increasing age. This may reflect changes in swimming mode with age, and/or that the production of large volumes of gametes during sexual maturation requires a

  14. Symptomatic intravertebral disc herniation (Schmorl's node) in the cervical spine.

    PubMed Central

    Lipson, S J; Fox, D A; Sosman, J L

    1985-01-01

    A case of a Schmorl's node in the cervical vertebra causing neck pain is reported. An inflammatory focus was found on histological examination of Schmorl's node indicating a possible mechanism of pain production. Images PMID:4083942

  15. Treatment of Combined Spinal Deformity in Patient with Ollier Disease and Abnormal Vertebrae

    PubMed Central

    Ryabykh, S. О.; Gubin, A. V.; Prudnikova, О. G.; Kobyzev, А. Е.

    2012-01-01

    We report staged treatment of severe combined spinal deformity in an 11-year-old patient with Ollier disease and abnormal cervical vertebra. Combined scoliosis with systemic pathology and abnormal vertebrae is a rare condition and features atypical deformity location and rapid progression rate and frequently involves the rib cage and pelvis, disturbing the function of chest organs and skeleton. Progressive deformity resulted in cachexia and acute respiratory failure. A halo-pelvic distraction device assembled of Ilizarov components was employed for a staged surgical treatment performed for lifesaving indications. After vital functions stabilized, the scoliosis curve of the cervical spine was corrected and fixed with a hybrid system of transpedicular supporting points, connecting rods, and connectors that provided staged distraction during growth. The treatment showed good functional and cosmetic result. PMID:24436859

  16. Treatment of combined spinal deformity in patient with ollier disease and abnormal vertebrae.

    PubMed

    Ryabykh, S О; Gubin, A V; Prudnikova, Capital O Cyrillic G; Kobyzev, Capital A Cyrillic Е

    2013-06-01

    We report staged treatment of severe combined spinal deformity in an 11-year-old patient with Ollier disease and abnormal cervical vertebra. Combined scoliosis with systemic pathology and abnormal vertebrae is a rare condition and features atypical deformity location and rapid progression rate and frequently involves the rib cage and pelvis, disturbing the function of chest organs and skeleton. Progressive deformity resulted in cachexia and acute respiratory failure. A halo-pelvic distraction device assembled of Ilizarov components was employed for a staged surgical treatment performed for lifesaving indications. After vital functions stabilized, the scoliosis curve of the cervical spine was corrected and fixed with a hybrid system of transpedicular supporting points, connecting rods, and connectors that provided staged distraction during growth. The treatment showed good functional and cosmetic result. PMID:24436859

  17. A framework of vertebra segmentation using the active shape model-based approach.

    PubMed

    Benjelloun, Mohammed; Mahmoudi, Saïd; Lecron, Fabian

    2011-01-01

    We propose a medical image segmentation approach based on the Active Shape Model theory. We apply this method for cervical vertebra detection. The main advantage of this approach is the application of a statistical model created after a training stage. Thus, the knowledge and interaction of the domain expert intervene in this approach. Our application allows the use of two different models, that is, a global one (with several vertebrae) and a local one (with a single vertebra). Two modes of segmentation are also proposed: manual and semiautomatic. For the manual mode, only two points are selected by the user on a given image. The first point needs to be close to the lower anterior corner of the last vertebra and the second near the upper anterior corner of the first vertebra. These two points are required to initialize the segmentation process. We propose to use the Harris corner detector combined with three successive filters to carry out the semiautomatic process. The results obtained on a large set of X-ray images are very promising. PMID:21826134

  18. Comparison of Cervical Spine Anatomy in Calves, Pigs and Humans

    PubMed Central

    Sheng, Sun-Ren; Xu, Hua-Zi; Wang, Yong-Li; Zhu, Qing-An; Mao, Fang-Min; Lin, Yan; Wang, Xiang-Yang

    2016-01-01

    Background Context Animals are commonly used to model the human spine for in vitro and in vivo experiments. Many studies have investigated similarities and differences between animals and humans in the lumbar and thoracic vertebrae. However, a quantitative anatomic comparison of calf, pig, and human cervical spines has not been reported. Purpose To compare fundamental structural similarities and differences in vertebral bodies from the cervical spines of commonly used experimental animal models and humans. Study Design Anatomical morphometric analysis was performed on cervical vertebra specimens harvested from humans and two common large animals (i.e., calves and pigs). Methods Multiple morphometric parameters were directly measured from cervical spine specimens of twelve pigs, twelve calves and twelve human adult cadavers. The following anatomical parameters were measured: vertebral body width (VBW), vertebral body depth (VBD), vertebral body height (VBH), spinal canal width (SCW), spinal canal depth (SCD), pedicle width (PW), pedicle depth (PD), pedicle inclination (PI), dens width (DW), dens depth (DD), total vertebral width (TVW), and total vertebral depth (TVD). Results The atlantoaxial (C1–2) joint in pigs is similar to that in humans and could serve as a human substitute. The pig cervical spine is highly similar to the human cervical spine, except for two large transverse processes in the anterior regions ofC4–C6. The width and depth of the calf odontoid process were larger than those in humans. VBW and VBD of calf cervical vertebrae were larger than those in humans, but the spinal canal was smaller. Calf C7 was relatively similar to human C7, thus, it may be a good substitute. Conclusion Pig cervical vertebrae were more suitable human substitutions than calf cervical vertebrae, especially with respect to C1, C2, and C7. The biomechanical properties of nerve vascular anatomy and various segment functions in pig and calf cervical vertebrae must be

  19. Primary Eosinophilic Granuloma of Adult Cervical Spine Presenting as a Radiculomyelopathy

    PubMed Central

    Bang, Woo-Seok; Cho, Dae-Chul; Sung, Joo-Kyung

    2013-01-01

    We report a case of 29-year-old man diagnosed as a primary eosinophilic granuloma (EG) lesion of the seventh cervical vertebra. He had paresthesia on both arms, and grasping weakness for 10 days. Cervical magnetic resonance image (MRI) showed an enhancing mass with ventral epidural bulging and cord compression on the seventh cervical vertebra. Additionally, we performed spine series MRI, bone scan and positive emission tomography for confirmation of other bone lesions. These studies showed no other pathological lesions. He underwent anterior cervical corpectomy of the seventh cervical vertebra and plate fixation with iliac bone graft. After surgical management, neurological symptoms were much improved. Histopathologic evaluation confirmed the diagnosis of EG. There was no evidence of tumor recurrence at 12 months postoperative cervical MRI follow-up. We reported symptomatic primary EG of cervical spine successfully treated with surgical resection. PMID:24044083

  20. Shape regression for vertebra fracture quantification

    NASA Astrophysics Data System (ADS)

    Lund, Michael Tillge; de Bruijne, Marleen; Tanko, Laszlo B.; Nielsen, Mads

    2005-04-01

    Accurate and reliable identification and quantification of vertebral fractures constitute a challenge both in clinical trials and in diagnosis of osteoporosis. Various efforts have been made to develop reliable, objective, and reproducible methods for assessing vertebral fractures, but at present there is no consensus concerning a universally accepted diagnostic definition of vertebral fractures. In this project we want to investigate whether or not it is possible to accurately reconstruct the shape of a normal vertebra, using a neighbouring vertebra as prior information. The reconstructed shape can then be used to develop a novel vertebra fracture measure, by comparing the segmented vertebra shape with its reconstructed normal shape. The vertebrae in lateral x-rays of the lumbar spine were manually annotated by a medical expert. With this dataset we built a shape model, with equidistant point distribution between the four corner points. Based on the shape model, a multiple linear regression model of a normal vertebra shape was developed for each dataset using leave-one-out cross-validation. The reconstructed shape was calculated for each dataset using these regression models. The average prediction error for the annotated shape was on average 3%.

  1. Vertebral artery injury in a patient with fractured C4 vertebra.

    PubMed

    Banić, Tihomir; Banić, Morana; Cvjetko, Ivan; Somun, Nenad; Bilić, Vide; Vidjak, Vinko; Pavić, Vladimir; Coc, Ivan; Kokić, Tomislav; Kejlal, Zvonko

    2014-09-01

    Vertebral artery injuries due to cervical spine trauma, although rarely described in the literature, are relatively common. While most of them will remain asymptomatic, a small percentage of patients may suffer life threatening complications. We report a case of the right vertebral artery injury in a patient with fracture of C4 vertebra, successfully treated with endovascular approach. A 78-year-old male patient was hospitalized for cervical spine injury caused by falling off the tractor. Radiological assessment revealed fracture of C4 vertebra with proximal two-thirds of C4 body dislocated five millimeters dorsally. Significant swelling of soft prevertebral tissues distally of C2 segment was also present. During emergency surgery using standard anterior approach for cervical spine, excessive bleeding started from the injured right vertebral artery. Bleeding was stopped by tamponade with oxidized regenerated cellulose sheet and C4-C5 anterior fixation; then partial reduction of displacement was done. Fifteen days later, after angiography, endovascular repair of the right vertebral artery was performed using percutaneous stent graft. Follow up computed tomography scan angiography showed valid stent patency without contrast extravasation. In cases of cervical spine trauma, surgeon should always be prepared to manage injury of vertebral artery. Bleeding can primarily be stopped by hemostatic packing, and definitive repair can be successfully achieved by endovascular approach using percutaneous stent graft. PMID:25509251

  2. Dimensional accuracy of 3D printed vertebra

    NASA Astrophysics Data System (ADS)

    Ogden, Kent; Ordway, Nathaniel; Diallo, Dalanda; Tillapaugh-Fay, Gwen; Aslan, Can

    2014-03-01

    3D printer applications in the biomedical sciences and medical imaging are expanding and will have an increasing impact on the practice of medicine. Orthopedic and reconstructive surgery has been an obvious area for development of 3D printer applications as the segmentation of bony anatomy to generate printable models is relatively straightforward. There are important issues that should be addressed when using 3D printed models for applications that may affect patient care; in particular the dimensional accuracy of the printed parts needs to be high to avoid poor decisions being made prior to surgery or therapeutic procedures. In this work, the dimensional accuracy of 3D printed vertebral bodies derived from CT data for a cadaver spine is compared with direct measurements on the ex-vivo vertebra and with measurements made on the 3D rendered vertebra using commercial 3D image processing software. The vertebra was printed on a consumer grade 3D printer using an additive print process using PLA (polylactic acid) filament. Measurements were made for 15 different anatomic features of the vertebral body, including vertebral body height, endplate width and depth, pedicle height and width, and spinal canal width and depth, among others. It is shown that for the segmentation and printing process used, the results of measurements made on the 3D printed vertebral body are substantially the same as those produced by direct measurement on the vertebra and measurements made on the 3D rendered vertebra.

  3. The Langerhans' cell histiocytosis (eosinophilic granuloma) of the cervical spine: a rare diagnosis of cervical pain.

    PubMed

    Simanski, C; Bouillon, B; Brockmann, M; Tiling, T

    2004-05-01

    We present the case of a 44-year-old man who complained of cervical pain. He was treated with physiotherapy and analgetics. Because of persistent pain, computed tomography (CT) scan and MRI were performed. They revealed an osteolytic destruction of the fourth cervical vertebra. The patient was treated surgically for removal of the tumor and stabilization of his cervical spine. Histology of the osteolytic material led to the diagnosis of an eosinophilic granuloma of the cervical spine. This case report describes the incidence, clinical significance, background and therapy of an eosinophilic granuloma of the spine. PMID:15120180

  4. Bizarre tubercles on the vertebrae of Eocene fossil birds indicate an avian disease without modern counterpart

    NASA Astrophysics Data System (ADS)

    Mayr, Gerald

    2007-08-01

    Remains of fossil birds with numerous bony tubercles on the cervical vertebrae are reported from the Middle Eocene of Messel in Germany and the Late Eocene of the Quercy fissure fillings in France. These structures, which are unknown from extant birds and other vertebrates, were previously described for an avian skeleton from Messel but considered a singular feature of this specimen. The new fossils are from a different species of uncertain phylogenetic affinities and show that tuberculated vertebrae have a wider taxonomic, temporal, and geographic distribution. In contrast to previous assumptions, they are no ontogenetic feature and arise from the vertebral surface. It is concluded that they are most likely of pathologic origin and the first record of a Paleogene avian disease. Their regular and symmetrical arrangement over most of the external vertebral surface indicates a systemic disorder caused by factors that do not affect extant birds, such as especially high-dosed phytohormones or extinct pathogens.

  5. Automated vertebra identification in CT images

    NASA Astrophysics Data System (ADS)

    Ehm, Matthias; Klinder, Tobias; Kneser, Reinhard; Lorenz, Cristian

    2009-02-01

    In this paper, we describe and compare methods for automatically identifying individual vertebrae in arbitrary CT images. The identification is an essential precondition for a subsequent model-based segmentation, which is used in a wide field of orthopedic, neurological, and oncological applications, e.g., spinal biopsies or the insertion of pedicle screws. Since adjacent vertebrae show similar characteristics, an automated labeling of the spine column is a very challenging task, especially if no surrounding reference structures can be taken into account. Furthermore, vertebra identification is complicated due to the fact that many images are bounded to a very limited field of view and may contain only few vertebrae. We propose and evaluate two methods for automatically labeling the spine column by evaluating similarities between given models and vertebral objects. In one method, object boundary information is taken into account by applying a Generalized Hough Transform (GHT) for each vertebral object. In the other method, appearance models containing mean gray value information are registered to each vertebral object using cross and local correlation as similarity measures for the optimization function. The GHT is advantageous in terms of computational performance but cuts back concerning the identification rate. A correct labeling of the vertebral column has been successfully performed on 93% of the test set consisting of 63 disparate input images using rigid image registration with local correlation as similarity measure.

  6. Structure and function of platyrrhine caudal vertebrae.

    PubMed

    Organ, Jason M

    2010-04-01

    The prehensile tail may have evolved twice (in parallel) in New World monkeys (platyrrhines), suggesting it is an effective adaptation to negotiating arboreal habitats. Yet, despite the obvious importance of the prehensile tail for balance, feeding behavior, and locomotion, the structural differences between prehensile and nonprehensile tails are poorly understood. Previous studies showed that some linear measurements of caudal vertebrae are capable of distinguishing prehensile from nonprehensile tails but only in the distal parts of the vertebral sequence. This study examines structural properties of the tail with external measurements that are selected to better approximate resistance to bending/torsion while also examining vertebral cross-sectional geometry with computed tomography-a direct measure of resistance to bending/torsion. Specifically, this study tests the hypotheses that the caudal vertebrae (and the tail as a whole) of prehensile-tailed platyrrhines are structured to resist higher torsional and bending stresses than their functional analogues in nonprehensile-tailed platyrrhines, and that the predicted differences become more drastic further distally within the sequence. Results of this study indicate that prehensile and nonprehensile tails are structured differently. Prehensile tails are characterized by longer proximal tail regions than nonprehensile tails. Furthermore, the hemal processes (the distal attachment for the primary tail flexors) of prehensile tail vertebrae are better developed and can distinguish prehensile from nonprehensile tails better than traditionally used external measurements. Finally, results confirm predictions that prehensile tail caudal vertebrae are capable of withstanding higher torsional and bending stresses than their nonprehensile tail counterparts, and that these disparities become more pronounced further distally within the sequence. PMID:20235328

  7. Lowest instrumented vertebra selection in AIS.

    PubMed

    Erickson, Mark A; Baulesh, David M

    2011-01-01

    Appropriate selection of the lowest instrumented vertebra (LIV) is crucial to ensure positive outcomes after surgical management of patients with adolescent idiopathic scoliosis. Failure to do so can lead to curve decompensation and "adding on" of additional vertebrae to the deformity. Correct identification of the stable, end, and neutral vertebra, whether the curve(s) is structural or nonstructural, and classifying the type of curve are essential aspects of preoperative planning. Evaluating curve flexibility using fulcrum, side bending, push-prone, and traction can be used to predict the amount of observed postoperative correction for both fused and unfused curves. In addition, these measures can be used to foresee potential residual LIV-tilt and disc wedging postoperatively. Intraoperative techniques such as fine tuning, derotation, wide release, and in situ contouring and instrumentation type used all influence the LIV selection and therefore, must be taken into account preoperatively. Surgical goals when treating adolescent idiopathic scoliosis include achieving a well-balanced spine in all planes while working to preserve segments and therefore, maintain mobility. PMID:21173622

  8. Identification and classification of spine vertebrae by automated methods

    NASA Astrophysics Data System (ADS)

    Long, L. Rodney; Thoma, George R.

    2001-07-01

    We are currently working toward developing computer-assisted methods for the indexing of a collection of 17,000 digitized x-ray images by biomedical content. These images were collected as part of a nationwide health survey and form a research resource for osteoarthitis and bone morphometry. This task requires the development of algorithms to robustly analyze the x-ray contents for key landmarks, to segment the vertebral bodies, to accurately measure geometric features of the individual vertebrae and inter-vertebral areas, and to classify the spine anatomy into normal or abnormal classes for conditions of interest, including anterior osteophytes and disc space narrowing. Subtasks of this work have been created and divided among collaborators. In this paper, we provide a technical description of the overall task, report on progress made by collaborators, and provide the most recent results of our own research into obtaining first-order location of the spine region of interest by automated methods. We are currently concentrating on images of the cervical spine, but will expand the work to include the lumbar spine as well. Development of successful image processing techniques for computer-assisted indexing of medical image collections is expected to have a significant impact within the medical research and patient care systems.

  9. Cervical Laminoplasty

    MedlinePlus

    ... Treatments for Spinal Pain Surgical Options Anterior Cervical Fusion Artificial Disc Replacement Bone Graft Alternatives Bone Morphogenetic ... Discectomy Percutaneous Vertebral Augmentation Posterior Cervical Foraminotomy Spinal Fusion ... Medicine Cervical Laminoplasty What is ...

  10. Langerhans cell histiocytosis of the cervical spine in an adult: a case report.

    PubMed

    Sayhan, Salih; Altinel, Deniz; Erguden, Cenk; Kizmazoglu, Ceren; Guray, Merih; Acar, Umit

    2010-07-01

    We present a case of a 47-year-old-woman with a complaint of cervical pain with paresthetic appearance on her left arm. She was treated with analgetics. Further radiological evaluation because of the persistent pain revealed an osteolytic destruction of the fourth cervical vertebra. The patient underwent anterior cervical corpectomy with total excision of the tumor. Stabilization of the cervical spine was performed. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH) of the cervical spine. This case report presents the histopathological evaluation, diagnostic work-up and the treatment procedures because of rarity of cervical spinal LCH cases in the literature. PMID:20669118

  11. The cervical anatomy of Samotherium, an intermediate-necked giraffid

    PubMed Central

    Danowitz, Melinda; Domalski, Rebecca; Solounias, Nikos

    2015-01-01

    Giraffidae are represented by many extinct species. The only two extant taxa possess diametrically contrasting cervical morphology, as the okapi is short-necked and the giraffe is exceptionally long-necked. Samotherium major, known from the Late Miocene of Samos in Greece and other Eurasian localities, is a key extinct giraffid; it possesses cervical vertebrae that are intermediate in the evolutionary elongation of the neck. We describe detailed anatomical features of the cervicals of S. major, and compare these characteristics with the vertebrae of the two extant giraffid taxa. Based on qualitative morphological characters and a quantitative analysis of cervical dimensions, we find that the S. major neck is intermediate between that of the okapi and the giraffe. Specifically, the more cranial (C2–C3) vertebrae of S. major represent a mosaic of features shared either with the giraffe or with the okapi. The more caudal (C5–C7) S. major vertebrae, however, appear transitional between the two extant taxa, and hence are more unique. Notably, the C6 of S. major exhibits a partially excavated ventral lamina that is strong cranially but completely absent on the caudal half of the ventral vertebral body, features between those seen in the giraffe and the okapi. Comprehensive anatomical descriptions and measurements of the almost-complete cervical column reveal that S. major is a truly intermediate-necked giraffid. Reconstructions of the neck display our findings. PMID:26716010

  12. The cervical anatomy of Samotherium, an intermediate-necked giraffid.

    PubMed

    Danowitz, Melinda; Domalski, Rebecca; Solounias, Nikos

    2015-11-01

    Giraffidae are represented by many extinct species. The only two extant taxa possess diametrically contrasting cervical morphology, as the okapi is short-necked and the giraffe is exceptionally long-necked. Samotherium major, known from the Late Miocene of Samos in Greece and other Eurasian localities, is a key extinct giraffid; it possesses cervical vertebrae that are intermediate in the evolutionary elongation of the neck. We describe detailed anatomical features of the cervicals of S. major, and compare these characteristics with the vertebrae of the two extant giraffid taxa. Based on qualitative morphological characters and a quantitative analysis of cervical dimensions, we find that the S. major neck is intermediate between that of the okapi and the giraffe. Specifically, the more cranial (C2-C3) vertebrae of S. major represent a mosaic of features shared either with the giraffe or with the okapi. The more caudal (C5-C7) S. major vertebrae, however, appear transitional between the two extant taxa, and hence are more unique. Notably, the C6 of S. major exhibits a partially excavated ventral lamina that is strong cranially but completely absent on the caudal half of the ventral vertebral body, features between those seen in the giraffe and the okapi. Comprehensive anatomical descriptions and measurements of the almost-complete cervical column reveal that S. major is a truly intermediate-necked giraffid. Reconstructions of the neck display our findings. PMID:26716010

  13. Ivory vertebra: imaging findings in different diagnoses*

    PubMed Central

    Braun, Richard Andreas; Milito, Carlos Felipe do Rego Barros; Goldman, Suzan Menasce; Fernandes, Eloy de Ávila

    2016-01-01

    Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. PMID:27141135

  14. Ivory vertebra: imaging findings in different diagnoses.

    PubMed

    Braun, Richard Andreas; Milito, Carlos Felipe do Rego Barros; Goldman, Suzan Menasce; Fernandes, Eloy de Ávila

    2016-01-01

    Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. PMID:27141135

  15. Transverse plane of apical vertebra of structural thoracic curve: vertebra displacement versus vertebral deformation.

    PubMed

    Kotwicki, Tomasz; Napiontek, Marek; Nowakowski, Andrzej

    2006-01-01

    CT transversal scans of the trunk provided at the level of Th8 or Th9 (apical vertebra) of 23 patients with structural thoracic scoliosis were reviewed. The following parameters were studied: 1) alpha angle formed by the axis of vertebra and the axis of spinous process, 2) beta concave and beta convex angle between the spinous process and the left and right transverse process respectively, 3) gamma concave and gamma convex angle between the axis of vertebra and the left and right transverse process respectively, 4) rotation angle to the sagittal plane according to Aaro and Dahlborn, 5) Cobb angle. Values of measured parameters demonstrated a common pattern of intravertebral deformity: counter clockwise deviation of the spinous process (alpha angle 15,0 +/-8,5 degrees), beta concave (69,8 +/-8,5 degrees) significantly greater than beta convex (38,8 +/-8,5 degrees), gamma concave (54,3 +/-7,8 degrees) not different from gamma convex (56,0 +/-8,0 degrees). Strong linear positive correlation between alpha angle and Aaro-Dahlborn angle was observed (r=0,78, p<0,05). Changes in morphology of apical vertebra due to intravertebral bone remodelling followed the vertebral spatial displacement and there existed a linear correlation in between. The two processes develop in opposite directions. PMID:17108421

  16. Dynamic cortex stripping for vertebra evaluation

    NASA Astrophysics Data System (ADS)

    Stieger, James; Burns, Joseph E.; Yao, Jianhua; Summers, Ronald M.

    2015-03-01

    Vertebral cortex removal through cancellous bone reconstruction (CBR) algorithms on CT has been shown to enhance the detection rate of bone metastases by radiologists and reduce average reading time per case. Removal of the cortical bone provides an unobstructed view of the inside of vertebrae without any anomalous distractions. However, these algorithms rely on the assumption that the cortical bone of vertebrae can be removed without the identification of the endosteal cortical margin. We present a method for the identification of the endosteal cortical margin based on vertebral models and CT intensity information. First, triangular mesh models are created using the marching cubes algorithm. A search region is established along the normal of the surface and the image gradient is calculated at every point along the search region. The location with the greatest image gradient is selected as the corresponding point on the endosteal cortical margin. In order to analyze the strength of this method, ground truth and control models were also created. Our method was shown to have a significantly reduce the average error from 0.80 mm +/- 0.14 mm to 0.65 mm +/- 0.17 mm (p <0.0001) when compared to erosion. This method can potentially improve CBR algorithms, which improve visualization of cancellous bone lesions such as metastases, by more accurately identifying the inner wall of the vertebral cortex.

  17. Hemophilic pseudotumor of the first lumbar vertebra.

    PubMed

    Nachimuthu, Gurusamy; Arockiaraj, Justin; Krishnan, Venkatesh; Sundararaj, Gabriel David

    2014-11-01

    Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases. PMID:25404776

  18. Hemophilic pseudotumor of the first lumbar vertebra

    PubMed Central

    Nachimuthu, Gurusamy; Arockiaraj, Justin; Krishnan, Venkatesh; Sundararaj, Gabriel David

    2014-01-01

    Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases. PMID:25404776

  19. Cervical fibrotic stenosis in a young Rottweiler.

    PubMed

    Baum, F; de Lahunta, A; Trotter, E J

    1992-10-15

    An 18-month-old neutered male Rottweiler was examined because of slowly progressive spastic tetraparesis and ataxia. Signalment and clinical signs were suggestive of 2 neuronal degenerative diseases presumed to be inherited in young Rottweilers: leukoencephalomyelopathy and neuroaxonal dystrophy. Myelography revealed an extradural compression at the articulation of the second and third cervical vertebrae. At surgery, focal hypertrophy of the yellow ligament was observed to compress the spinal cord ventrally at that site. PMID:1429164

  20. The Cervical Osteology of Okapia johnstoni and Giraffa camelopardalis.

    PubMed

    Danowitz, Melinda; Solounias, Nikos

    2015-01-01

    Giraffidae is the only family of ruminants that is represented by two extant species; Okapia johnstoni and Giraffa camelopardalis. Of these taxa, O. johnstoni represents a typical short-necked ungulate, and G. camelopardalis exemplifies the most extreme cervical elongation seen in any ruminant. We utilize these two species to provide a comprehensive anatomic description of the cervical vertebrae. In addition, we compare the serial morphologic characteristics of the okapi and giraffe cervical vertebrae, and report on several osteologic differences seen between the two taxa. The giraffe neck appears to exhibit homogenization of C3-C7; the position of the dorsal tubercle, thickness of the cranial articular process, shape of the ventral vertebral body, and orientation of the ventral tubercle are constant throughout these vertebrae, whereas these features are serially variable in the okapi. We also report on several specializations of the giraffe C7, which we believe relates to an atypical cervico-thoracic junction, corresponding to the substantial neck lengthening. The morphologic differences exhibited between the okapi and giraffe cervical vertebrae have implications on the function of the necks relating to both fighting and feeding. PMID:26302156

  1. Some borderlands of the cervical spine. Pt. 2

    SciTech Connect

    Kattan, K.R.; Pais, M.J.

    1982-03-01

    The complexity of the structure of the cervical spine as well superimposition by the parts of adjacent vertebrae, as well as other structures may cause some abnormalities to be overlooked. Among those abnormalities are, the short sagittal diameter, neoplasm in the cancellous part of the vertebral bodies, spurs in the apophyseal joints, trauma, infection and others.

  2. Differential diagnosis of multiple vertebral compression: butterfly vertebrae

    PubMed Central

    Ozaras, Nihal; Gumussu, Kevser; Demir, Saliha Eroglu; Rezvani, Aylin

    2015-01-01

    [Purpose] A butterfly vertebra is a rare congenital anomaly resulting from a symmetric fusion defect. Only a few cases of butterfly vertebra have been described. This anomaly may be isolated or associated with Pfeiffer, Jarcho-Levins, Crouzon, or Alagille syndrome. [Subject and Methods] We herein describe a 38-year-old man who presented with neck and low back pain and was found to have butterfly vertebrae at the T9 and L3 levels. He also had Behçet’s disease and psoriasis. [Results] The patient’s symptoms improved with analgesics and physiotherapy. [Conclusion] To our knowledge, butterfly vertebrae at two levels have never been reported. Butterfly vertebrae may be confused with vertebral fractures in lateral radiographs, and awareness of this anomaly is important for a correct diagnosis. PMID:26696746

  3. Computed tomographic evaluation of cervical vertebral canal and spinal cord morphometry in normal dogs

    PubMed Central

    Seo, Eunjeong; Choi, Jihye; Choi, Mincheol

    2014-01-01

    The height, width, and cross-sectional area of the vertebral canal and spinal cord along with the area ratio of spinal cord to vertebral canal in the cervical vertebra were evaluated in images obtained using computed tomography (CT). Measurements were taken at the cranial, middle, and caudal point of each cervical vertebra in eight clinically normal small breed dogs (two shih tzu, two miniature schnauzers, and four mixed breed), 10 beagles, and four German shepherds. CT myelography facilitated the delineation of the epidural space, subarachnoid space, and spinal cord except at the caudal portion of the 7th cervical vertebra. The spinal cord had a tendency to have a clear ventral border in the middle portion of the vertebral canal and lateral borders near both end plates. The height, width, and area of the vertebral canal and spinal cord in the cervical vertebra were increased as the size of dog increased. However, the ratio of the spinal cord area to vertebral canal area in the small dogs was higher than that of the larger dogs. Results of the present study could provide basic and quantitative information for CT evaluation of pathologic lesions in the cervical vertebra and spinal cord. PMID:24136210

  4. Cervical Vertebral Body's Volume as a New Parameter for Predicting the Skeletal Maturation Stages

    PubMed Central

    Choi, Youn-Kyung; Kim, Jinmi; Maki, Koutaro; Ko, Ching-Chang

    2016-01-01

    This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5–18 years of age). We performed Pearson's correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P < 0.05). The simple regression model with the greatest R-square indicated the fourth-cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level. PMID:27340668

  5. Bilateral cervical ribs in a Dobermann Pinscher.

    PubMed

    Ricciardi, M; De Simone, A; Gernone, F; Giannuzzi, P

    2015-01-01

    An 11-year-old intact female Doberman Pinscher was presented with the complaint of non-ambulatory tetraparesis. Clinical and neurological examination revealed a caudal cervical spinal cord disfunction (C6-T2 spinal cord segments). Magnetic resonance imaging and computed tomographic (CT) findings of the cervical spine were consistent with caudal cervical spondylomyelopathy (CSM). During the diagnostic work-up for the cervical spine, bilateral bone anomalies involving the seventh cervical vertebra and the first ribs were found on radiographs and CT examination. The rib anomalies found in this dog appear similar to cervical ribs widely described in human medicine. In people, cervical ribs are associated with a high rate of stillbirth, early childhood cancer, and can cause the thoracic outlet syndrome, characterized by neurovascular compression at level of superior aperture of the chest. In dogs, only some sporadic anatomopathological descriptions of cervical ribs exist. In this report the radiographic and CT findings of these particular vertebral and rib anomalies along with their relationships with adjacent vasculature and musculature are shown intravitam in a dog. Specific radiographic and CT findings described in this report may help in reaching a presumptive diagnosis of this anomaly. Finally, their clinical and evolutionary significance are discussed. PMID:25650786

  6. Cervical dysplasia

    MedlinePlus

    ... cervical dysplasia is caused by the human papillomavirus (HPV). HPV is a common virus that is spread through sexual contact. There are many types of HPV. Some types lead to cervical dysplasia or cancer. ...

  7. Cervical Cancer

    MedlinePlus

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  8. Cervical cancer

    MedlinePlus

    ... and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to ... Pap smears and cervical cancer References Committee on Adolescent Health Care of the American College of Obstetricians ...

  9. Cervical dysplasia

    MedlinePlus

    Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix; Cervical cancer - dysplasia ... lesion (SIL). On the Pap smear report, these changes will be described as: Low-grade (LSIL) High- ...

  10. Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

    PubMed Central

    Chan, Chi Hin; Wong, Kam Kwong; Wong, Wing Cheung

    2016-01-01

    Study Design Retrospective study. Purpose To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. Overview of Literature C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. Methods We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. Results CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. Conclusions The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan. PMID:27559451

  11. Dimensional coordinate measurements: application in characterizing cervical spine motion

    NASA Astrophysics Data System (ADS)

    Zheng, Weilong; Li, Linan; Wang, Shibin; Wang, Zhiyong; Shi, Nianke; Xue, Yuan

    2014-06-01

    Cervical spine as a complicated part in the human body, the form of its movement is diverse. The movements of the segments of vertebrae are three-dimensional, and it is reflected in the changes of the angle between two joint and the displacement in different directions. Under normal conditions, cervical can flex, extend, lateral flex and rotate. For there is no relative motion between measuring marks fixed on one segment of cervical vertebra, the cervical vertebrae with three marked points can be seen as a body. Body's motion in space can be decomposed into translational movement and rotational movement around a base point .This study concerns the calculation of dimensional coordinate of the marked points pasted to the human body's cervical spine by an optical method. Afterward, these measures will allow the calculation of motion parameters for every spine segment. For this study, we choose a three-dimensional measurement method based on binocular stereo vision. The object with marked points is placed in front of the CCD camera. Through each shot, we will get there two parallax images taken from different cameras. According to the principle of binocular vision we can be realized three-dimensional measurements. Cameras are erected parallelly. This paper describes the layout of experimental system and a mathematical model to get the coordinates.

  12. Level Set Segmentation of Lumbar Vertebrae Using Appearance Models

    NASA Astrophysics Data System (ADS)

    Fritscher, Karl; Leber, Stefan; Schmölz, Werner; Schubert, Rainer

    For the planning of surgical interventions of the spine exact knowledge about 3D shape and the local bone quality of vertebrae are of great importance in order to estimate the anchorage strength of screws or implants. As a prerequisite for quantitative analysis a method for objective and therefore automated segmentation of vertebrae is needed. In this paper a framework for the automatic segmentation of vertebrae using 3D appearance models in a level set framework is presented. In this framework model information as well as gradient information and probabilities of pixel intensities at object edges in the unseen image are used. The method is tested on 29 lumbar vertebrae leading to accurate results, which can be useful for surgical planning and further analysis of the local bone quality.

  13. Multi-modal vertebrae recognition using Transformed Deep Convolution Network.

    PubMed

    Cai, Yunliang; Landis, Mark; Laidley, David T; Kornecki, Anat; Lum, Andrea; Li, Shuo

    2016-07-01

    Automatic vertebra recognition, including the identification of vertebra locations and naming in multiple image modalities, are highly demanded in spinal clinical diagnoses where large amount of imaging data from various of modalities are frequently and interchangeably used. However, the recognition is challenging due to the variations of MR/CT appearances or shape/pose of the vertebrae. In this paper, we propose a method for multi-modal vertebra recognition using a novel deep learning architecture called Transformed Deep Convolution Network (TDCN). This new architecture can unsupervisely fuse image features from different modalities and automatically rectify the pose of vertebra. The fusion of MR and CT image features improves the discriminativity of feature representation and enhances the invariance of the vertebra pattern, which allows us to automatically process images from different contrast, resolution, protocols, even with different sizes and orientations. The feature fusion and pose rectification are naturally incorporated in a multi-layer deep learning network. Experiment results show that our method outperforms existing detection methods and provides a fully automatic location+naming+pose recognition for routine clinical practice. PMID:27104497

  14. Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine.

    PubMed

    Egerter, Alexander C; Kim, Eric S; Lee, Darrin J; Liu, Jonathan J; Cadena, Gilbert; Panchal, Ripul R; Kim, Kee D

    2015-10-01

    Study Design Retrospective case series. Objective Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease involves hyperostosis of the spinal column. Hyperostosis involving the anterior margin of the cervical vertebrae can cause dysphonia, dyspnea, and/or dysphagia. However, the natural history pertaining to the risk factors remain unknown. We present the surgical management of two cases of dysphagia secondary to cervical hyperostosis and discuss the etiology and management of DISH based on the literature review. Methods This is a retrospective review of two patients with DISH and anterior cervical osteophytes. We reviewed the preoperative and postoperative images and clinical history. Results Two patients underwent anterior cervical osteophytectomies due to severe dysphagia. At more than a year follow-up, both patients noted improvement in swallowing as well as their associated pain. Conclusion The surgical removal of cervical osteophytes can be highly successful in treating dysphagia if refractory to prolonged conservative therapy. PMID:26430607

  15. Cervical radiculopathy.

    PubMed

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  16. Cervical spondylosis

    MedlinePlus

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures to the spine from osteoporosis

  17. Automatic localization of vertebrae based on convolutional neural networks

    NASA Astrophysics Data System (ADS)

    Shen, Wei; Yang, Feng; Mu, Wei; Yang, Caiyun; Yang, Xin; Tian, Jie

    2015-03-01

    Localization of the vertebrae is of importance in many medical applications. For example, the vertebrae can serve as the landmarks in image registration. They can also provide a reference coordinate system to facilitate the localization of other organs in the chest. In this paper, we propose a new vertebrae localization method using convolutional neural networks (CNN). The main advantage of the proposed method is the removal of hand-crafted features. We construct two training sets to train two CNNs that share the same architecture. One is used to distinguish the vertebrae from other tissues in the chest, and the other is aimed at detecting the centers of the vertebrae. The architecture contains two convolutional layers, both of which are followed by a max-pooling layer. Then the output feature vector from the maxpooling layer is fed into a multilayer perceptron (MLP) classifier which has one hidden layer. Experiments were performed on ten chest CT images. We used leave-one-out strategy to train and test the proposed method. Quantitative comparison between the predict centers and ground truth shows that our convolutional neural networks can achieve promising localization accuracy without hand-crafted features.

  18. Automatic labeling and segmentation of vertebrae in CT images

    NASA Astrophysics Data System (ADS)

    Rasoulian, Abtin; Rohling, Robert N.; Abolmaesumi, Purang

    2014-03-01

    Labeling and segmentation of the spinal column from CT images is a pre-processing step for a range of image- guided interventions. State-of-the art techniques have focused either on image feature extraction or template matching for labeling of the vertebrae followed by segmentation of each vertebra. Recently, statistical multi- object models have been introduced to extract common statistical characteristics among several anatomies. In particular, we have created models for segmentation of the lumbar spine which are robust, accurate, and computationally tractable. In this paper, we reconstruct a statistical multi-vertebrae pose+shape model and utilize it in a novel framework for labeling and segmentation of the vertebra in a CT image. We validate our technique in terms of accuracy of the labeling and segmentation of CT images acquired from 56 subjects. The method correctly labels all vertebrae in 70% of patients and is only one level off for the remaining 30%. The mean distance error achieved for the segmentation is 2.1 +/- 0.7 mm.

  19. Cervical Cancer

    MedlinePlus

    ... dysplasia of the cervix, vagina, or vulva • A family history of cervical cancer •Smoking •Certain sexually transmitted infections , such as chlamydia • ... to treat your cancer, you still need cervical cancer screening. Cells are taken from the upper vagina ... smallest units of a structure in the body; the building blocks for all ...

  20. The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing.

    PubMed

    Mekata, Kojiro; Takigawa, Tomoyuki; Matsubayashi, Jun; Toda, Kazukiyo; Hasegawa, Yasuhiro; Ito, Yasuo

    2016-02-01

    Cervical orthosis is used to immobilize the neck in various disorders such as trauma and post-operation. However, it is still uncertain how cervical orthosis restricts the degree of movement of the cervical spine during swallowing and how they affect swallowing physiology. The purpose of this study was to evaluate these issues using the Philadelphia(®) Collar. We conducted videofluorography of swallowing in 39 healthy subjects (23 men, 16 women; mean age of 34.3 years) with and without cervical orthosis. To compare the two conditions regarding the cervical spine motion, we determined the angular and positional changes of the occipital bone (C0) and each cervical vertebra (C1-C7) from the oral phase to the pharyngeal phase. Similarly, to compare swallowing physiology, we assessed the start and end times and the durations of soft palate elevation, rapid hyoid anterosuperior movement, epiglottis inversion, closure of the laryngeal vestibule, and pharyngoesophageal segment (PES) opening. Finally, we compared the transit times of contrast agent in the two conditions. The respective extensions of C1, C2, and C3 were 0.31°, 0.07°, and 0.05° (mean) with cervical orthosis, and the respective flexions of C1, C2, and C3 were 0.98°, 1.42°, and 0.85° (mean) without. These results suggested that cervical orthosis restricted the flexion of C1-C3. Analysis of swallowing physiology revealed that the average durations of hyoid anterosuperior elevation, epiglottic inversion, and PES opening were prolonged by 0.09, 0.19, and 0.05 s, respectively. In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology. PMID:26607160

  1. Cervical spondylomyelopathy (wobbler syndrome) in the Boerboel.

    PubMed

    Gray, M J; Kirberger, R M; Spotswood, T C

    2003-12-01

    The Boerboel is a South African large-breed dog resembling a Bullmastiff. The records of Onderstepoort Veterinary Academic Hospital were searched for dogs that had presented, between 1998 and 2003, with symptoms indicative of wobbler syndrome and had undergone survey radiographic and myelographic studies. Ten cases fitted the inclusion criteria. Dogs presented within the first 2 years of life, often with acute onset of symptoms. All presented with pelvic limb and 6 with concomitant thoracic limb ataxia or paresis. Treatment varied and included none (4), prednisolone (2), and dorsal laminectomy (2). Two dogs were euthanased at the time of diagnosis. The breed appears to be affected with a form of spondylomyelopathy that comprises bony malformation of cervical and/or thoracic vertebrae. In 8 dogs, malformations were evident on survey radiographs and were characterised by enlarged, irregular articular facets and associated medial deviation of the pedicles. These changes resulted in axial compression of the spinal cord best seen on ventrodorsal or dorsoventral myelographic studies. Multiple vertebrae were affected in some dogs and lesions were not confined to the caudal area of the cervical spine. Three dogs were alive and without symptoms at follow-up. Four were euthanased as a result of the disease and 1 died as a result of post-operative complications. Two additional dogs presenting with wobbler clinical signs are also described. One had medial deviation of the T5 and T6 caudal pedicles and 1 dog suffered from multiple cervical articular facet synovial cysts. PMID:15038422

  2. 3D imaging of fetus vertebra by synchrotron radiation microtomography

    NASA Astrophysics Data System (ADS)

    Peyrin, Francoise; Pateyron-Salome, Murielle; Denis, Frederic; Braillon, Pierre; Laval-Jeantet, Anne-Marie; Cloetens, Peter

    1997-10-01

    A synchrotron radiation computed microtomography system allowing high resolution 3D imaging of bone samples has been developed at ESRF. The system uses a high resolution 2D detector based on a CCd camera coupled to a fluorescent screen through light optics. The spatial resolution of the device is particularly well adapted to the imaging of bone structure. In view of studying growth, vertebra samples of fetus with differential gestational ages were imaged. The first results show that fetus vertebra is quite different from adult bone both in terms of density and organization.

  3. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths.

    PubMed

    Reumer, Jelle W F; Ten Broek, Clara M A; Galis, Frietson

    2014-01-01

    The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects). Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3%) and approximately 10 times higher than that of extant elephants (3.6%). Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side) and seventh (anterior side) cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene. PMID:24711969

  4. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths

    PubMed Central

    Reumer, Jelle W.F.; ten Broek, Clara M.A.

    2014-01-01

    The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects). Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3%) and approximately 10 times higher than that of extant elephants (3.6%). Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side) and seventh (anterior side) cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene. PMID:24711969

  5. Cervical Cap

    MedlinePlus

    ... and remove the cap. How Much Does It Cost? A cervical cap costs about $70 and should be replaced every year. In addition, there is also the cost of the doctor's visit. Many health insurance plans ...

  6. [Cervical cerclage].

    PubMed

    Akladios, C Y; Sananes, N; Gaudineau, A; Boudier, E; Langer, B

    2015-10-01

    Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination. The McDonald's technique is the most recommended. In case of failure, it is proposed to realize cerclage at a higher level on the cervix either by vaginal or abdominal route. PMID:26144289

  7. Diffuse idiopathic skeletal hyperostosis of cervical spine - An unusual cause of difficult flexible fiber optic intubation

    PubMed Central

    Baxi, Vaibhavi; Gaiwal, Sucheta

    2010-01-01

    This is a report of anterior osteophytes on the cervical vertebra resulting in distortion of the airway and leading to difficulty during intubation. The osteophytes associated with the syndrome of diffuse idiopathic skeletal hyperostosis were at the C2-3 and C6-7, T1 level and resulted in anterior displacement of the pharynx and the trachea respectively. PMID:20668561

  8. Torsional deformity of apical vertebra in adolescent idiopathic scoliosis.

    PubMed

    Kotwicki, Tomasz; Napiontek, Marek

    2002-01-01

    CT scans of structural thoracic idiopathic scoliosis were reviewed in nine patients admitted to our department for scoliosis surgery. The apical vertebra scans were chosen and the following parameters were evaluated: 1) alpha angle formed by the axis of vertebra and the axis of spinous process 2) beta concave and beta convex angle between the spinous process and the left and right transverse process, respectively, 3) gamma concave and gamma convex angle between the axis of vertebra and the left and right transverse process, respectively, 4) the rotation angle to the sagittal plane. The constant deviation of the spinous process towards the convex side of the curve was observed. The vertebral body itself was distorted towards the concavity of the curve. The angle between the spinous process and the transverse process was smaller on the convex side of the curve. The torsional, intravertebral deformity of the apical vertebra was a factor acting in the direction opposite to the rotation, in the sense to reduce the deformity of the spine in idiopathic scoliosis. PMID:15456062

  9. Establishment of a new animal model for ischemic lumbar vertebrae

    PubMed Central

    Hou, Changlong; Tan, Guosheng; Zhuang, Wenquan; Yang, Jianyong

    2015-01-01

    Degeneration and ischemia of lumbar intervertebral disc has become a more and more important issue for elder people. However the mechanism for this is still known, largely due to a lack of a suitable animal model. In this study, we constructed a new animal model for the study of ischemic lumbar vertebrae. 42 New Zealand white rabbits were chosen for the study. For each rabbit, two vertebrae were used. L5 was set as the experimental group and L4 was set as the control group. Percutaneous lumbar puncture needles were applied in vertebrae adjacent to endplate for L5 and L4. For L4 1 ml saline was injected and for L5 1 ml pingyangmycin (2 mg/mL) was used. 1, 2, 3, 4, 5 weeks; 2 and 3 months after surgery, 6 rabbits at each time point were randomly chosen and underwent MRI, pathological test. The results in L5 and L4 were compared. Another 6 rabbits were used for DSA (Digital Subtraction Angiography) and vascular cast to study the length and diameters of the branches of lumbar artery. It was identified that since the third week, slightly hyperintense signal on T2-weighted image (T2WI) and fat-suppression T2-weighted image (FS T2WI) were detected. Lumbar vertebrae damage could be identified since the fourth week. Results of MRI and the size of pathological area were positively related (r=0.965, P<0.05). DSA and vascular cast could both clearly show the third level branches of lumbar artery. Our study suggested that injection of pingyangmycin via percutaneous lumbar needle could successfully induce ischemia in lumbar endplate. This method had little trauma, required a simple operation process and is highly repetitive. Besides, by vascular cast, the most important source of blood supply is the media branch of the lumbar artery. This branch could be a new therapy pathway for the degeneration of lumbar vertebrae. PMID:26379856

  10. Automated identification of spinal cord and vertebras on sagittal MRI

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Dong, Qian; He, Bo; Wei, Jun; Hadjiiski, Lubomir M.; Couriel, Daniel

    2014-03-01

    We are developing an automated method for the identification of the spinal cord and the vertebras on spinal MR images, which is an essential step for computerized analysis of bone marrow diseases. The spinal cord segment was first enhanced by a newly developed hierarchical multiscale tubular (HMT) filter that utilizes the complementary hyper- and hypo- intensities in the T1-weighted (T1W) and STIR MRI sequences. An Expectation-Maximization (EM) analysis method was then applied to the enhanced tubular structures to extract candidates of the spinal cord. The spinal cord was finally identified by a maximum-likelihood registration method by analysis of the features extracted from the candidate objects in the two MRI sequences. Using the identified spinal cord as a reference, the vertebras were localized based on the intervertebral disc locations extracted by another HMT filter applied to the T1W images. In this study, 5 and 30 MRI scans from 35 patients who were diagnosed with multiple myeloma disease were collected retrospectively with IRB approval as training and test set, respectively. The vertebras manually outlined by a radiologist were used as reference standard. A total of 422 vertebras were marked in the 30 test cases. For the 30 test cases, 100% (30/30) of the spinal cords were correctly segmented with 4 false positives (FPs) mistakenly identified on the back muscles in 4 scans. A sensitivity of 95.0% (401/422) was achieved for the identification of vertebras, and 5 FPs were marked in 4 scans with an average FP rate of 0.17 FPs/scan.

  11. Cervical spinal deformity in craniometaphyseal dysplasia.

    PubMed

    Yamada, H; Yamanaka, T; Tanaka, Y; Nakamura, S

    1987-03-01

    A child with craniometaphyseal dysplasia had the presenting symptoms of progressive quadriparesis. She exhibited proportionate tall stature, peculiar face with craniomegaly, genu valgum, and 46,XX,t(12;18)(q13;q12) chromosome aberration. Delayed physical development and mild mental retardation were also present. Subluxation of C-2 on C-3 and kyphosis of the cervical spine, and myelographic blockage at this level were noted. Treatment consisted of fusion of the C-2 to C5-6 vertebra following laminectomies of C-3 and C-4 with satisfactory results. Early detection and surgery for cervical spine deformity and cord compression are necessary to prevent profound neurological deficits in this disorder. PMID:3810462

  12. Cervical Dysplasia

    PubMed Central

    Carmichael, John A.

    1983-01-01

    Invasive squamous carcinoma of the cervix is preceded by a series of premalignant changes described as mild, moderate, or severe dysplasia, and carcinoma in situ. These premalignant states are identified by cervical cytology, diagnosed by colposcopy and if effectively treated, can prevent invasive squamous carcinoma of the cervix. Because of the apparent biological variation of the premalignant states, even the most aggressive cervical screening program cannot be expected to eliminate all invasive squamous cancer of the cervix. Optimal results of a cervical screening program will be achieved when all women under 35 years of age and sexually active have an annual cytological smear; the cytology is screened by a laboratory with high quality control; the patient's positive cytology is accurately assessed by an experienced colposcopist, and the premalignant lesion is effectively treated. PMID:21283455

  13. Cervical cancer.

    PubMed

    Koh, Wui-Jin; Greer, Benjamin E; Abu-Rustum, Nadeem R; Apte, Sachin M; Campos, Susana M; Chan, John; Cho, Kathleen R; Cohn, David; Crispens, Marta Ann; DuPont, Nefertiti; Eifel, Patricia J; Gaffney, David K; Giuntoli, Robert L; Han, Ernest; Huh, Warner K; Lurain, John R; Martin, Lainie; Morgan, Mark A; Mutch, David; Remmenga, Steven W; Reynolds, R Kevin; Small, William; Teng, Nelson; Tillmanns, Todd; Valea, Fidel A; McMillian, Nicole R; Hughes, Miranda

    2013-03-01

    These NCCN Clinical Practice Guidelines in Oncology for Cervical Cancer focus on early-stage disease, because it occurs more frequently in the United States. After careful clinical evaluation and staging, the primary treatment of early-stage cervical cancer is either surgery or radiotherapy. These guidelines include fertility-sparing and non-fertility-sparing treatment for those with early-stage disease, which is disease confined to the uterus. A new fertility-sparing algorithm was added for select patients with stage IA and IB1 disease.. PMID:23486458

  14. Distraction-stabilisation of two adjacent intervertebral spaces in a Dalmatian dog with caudal cervical spondylomyelopathy.

    PubMed

    Beranek, J; Tomek, A; Lorinson, D

    2013-05-01

    A 4-year-old, 40-kg, male, entire Dalmatian was presented for evaluation of chronic neck pain and pelvic limb ataxia. Myelography revealed ventrodorsal (hourglass) extradural compression over the intervertebral space between the 5th and 6th cervical vertebra and ventral extradural compression between the 6th and 7th cervical vertebra. Cranial compression disappeared and caudal compression markedly diminished after performing cervical traction. MRI scan confirmed protrusion of intervertebral discs and spinal cord compression in previously mentioned intervertebral spaces. Surgical distraction-stabilization of both intervertebral spaces was performed using threaded pins and polymethylmethacrylate. The convalescence from surgery was uneventful and the dog was walking without any signs of paresis until 5 months after surgery when radiography revealed implants loosening. The dog recovered fully of the implant removal and remained asymptomatic for more than 30 months. PMID:23644293

  15. Vertebroplasty reduces progressive ׳creep' deformity of fractured vertebrae.

    PubMed

    Luo, J; Pollintine, P; Annesley-Williams, D J; Dolan, P; Adams, M A

    2016-04-11

    Elderly vertebrae frequently develop an "anterior wedge" deformity as a result of fracture and creep mechanisms. Injecting cement into a damaged vertebral body (vertebroplasty) is known to help restore its shape and stiffness. We now hypothesise that vertebroplasty is also effective in reducing subsequent creep deformations. Twenty-eight spine specimens, comprising three complete vertebrae and the intervening discs, were obtained from cadavers aged 67-92 years. Each specimen was subjected to increasingly-severe compressive loading until one of its vertebrae was fractured, and the damaged vertebral body was then treated by vertebroplasty. Before and after fracture, and again after vertebroplasty, each specimen was subjected to a static compressive force of 1kN for 1h while elastic and creep deformations were measured in the anterior, middle and posterior regions of each adjacent vertebral body cortex, using a 2D MacReflex optical tracking system. After fracture, creep in the anterior and central regions of the vertebral body cortex increased from an average 4513 and 885 microstrains, respectively, to 54,107 and 34,378 microstrains (both increases: P<0.001). Elastic strains increased by a comparable amount. Vertebroplasty reduced creep in the anterior and central cortex by 61% (P=0.006) and 66% (P=0.017) respectively. Elastic strains were reduced by less than half this amount. Results suggest that the beneficial effects of vertebroplasty on the vertebral body continue long after the post-operative radiographs. Injected cement not only helps to restore vertebral shape and elastic properties, but also reduces subsequent creep deformation of the damaged vertebra. PMID:26459490

  16. A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome

    PubMed Central

    Jancuska, Jeffrey M.; Spivak, Jeffrey M.

    2015-01-01

    Background Lumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. This review will focus on the clinical significance of LSTV, disruptions in normal spine biomechanics, imaging techniques, diagnosis, and treatment. Methods A Pubmed search using the specific key words “LSTV,” “lumbosacral transitional vertebrae,” and “Bertolotti's Syndrome” was performed. The resulting group of manuscripts from our search was evaluated. Results LSTV are associated with alterations in biomechanics and anatomy of spinal and paraspinal structures, which have important implications on surgical approaches and techniques. LSTV are often inaccurately detected and classified on standard AP radiographs and MRI. The use of whole-spine images as well as geometric relationships between the sacrum and lumbar vertebra increase accuracy. Uncertainty regarding the cause, clinical significance, and treatment of LSTV persists. Some authors suggest an association between LSTV types II and IV and low back pain. Pseudoarticulation between the transverse process and the sacrum creates a “false joint” susceptible to arthritic changes and osteophyte formation potentially leading to nerve root entrapment. The diagnosis of symptomatic LSTV is considered with appropriate patient history, imaging studies, and diagnostic injections. A positive radionuclide study along with a positive effect from a local injection helps distinguish the transitional vertebra as a significant pain source. Surgical resection is reserved for a subgroup of LSTV patients who fail conservative treatment and whose pain is definitively attributed to the anomalous pseudoarticulation. Conclusions Due to the common finding of low back pain and the wide prevalence of LSTV in the general population, it is essential to differentiate between symptoms originating from an anomalous psuedoarticulation from other potential

  17. Adaptive geodesic transform for segmentation of vertebrae on CT images

    NASA Astrophysics Data System (ADS)

    Gaonkar, Bilwaj; Shu, Liao; Hermosillo, Gerardo; Zhan, Yiqiang

    2014-03-01

    Vertebral segmentation is a critical first step in any quantitative evaluation of vertebral pathology using CT images. This is especially challenging because bone marrow tissue has the same intensity profile as the muscle surrounding the bone. Thus simple methods such as thresholding or adaptive k-means fail to accurately segment vertebrae. While several other algorithms such as level sets may be used for segmentation any algorithm that is clinically deployable has to work in under a few seconds. To address these dual challenges we present here, a new algorithm based on the geodesic distance transform that is capable of segmenting the spinal vertebrae in under one second. To achieve this we extend the theory of the geodesic distance transforms proposed in1 to incorporate high level anatomical knowledge through adaptive weighting of image gradients. Such knowledge may be provided by the user directly or may be automatically generated by another algorithm. We incorporate information 'learnt' using a previously published machine learning algorithm2 to segment the L1 to L5 vertebrae. While we present a particular application here, the adaptive geodesic transform is a generic concept which can be applied to segmentation of other organs as well.

  18. Adjacent Segment Pathology after Anterior Cervical Fusion

    PubMed Central

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon

    2016-01-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion. PMID:27340541

  19. Adjacent Segment Pathology after Anterior Cervical Fusion.

    PubMed

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion. PMID:27340541

  20. Computer Based Assessment of Cervical Vertebral Maturation Stages Using Digital Lateral Cephalograms

    PubMed Central

    Dzemidzic, Vildana; Sokic, Emir; Tiro, Alisa; Nakas, Enita

    2015-01-01

    Objective: This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. Material and methods: For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no history of trauma at the cervical region. Subjects with lateral cephalograms of low quality were excluded from the study. For the purpose of this study a computer application Cephalometar HF V1 was developed. This application was used to mark the contours of the second, third and fourth cervical vertebrae on the digital lateral cephalograms, which enabled a computer to determine the stage of cervical vertebral maturation. The assessment of the stages of cervical vertebral maturation was carried out by an experienced orthodontist. The assessment was conducted according to the principles of the method proposed by authors Hassel and Farman. The degree of the agreement between the computer application and the researcher was analyzed using by statistical Cohen Kappa test. Results: The results of this study showed the agreement between the computer assessment and the researcher assessment of the cervical vertebral maturation stages, where the value of the Cohen Kappa coefficient was 0.985. Conclusion: The computer application Cephalometar HF V1 proved to be a reliable method for assessing the stages of cervical vertebral maturation. This program could help the orthodontists to identify the stage of cervical vertebral maturation when planning the orthodontic treatment for the patients with skeletal disharmonies. PMID:26862247

  1. METHANOL EXPOSURE DURING GASTRULATION CAUSES HOLOPROSENCEPHALY, FACIAL DYSGENESIS AND CERVICAL VERTEBRAL MALFORMATIONS IN C57BL/6J MICE

    EPA Science Inventory

    Exposure of pregnant CD-1 mice to methanol during the period of gastrulation results in exencephaly, cleft palate, and cervical vertebra malformations (Rogers and Mole, 1997, Teratology 55, 364). C57BL/6J mice are sensitive to the teratogenicity of ethanol; fetuses of this strai...

  2. Multirigid registration of MR and CT images of the cervical spine

    NASA Astrophysics Data System (ADS)

    Hu, Yangqiu; Haynor, David R.

    2004-05-01

    We present our work on fusion of MR and CT images of the cervical spine. To achieve the required registration accuracy of approximately 1mm, the spine is treated as a collection of rigid vertebrae, and a separate rigid body transformation applied to each (Hawkes). This in turn requires segmentation of the CT datasets into separate vertebral images, which is difficult because the narrow planes separating adjacent vertebrae are parallel to the axial plane of the CT scans. We solve this problem by evolving all the vertebral contours simultaneously using a level set method, and use contour competition to estimate the position of the vertebral edges when a clean separation between adjacent vertebrae is not seen. Contour competition is based in turn on the vertical scan principle: no part of a given vertebra is vertically below any part of an inferior vertebra. Once segmentation is complete, the individual rigid body transforms are then estimated using mutual information maximization, and the CT images of the vertebrae superimposed on the MR scans. The resultant fused images contain the bony detail of CT and the soft tissue discrimination of MR and appear to be diagnostically equivalent, or superior, to CT myelograms. A formal test of these conclusions is planned for the next phase of our work.

  3. General Information about Cervical Cancer

    MedlinePlus

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Go to Health Professional Version ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  4. Cervical Spondylosis and Hypertension

    PubMed Central

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  5. Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

    PubMed

    Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

    2009-03-01

    Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation. PMID:19368265

  6. Spaceflight effects on biomechanical and biochemical properties of rat vertebrae

    NASA Technical Reports Server (NTRS)

    Zernicke, R. F.; Vailas, A. C.; Grindeland, R. E.; Kaplansky, A.; Salem, G. J.; Martinez, D. A.

    1990-01-01

    The biomechanical and biochemical responses of lumbar vertebral bodies during a 12.5-day spaceflight (Cosmos 1887 biosatellite) were determined for rapidly growing rats (90-day-old, Czechoslovakian-Wistar). By use of age-matched vivarium controls (normal cage environment) and synchronous controls (simulated flight conditions), as well as a basal control group (killed before lift-off on the 1st day of flight), the combined influences of growth and space-flight could be examined. Centra of the sixth lumbar vertebrae (L6) were compressed to 50% strain at a fast strain rate while immersed in physiological buffer (37 degrees C). The body masses of vivarium and synchronous controls were significantly heavier than either the flight or basal controls. The flight group had an L6 vertebral body compressional stiffness that was 39% less than the vivarium controls, 47% less than the synchronous control, and 16% less than the basal controls. In addition, the average initial maximum load of the flight L6 was 22% less than vivarium controls and 18% less than the synchronous controls, whereas the linear compressional load of the flight group averaged 34% less than the vivarium and 25% less than the synchronous groups. The structural properties of the vertebrae from the 12.5-day-younger basal group closely resembled the flight vertebrae. Calcium, phosphorous, and hydroxyproline concentrations were not significantly different among the groups. Nevertheless, the lack of strength and stiffness development in spaceflight, coupled with a smaller proportion of mature hydroxypyridinoline cross-links, suggested that the 12.5 days of spaceflight slowed the maturation of trabecular bone in the vertebral bodies of rapidly growing rats.

  7. Cervical cancer.

    PubMed

    Shepherd, John H

    2012-06-01

    Standard treatment for invasive cervical cancer involves either radical surgery or radiotherapy. Childbearing is therefore impossible after either of these treatments. A fertility-sparing option, however, by radical trachelectomy has been shown to be effective, provided that strict criteria for selection are followed. Fertility rates are high, whereas recurrence is low, indicating that a more conservative approach to dealing with early small cervical tumours is feasible. Careful preoperative assessment by magnetic resonance imaging scans allows accurate measurement of the tumour with precise definition to plan surgery. This will ensure an adequate clear margin by wide excision of the tumour excising the cervix by radical vaginal trachelectomy with surrounding para-cervical and upper vaginal tissues. An isthmic cerclage is inserted to provide competence at the level of the internal orifice. A primary vagino-isthmic anastomosis is conducted to restore continuity of the lower genital tract. Subsequent pregnancies require careful monitoring in view of the high risk of spontaneous premature rupture of the membranes. Delivery by classical caesarean section is necessary at the onset of labour or electively before term. Over 1100 such procedures have been carried out vaginally or abdominally, resulting in 240 live births. Radical vaginal trachelectomy with a laparoscopic pelvic-node dissection offers the least morbid and invasive route for surgery, provided that adequate surgical skills have been obtained. PMID:22353492

  8. Quantitative histochemistry of rat lumbar vertebrae following spaceflight

    NASA Technical Reports Server (NTRS)

    Eurell, J. A.; Kazarian, L. E.

    1983-01-01

    The histochemical effects of the return to gravity immediately and 6 and 29 days following spaceflight on the bone of rat vertebral bodies were investigated. No significant change in the calcium salt content of the vertebrae was found immediately postflight, although 6 days later it was significantly decreased. The calcium content was found to have returned to normal by 29 days postflight. While postflight collagen content was not significantly altered, keratosulfate was found to be significantly higher in trabecular bone of rats immediately postflight and 6 days postflight. In addition, chondroitin sulfate was found to be increased in vertebral bone on days 6 and 29 postflight. These findings indicate that bone turnover slows in vertebrae during spaceflight allowing bone aging, which support the contention that a form of osteolysis begins immediately upon return to gravity to remove components of old bone at which time mineral levels decrease and levels of chondroitin and keratkosulfates shift. It was found that the osteolysis phase was quickly followed by new bone replacement which was completed before 29 days postspaceflight.

  9. Ossified Ligamentum Longitudinale Anterius in Adult Human Dry Vertebrae

    PubMed Central

    Venumadhav, Nelluri; KS, Siddaraju

    2014-01-01

    Background: The ligamentum longitudinale anterius is a broad and strong band of fibrous tissue that runs along the anterior surfaces of the bodies of the vertebrae. Aim: The study was undertaken to evaluate the incidence of ossified ligamentum longitudinale anterius in adult dry human vertebra. Materials and Methods: This study was carried out on 95 sets of dry human vertebral columns irrespective of age and sex at Mayo Institute of Medical Sciences- Barabanki,-UP, Melaka Manipal Medical College-Manipal University and Department of Anatomy, KMCT Medical College, Manassery- Calicut, India. All the sets of vertebral columns were macroscopically inspected for the ossified ligamentum longitudinale anterius. Results: It was observed that out of 95 sets of vertebral columns, 27 (28.42%) vertebral columns showed ossification. Out of 27 vertebral columns, 17 (17.89%) vertebral columns showed segmental type of ossification, 2 (2.11%) vertebral columns showed continuous type of ossification and 8 (8.42%) vertebral columns showed mixed type of ossification at different vertebral level. Conclusion: Such type of ossification will affect the biomechanics of the spine and may result in stiff neck, low back pain, dysphagia, odynophagia, compression of the brachial plexus, aphonia, immobility or mucosal thickening of larynx. Hence, knowledge of such abnormalities should be kept in mind to minimise serious complications in any surgical intervention or investigative procedures in the region. PMID:25302180

  10. Aneurysmal bone cyst involving the c2 vertebra.

    PubMed

    Bivins, Eugene; Alidina, Jasim A; Bancroft, Laura W

    2015-02-01

    A 9-year-old boy presented with a 3-month history of cervical pain, limited range of motion, and a palpable "bump" in his posterior neck. After treatment with antibiotics for presumptive adenopathy and progression of the palpable finding, radiographs were obtained. PMID:25665113

  11. Biomarkers in Cervical Cancer

    PubMed Central

    Yim, Eun-Kyoung; Park, Jong-Sup

    2006-01-01

    Cervical cancer, a potentially preventable disease, remains the second most common malignancy in women worldwide. Human papillomavirus (HPV) is the single most important etiological agent in cervical cancer, contributing to neoplastic progression through the action of viral oncoproteins, mainly E6 and E7. Cervical screening programs using Pap smear testing have dramatically improved cervical cancer incidence and reduced deaths, but cervical cancer still remains a global health burden. The biomarker discovery for accurate detection and diagnosis of cervical carcinoma and its malignant precursors (collectively referred to as high-grade cervical disease) represents one of the current challenges in clinical medicine and cytopathology. PMID:19690652

  12. Hematogenous cervical spondylodiscitis after severe burn injury.

    PubMed

    Riedel, G; Becker, S; Steen, M

    2001-12-01

    A 47-year-old man sustained a 31% TBSA burn injury. In spite of early escharectomy and mesh-graft-transplantation the patient suffered a septicaemic phase in the first week, which was treated by a specific antibiotic. Five weeks after the burn injury a cervical spondylodiscitis was diagnosed. Immediate wound debridement, ventral and dorsal spondylodesis with a tricortical bone-graft from the left iliac crest and titanium plates and specific antibiotic therapy led to the stabilization and healing of the cervical spinal column. The spondylodiscitis was microbiologically proved to be hematogenous after spread of Staphylococcus aureus from the blood in the early septicaemic phase. Swab culture from the burn surface wound, infected vertebrae and blood during the septicaemic phase revealed coagulase positive S. aureus. The aetiology, predisposing factors and management of this rare, but recognized, complication of major burns are discussed. Case features of this patient are compared with the single site's reported case of hematogenous cervical spondylodiscitis after severe burn injury. PMID:11718988

  13. Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study.

    PubMed

    Woodfield, H Charles; Hasick, D Gordon; Becker, Werner J; Rose, Marianne S; Scott, James N

    2015-01-01

    Introduction. In a migraine case study, headache symptoms significantly decreased with an accompanying increase in intracranial compliance index following atlas vertebrae realignment. This observational pilot study followed eleven neurologist diagnosed migraine subjects to determine if the case findings were repeatable at baseline, week four, and week eight, following a National Upper Cervical Chiropractic Association intervention. Secondary outcomes consisted of migraine-specific quality of life measures. Methods. After examination by a neurologist, volunteers signed consent forms and completed baseline migraine-specific outcomes. Presence of atlas misalignment allowed study inclusion, permitting baseline MRI data collection. Chiropractic care continued for eight weeks. Postintervention reimaging occurred at week four and week eight concomitant with migraine-specific outcomes measurement. Results. Five of eleven subjects exhibited an increase in the primary outcome, intracranial compliance; however, mean overall change showed no statistical significance. End of study mean changes in migraine-specific outcome assessments, the secondary outcome, revealed clinically significant improvement in symptoms with a decrease in headache days. Discussion. The lack of robust increase in compliance may be understood by the logarithmic and dynamic nature of intracranial hemodynamic and hydrodynamic flow, allowing individual components comprising compliance to change while overall it did not. Study results suggest that the atlas realignment intervention may be associated with a reduction in migraine frequency and marked improvement in quality of life yielding significant reduction in headache-related disability as observed in this cohort. Future study with controls is necessary, however, to confirm these findings. Clinicaltrials.gov registration number is NCT01980927. PMID:26783523

  14. Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study

    PubMed Central

    Woodfield, H. Charles; Hasick, D. Gordon; Becker, Werner J.; Rose, Marianne S.; Scott, James N.

    2015-01-01

    Introduction. In a migraine case study, headache symptoms significantly decreased with an accompanying increase in intracranial compliance index following atlas vertebrae realignment. This observational pilot study followed eleven neurologist diagnosed migraine subjects to determine if the case findings were repeatable at baseline, week four, and week eight, following a National Upper Cervical Chiropractic Association intervention. Secondary outcomes consisted of migraine-specific quality of life measures. Methods. After examination by a neurologist, volunteers signed consent forms and completed baseline migraine-specific outcomes. Presence of atlas misalignment allowed study inclusion, permitting baseline MRI data collection. Chiropractic care continued for eight weeks. Postintervention reimaging occurred at week four and week eight concomitant with migraine-specific outcomes measurement. Results. Five of eleven subjects exhibited an increase in the primary outcome, intracranial compliance; however, mean overall change showed no statistical significance. End of study mean changes in migraine-specific outcome assessments, the secondary outcome, revealed clinically significant improvement in symptoms with a decrease in headache days. Discussion. The lack of robust increase in compliance may be understood by the logarithmic and dynamic nature of intracranial hemodynamic and hydrodynamic flow, allowing individual components comprising compliance to change while overall it did not. Study results suggest that the atlas realignment intervention may be associated with a reduction in migraine frequency and marked improvement in quality of life yielding significant reduction in headache-related disability as observed in this cohort. Future study with controls is necessary, however, to confirm these findings. Clinicaltrials.gov registration number is NCT01980927. PMID:26783523

  15. Muscular Arrangement and Muscle Attachment Sites in the Cervical Region of the American Barn Owl (Tyto furcata pratincola).

    PubMed

    Boumans, Mark L L M; Krings, Markus; Wagner, Hermann

    2015-01-01

    Owls have the largest head rotation capability amongst vertebrates. Anatomical knowledge of the cervical region is needed to understand the mechanics of these extreme head movements. While data on the morphology of the cervical vertebrae of the barn owl have been provided, this study is aimed to provide an extensive description of the muscle arrangement and the attachment sites of the muscles on the owl's head-neck region. The major cervical muscles were identified by gross dissection of cadavers of the American barn owl (Tyto furcata pratincola), and their origin, courses, and insertion were traced. In the head-neck region nine superficial larger cervical muscles of the craniocervical, dorsal and ventral subsystems were selected for analysis, and the muscle attachment sites were illustrated in digital models of the skull and cervical vertebrae of the same species as well as visualised in a two-dimensional sketch. In addition, fibre orientation and lengths of the muscles and the nature (fleshy or tendinous) of the attachment sites were determined. Myological data from this study were combined with osteological data of the same species. This improved the anatomical description of the cervical region of this species. The myological description provided in this study is to our best knowledge the most detailed documentation of the cervical muscles in a strigiform species presented so far. Our results show useful information for researchers in the field of functional anatomy, biomechanical modelling and for evolutionary and comparative studies. PMID:26222908

  16. Muscular Arrangement and Muscle Attachment Sites in the Cervical Region of the American Barn Owl (Tyto furcata pratincola)

    PubMed Central

    Boumans, Mark L. L. M.; Krings, Markus; Wagner, Hermann

    2015-01-01

    Owls have the largest head rotation capability amongst vertebrates. Anatomical knowledge of the cervical region is needed to understand the mechanics of these extreme head movements. While data on the morphology of the cervical vertebrae of the barn owl have been provided, this study is aimed to provide an extensive description of the muscle arrangement and the attachment sites of the muscles on the owl’s head-neck region. The major cervical muscles were identified by gross dissection of cadavers of the American barn owl (Tyto furcata pratincola), and their origin, courses, and insertion were traced. In the head-neck region nine superficial larger cervical muscles of the craniocervical, dorsal and ventral subsystems were selected for analysis, and the muscle attachment sites were illustrated in digital models of the skull and cervical vertebrae of the same species as well as visualised in a two-dimensional sketch. In addition, fibre orientation and lengths of the muscles and the nature (fleshy or tendinous) of the attachment sites were determined. Myological data from this study were combined with osteological data of the same species. This improved the anatomical description of the cervical region of this species. The myological description provided in this study is to our best knowledge the most detailed documentation of the cervical muscles in a strigiform species presented so far. Our results show useful information for researchers in the field of functional anatomy, biomechanical modelling and for evolutionary and comparative studies. PMID:26222908

  17. 3D CT spine data segmentation and analysis of vertebrae bone lesions.

    PubMed

    Peter, R; Malinsky, M; Ourednicek, P; Jan, J

    2013-01-01

    A method is presented aiming at detecting and classifying bone lesions in 3D CT data of human spine, via Bayesian approach utilizing Markov random fields. A developed algorithm for necessary segmentation of individual possibly heavily distorted vertebrae based on 3D intensity modeling of vertebra types is presented as well. PMID:24110203

  18. Ivory vertebra on 18F-sodium fluoride scan: an old sign in a new modality.

    PubMed

    Oldan, Jorge Daniel; Kuzminski, Samuel; James, Olga

    2014-11-01

    We report a case of ivory vertebra on 18F-sodium fluoride. A prostate cancer patient had a 18F-sodium fluoride PET scan to evaluate overall spread of disease. In addition to other findings of metastatic disease, the patient had an ivory vertebra. PMID:24566404

  19. New Classification for Clinically Symptomatic Adjacent Segment Pathology in Cervical Disc Disease

    PubMed Central

    2015-01-01

    Study Design Clinical adjacent segment pathology (CASP) is common after cervical disc surgery. A critical examination of 320 patients operated for cervical disc prolapse revealed that CASP can also occur in patients with congenital and degenerative fusion of cervical spine. This has not been studied in depth and there is a need for a practically applicable classification of CASP. Purpose To develop a new classification scheme of CASP. Overview of Literature A review of the literature did not reveal a practically applicable classification incorporating the occurrence of CASP in congenital and degenerative fusion cases. Methods This was a retrospective analysis of 320 patients operated (509 disc spaces) on for cervical disc prolapse. Cases (n=316) were followed-up for 3-11 years. Random sampling of 220 patients with postoperative magnetic resonance imaging (MRI) in 165 cases was analyzed. Results Six symptomatic CASP cases required resurgery (1.9%), eight cases involved MRI proven CASP with axial neck pain only and 13 patients were asymptomatic with radiological adjacent segment pathology (RASP). The frequency rate was 8.5% (27/316). Four cases of congenital or degenerative fusion of vertebra developed CASP requiring surgery. CASP is classified as primary or secondary follows. Primary A1 was congenital fusion of vertebra and primary A2 was degenerative fusion of the vertebra. Secondary, which was after cervical disc surgery, comprised B1 (RASP in asymptomatic patients), B2 (CASP in patients with axial neck pain), and B3 (CASP with myeloradiculopathy). B3 was subdivided into single-level CASP (B3a) and multiple-level CASP (B3b). Conclusions Symptomatic CASP requiring resurgery is infrequent. CASP can occur in patients with congenital and degenerative fusion of the cervical spine. A new classification for CASP along with treatment strategy is proposed. Patients in Primary CASP and B3 CASP require resurgery while others require only observation. PMID:26712514

  20. Cervical Vertebral Trabecular Bone Mineral Density in Great Danes With and Without Osseous-Associated Cervical Spondylomyelopathy

    PubMed Central

    Armstrong, J.; da Costa, R.C.; Martin-Vaquero, P.

    2015-01-01

    Background Great Danes (GDs) with osseous-associated cervical spondylomyelopathy (CSM) have osteoarthritis (OA) of the cervical vertebrae. OA is often associated with increases in bone mineral density (BMD) in people and dogs. Hypothesis/Objectives To compare the trabecular BMD of the cervical vertebrae between clinically normal (control) GDs and GDs with osseous-associated CSM by using computed tomography (CT). We hypothesized that the vertebral trabecular BMD of CSM-affected GDs would be higher than that of control GDs. Animals Client-owned GDs: 12 controls, 10 CSM affected. Methods Prospective study. CT of the cervical vertebral column was obtained alongside a calibration phantom. By placing a circular region of interest at the articular process joints, vertebral body, pedicles, and within each rod of the calibration phantom, trabecular BMD was measured in Hounsfield units, which were converted to diphosphate equivalent densities. Trabecular BMD measurements were compared between CSM-affected and control dogs, and between males and females within the control group. Results Differences between CSM-affected and control dogs were not significant for the articular processes (mean = −39; P = .37; 95% CI: −102 to 24), vertebral bodies (mean = −62; P = .08; 95% CI: −129 to 6), or pedicles (mean = −36; P = .51; 95% CI: −105 to 33). Differences between female and male were not significant. Conclusions and Clinical Importance This study revealed no difference in BMD between control and CSM-affected GDs. Based on our findings no association was detected between cervical OA and BMD in GDs with CSM. PMID:25312453

  1. Dynamic sagittal flexibility coefficients of the human cervical spine.

    PubMed

    Ivancic, Paul C; Ito, Shigeki; Panjabi, Manohar M

    2007-07-01

    The goal of the present study was to determine the dynamic sagittal flexibility coefficients, including coupling coefficients, throughout the human cervical spine using rear impacts. A biofidelic whole cervical spine model (n=6) with muscle force replication and surrogate head was rear impacted at 5 g peak horizontal accelerations of the T1 vertebra within a bench-top mini-sled. The dynamic main and coupling sagittal flexibility coefficients were calculated at each spinal level, head/C1 to C7/T1. The average flexibility coefficients were statistically compared (p<0.05) throughout the cervical spine. To validate the coefficients, the average computed displacement peaks, obtained using the average flexibility matrices and the measured load vectors, were statistically compared to the measured displacement peaks. The computed and measured displacement peaks showed good overall agreement, thus validating the computed flexibility coefficients. These peaks could not be statistically differentiated, with the exception of extension rotation at head/C1 and posterior shear translation at C7/T1. Head/C1 was significantly more flexible than all other spinal levels. The cervical spine was generally more flexible in posterior shear, as compared to axial compression. The coupling coefficients indicated that extension moment caused coupled posterior shear translation while posterior shear force caused coupled extension rotation. The present results may be used towards the designs of anthropometric test dummies and mathematical models that better simulate the cervical spine response during dynamic loading. PMID:17140545

  2. Gunshot-caused Facial Injury Combined with Lower Cervical Spine Injury: A Case Report

    PubMed Central

    Wang, J; Ye, CY; Zhu, MY; Yuan, JD; Ten, HL

    2014-01-01

    A 32-year old male patient was wounded by a pistol. As shown in computed tomography (CT) scanning images, there was comminuted fracture of the left mandible and the bullet was found in the left side behind the sixth cervical vertebra. After the patient was hospitalized, the debridement was done in the emergency room and the operation of open reduction and internal fixation for comminuted fracture of left mandible was performed successfully. Eighteen days later, the patient was taken to surgery for anterior cervical decompression and fusion with autogenous iliac bone grafting for the sixth cervical vertebra. Postoperative follow-up of the patient over two years indicated that the left biceps muscle strength was recovered to level 4. Gunshot wound to the face associated with injury of the low cervical spine has the possibility of survival. It is safe to treat facial wounds early in the patient's treatment course, even if the bullet remains in the cervical vertebral body and there is neurological function damage. PMID:25429487

  3. Head size, weaponry, and cervical adaptation: Testing craniocervical evolutionary hypotheses in Ceratopsia.

    PubMed

    VanBuren, Collin S; Campione, Nicolás E; Evans, David C

    2015-07-01

    The anterior cervical vertebrae form the skeletal connection between the cranial and postcranial skeletons in higher tetrapods. As a result, the morphology of the atlas-axis complex is likely to be shaped by selection pressures acting on either the head or neck. The neoceratopsian (Reptilia:Dinosauria) syncervical represents one of the most highly modified atlas-axis regions in vertebrates, being formed by the complete coalescence of the three most anterior cervical vertebrae. In ceratopsids, the syncervical has been hypothesized to be an adaptation to support a massive skull, or to act as a buttress during intraspecific head-to-head combat. Here, we test these functional/adaptive hypotheses within a phylogenetic framework and critically examine the previously proposed methods for quantifying relative head size in the fossil record for the first time. Results indicate that neither the evolution of cranial weaponry nor large head size correlates with the origin of cervical fusion in ceratopsians, and we, therefore, reject both adaptive hypotheses for the origin of the syncervical. Anterior cervical fusion has evolved independently in a number of amniote clades, and further research on extant groups with this peculiar anatomy is needed to understand the evolutionary basis for cervical fusion in Neoceratopsia. PMID:26095296

  4. Gunshot-caused Facial Injury Combined with Lower Cervical Spine Injury: A Case Report.

    PubMed

    Wang, J; Ye, C Y; Zhu, M Y; Yuan, J D; Ten, H L

    2014-08-01

    A 32-year old male patient was wounded by a pistol. As shown in computed tomography (CT) scanning images, there was comminuted fracture of the left mandible and the bullet was found in the left side behind the sixth cervical vertebra. After the patient was hospitalized, the debridement was done in the emergency room and the operation of open reduction and internal fixation for comminuted fracture of left mandible was performed successfully. Eighteen days later, the patient was taken to surgery for anterior cervical decompression and fusion with autogenous iliac bone grafting for the sixth cervical vertebra. Postoperative follow-up of the patient over two years indicated that the left biceps muscle strength was recovered to level 4. Gunshot wound to the face associated with injury of the low cervical spine has the possibility of survival. It is safe to treat facial wounds early in the patient's treatment course, even if the bullet remains in the cervical vertebral body and there is neurological function damage. PMID:25429487

  5. Intervertebral and intravertebral ratios in Doberman pinscher dogs with cervical spondylomyelopathy.

    PubMed

    da Costa, Ronaldo C; Johnson, Jacqueline A

    2012-01-01

    No screening method is currently available to differentiate dogs with and without cervical spondylomyelopathy. Intravertebral and intervertebral ratios are used in horses and can predict cervical vertebral malformation. Intervertebral ratios could be a useful screening method for canine cervical spondylomyelopathy. Our purpose was to compare cervical intervertebral and intravertebral ratios in normal vs. affected Doberman pinschers. Forty dogs were studied, 27 affected and 13 normal. Cervical radiographs were obtained in all dogs. The minimum intra- and intervertebral sagittal diameter ratios were established for each cervical vertebrae and disc space from C(2) to C(7) . Comparisons were made between groups and specific vertebral body and disc levels. The effect of gender, age, and method of measurement (analog or digital radiographs) was also studied. There was no difference in either the intervertebral or intravertebral ratio between normal vs. affected dogs. The ratios decreased progressively along the cervical spine, being smallest at C(6) -C(7) and C(7) , respectively. Age, gender, and method of measurement had a significant influence on both inter- and intravertebral ratios, with smaller ratios seen as dogs aged and in male dogs. Based on our results, inter- or intravertebral ratios have no value to distinguish between clinically normal Doberman pinschers and Doberman pinschers with cervical spondylomyelopathy. PMID:22702434

  6. Cervical Pedicle Screw Fixation: Anatomic Feasibility of Pedicle Morphology and Radiologic Evaluation of the Anatomical Measurements

    PubMed Central

    2014-01-01

    Study Design All parameters were measured manually and with a computed tomography (CT) scanner. For the manual measurements, a Vernier scale instrument was used. Purpose This study evaluates quantitatively pedicles of middle and lower cervical spine (C3 to C7) and to evaluate the possibilities of using these structures as anchors in posterior cervical fusion. Overview of Literature Pedicle screws may be an alternative fixation technique for posterior cervical instrumentation. Methods Twenty-two bony sets of adult cervical spines were studied (110 vertebrae, 220 pedicles) from C3 down to C7. Results CT measurement of cervical pedicles appeared to be accurate and valuable for preoperative planning of cervical pedicle screw instrumentation. The study showed a high correlation between the values obtained by manual and CT measurements of pedicle dimensions. The technical challenge of insertion is the obvious theoretical drawback of the use of cervical pedicle screws. Many technical factors are important to consider, namely, the point of screw entry, the pedicle dimensions, the screw direction according to the pedicle angle and orientation, the screw diameter and length, and the method of screw introduction. Conclusions Transpedicular screw fixation of the cervical spine appears to be promising. Anatomic limitations should be clear to the surgeon. Further clinical and biomechanical studies are needed to settle this technique. PMID:24967041

  7. Congenital variations of the upper cervical spine and their importance in preoperative diagnosis. A case report and a review of the literature.

    PubMed

    Lampropoulou-Adamidou, Kalliopi; Athanassacopoulos, Michael; Karampinas, Panagiotis K; Vlamis, John; Korres, Demetrios S; Pneumaticos, Spiros G

    2013-07-01

    Several variations of the bony and vascular anatomy around the first and second cervical vertebrae have been reported. Failure to recognise these variations can complicate operations on the upper cervical spine. We present a patient with recent onset of cervical myelopathy due to stenosis at the C3-4 level. Preoperative evaluation identified Klippel-Feil syndrome with cervical fusion of C2-3, aplasia of posterior arch of C1, anomalous vertebral artery course and a "ponticulus posticus" of C2. The combination of these variations in a Klippel-Feil syndrome patient has never been reported. Thus, we recommend a thorough preoperative imaging evaluation, with CT scan and CT angiography or DSA, in addition to plain radiographs. This evaluation is imperative, before a cervical spine surgery, allowing a better understanding of the anatomy, in order to minimise the risks of misplacement of cervical instrumentation especially in such patients. PMID:23563588

  8. Surgical management of multilevel cervical spinal stenosis and spinal cord injury complicated by cervical spine fracture

    PubMed Central

    2014-01-01

    Background There are few reports regarding surgical management of multilevel cervical spinal stenosis with spinal cord injury. Our purpose is to evaluate the safety and feasibility of open-door expansive laminoplasty in combination with transpedicular screw fixation for the treatment of multilevel cervical spinal stenosis and spinal cord injury in the trauma population. Methods This was a retrospective study of 21 patients who had multilevel cervical spinal stenosis and spinal cord injury with unstable fracture. An open-door expansive posterior laminoplasty combined with transpedicular screw fixation was performed under persistent intraoperative skull traction. Outcome measures included postoperative improvement in Japanese Orthopedic Association (JOA) score and incidence of complications. Results The average operation time was 190 min, with an average blood loss of 437 ml. A total of 120 transpedicular screws were implanted into the cervical vertebrae between vertebral C3 and C7, including 20 into C3, 34 into C4, 36 into C5, 20 into C6, and 10 into C7. The mean preoperative JOA score was 3.67 ± 0.53. The patients were followed for an average of 17.5 months, and the average JOA score improved to 8.17 ± 1.59, significantly higher than the preoperative score (t = 1.798, P < 0.05), with an average improvement of 44.7 ± 11.7%. Postoperative complications in four patients included cerebrospinal fluid leakage, delayed wound healing, pulmonary infection, and urinary system infection. All four patients were responsive to antibiotic treatment; one died from respiratory failure 3 months postoperatively. Conclusions The open-door expansive laminoplasty combined with posterior transpedicular screw fixation is feasible for treating multilevel cervical spinal stenosis and spinal cord injury complicated by unstable fracture. Its advantages include minimum surgical trauma, less intraoperative blood loss, and satisfactory stable supportive effect for

  9. Cervical Cancer Stage IVB

    MedlinePlus

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, Medical Illustration Source: National Cancer Institute ...

  10. Cervical Cancer Screening

    MedlinePlus

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  11. A Case of Cervical Spine Tuberculosis in an Infant

    PubMed Central

    Bhatt, Trilok C; Kumar, Savit; Chauhan, Vikas; Pandey, Anjali

    2016-01-01

    Tuberculosis of cervical spine is an extremely rare entity in infants with only few case reports available in the literature. The diagnosis is often delayed due to less dramatic effects of paraplegia or quadriplegia in an infant as compared to older paediatric population. Along with clinical and laboratory investigations, imaging plays a crucial role in defining the extent of involvement, evaluation of complications, providing suitable differential diagnosis and monitoring response to treatment. Tuberculosis typically involves the discovertebral complex while involvement of isolated vertebral body or multiple vertebrae without involving the intervertebral discs is much less common. We present such an unusual case of cervical spine tuberculosis in an infant involving a single vertebral body without adjacent intervertebral disc involvement complicated with tuberculous meningitis (TBM) and communicating hydrocephalus. The early medical intervention in this case resulted in early diagnosis, active treatment and resultant near normal recovery. PMID:26894144

  12. Imaging diagnosis--cervical spine chondroma in a dog.

    PubMed

    Ródenas, Sergio; Pumarola, Martí; Añor, Sònia

    2008-01-01

    An extradural chondroma originating in the cervical spine was diagnosed in an 8-year-old, intact male Chow-Chow that presented acute cervical pain and chronic right thoracic limb lameness. Myelographic images were within normal limits. With magnetic resonance (MR) imaging, an extradural mass was identified at the level of the C4-C5 vertebrae. This mass was excised, and the histologic diagnosis was chondroma. Fifteen months after surgery, the dog was clinically normal, and no regrowth of the mass was identified on follow-up MR images. Spinal chondromas are rare tumors in the dog, but should be considered as a rule out for contrast-enhancing extradural vertebral masses. PMID:18833956

  13. Cervical exenteration.

    PubMed

    Grillo, H C; Mathisen, D J

    1990-03-01

    Cervical exenteration is a radical operation to remove the larynx, portion of the trachea, and the esophagus, and frequently requires a mediastinal tracheostomy. Highly selected patients with obstructing neoplasms of the esophagus and airway can be palliated and sometimes cured by this aggressive surgical approach. Fatal hemorrhage from pressure or exposure of the innominate artery is avoided by elective division of the artery (preoperative angiograms and intraoperative electroencephalographic control are essential), using the omentum to separate the trachea and great vessels, and removal of a bony plaque of chest wall to allow a well-vascularized bipedicled skin flap to drop into the mediastinum for the tracheocutaneous anastomosis. Eighteen exenterations were performed. Mediastinal tracheostomy was performed in 14 patients and division of the innominate artery was performed in 7. Esophageal replacement was predominantly with the left colon. Complications include esophageal leak (2 patients), stomal separation (2), transient hemiplegia (1), colonic obstruction by substernal tunnel (1), and need for prolonged mechanical ventilation (4). There was a single operative death. Postoperative survival was disease dependent. All patients achieved an excellent airway and relief from dysphagia. PMID:2178569

  14. Cervical Cancer Stage IA

    MedlinePlus

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  15. Veliparib, Topotecan Hydrochloride, and Filgrastim or Pegfilgrastim in Treating Patients With Persistent or Recurrent Cervical Cancer

    ClinicalTrials.gov

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Recurrent Cervical Carcinoma; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  16. Gender dependent cervical spine anatomical differences in size-matched volunteers - biomed 2009.

    PubMed

    Stemper, Brian D; Derosia, John J; Yogananan, Narayan; Pintar, Frank A; Shender, Barry S; Paskoff, Glenn R

    2009-01-01

    The objective was to examine significant differences in the bony structure of cervical spine vertebrae based on gender and spinal level that may influence injury risk in women following automotive rear impact. Male and female subjects were recruited for a separate study and data from two subsets were selected for inclusion in this study. Subjects were size-matched based on sitting height (17 males, 11 females) and head circumference (9 males, 18 females). Axial CT scans were obtained of the cervical spine from the C1 through C6. Bony boundaries of cervical vertebrae were defined using image-analysis software and biomechanically-relevant dimensions were derived at spinal levels C2 through C6. Six of seven vertebral dimensions were significantly dependent upon gender and spinal level in both subgroups. Male vertebrae had larger dimensions for each metric. Depth dimensions were greatest at caudal and cranial extents, whereas width dimensions were smallest at C2 and increased caudally. Greater linear and areal dimensions in size-matched male subjects indicates a more stable cervical spinal column that may be more capable of resisting inertial loading of the head-neck complex during automotive rear impacts. Although the explanation for greater injury susceptibility in females is likely multi-factorial, including differences in spinal material properties, soft tissue tolerance thresholds, occupant-seatback orientation, and neck muscle size/orientations, the present study has identified significant differences in cervical spine anatomical dimensions that may contribute to greater rates of whiplash injury in that population. PMID:19369755

  17. Radiotherapy in Ewing tumors of the vertebrae: Treatment results and local relapse analysis of the Chess 81/86 and EICESS 92 trials

    SciTech Connect

    Schuck, Andreas . E-mail: schuck@uni-muenster.de; Ahrens, Susanne; Schorlemer, Ines von; Kuhlen, Michaela; Paulussen, Michael; Hunold, Andrea; Gosheger, Georg; Winkelmann, Winfried; Dunst, Juergen; Willich, Normann; Juergens, Heribert

    2005-12-01

    Purpose: Treatment results in patients with Ewing tumors of the vertebrae enrolled in the Cooperative Ewing's Sarcoma Study (CESS) 81, 86, and the European Intergroup Cooperative Ewing's Sarcoma Study (EICESS) 92 trials were analyzed with special emphasis on radiation-associated factors. Patients and Methods: A retrospective analysis was performed on 116 patients with primary tumors of the cervical, thoracic, or lumbar vertebrae treated between 1981 and 1999. Furthermore, a relapse analysis was done on those patients who underwent radiotherapy and subsequently had a local recurrence. Results: A total of 64.6% of the patients received definitive radiotherapy; 27.5% of patients had surgery and radiotherapy. Only 4 patients (3.4%) underwent definitive surgery. Twenty-seven patients presented with metastases at diagnosis. 22.4% of the total group developed a local relapse. Among the subgroup with definitive radiotherapy, local recurrence was seen in 17 of 75 patients (22.6%). Event-free survival and survival at 5 years were 47% and 58%, respectively. Of the 14 evaluable patients with a local relapse after radiotherapy, 13 were in-field. No correlation between radiation dose and local control could be found. Conclusion: Surgery with wide resection margins is rarely possible. The results after definitive radiotherapy in vertebral tumors are comparable to those of other tumor sites when definitive radiotherapy is given. Nearly all local relapses after radiotherapy are in-field.

  18. Elements of a general theory of joints. 7. Mechanical structures of the relative motion of adjacent vertebrae.

    PubMed

    Nägerl, H; Kubein-Meesenburg, D; Fanghänel, J

    1992-02-01

    The mechanical structure of the relative motion of adjacent vertebrae is given by the interplay of the artt. zygapophysiales, the intervertebral disk and the ligaments, respectively. This structure will be described in the 3 main functional planes. Horizontal plane (parallel to the disk): The two artt. zygapophysiales structurally represent a force locked, kinematically contrained four-bar-chain (link quadrangle). It possesses but one degree of freedom. The intervertebral disk does not influence, therefore, the kinematic structure but the extent of the motion. Frontal-coronal plane: The four-bar-chain of the frontal plane seems to be inflexible. Lateral bending is only possible combined with a right or left handed axial rotation. Vertical-sagittal plane: The artt. zygapophysiales work as a single dimeric link chain. The momentary rotational center lies on the common normal of the two articular surfaces. Its position upon that is determined by the geometry of the applied force system according to the "reciprocal theorem of synarthroses". Solely one direction of translation is possible. A translation perpendicular to the intervertebral disk is impossible in the cervical and thoracic region. PMID:1605362

  19. Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability

    PubMed Central

    Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

    2014-01-01

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of

  20. A statistical multi-vertebrae shape+pose model for segmentation of CT images

    NASA Astrophysics Data System (ADS)

    Rasoulian, Abtin; Rohling, Robert N.; Abolmaesumi, Purang

    2013-03-01

    Segmentation of the spinal column from CT images is a pre-processing step for a range of image guided interventions. Current techniques focus on identification and separate segmentation of each vertebra. Recently, statistical multi-object shape models have been introduced to extract common statistical characteristics between several anatomies. These models are also used for segmentation purposes and are shown to be robust, accurate, and computationally tractable. In this paper, we reconstruct a statistical multi-vertebrae shape+pose model and propose a novel technique to register such a model to CT images. We validate our technique in terms of accuracy of the multi-vertebrae segmentation of CT images acquired from 16 subjects. The mean distance error achieved for all vertebrae is 1.17 mm with standard deviation of 0.38 mm.

  1. Multi-focal histiocytosis X of bone in two adjacent vertebrae causing paraplegia.

    PubMed

    Turgut, M; Gurçay, O

    1992-03-01

    This report describes a case of multi-focal histiocytosis X of bone in two adjacent vertebrae that caused a spinal cord compression. This case was treated radically with combined surgery and postoperative radiotherapy (RT). PMID:1550511

  2. The early origin of vertebral anomalies, as illustrated by a 'butterfly vertebra'.

    PubMed Central

    Müller, F; O'Rahilly, R; Benson, D R

    1986-01-01

    An anomalous (butterfly) eleventh thoracic vertebra in a fetus of 63 mm greatest length is described and graphic reconstructions (together with normal controls) are provided. The cartilaginous hemicentra are separated by disc-like material. Cartilaginous bars to adjacent vertebrae are present. The neural arch is complete. The notochord is not duplicated. Only one comparable case in the embryonic period has been described previously. After a discussion of cleft vertebrae in the human and in experimental animals, a developmental timetable of the appearance of several vertebral anomalies is provided. The sensitive period for butterfly vertebrae, depending on the mode of origin, seems to be 3-6 postovulatory weeks. More severe anomalies, such as the split notochord syndrome, appear earlier. It is concluded that most of the vertebral anomalies discussed arise during the embryonic period proper, although the timing of a few, such as spina bifida occulta, extends into the early fetal period. Images Fig. 1 Fig. 3 Fig. 5 PMID:3693103

  3. A semi-automated method for hexahedral mesh construction of human vertebrae from CT scans.

    PubMed

    Dai, Yifei; Niebur, Glen L

    2009-10-01

    Generation of finite element (FE) meshes of vertebrae from computed tomography (CT) scans is labour intensive due to their geometric complexity. As such, techniques that simplify creation of meshes of vertebrae are needed to make FE analysis feasible for large studies and clinical applications. Techniques to obtain a geometric representation of bone contours from CT scans of vertebrae and construct a hexahedral mesh from the contours were developed. An automated edge detection technique was developed to identify surface contours of the vertebrae, followed by atlas based B-spline curve fitting to construct curves from the edge points. The method was automatic and robust to missing data, with a controllable degree of smoothing and interpolation. Parametric mapping was then used to generate nodes for each CT slice, which were connected between slices to obtain a hexahedral mesh. This method could be adapted for modelling a variety of orthopaedic structures. PMID:19308870

  4. Feasibility of C2 Vertebra Screws Placement in Patient With Occipitalization of Atlas: A Tomographic Study.

    PubMed

    Ji, Wei; Liu, Xiang; Huang, Wenhan; Huang, Zucheng; Li, Xueshi; Chen, Jianting; Wu, Zenghui; Zhu, Qingan

    2015-09-01

    Occipitalization of atlas (OA) is a congenital disease with the possibility of anomalous bony anatomies and the C2 pedicle screw insertion is technically challenging. However, there are no existing literatures clarified the dimensions and angulations of the C2 pedicles, lamina and lateral masses for screw insertion in patients with OA. Therefore, the aim of this study was to assess the morphometric features of C2 for screw placement in OA to guide the use of surgical screws. Measurements of the OA patients on the computer tomography (CT) images including lamina angle, length and thickness, pedicle angle, length and thickness, and lateral mass thickness and length of the axis vertebra. The OA patients data were compared with age and gender matched cohort of randomly selected patients in a control group without OA. The picture archiving and communication system was used for all patients who had received cervical CT scanning between January 2001 and January 2015. Measurements were performed independently by 2 experienced observers who reviewed the CT scans and recorded the patients with OA. Statistical analysis was performed at a level of significance P < 0.05. A total of 73 patients (29 males and 44 females) were eligible to be included in the OA group. In most of the measurements the pathological cohort had significantly smaller values compared to the control group (P < 0.05). In the OA group, only 45% of the pedicles and 88% of the lamina had thicknesses bigger than 3.5 mm. Both groups had all pedicle and lamina lengths bigger than 12 mm. Regarding the length of the lateral mass, no value was bigger than 12 mm in the OA group, whereas 40% of the values in the control group were bigger than 12 mm. The average pedicle and laminar angles were 37° and 49° in the patients with OA, respectively. The variable anatomy in patients with OA needs to be taken into account when performing spinal stabilization as the C2 bony architectures are significantly

  5. ADXS11-001 High Dose HPV+ Cervical Cancer

    ClinicalTrials.gov

    2016-06-17

    Effects of Immunotherapy; Metastatic/Recurrent Cervical Cancer; Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Small Cell Carcinoma; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  6. FDG and FMISO PET Hypoxia Evaluation in Cervical Cancer

    ClinicalTrials.gov

    2015-06-03

    Cervical Adenocarcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  7. [The forensic medical evaluation of the injuries to the cervical spine in the driver and the front-seat passenger of a modern motor vehicle after the frontal crash].

    PubMed

    Pigolkin, I; Dubrovin, A; Sedykh, E p; Mosoyan

    2015-01-01

    The objective of the present study was to elucidate the specific features of the lesions of the cervical spine in the driver and the front-seat passenger of a modern car after the frontal crash. We made use of the archival materials of forensic medical expertises concerning the traffic accidents carried out in the city of Moscow during the period from 2005 to 2012. The study was focused on the analysis of the character of the fractures of cervical vertebrae in the drivers (n = 55) and the front-seat passengers (n = 85) of a modern motor vehicle involved in a traffic accident. It was shown that the drivers most frequently suffer bending-extension fractures of the cervical vertebrae, with the II-IV vertebrae being especially frequently subject to multiple fractures resulting in the damage to the anterior support column, sometimes to both the anterior and posterior columns, and much rarer to the posterior column. The front-seat passengers also suffer bending-extension fractures. The IV-VI vertebrae are most frequently affected in them with isolated damages to either the anterior or the posterior support column of the neck vertebrae. PMID:26856055

  8. Traumatic Spondylolisthesis of the Axis Vertebra in Adults.

    PubMed

    Schleicher, Philipp; Scholz, Matti; Pingel, Andreas; Kandziora, Frank

    2015-08-01

    Study Design Narrative review. Objective To elucidate the current concepts in diagnosis and treatment of traumatic spondylolisthesis of the axis. Methods Literature review using PubMed, Google Scholar, and Cochrane databases. Results The traumatic spondylolisthesis of the axis accounts to 5% of all cervical spine injuries and is defined by a bilateral separation of the C2 vertebral body from the neural arch. The precise location of the fracture line may vary widely. For understanding the pathobiomechanics, the involvement of the C2-C3 disk is essential. Although its synonym "hangman's fracture" suggests an extension moment as primary injury mechanism, flexion moments are also proven to cause such fracture morphology. The axial force vector (distraction versus compression) is thought to have a significant effect on the neurologic involvement. The most widely accepted classifications, according to Effendi and modified by Levine, regard the displacement of the C2 vertebral body and possible locking of the facet joints. For decisions on conservative versus surgical therapy, a definitive statement about the stability is essential. The stability is determined by involvement of the C2-C3 disk and longitudinal ligaments, which frequently cannot be assessed by X-ray or computed tomography alone. The assessment of this soft tissue injury therefore requires additional imaging either by magnetic resonance imaging to display the disk and longitudinal ligaments or dynamic fluoroscopy to assess functional behavior of the C2-C3 motion segment. If stability is proven, an immobilization of the cervical spine in a semirigid cervical collar is sufficient. Unstable lesions require surgical stabilization. The standard procedure is an anterior C2-C3 diskectomy and fusion, because of the lower morbidity of the anterior approach and the motion preservation between C1 and C2. In rare cases (irreducible locked facet joints, the necessity of decompression of the vertebral artery

  9. Automatic lumbar vertebra segmentation from clinical CT for wedge compression fracture diagnosis

    NASA Astrophysics Data System (ADS)

    Ghosh, Subarna; Alomari, Raja'S.; Chaudhary, Vipin; Dhillon, Gurmeet

    2011-03-01

    Lumbar vertebral fractures vary greatly in types and causes and usually result from severe trauma or pathological conditions such as osteoporosis. Lumbar wedge compression fractures are amongst the most common ones where the vertebra is severely compressed forming a wedge shape and causing pain and pressure on the nerve roots and the spine. Since vertebral segmentation is the first step in any automated diagnosis task, we present a fully automated method for robustly localizing and segmenting the vertebrae for preparation of vertebral fracture diagnosis. Our segmentation method consists of five main steps towards the CAD(Computer-Aided Diagnosis) system: 1) Localization of the intervertebral discs. 2) Localization of the vertebral skeleton. 3) Segmentation of the individual vertebra. 4) Detection of the vertebrae center line and 5) Detection of the vertebrae major boundary points. Our segmentation results are promising with an average error of 1.5mm (modified Hausdorff distance metric) on 50 clinical CT cases i.e. a total of 250 lumbar vertebrae. We also present promising preliminary results for automatic wedge compression fracture diagnosis on 15 cases, 7 of which have one or more vertebral compression fracture, and obtain an accuracy of 97.33%.

  10. Bone Lose of the Ancient Mediterranean lumbar vertebrae : Iasos, 6th century ad.

    NASA Astrophysics Data System (ADS)

    Kaya, Serdar; Solmaz, Ilker; Ilıca, A. Turan; Karaçalıoğlu, Özgür; Damla Yılmaz, Nalan; Başoğlu, Okşan; Kılıc, Selim; Izci, Yusuf

    Evaluation of bone mineral density (BMD) of the ancient peoples has received great interest by anthropologists. The aims of this study are to investigate the lumbar vertebrae of the Iasos people during the Byzantine period, in order to determine the prevalence of bone loss and to interpret dietary conditions of ancient Mediterranean populations. Lumbar vertebrae belonging to twenty eight skeletons of the 6th c AD were analyzed by radiographs and dual energy X-ray absorptiometry. The BMD values for each biologic sex and age group were compared. The correlation between the BMD and radiological features was also analyzed. The mean BMD was 0.940 g/cm2. BMD was decreased by aging in both sexes, but it was not significant. Osteopenia was found in 11 (39%) and osteoporosis in 4 (14.3%) out 28 vertebrae. The BMD was normal in 13 (46%) out of 28 vertebrae. Osteopenia was present in 7 (38%) of 18 male vertebrae and 4 (40%) of 10 female vertebrae. The spine score was high in the male group and there was a strong positive correlation between the BMD and spine score for both sexes. This study revealed that the BMD decreased by aging and that osteopenia was a problem in both sexes of the Iasos people during the 6th c AD. There was no correlation between the BMD and radiological features for age groups and biological sexes.

  11. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study.

    PubMed

    Gudavalli, M R; Potluri, T; Carandang, G; Havey, R M; Voronov, L I; Cox, J M; Rowell, R M; Kruse, R A; Joachim, G C; Patwardhan, A G; Henderson, C N R; Goertz, C

    2013-01-01

    The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction. PMID:24023587

  12. Idiopathic spinal cord herniation of the cervical cord: unusual cause of proximal muscle weakness in upper limbs.

    PubMed

    Rajapakse, Dilina; Mapara, Leah; Maniharan, Sathiyaseelan

    2016-01-01

    Idiopathic spinal cord herniation (ISCH) is a recognised rare cause of progressive and potentially curable myelopathy. Around 170 cases have been described in the literature, all to be found between the T2 and T8 vertebrae. We report a case of ISCH in the cervical region. A 23-year-old man with no history of trauma presented with a 6-year history of bilateral mild resting hand tremor and left scapular pain radiating to the left arm for a duration of 8 months. Nerve conduction studies showed some denervation changes of the upper limbs and bulbar regions. MRI of the spine showed anterior midline herniation of the spinal cord at the level of C7 vertebra with an associated collection of cerebrospinal fluid in the extradural space in the cervical region. Owing to the non-progressive nature of symptoms, currently the patient is managed conservatively. PMID:27190115

  13. Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment

    PubMed Central

    Yang, Hui; Zhou, Yan; Lin, Jin

    2016-01-01

    Background While appropriate pillow height is crucial to maintaining the quality of sleep and overall health, there are no universal, evidence-based guidelines for pillow design or selection. We aimed to evaluate the effect of pillow height on cranio-cervical pressure and cervical spine alignment. Methods Ten healthy subjects (five males) aged 26 ± 3.6 years were recruited. The average height, weight, and neck length were 167 ± 9.3 cm, 59.6 ± 11.9 kg, and 12.9 ± 1.2 cm respectively. The subjects lay on pillows of four different heights (H0, 110 mm; H1, 130 mm; H2, 150 mm; and H3, 170 mm). The cranio-cervical pressure distribution over the pillow was recorded; the peak and average pressures for each pillow height were compared by one-way ANOVA with repeated measures. Cervical spine alignment was studied using a finite element model constructed based on data from the Visible Human Project. The coordinate of the center of each cervical vertebra were predicted for each pillow height. Three spine alignment parameters (cervical angle, lordosis distance and kyphosis distance) were identified. Results The average cranial pressure at pillow height H3 was approximately 30% higher than that at H0, and significantly different from those at H1 and H2 (p < 0.05). The average cervical pressure at pillow height H0 was 65% lower than that at H3, and significantly different from those at H1 and H2 (p < 0.05). The peak cervical pressures at pillow heights H2 and H3 were significantly different from that at H0 (p < 0.05). With respect to cervical spine alignment, raising pillow height from H0 to H3 caused an increase of 66.4% and 25.1% in cervical angle and lordosis distance, respectively, and a reduction of 43.4% in kyphosis distance. Discussion Pillow height elevation significantly increased the average and peak pressures of the cranial and cervical regions, and increased the extension and lordosis of the cervical spine. The cranio-cervical pressures and cervical spine alignment

  14. Morphological variation of the thoracolumbar vertebrae in Macropodidae and its functional relevance.

    PubMed

    Chen, Xinmin; Milne, Nick; O'Higgins, Paul

    2005-11-01

    The present study was designed to investigate how the form of the marsupial thoracolumbar vertebrae varies to cope with the particular demands of diverse loading and locomotor behaviors. The vertebral columns of 10 species of Macropodidae, with various body masses and modes of locomotion, together with two other arboreal marsupials, koala and cuscus, were selected. Seventy-four three-dimensional landmark coordinates were acquired on each of the 10 last presacral vertebrae of the 70 vertebral columns. The interspecific variations of the third lumbar vertebra (L3, which approximates the mean) and the transitional patterns of the thoracolumbar segments were examined using the combined approach of generalized Procrustes analysis (GPA) and principal components analysis (PCA). The results of analyses of an individual vertebra (L3) and of the transitional patterns indicate significant interspecific differences. In the L3 study the first PC shows allometric shape variation, while the second PC seems to relate to adaptation for terrestrial versus arboreal locomotion. When the L3 vertebrae of the common spotted cuscus and koala are included for comparison, the vertebra of the tree kangaroo occupies an intermediate position between the hopping kangaroo and these arboreal marsupials. The L3 vertebrae in the arboreal marsupials possess a distinct dorsoventrally expanded vertebral body, and perpendicularly orientated spinous and transverse processes. The results of the present study suggest that vertebral shape in the kangaroo and wallaroos provides a structural adaptation to hopping through a relatively enlarged loading area and powerful lever system. In contrast, the small-sized bettongs (or rat kangaroos) have a relatively flexible column and elongated levers for the action of back muscles that extend and laterally flex the spine. The complex pattern of vertebral shape transition in the last 10 presacral vertebrae was examined using PCAs that compare between species

  15. A neglected point in surgical treatment of adolescent idiopathic scoliosis: Variations in the number of vertebrae.

    PubMed

    Hu, Zongshan; Zhang, Zhen; Zhao, Zhihui; Zhu, Zezhang; Liu, Zhen; Qiu, Yong

    2016-08-01

    Inaccurate identification of vertebral levels is the main cause of wrong-site spine surgery which is performed by nearly half of the spine surgeons. Unusual anatomy and failure to verify the surgical level on radiographs have been commonly reported. We aimed at investigating the variations in vertebral number in adolescent idiopathic scoliosis (AIS) patients and thus to raise awareness of the possibility for wrong-level spinal surgery and to make a comparison with normal adolescents. A cohort of 657 AIS patients and 248 normal adolescents, presented to our center from June 2008 to February 2013, who met the inclusion criteria, were recruited. Radiographs were reviewed to identify the number of thoracic or lumbar vertebrae and the presence of a lumbosacral transitional vertebra. In the AIS group, 70 (10.6%) patients had variations in the number of thoracic and/or lumbar vertebrae. Remarkably, the prevalence of variations in male subjects was significantly higher than that in female subjects (P < 0.05). Thirty-seven patients (5.6%) had an atypical number of thoracic vertebrae, with 33 having 11 thoracic vertebrae and 4 patients having 13. Forty-eight patients (7.3%) had an atypical number of lumbar vertebrae, with 14 having 4 lumbar vertebrae and 34 patients having 6. Multilevel vertebral anomalies were present in 2.3% of the patients (15 of 657). A variation in the number of vertebrae had been identified in 1.7% (11) of the reports by the radiologist. In the normal group, 27 (10.9%) subjects showed variations in the vertebral number. There was no significant difference in the prevalence of atypical numbers of vertebral number between the AIS and normal groups (P > 0.05). Therefore, we concluded that variations in the number of thoracic-lumbar vertebrae were found in up to10.6% of AIS patients. Identification of variations in the number of vertebrae is crucial to serve to decrease the risk of wrong-level surgery. PMID:27559975

  16. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones.

    PubMed

    Aleman, Monica; Dimock, Abigail N; Wisner, Erik R; Prutton, Jamie W; Madigan, John E

    2014-11-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  17. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones

    PubMed Central

    Aleman, Monica; Dimock, Abigail N.; Wisner, Erik R.; Prutton, Jamie W.; Madigan, John E.

    2014-01-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  18. Elastic Anisotropy of Trabecular Bone in the Elderly Human Vertebra.

    PubMed

    Unnikrishnan, Ginu U; Gallagher, John A; Hussein, Amira I; Barest, Glenn D; Morgan, Elise F

    2015-11-01

    Knowledge of the nature of the elastic symmetry of trabecular bone is fundamental to the study of bone adaptation and failure. Previous studies have classified human vertebral trabecular bone as orthotropic or transversely isotropic but have typically obtained samples from only selected regions of the centrum. In this study, the elastic symmetry of human vertebral trabecular bone was characterized using microfinite element (μFE) analyses performed on 1019 cubic regions of side length equal to 5 mm, obtained via thorough sampling of the centrums of 18 human L1 vertebrae (age = 81.17 ± 7.7 yr; eight males and ten females). An optimization procedure was used to find the closest orthotropic representation of the resulting stiffness tensor for each cube. The orthotropic elastic constants and orientation of the principal elastic axes were then recorded for each cube and were compared to the constants predicted from Cowin's fabric-based constitutive model (Cowin, 1985, "The Relationship Between the Elasticity Tensor and the Fabric Tensor," Mech. Mater., 4(2), pp. 137-147.) and the orientation of the principal axes of the fabric tensor, respectively. Deviations from orthotropy were quantified by the "orthotropic error" (van Rietbergen et al., 1996, "Direct Mechanics Assessment of Elastic Symmetries and Properties of Trabecular Bone Architecture," J. Biomech., 29(12), pp. 1653-1657), and deviations from transverse isotropy were determined by statistical comparison of the secondary and tertiary elastic moduli. The orthotropic error was greater than 50% for nearly half of the cubes, and the secondary and tertiary moduli differed from one another (p < 0.0001). Both the orthotropic error and the difference between secondary and tertiary moduli decreased with increasing bone volume fraction (BV/TV; p ≤ 0.007). Considering only the cubes with an orthotropic error less than 50%, only moderate correlations were observed between the fabric-based and the

  19. Solitary juvenile xanthogranuloma of the cervical spine in a child: A case report and review of literature

    PubMed Central

    Bhaisora, Kamlesh Singh; Jaiswal, Awadhesh Kumar; Mehrotra, Anant; Sahu, Rabi Narayan; Srivastava, Arun; Jaiswal, Sushila; Behari, Sanjay

    2015-01-01

    The authors present a case of 15 years male child who presented with neck pain and progressive ascending quadriparesis. Magnetic resonance imaging showed lytic mass involving C5 and C6 vertebra with soft tissue extension. Surgical excision of mass done using anterior cervical approach. Postoperatively, patient showed improvement in spasticity and power. Histopathological examination of mass was suggestive of juvenile xanthogranuloma (JXG). At 6 months follow–up, patient was improving without any evidence of recurrence. Only 12 cases of JXG of spine have been reported till date including only four cases involving the cervical spine and among these four cases only two were of pediatric age group. PMID:25767592

  20. Drugs Approved for Cervical Cancer

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Cervical Cancer This page lists cancer ... in cervical cancer that are not listed here. Drugs Approved to Prevent Cervical Cancer Cervarix (Recombinant HPV ...

  1. Cervical cancer - screening and prevention

    MedlinePlus

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain types ...

  2. Detection of degenerative change in lateral projection cervical spine x-ray images

    NASA Astrophysics Data System (ADS)

    Jebri, Beyrem; Phillips, Michael; Knapp, Karen; Appelboam, Andy; Reuben, Adam; Slabaugh, Greg

    2015-03-01

    Degenerative changes to the cervical spine can be accompanied by neck pain, which can result from narrowing of the intervertebral disc space and growth of osteophytes. In a lateral x-ray image of the cervical spine, degenerative changes are characterized by vertebral bodies that have indistinct boundaries and limited spacing between vertebrae. In this paper, we present a machine learning approach to detect and localize degenerative changes in lateral x-ray images of the cervical spine. Starting from a user-supplied set of points in the center of each vertebral body, we fit a central spline, from which a region of interest is extracted and image features are computed. A Random Forest classifier labels regions as degenerative change or normal. Leave-one-out cross-validation studies performed on a dataset of 103 patients demonstrates performance of above 95% accuracy.

  3. Vertebral body split fracture after a single-level cervical total disc replacement.

    PubMed

    Tu, Tsung-Hsi; Wu, Jau-Ching; Fay, Li-Yu; Ko, Chin-Chu; Huang, Wen-Cheng; Cheng, Henrich

    2012-03-01

    Cervical total disc replacement (TDR) is a viable option for the surgical treatment of degenerative disc disease. This 67-year-old nonsmoking male patient underwent single-level ProDisc-C cervical TDR at C5-6 without any intraoperative problem. His radicular pain improved and he had no neck pain immediately after the operation. However, on postoperative Day 3, a radiograph demonstrated a vertical split fracture of the C-5 vertebra. This fracture was managed conservatively, and 2 years postoperatively a follow-up CT scan demonstrated stable device position and fusion of the fracture. Although the linear fracture caused no neurological symptoms or device migration, the authors advocate prudence in selection and installation of keel-design prostheses, even in a single-level cervical TDR scenario. PMID:22176434

  4. Cervical chordoma in a domestic ferret (Mustela putorius furo) with pulmonary metastasis.

    PubMed

    Frohlich, Jennifer R; Donovan, Taryn A

    2015-09-01

    A 4-year-old, male neutered domestic ferret (Mustela putorius furo) was evaluated for a mass in the left cervical region. The owner elected humane euthanasia, and an autopsy was performed, revealing a neoplasm with infiltration into the left cranial articular fovea of the atlas and cervical vertebrae, with regional compression of the spinal cord. Histologic evaluation was consistent with cervical chordoma. At autopsy, a left cranial lung lobe nodule was observed. Additional sectioning and histologic evaluation revealed multiple foci of metastatic chordoma at this site. A small focus of micrometastasis was also detected in a section from the right lung lobes. Chordoma is the most common musculoskeletal neoplasm of ferrets, arising from remnant fetal notochord. To our knowledge, pulmonary chordoma metastasis has not been previously reported in the ferret. This case demonstrates the potential for visceral metastasis of chordoma in the ferret, as has been reported in other species. PMID:26330397

  5. Pullout strength of misplaced pedicle screws in the thoracic and lumbar vertebrae - A cadaveric study

    PubMed Central

    Saraf, Shyam K; Singh, Ravindra P; Singh, Vakil; Varma, Ashish

    2013-01-01

    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. PMID:23798753

  6. Positive Outcome After a Small-Caliber Gunshot Fracture of the Upper Cervical Spine without Neurovascular Damage

    PubMed Central

    Walter, Thula; Schwabe, Philipp; Schaser, Klaus-Dieter; Maurer, Martin

    2016-01-01

    Summary Background Gunshot wounds to the cervical spine most frequently concur with serious injuries to the spinal cord and cervical vessels and often have a fatal outcome. Case Report We describe the case of a 35-year-old male with a complex fracture of the C2 vertebra body and a mandibular fracture after a penetration gunshot to the cervical spine. Computed tomography (CT) at admission revealed the exact extent of the fractures and the small caliber bullet lodged next to the C2 vertebra. In this rare and extremely lucky case no collateral vascular or neurological damage was detected. Eighteen months after surgical bullet removal and posterior C1–C3 fusion complete bone healing of the C2 vertebra was achieved and there were no secondary neurovascular deficits. Conclusions Immediate surgical C1–C3 fixation resulted in an excellent outcome without secondary neurovascular deficits in this rare case of traumatic complex C2 vertebral fracture caused by a gunshot injury. PMID:27081417

  7. Correlation between cervical vertebral maturation and chronological age in a group of Iranian females

    PubMed Central

    Safavi, Seyed Mohammadreza; Beikaii, Hanie; Hassanizadeh, Raheleh; Younessian, Farnaz; Baghban, Alireza Akbarzadeh

    2015-01-01

    Background: Correlation between chronological age at different stages of cervical vertebral maturation (CVM) is important in clinical orthodontic practice. The objective of this study was to evaluate the correlation between CVM stage and chronological age in a group of Iranian female patients. Materials and Methods: This study was conducted on 196 digital lateral cephalometry of female patients with the age ranged 9-14 years. The CVM stage was determined with two calibrated examiners, using the method developed by Baccetti and its correlation with mean chronological age was assessed by the Spearman rank-order. The intra and inter-agreements were evaluated by weighted Kappa statistics in overall diagnosis of stages, in addition to determination of presence or absent of concavities at the lower border of second, third and fourth cervical vertebrae and the shapes of the third and fourth vertebrae. P < 0.05 was considered as significant. Results: The correlation coefficient between CVM stages and chronological age was relatively low (r = 0.62). The least amount of inter-observer agreement was determined to be at the clinical decision of the shape of the fourth vertebra. Conclusion: Regarding the low reported correlation, the concomitant usage of other skeletal indicators seems necessary for precise determination of physiological age of the patients. PMID:26604958

  8. Fully automatic detection of the vertebrae in 2D CT images

    NASA Astrophysics Data System (ADS)

    Graf, Franz; Kriegel, Hans-Peter; Schubert, Matthias; Strukelj, Michael; Cavallaro, Alexander

    2011-03-01

    Knowledge about the vertebrae is a valuable source of information for several annotation tasks. In recent years, the research community spent a considerable effort for detecting, segmenting and analyzing the vertebrae and the spine in various image modalities like CT or MR. Most of these methods rely on prior knowledge like the location of the vertebrae or other initial information like the manual detection of the spine. Furthermore, the majority of these methods require a complete volume scan. With the existence of use cases where only a single slice is available, there arises a demand for methods allowing the detection of the vertebrae in 2D images. In this paper, we propose a fully automatic and parameterless algorithm for detecting the vertebrae in 2D CT images. Our algorithm starts with detecting candidate locations by taking the density of bone-like structures into account. Afterwards, the candidate locations are extended into candidate regions for which certain image features are extracted. The resulting feature vectors are compared to a sample set of previously annotated and processed images in order to determine the best candidate region. In a final step, the result region is readjusted until convergence to a locally optimal position. Our new method is validated on a real world data set of more than 9 329 images of 34 patients being annotated by a clinician in order to provide a realistic ground truth.

  9. Gradual Height Decrease of Augmented Vertebrae after Vertebroplasty at the Thoracolumbar Junction

    PubMed Central

    Oh, Han San; Kim, Hyun Gon; Park, Kwan Ho

    2016-01-01

    Objective Vertebroplasty is an effective treatment for vertebral compression fracture, but may progress gradual vertebral height decrease in spite of vertebroplasty. Gradual vertebral height decrease also may induce aggravation of kyphotic change without severe pain. The purpose of this study was to evaluate risk factors for gradual vertebral height decrease in the absence of recurrent severe back pain. Methods A retrospective analysis was performed on 44 patients who were diagnosed with a first osteoporotic compression fracture at a single level at the thoracolumbar junction. All patients were taken vertebroplasty. Possible risk factors for gradual vertebral height decrease, such as sex, age, bone mineral density, body mass index, level of compression fracture, volume of injected cement, cement leakage into disc space, and air clefts within fractured vertebrae, were analyzed. Results Gradual vertebral height decrease of augmented vertebrae occurred commonly when more than 4 cc of injected cement was used, and when air clefts within fractured vertebrae were seen on admission. In addition, the sagittal Cobb angle more commonly increased during the follow-up period in such cases. Conclusion Injection of more than 4 cc of cement during vertebroplasty and air cleft within fractured vertebrae on admission induced gradual vertebral height decrease in augmented vertebrae. Thus, longer follow-up will be needed in such cases, even when patients do not complain of recurrent severe back pain. PMID:27182497

  10. Automatic location of vertebrae on DXA images using random forest regression.

    PubMed

    Roberts, M G; Cootes, Timothy F; Adams, J E

    2012-01-01

    We provide a fully automatic method of segmenting vertebrae in DXA images. This is of clinical relevance to the diagnosis of osteoporosis by vertebral fracture, and to grading fractures in clinical trials. In order to locate the vertebrae we train detectors for the upper and lower vertebral endplates. Each detector uses random forest regressor voting applied to Haar-like input features. The regressors are applied at a grid of points across the image, and each tree votes for an endplate centre position. Modes in the smoothed vote image are endplate candidates, some of which are the neighbouring vertebrae of the one sought. The ambiguity is resolved by applying geometric constraints to the connections between vertebrae, although there can be some ambiguity about where the sequence starts (e.g., is the lowest vertebra L4 or L5, fig 2a). The endplate centres are used to initialise a final phase of active appearance model search for a detailed solution. The method is applied to a dataset of 320 DXA images. Accuracy is comparable to manually initialised AAM segmentation in 91% of images, but multiple grade 3 fractures can cause some edge confusion in severely osteoporotic cases. PMID:23286151

  11. Body height estimation based on dimensions of sacral and coccygeal vertebrae.

    PubMed

    Pelin, Can; Duyar, Izzet; Kayahan, Esra M; Zağyapan, Ragiba; Ağildere, A Muhteşem; Erar, Aydin

    2005-03-01

    This study is to evaluate whether it is possible to predict living stature from sacral and coccygeal vertebral dimensions. Individual vertebral body heights, sacral height (SH), and sacrococcygeal height (SCH) were recorded from the magnetic resonance images of 42 adult males. Sum of the heights of five sacral vertebrae (sigmaS), the first four coccygeal vertebrae (sigmaC), and the total height of the sacral and the first four coccygeal vertebrae together (sigmaSC) were also recorded. Linear regression equations for stature estimation were produced using the above mentioned variables. The regression equations were constructed and tested by using jack-knife procedure. Statistical analyses indicated that the combined variables (SH, SCH, sigmaS, sigmaC, sigmaSC) were more accurate predictors of stature than the heights of individual vertebrae. The results of the study pointed out that the equations derived from sacrococcygeal dimensions perform somewhat better than ones based on foot and head variables, but worse than those based on long-bone length. As a conclusion, the dimensions of sacral and coccygeal vertebrae could be used for stature estimation when long bones are not available. PMID:15813539

  12. Bevacizumab, Radiation Therapy, and Cisplatin in Treating Patients With Previously Untreated Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2014-09-22

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer

  13. A comparison of cervical spine movement during laryngoscopy using the Airtraq or Macintosh laryngoscopes.

    PubMed

    Hirabayashi, Y; Fujita, A; Seo, N; Sugimoto, H

    2008-06-01

    The Airtraq laryngoscope has an oropharyngeal airway-shaped blade that provides a non-line-of-sight view of the glottis. The configuration of the blade should mean that less movement of the cervical spine is required during laryngeal visualisation. We compared the degree of cervical spine movement in laryngoscopy performed using the Airtraq and conventional Macintosh laryngoscope. In 20 patients requiring general anaesthesia and tracheal intubation, we measured cervical spine movement using radiography in the same patient during consecutive procedures using the two laryngoscopes. Although significant movement of the cervical spine from baseline was noted during all procedures (p < 0.05), cervical spinal extension with the Airtraq was 29% less than that measured during Macintosh laryngoscopy between the occiput and C4, and 44% less at the C3/C4 motion segment (p < 0.05). Anterior deviations of the vertebral bodies from baseline were 32%, 35%, 38% and 40% less at the atlas, C2, C3, and C4 vertebrae, respectively, during Airtraq laryngoscopy than those measured during Macintosh laryngoscopy (p < 0.01). Our study demonstrated that laryngoscopy using the Airtraq laryngoscope involves less movement of the cervical spine compared to conventional procedures using a Macintosh laryngoscope. PMID:18477276

  14. Spontaneous delivery through a cervical tear without cervical os dilatation.

    PubMed

    Djokovic, Dusan; Costa, Cristina; Martins, Ana; Abushad, Shadi

    2015-01-01

    Spontaneous delivery through a cervical tear, provoked by prostaglandin-induced uterine contractions, was described in a G2P0 woman with a history of cervical dilatation and uterine curettage. This rare complication with potentially serious maternal-fetal consequences can be predicted by an aberrant cervical response to prostaglandins in parturients with previous cervical interventions. PMID:25678963

  15. Cervical Discitis in Children.

    PubMed

    Scheuerman, Oded; Landau, Daniel; Schwarz, Michael; Hoffer, Vered; Marcus, Nufar; Hoffnung, Liat Ashkenazi; Levy, Itzhak

    2015-07-01

    Cervical discitis, though rare, should be included in the differential diagnosis of torticollis, neck pain and neurodevelopmental regression in motor skills in children and infants. Magnetic resonance imaging is the diagnostic method of choice. Treatment should be conservative with antibiotics only. The aim of this study was to describe the 10-year experience of a tertiary pediatric medical center with cervical discitis. PMID:25886786

  16. Limbus Vertebra Presenting with Inflammatory Low Back Pain: A Case Report.

    PubMed

    Tuna, Serpil; Özdemir, Tayfun; Öz, Hande Ece

    2016-03-01

    Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus pulposus, and causes non specific symptoms like low back pain, back pain, muscle spasms and radiculopathy. It is frequently confused with vertebral fracture, infection, schmorl nodule or tumour because it has not a spesific symptom. It usually causes mechanical low back pain rather than inflammatory low back pain. We reported a patient presented with inflammatory low back pain and diagnosed with anterior limbus vertebra because it is rare and the patient has atypical clinical presentation. PMID:27134989

  17. Limbus Vertebra Presenting with Inflammatory Low Back Pain: A Case Report

    PubMed Central

    Özdemir, Tayfun; Öz, Hande Ece

    2016-01-01

    Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus pulposus, and causes non specific symptoms like low back pain, back pain, muscle spasms and radiculopathy. It is frequently confused with vertebral fracture, infection, schmorl nodule or tumour because it has not a spesific symptom. It usually causes mechanical low back pain rather than inflammatory low back pain. We reported a patient presented with inflammatory low back pain and diagnosed with anterior limbus vertebra because it is rare and the patient has atypical clinical presentation. PMID:27134989

  18. Postoperative Increase in Occiput–C2 Angle Negatively Impacts Subaxial Lordosis after Occipito–Upper Cervical Posterior Fusion Surgery

    PubMed Central

    Inada, Taigo; Furuya, Takeo; Kamiya, Koshiro; Ota, Mitsutoshi; Maki, Satoshi; Suzuki, Takane; Takahashi, Kazuhisa; Yamazaki, Masashi; Aramomi, Masaaki; Mannoji, Chikato

    2016-01-01

    Study Design Retrospective case series. Purpose To elucidate the impact of postoperative occiput–C2 (O–C2) angle change on subaxial cervical alignment. Overview of Literature In the case of occipito–upper cervical fixation surgery, it is recommended that the O–C2 angle should be set larger than the preoperative value postoperatively. Methods The present study included 17 patients who underwent occipito–upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of various etiologies. Plain lateral cervical radiographs in a neutral position at standing were obtained and the O–C2 angle and subaxial lordosis angle (the angle between the endplates of the lowest instrumented vertebra (LIV) and C7 vertebrae) were measured preoperatively and postoperatively soon after surgery and ambulation and at the final follow-up visit. Results There was a significant negative correlation between the average postoperative alteration of O–C2 angle (DO–C2) and the average postoperative alteration of subaxial lordosis angle (Dsubaxial lordosis angle) (r=–0.47, p=0.03). Conclusions There was a negative correlation between DO–C2 and Dsubaxial lordosis angles. This suggests that decrease of mid-to lower-cervical lordosis acts as a compensatory mechanism for lordotic correction between the occiput and C2. In occipito-cervical fusion surgery, care must be taken to avoid excessive O–C2 angle correction because it might induce mid-to-lower cervical compensatory decrease of lordosis. PMID:27559456

  19. Effects of Repeated +Gz Exposure on Cervical Intervertebral Disc in Rabbits

    NASA Astrophysics Data System (ADS)

    Wang, Yong-chun; Sun, Xi-qing; Cao, Xin-sheng

    2008-06-01

    Background This study was to explore the cumulative effect of exposure to +Gz on intervertebral disc in rabbits. Method 25 rabbits were randomly divided into 5 groups: control, +6Gz/1d, +6Gz/2wk, +6Gz/4wk and +6Gz/6wk group. Lateral Cervical Radiographies of each rabbit were studied with self-control method. Pathological changes of the cervical vertebrae were observed by light microscope after staining with hematoxylin-eosin. Results The X-ray films revealed that there were no changes of cervical vertebrae in rabbits of control, +6Gz/1d and 2wks group, while significant degenerative changes of intervertebral discs were observed in rabbits suffered to 4wks and 6wks of +6Gz exposure(P<0.01). Fissure and irregular arrangement were found in fibrous ring of intervertebral disc by histological examination in rabbits of 2wks, 4wks and 6wks of +6Gz exposure. Shrinking of nucleus pulposus and proliferation of cartilage cells occurred in rabbits suffered to 6 wks of +6Gz exposure. Conclusion Repeated +6Gz exposure for 4wks and 6wks may induce degeneration of intervertebral disc in rabbits.

  20. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    ClinicalTrials.gov

    2016-06-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  1. Traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child.

    PubMed

    Shapira, Gali; Militianu, Daniela

    2015-09-01

    Neurocentral synchondroses (NCS) are growth plates that contribute to the transverse growth of the vertebra. Fractures through these NCS are very rare and none have been reported in the lumbar spine. We present a rare case of a traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child. PMID:25975183

  2. [Isolated anterior cervical hypertrichosis].

    PubMed

    Monteagudo, B; Cabanillas, M; de las Heras, C; Cacharrón, J M

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding. PMID:19268113

  3. High-resolution time-lapse tomography of rat vertebrae during compressive loading: deformation response analysis

    NASA Astrophysics Data System (ADS)

    Fíla, T.; Kytýř, D.; Zlámal, P.; Kumpová, I.; Doktor, T.; Koudelka, P.; Jiroušek, O.

    2014-05-01

    This paper is focused on investigation of mechanical properties of rat vertebrae during compressive loading in the longitudinal direction of rat's spine. High-resolution time-lapse micro-tomography was used as a tool to create models of the inner structure and deformed shape in pre-defined deformation steps. First, peripheral areas of vertebra specimen were embedded in polymethyl methacrylate to obtain proper boundary conditions of contact between specimen and loading plattens. Experimental loading device designed for application in X-ray setups was utilized to compress the vertebrae in several deformation steps. High-resolution micro-tomography scanning was carried out at each deformation step. Specimen was irradiated in tomography device equipped with microfocus X-ray tube with 5μm focal spot size and large area flat panel detector. Spatial resolution of reconstructed three-dimensional images was approximately 10μm. Digital volume correlation algorithm was utilized in order to assess displacements in the microstructure in every loading increment. Finite element model of vertebra was created from volumetric data reconstructed from tomography of the undeformed specimen. Simulated compressive test of the developed finite element model was performed in order to compare stiffness and displacements obtained by digital volume correlation and finite element simulation.

  4. A study of vertebra number in pigs confirms the association of vertnin and reveals additional QTL

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Formation of the vertebral column is a critical developmental stage in mammals. The strict control of this process has resulted in little variation in number of vertebrae across mammalian species and no variation within most mammalian species. The pig is quite unique as considerable vari...

  5. 2D-3D Registration of CT Vertebra Volume to Fluoroscopy Projection: A Calibration Model Assessment

    NASA Astrophysics Data System (ADS)

    Bifulco, P.; Cesarelli, M.; Allen, R.; Romano, M.; Fratini, A.; Pasquariello, G.

    2009-12-01

    This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume) and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1 mm for displacements parallel to the fluoroscopic plane, and of order of 10 mm for the orthogonal displacement.

  6. Andreas Vesalius on the anatomy and function of the lower thoracic vertebrae.

    PubMed

    Biesbrouck, Maurits; Vanden Berghe, Alex

    2016-04-01

    Some remarkable statements made by Andreas Vesalius (1514-1564) in his principal work De Humani Corporis Fabrica (1543) about the anatomy and function of the lower thoracic vertebrae are discussed in the light of information from the literature. Their accuracy is evaluated on the basis of several pieces of anatomical evidence and clinical cases. PMID:27385301

  7. Reliability and reproducibility of interapical distance assessment of the lateral deviation of vertebrae in scoliosis.

    PubMed

    Lim, Jeong Hoon; Lee, Jongmin; Koh, Seong-Eun; Lee, In-Sik

    2015-04-01

    [Purpose] The purpose of this study was to investigate the interobserver reliability and intraobserver reproducibility of interapical distance (IAD) and to analyze its correlation with the Cobb angle (CA). [Subjects and Methods] IAD, a handy tool for assessment of the lateral deviation of vertebrae with a metric scale, was defined as the horizontal distance between one apical vertebra and its counterpart, the opposite apical vertebra in the case of a double curve and the farthest vertebra in the case of a single curve. Fifty full-length, standing anteroposterior radiographs of "idiopathic scoliosis" were reviewed. Three investigators independently measure the CA and IAD at the same time and remeasured the IAD on the same radiograph a week later. [Results] There was no interobserver difference (reliability) in the measurement of IAD or statistical differences in intraobserver reproducibility for each observer. IAD was well correlated with the CA for each observer (r=0.765, r=0.737, and r=0.764). [Conclusion] IAD is useful when assessing lateral deviation in scoliosis and may be a reliable and reproducible index that is well correlated with the CA, and it can be used as a supplementary measure to describe the overall derangement of scoliosis in the coronal plane. PMID:25995588

  8. The demands of professional opera singing on cranio-cervical posture

    PubMed Central

    Skinner, Margot

    2009-01-01

    Difficulty with singing is a rare but important complication following cervical spine surgery but there is little objective information regarding the cervical and head postural changes taking place during singing. The aim of this study was to identify postural changes in the cranio-cervical region associated with the demands of voice production in professional opera singing. The two Roentgen-cephalograms, one of which are taken whilst performing a specified singing task were taken from 18 professional opera students, 12 females (mean age 20.86 ± 3.07 years) and six males (18.66 ± 1.36 years). A paired t test compared mean cranio-cervical postural and pharyngeal/hyoid variables between the two registrations (P = 0.05). The association between the cranio-cervical postural variables and the pharyngeal/hyoid region in each registration position was examined using Spearman’s rank correlation coefficient. In singing, the position of the atlas with respect to the true vertical (P < 0.001), the axis (P < 0.001) and the C4 vertebra both with respect to the horizontal (P < 0.001), and the axis with respect to the cranium (P < 0.001), were all significantly different to those at rest. Of the cranio-cervical postural variables in the singing registration, the angles measuring positional change of the atlas and C4 relative to the true horizontal were shown be significantly related to an increased pharyngeal airway space at the C3 level (P < 0.01). An appreciation of the requirement for the cervical spine to undergo postural change during professional opera singing has relevance to the potential impact on voice quality in professional opera singers should they undergo cervical spine surgery. PMID:19165506

  9. Cervical Cancer Stage IIIB

    MedlinePlus

    ... Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing shows cancer in the cervix, the vagina, and ... that connect the kidneys to the bladder). The drawing shows the ureter on the right blocked by ...

  10. Prevent Cervical Cancer

    MedlinePlus

    ... Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ... uterus, vagina, and vulva. Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ...

  11. Cervical Cancer Screening

    MedlinePlus

    ... cervical cancer in women aged 30–65 years. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Human Papillomavirus ( ...

  12. Immunotherapy for Cervical Cancer

    Cancer.gov

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  13. [Symptomatic Langerhans-cell-histiocytosis of the cervical spine in a child: case report].

    PubMed

    Schroers, C; Donauer, E; Laudan, M; Herbst, E W; Barz, H

    2000-01-01

    We report on a six year old female presented with a painful torticollis and a hemidysaesthesia caused by destruction of the third cervical vertebra and a paravertebral soft-tissue mass. At diagnostic routine finally a biopsy gives the diagnosis of Langerhans cell histiocytosis. In a second open approach the destructed vertebral body was replaced by a precisely adjusted autologous bone interponate and the patient was maintained in halo vest immobilisation. The outcome is described and an overview of the current literature is given. PMID:10916784

  14. Revised Vertebral Count in the “Longest-Necked Vertebrate” Elasmosaurus platyurus Cope 1868, and Clarification of the Cervical-Dorsal Transition in Plesiosauria

    PubMed Central

    Sachs, Sven; Kear, Benjamin P.; Everhart, Michael J.

    2013-01-01

    Elasmosaurid plesiosaurians are renowned for their immensely long necks, and indeed, possessed the highest number of cervical vertebrae for any known vertebrate. Historically, the largest count has been attributed to the iconic Elasmosaurus platyurus from the Late Cretaceous of Kansas, but estimates for the total neck series in this taxon have varied between published reports. Accurately determining the number of vertebral centra vis-à-vis the maximum length of the neck in plesiosaurians has significant implications for phylogenetic character designations, as well as the inconsistent terminology applied to some osteological structures. With these issues in mind, we reassessed the holotype of E. platyurus as a model for standardizing the debated cervical-dorsal transition in plesiosaurians, and during this procedure, documented a “lost” cervical centrum. Our revision also advocates retention of the term “pectorals” to describe the usually three or more distinctive vertebrae close to the cranial margin of the forelimb girdle that bear a functional rib facet transected by the neurocentral suture, and thus conjointly formed by both the parapophysis on the centrum body and diapophysis from the neural arch (irrespective of rib length). This morphology is unambiguously distinguishable from standard cervicals, in which the functional rib facet is borne exclusively on the centrum, and dorsals in which the rib articulation is situated above the neurocentral suture and functionally borne only by the transverse process of the neural arch. Given these easily distinguishable definitions, the maximum number of neck vertebrae preserved in E. platyurus is 72; this is only three vertebrae shorter than the recently described Albertonectes, which together with E. platyurus constitute the “longest necked” animals ever to have lived. PMID:23940656

  15. Redislocation After a Failed Surgery to Treat C6/7 Fracture-Dislocation With Pedicular Fracture of the C6 Vertebra: Case Report of a Successful Revision Surgery, Analysis of the Causes, and Discussion of Revision Surgical Strategies.

    PubMed

    Yang, Yi; Ma, Litai; Li, Tao; Liu, Hao

    2016-03-01

    Cervical spinal fracture-dislocation with pedicular fracture of the vertebra has been little reported and the management of such a patient is difficult. Considering the little knowledge of this area, we present this special case of a successful revision surgery for the treatment of redislocation after a failed surgery to treat C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra to share our experience.A 45-year-old male patient presented to our hospital with history of neck pain for 4 months. According to his medical records, he was involved in an architectural accident and diagnosed with C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra (ASIA: D). A surgery of posterior lateral mass screw fixation (bilateral in C5 and C7; left side in C6) was performed in a different institution. However, 4 months after his primary surgery, he was still troubled by serious neck pain and muscle weakness in all right side limbs. The physical examination of the patient showed hypoesthesia in the right side limbs, myodynamia of the right side limbs weakened to Grade 4. Cervical X-rays, computed tomography (CT), and magnetic resonance imaging confirmed the redislocation of C6/7. A successful revision surgery of anterior cervical corpectomy and fusion (ACCF) with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate was performed. The 3 months postoperative X-rays and CT scan showed the good position of the implant and bony fusion. The patient's neck pain was relived and the neurological function recovered to ASIA E grade at the 3rd month follow-up.ACCF with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate is effective for the treatment of redislocation after a failed surgery in patients of fracture-dislocation with pedicular fracture. The best method to avoid such a failed surgery is a combined anterior-posterior approach surgery in our opinion. PMID:26962843

  16. Radiation Therapy Plus Cisplatin and Gemcitabine in Treating Patients With Cervical Cancer

    ClinicalTrials.gov

    2014-12-23

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  17. Anatomical transformation in mammals: developmental origin of aberrant cervical anatomy in tree sloths.

    PubMed

    Buchholtz, Emily A; Stepien, Courtney C

    2009-01-01

    Mammalian cervical count has been fixed at seven for more than 200 million years. The rare exceptions to this evolutionary constraint have intrigued anatomists since the time of Cuvier, but the developmental processes that generate them are unknown. Here we evaluate competing hypotheses for the evolutionary origin of cervical variants in Bradypus and Choloepus, tree sloths that have broken the seven cervical vertebrae barrier independently and in opposite directions. Transitional and mediolaterally disjunct anatomy characterizes the cervicothoracic vertebral boundary in each genus, although polarities are reversed. The thoracolumbar, lumbosacral, and sacrocaudal boundaries are also disrupted, and are more extreme in individuals with more extreme cervical counts. Hypotheses of homologous, homeotic, meristic, or associational transformations of traditional vertebral column anatomy are not supported by these data. We identify global homeotic repatterning of abaxial relative to primaxial mesodermal derivatives as the origin of the anomalous cervical counts of tree sloths. This interpretation emphasizes the strong resistance of the "rule of seven" to evolutionary change, as morphological stasis has been maintained primaxially coincident with the generation of a functionally longer (Bradypus) or shorter (Choloepus) neck. PMID:19196334

  18. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    NASA Astrophysics Data System (ADS)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  19. Measurement of Intervertebral Cervical Motion by Means of Dynamic X-Ray Image Processing and Data Interpolation

    PubMed Central

    Bifulco, Paolo; Cesarelli, Mario; Romano, Maria; Sansone, Mario

    2013-01-01

    Accurate measurement of intervertebral kinematics of the cervical spine can support the diagnosis of widespread diseases related to neck pain, such as chronic whiplash dysfunction, arthritis, and segmental degeneration. The natural inaccessibility of the spine, its complex anatomy, and the small range of motion only permit concise measurement in vivo. Low dose X-ray fluoroscopy allows time-continuous screening of cervical spine during patient's spontaneous motion. To obtain accurate motion measurements, each vertebra was tracked by means of image processing along a sequence of radiographic images. To obtain a time-continuous representation of motion and to reduce noise in the experimental data, smoothing spline interpolation was used. Estimation of intervertebral motion for cervical segments was obtained by processing patient's fluoroscopic sequence; intervertebral angle and displacement and the instantaneous centre of rotation were computed. The RMS value of fitting errors resulted in about 0.2 degree for rotation and 0.2 mm for displacements. PMID:24288523

  20. [Cervical fractures in autopsy records].

    PubMed

    Pankowski, Rafał; Wilmanowska, Anita; Gos, Tomasz; Smoczyński, Andrzej

    2003-01-01

    We reviewed the autopsy records of 1872 cases of death because of politrauma, gunshot wounds and suicidal hanging. The analysis included causes and frequency of cervical spine fractures, their most common localisation, architecture of bone destruction and their influence on cervical cord. The most common cause of cervical spine injury was motor vehicle accidents. We examined 82 specimens with traumatic fractures of cervical spine obtained from accident victims. About half of the injuries occurred in upper cervical spine. The most common fracture localisation was C2 with dens fracture as the most frequent injury. The most common spinal cord lesion was complete rupture mainly at the upper cervical spine level. PMID:14564791

  1. Vertebrae in compression: Mechanical behavior of arches and centra in the gray smooth-hound shark (Mustelus californicus).

    PubMed

    Porter, Marianne E; Long, John H

    2010-03-01

    In swimming sharks, vertebrae are subjected, in part, to compressive loads as axial muscles contract. We currently have no information about which vertebral elements, centra, arch cartilages, or both, actually bear compressive loads in cartilaginous vertebrae. To address this issue, the goal of this experiment was to determine the load-bearing ability of arch and centrum cartilages in compression, to determine the material properties of shark vertebrae, and to document fracture patterns in the centra with and without the arches. Intact vertebrae and vertebrae with the arch cartilages experimentally removed (centra alone) were subjected to compressive loading to failure at a single strain rate. The maximum compressive forces sustained by the vertebrae and the centra are statistically indistinguishable. Thus we conclude that under these testing conditions the arch does not bear appreciable loads. Independent evidence for this conclusion comes from the fact that vertebrae fail in compression at the centra, and not at the arches. Overall, the results of these mechanical tests suggest that the neural arches are not the primary load-bearing structure during axial compression. PMID:19862836

  2. Nivolumab in Treating Patients With Persistent, Recurrent, or Metastatic Cervical Cancer

    ClinicalTrials.gov

    2016-09-12

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Recurrent Cervical Carcinoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  3. Cervical Perineural Cyst Masquerading as a Cervical Spinal Tumor

    PubMed Central

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha

    2014-01-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor. PMID:24761204

  4. Cervical perineural cyst masquerading as a cervical spinal tumor.

    PubMed

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor. PMID:24761204

  5. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    PubMed Central

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-01-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study. PMID:27225189

  6. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    NASA Astrophysics Data System (ADS)

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-05-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study.

  7. Get Tested for Cervical Cancer

    MedlinePlus

    ... section Cervical Cancer 3 of 5 sections Take Action! Take Action: Get Tested Take these steps to help prevent ... section Pap Test 4 of 5 sections Take Action: Lower Your Risk Lower your risk of cervical ...

  8. Spinal surgery -- cervical - series (image)

    MedlinePlus

    The cervical spinal column is made up of vertebral bodies which protect the spinal cord. ... spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine ...

  9. Suspected cervical spinal cord vascular anomaly in an African warthog (Phacochoerus africanus).

    PubMed

    Whiteside, Douglas P; Shury, Todd K; Black, Sandra R; Raverty, Stephen

    2006-09-01

    Vascular myelopathies of the spinal cord have not been described in Suidae, and are a rare finding in companion animals. An 8.5-yr female African warthog (Phacochoerus africanus) presented with an acute onset of tetraparesis. Based on neurologic findings, a cervical spinal cord lesion between C7-T2 was suspected. Magnetic resonance imaging revealed severe intramedullary hemorrhage with suspected abnormal vessels in the spinal cord at the level of the seventh cervical vertebrae. The acute onset of clinical signs and rapid deterioration of neurological status precluded surgical managements. A vascular anomaly was suspected on gross pathology and histology. Immunohistochemistry identified the lesion as a spontaneous intramedullary hematoma. Spontaneous intramedullary hematomyelia should be considered as a differential for acute onset of paresis in suid species. PMID:17319141

  10. SURGICAL CORRECTION OF A CERVICAL SPINAL FRACTURE IN A BENNETT'S WALLABY (MACROPUS RUFOGRISEUS).

    PubMed

    Kragness, Brandy J; Graham, Jennifer E; Bedenice, Daniela; Restifo, Melissa M; Boudrieau, Randy J

    2016-03-01

    Macropods are susceptible to trauma, and fractures of the cervical vertebrae due to collisions are relatively common. A 4-yr-old, intact male Bennett's wallaby (Macropus rufogriseus) was presented acutely nonambulatory and tetraparetic but with motor function present in all limbs. Cervical radiographs revealed a C4 vertebral fracture. Surgical stabilization was obtained through a ventral midline approach whereby the vertebral bodies were distracted and then secured with screws and polymethylmethacrylate (PMMA). Postoperative radiographs revealed restoration of the spinal canal and appropriate implant placement. The patient was discharged 4 days postoperatively and gradually recovered full neurologic function per the owner over the ensuing 10 wk. Subsequent radiographs obtained 10.5 mo postoperatively revealed a healed fracture with stable implants. The ventral spinal distraction and stabilization technique using screws and PMMA, as are used in the domestic dog, was successful in this wallaby despite its smaller vertebral size and comparable lack of soft-tissue support. PMID:27010308

  11. Short communication: Traits unique to genus Homo within primates at the cervical spine (C2-C7).

    PubMed

    Rios, Luis; Muñoz, Alexandra; Cardoso, Hugo; Pastor, Francisco

    2014-05-01

    From a comparative study of 222 human and 261 nonhuman primates complete cervical spines, two bony variants associated to the course of the vertebral artery are proposed as unique to genus Homo within primates. First, the opening of the foramen transversarium at C2, a trait present at low frequency in humans (3 to 5.6%). Second, the presence of a bipartite foramen transversarium in the cervical segment C3-C6, a trait that can be observed fully formed in human fetal skeletons, with a clear frequency pattern along the cervical spine (C3>C4>C5>C6cervical vertebrae for genus Homo. The test of a possible explanation of these differences as associated to anatomical changes of the cervical spine due to erect posture and bipedal locomotion needs further research in the morphology and function of the primate cervical spine. PMID:24439363

  12. A Comparison of Hand Wrist Bone Analysis with Two Different Cervical Vertebral Analysis in Measuring Skeletal Maturation

    PubMed Central

    Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

    2014-01-01

    Background: Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. Materials and Methods: Hand wrist radiographs and lateral cephalograms of 72 subjects aged between 7 and 16 years both male and female from the patients visiting Department of Orthodontics and Dentofacial Orthopedics, R.V. Dental College and Hospital. The 9 stages were reduced to 5 stages to compare with cervical vertebral maturation stage by Baccetti et al. The Bjork, Grave and Brown stages were reduced to six intervals to compare with cervical vertebral maturational index (CVMI) staging by Hassel and Farman. These measurements were then compared with the hand wrist bone analysis, and the results were statistically analyzed using the Mann–Whitney test. Results: There was no significant difference between the hand wrist analysis and the two different cervical vertebral analyses for assessing skeletal maturation. There was no significant difference between the two cervical vertebral analyses, but the CVMI method, which is visual method is less time consuming. Conclusion: Vertebral analysis on a lateral cephalogram is as valid as the hand wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects. PMID:25395791

  13. Morphological Study of Subaxial Cervical Pedicles by Using Three-Dimensional Computed Tomography Reconstruction Image

    PubMed Central

    WASINPONGWANICH, Kanthika; PAHOLPAK, Permsak; TUAMSUK, Panya; SIRICHATIVAPEE, Winai; WISANUYOTIN, Taweechok; KOSUWON, Weerachai; JEERAVIPOOLVARN, Polasak

    2014-01-01

    Malpositioning of cervical screws risks neurovascular injury. A cervical screw fixation system can provide proper rigidity, alignment correction, and high rates of fusion afforded by high pullout biomechanical strength. The objective is to assess the dimensions and axis of the C3–C7 cervical pedicles. A 1-mm slice thickness computed tomography (CT) scan of the cervical spine of 30 patients (15 males, 15 females) were analyzed and reconstructed in three-dimensions using Mimics® 10.01 software. We measured pedicle axis length (PAL), pedicle and lateral mass length (PL-LM), pedicle length (PL), outer pedicle width (OPW), and pedicle transverse angle (PTA) from the axial image and outer pedicle height (OPH) and pedicle sagittal angle (PSA) from the sagittal image. The OPH and OPW at all subaxial cervical spines were suitable for insertion of 3.5 mm cervical pedicle screws. PSA was directed cranially at C3 to C5 (13.84, 7.09, and 2.71) and directed caudally at C6 and C7 (–4.55, –6.94). PTA was greatest at C5 and smallest at C7. The respective difference between the left and right side for nearly all parameters was not statistically significant (except for C6 PL and C7 OPH). Females had a significantly smaller OPH and OPW than males at nearly all levels. The PTA was not significantly different between the sexes. Cervical pedicle screw fixation in the Thai population can be safely performed and guidelines for insertion at each vertebra documented. Appropriate preoperative planning is necessary to achieve safe and accurate placement of the screws. PMID:25169140

  14. A Female Ligamentous Cervical Spine Finite Element Model Validated for Physiological Loads.

    PubMed

    Östh, Jonas; Brolin, Karin; Svensson, Mats Y; Linder, Astrid

    2016-06-01

    Mathematical cervical spine models allow for studying of impact loading that can cause whiplash associated disorders (WAD). However, existing models only cover the male anthropometry, despite the female population being at a higher risk of sustaining WAD in automotive rear-end impacts. The aim of this study is to develop and validate a ligamentous cervical spine intended for biomechanical research on the effect of automotive impacts. A female model has the potential to aid the design of better protection systems as well as improve understanding of injury mechanisms causing WAD. A finite element (FE) mesh was created from surface data of the cervical vertebrae of a 26-year old female (stature 167 cm, weight 59 kg). Soft tissues were generated from the skeletal geometry and anatomical literature descriptions. Ligaments were modeled with nonlinear elastic orthotropic membrane elements, intervertebral disks as composites of nonlinear elastic bulk elements, and orthotropic anulus fibrosus fiber layers, while cortical and trabecular bones were modeled as isotropic plastic-elastic. The model has geometrical features representative of the female cervical spine-the largest average difference compared with published anthropometric female data was the vertebral body depth being 3.4% shorter for the model. The majority the cervical segments compare well with respect to biomechanical data at physiological loads, with the best match for flexion-extension loads and less biofidelity for axial rotation. An average female FE ligamentous cervical spine model was developed and validated with respect to physiological loading. In flexion-extension simulations with the developed female model and an existing average male cervical spine model, a greater range of motion (ROM) was found in the female model. PMID:26974520

  15. Measurement and Visualization of Three-Dimensional Vertebra Shape by Freehand Ultrasound Scanning

    NASA Astrophysics Data System (ADS)

    Kohyama, Kazuhiro; Yasumuro, Yoshihiro; Imura, Masataka; Manabe, Yoshitsugu; Oshiro, Osamu; Moroi, Keishichiro; Chihara, Kunihiro

    2005-06-01

    Paracentesis is a common operation for pain clinics and spinal anesthetics administration and requires empirical training and flexible skills to cope with the various cases of individual patients. We propose a method of measuring and visualizing three-dimensional vertebra shapes for assisting anesthesiologists, by an ultrasound imaging technique that is prevalent in many hospitals and has no harmful risks to the human body. The proposed system enables anesthesiologists to investigate vertebra shapes by freehand probing. Three-dimensional reconstruction and graphical rendering can be performed by monitoring the motion of the ultrasound probe and registering the scanned echography into the identical three-dimensional space. Considering the echography imaging features, volume rendering of hard tissue surfaces is achieved and interactive measurement is possible. This paper describes the practicability of the proposed method based on experimental measurement of both phantom and real lumbar vertebre and sacra.

  16. Simulation analysis for effects of bone loss on acceleration tolerance of human lumbar vertebra

    NASA Astrophysics Data System (ADS)

    Ma, Honglei; Zhang, Feng; Zhu, Yu; Xiao, Yanhua; Wazir, Abrar

    2014-02-01

    The purpose of the present study was to analyze and predict the changes in acceleration tolerance of human vertebra as a result of bone loss caused by long-term space flight. A human L3-L4 vertebra FEM model was constructed, in which the cancellous bone was separated, and surrounding ligaments were also taken into account. The simulation results demonstrated that bone loss has more of an effect on the acceleration tolerance in x-direction. The results serve to aid in the creation of new acceleration tolerance standards, ensuring astronauts return home safely after long-term space flight. This study shows that more attention should be focused on the bone degradation of crew members and to create new protective designs for space capsules in the future.

  17. Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae

    PubMed Central

    Ko, Sanghyung; Park, Noh Kyoung; Cho, Kyoung Jin; Baek, Jung Hyun; Lim, Jeong-Wook; Choi, Dongjin

    2015-01-01

    Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury. PMID:26619145

  18. Fat4-Dchs1 signalling controls cell proliferation in developing vertebrae.

    PubMed

    Kuta, Anna; Mao, Yaopan; Martin, Tina; Ferreira de Sousa, Catia; Whiting, Danielle; Zakaria, Sana; Crespo-Enriquez, Ivan; Evans, Philippa; Balczerski, Bartosz; Mankoo, Baljinder; Irvine, Kenneth D; Francis-West, Philippa H

    2016-07-01

    The protocadherins Fat4 and Dchs1 act as a receptor-ligand pair to regulate many developmental processes in mice and humans, including development of the vertebrae. Based on conservation of function between Drosophila and mammals, Fat4-Dchs1 signalling has been proposed to regulate planar cell polarity (PCP) and activity of the Hippo effectors Yap and Taz, which regulate cell proliferation, survival and differentiation. There is strong evidence for Fat regulation of PCP in mammals but the link with the Hippo pathway is unclear. In Fat4(-/-) and Dchs1(-/-) mice, many vertebrae are split along the midline and fused across the anterior-posterior axis, suggesting that these defects might arise due to altered cell polarity and/or changes in cell proliferation/differentiation. We show that the somite and sclerotome are specified appropriately, the transcriptional network that drives early chondrogenesis is intact, and that cell polarity within the sclerotome is unperturbed. We find that the key defect in Fat4 and Dchs1 mutant mice is decreased proliferation in the early sclerotome. This results in fewer chondrogenic cells within the developing vertebral body, which fail to condense appropriately along the midline. Analysis of Fat4;Yap and Fat4;Taz double mutants, and expression of their transcriptional target Ctgf, indicates that Fat4-Dchs1 regulates vertebral development independently of Yap and Taz. Thus, we have identified a new pathway crucial for the development of the vertebrae and our data indicate that novel mechanisms of Fat4-Dchs1 signalling have evolved to control cell proliferation within the developing vertebrae. PMID:27381226

  19. Scaling of lumbar vertebrae in anthropoids and implications for evolution of the hominoid axial skeleton.

    PubMed

    Nakatsukasa, Masato; Hirose, Youichi

    2003-04-01

    We investigated allometric relationships between vertebral centrum cranial surface areas and body weight and skeletal lumbar length in extant platyrrhine and cercopithecid species. Platyrrhines have smaller lumbar vertebral centra regarding the cranial surface area relative to their body weight than extant catarrhines. However, the stress to the spine of quadrupeds is not only influenced by the body weight but also its length, which contributes to the amount of bending moment. Our results indicated that platyrrhines and cercopithecids have similar lumbar vertebral centrum surface areas when they are scaled on the product of the body weight and skeletal lumbar length. Platyrrhines generally tend to have relatively short lumbar columns for a given body weight. As a result of this tendency, their vertebral centra appear relatively small if only body weight is taken into account. The centrum surface area is rather constant relative to the product of the body weight and skeletal lumbar length within platyrrhines or cercopithecids, despite the fact that skeletal lumbar length is in itself rather variable relative to body weight. This result indicates that the vertebral centrum articular area, the lumbar column length and the body weight are strongly correlated with each other and that such relationships are similar between platyrrhines and cercopithecids. These relationships were observed using both the zygapophyseal and rib definitions of the lumbar vertebrae. However, they were more clearly observed when the zygapophyseal definition was adopted. It appeared that lumbar vertebrae of Proconsul nyanzae (KNM-MW 13142) had distinctively smaller surface areas relative to its body weight and lumbar length than for platyrrhines and cercopithecids, differing from extant hominoids, which have comparatively larger lumbar vertebrae. In the case of Morotopithecus, the lumbar vertebral surface area seems to be as large as in extant platyrrhines and cercopithecids if it had a reduced

  20. Cervical spine geometry in the automotive seated posture: variations with age, stature, and gender.

    PubMed

    Desantis Klinich, Kathleen; Ebert, Sheila M; Van Ee, Chris A; Flannagan, Carol A C; Prasad, Monica; Reed, Matthew P; Schneider, Lawrence W

    2004-11-01

    In the mid 1970s, UMTRI investigated the biomechanical properties of the head and neck using 180 "normal" adult subjects selected to fill eighteen subject groups based on age (young, mid-aged, older), gender, and stature (short, medium, and tall by gender). Lateral-view radiographs of the subjects' cervical spines and heads were taken with the subjects seated in a simulated automotive neutral posture, as well as with their necks in full-voluntary flexion and full-voluntary extension. Although the cervical spine and lower head geometry were previously measured manually and documented, new technologies have enabled computer digitization of the scanned x-ray images and a more comprehensive and detailed analysis of the variation in cervical spine and lower head geometry with subject age, stature, and gender. After scanning the radiographic images, 108 skeletal landmarks on the cervical vertebrae and 10 head landmarks were digitized. The resulting database of cervical spine and head geometry was used to study cervical spine curvature, vertebral dimensions, and head/neck orientation as functions of age, gender, and stature. The data were used to characterize neutral posture cervical spine curvatures using two methods: a curvature index and Bézier spline functions. Lateral-view vertebral dimensions were also calculated for each subject, and a cascading series of equations was developed to estimate vertebral size and shape for a selected age, stature, and gender. The orientation of the cervical spine was defined using a neck chord angle, where the neck chord was varied to use different anatomical landmarks and estimates of joint centers for the top and bottom of the neck chord. Results from the study have been incorporated into a MS-Access based software package that allows researchers and modelers to generate cervical spine geometries for occupants of a specified age, gender, and stature. The program allows selection of individual occupants from the database that meet

  1. Technique for ultrasound-guided intraarticular cervical articular process injection in the dog.

    PubMed

    Levy, Matthew; Gaschen, Lorrie; Rademacher, Nathalie; Bragulla, Hermann

    2014-01-01

    Ultrasound-guided intraarticular injection of cervical articular process joints is a well-established procedure in both humans and horses for neck pain resulting from osteoarthritis, but the technique has not been described in dogs. Aims of this study were to describe the ultrasonographic anatomy and landmarks for cervical articular process joint injections in the dog, develop a technique for articular process joint injections using these landmarks, and determine the accuracy of injections and factors that may influence it. Eleven canine cadavers were used and bilateral joint spaces from C2-3 to C7-T1 were injected under ultrasound guidance with a blue radiopaque solution. A computed tomographic scan was acquired following each injection, and an injection score was assigned and compared with other patient-specific factors. Of the 132 injections performed, 110 (83.3%) were intraarticular, 20 (15.1%) were periarticular within 5 mm, and 2 (1.5%) were periarticular beyond 5 mm from the joint. There was no significant difference in mean scores between dogs. Only C2-3 had a significantly lower mean score than any other joint. There was no significant correlation between injection score and any other factors measured. The transverse processes of the cervical vertebrae served as excellent ultrasonographic landmarks for identifying the cervical articular process joints in dogs regardless of the size of the dog or location along the vertebrae. Accuracy of ultrasound-guided intraarticular process joint injection was 83% in dogs and similar to published techniques in horses. Further studies are needed to examine the safety and efficacy of this procedure in live animals. PMID:24506833

  2. Sensory Neuron Development in Mouse Coccygeal Vertebrae and Its Relationship to Tail Biopsies for Genotyping

    PubMed Central

    Silverman, Jerald; Hendricks, Gregory

    2014-01-01

    A common method of genotyping mice is via tissue obtained from tail biopsies. However, there is no available information on the temporal development of sensory neurons in the tail and how their presence or absence might affect the age for performing tail biopsies. The goals of this study were to determine if afferent sensory neurons, and in particular nociceptive neurons, are present in the coccygeal vertebrae at or near the time of birth and if not, when they first can be visualized on or in those vertebrae. Using toluidine blue neuronal staining, transmission electron microscopy, and calcitonin-related gene peptide immunostaining, we found proximal to distal maturation of coccygeal nerve growth in the C57BL/6J mouse. Single nerve bundles were first seen on postpartum day (PPD) 0. On PPD 3 presumptive nociceptive sensory nerve fibers were seen entering the vertebral perichondrium. Neural development continued through the last time point (PPD 7) but at no time were neural fibers seen entering the body of the vertebrae. The effect of age on the development of pain perception in the neonatal mouse is discussed. PMID:24505409

  3. Enhanced detection of the vertebrae in 2D CT-images

    NASA Astrophysics Data System (ADS)

    Graf, Franz; Greil, Robert; Kriegel, Hans-Peter; Schubert, Matthias; Cavallaro, Alexander

    2012-02-01

    In recent years, a considerable amount of methods have been proposed for detecting and reconstructing the spine and the vertebrae from CT and MR scans. The results are either used for examining the vertebrae or serve as a preprocessing step for further detection and annotation tasks. In this paper, we propose a method for reliably detecting the position of the vertebrae on a single slice of a transversal body CT scan. Thus, our method is not restricted by the available portion of the 3D scan, but even suffices with a single 2D image. A further advantage of our method is that detection does not require adjusting parameters or direct user interaction. Technically, our method is based on an imaging pipeline comprising five steps: The input image is preprocessed. The relevant region of the image is extracted. Then, a set of candidate locations is selected based on bone density. In the next step, image features are extracted from the surrounding of the candidate locations and an instance-based learning approach is used for selecting the best candidate. Finally, a refinement step optimizes the best candidate region. Our proposed method is validated on a large diverse data set of more than 8 000 images and improves the accuracy in terms of area overlap and distance from the true position significantly compared to the only other method being proposed for this task so far.

  4. Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis

    NASA Astrophysics Data System (ADS)

    Tan, Sovira; Yao, Jianhua; Ward, Michael M.; Yao, Lawrence; Summers, Ronald M.

    2006-03-01

    Ankylosing Spondylitis is a disease of the vertebra where abnormal bone structures (syndesmophytes) grow at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is necessary to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures on 3-D CT images. Very fine segmentation of the vertebral body is required to capture the small structures caused by the pathology. We propose a segmentation algorithm based on a cascade of three level set stages and requiring no training or prior knowledge. First, the noise inside the vertebral body that often blocks the proper evolution of level set surfaces is attenuated by a sigmoid function whose parameters are determined automatically. The 1st level set (geodesic active contour) is designed to roughly segment the interior of the vertebra despite often highly inhomogeneous and even discontinuous boundaries. The result is used as an initial contour for the 2nd level set (Laplacian level set) that closely captures the inner boundary of the cortical bone. The last level set (reversed Laplacian level set) segments the outer boundary of the cortical bone and also corrects small flaws of the previous stage. We carried out extensive tests on 30 vertebrae (5 from each of 6 patients). Two medical experts scored the results at intervertebral disk spaces focusing on end plates and syndesmophytes. Only two minor segmentation errors at vertebral end plates were reported and two syndesmophytes were considered slightly under-segmented.

  5. Bone reactions to nacre injected percutaneously into the vertebrae of sheep.

    PubMed

    Lamghari, M; Berland, S; Laurent, A; Huet, H; Lopez, E

    2001-03-01

    We have studied the osteogenic effects of nacre (mother of pearl) placed in experimental cavities prepared in the lumbar vertebrae of sheep. Some of cavities were filled with nacre, some with PMMA, and some were left empty. The vertebrae were removed 1, 8, 12 weeks after surgery, and assessed histologically and morphometrically. The nacre particles in the bone cavity and the surrounding intertrabecular spaces gradually dissolved beginning at 8 weeks after surgery. There were layers of newly formed bone, both woven and lamellar, in various stages of maturation in contact with or adjacent to the dissolving nacre. Quantitative assessment of the activation of bone formation adjacent to the cavities filled with nacre indicated significant activation of bone formation, which continued until week 12. There was also increased mineralization of the host bone at this time. There was no new bone formation in the empty cavities, or in those filled with PMMA. PMMA also caused necrosis of surrounding bone cells with a change in bone architecture and significant reductions in bone formation and mineralization. This study demonstrates that nacre stimulates bone-forming cells in vertebrae and appears to result in new bone formation. PMID:11219719

  6. Cervical Total Disc Arthroplasty

    PubMed Central

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc arthroplasty devices have come onto the market and completed Food and Drug Administration Investigational Device Exemption trials. Though some of the early results demonstrate equivalency of arthroplasty to fusion, compelling evidence of benefits in terms of symptomatic adjacent segment degeneration are lacking. In addition, non-industry-sponsored studies indicate that these devices are equivalent to fusion in terms of adjacent segment degeneration. Longer-term studies will eventually provide the definitive answer. PMID:24353955

  7. The degenerative cervical spine.

    PubMed

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

  8. Assessment of ultrasound as a diagnostic modality for detecting potentially unstable cervical spine fractures in pediatric severe traumatic brain injury: A feasibility study

    PubMed Central

    Agrawal, Deepak; Sinha, Tej Prakash; Bhoi, Sanjeev

    2015-01-01

    Background: Early cervical spine clearance is extremely important in unconscious trauma patients and may be difficult to achieve in emergency setting. Objectives: The aim of this study was to assess the feasibility of standard portable ultrasound in detecting potentially unstable cervical spine injuries in severe traumatic brain injured (TBI) patients during initial resuscitation. Materials and Methods: This retro-prospective pilot study carried out over 1-month period (June–July 2013) after approval from the institutional ethics committee. Initially, the technique of cervical ultrasound was standardized by the authors and tested on ten admitted patients of cervical spine injury. To assess feasibility in the emergency setting, three hemodynamically stable pediatric patients (≦18 years) with isolated severe head injury (Glasgow coma scale ≤8) coming to emergency department underwent an ultrasound examination. Results: The best window for the cervical spine was through the anterior triangle using the linear array probe (6–13 MHz). In the ten patients with documented cervical spine injury, bilateral facet dislocation at C5–C6 was seen in 4 patients and at C6–C7 was seen in 3 patients. C5 burst fracture was present in one and cervical vertebra (C2) anterolisthesis was seen in one patient. Cervical ultrasound could easily detect fracture lines, canal compromise and ligamental injury in all cases. Ultrasound examination of the cervical spine was possible in the emergency setting, even in unstable patients and could be done without moving the neck. Conclusions: Cervical ultrasound may be a useful tool for detecting potentially unstable cervical spine injury in TBI patients, especially those who are hemodynamically unstable. PMID:26167212

  9. Morphometrics of the skeleton of Dermophis mexicanus (Amphibia: Gymnophiona). Part I. The vertebrae, with comparisons to other species.

    PubMed

    Wake, M H

    1980-08-01

    Morphometric analysis of vertebral structure in caecilians (Amphibia: Gymnophiona) is presented. Ontogenetic variation in Dermophis mexicanus is analyzed through the 100+ vertebrae composing the column. Vertebral structure in adult D. mexicanus is compared with that in Ichthyophis glutinosus and Typhlonectes compressicauda. Centra of the atlas, second, tenth, 20th, and 50th vertebrae grow at allometrically different rates in D. mexicanus, though the 20th and 50th are not significantly different. Growth appears significantly slower in several dimensions of anterior and posterior vertebrae relative to midtrunk vertebrae in all three species. Mensural patterns throughout the entire column are similar in the terrestrail burrowers D. mexicanus and I. glutinosus; patterns in the aquatic T. compressicauda differ substantially from those of the burrowing species and are strongly influenced by allometry. Of the 112 D. mexicanus examined, 13.4% had vertebral anomalies, usually fusions. PMID:7452726

  10. Noninvasive Failure Load Prediction of Vertebrae with Simulated Lytic Defects and Biomaterial Augmentation.

    PubMed

    Giambini, Hugo; Fang, Zhong; Zeng, Heng; Camp, Jon J; Yaszemski, Michael J; Lu, Lichun

    2016-08-01

    The spine is the most common site for secondary bone metastases, and clinical management for fractures is based on size and geometry of the defect. About 75% of the bone needs to be damaged before lesions are detectable, so clinical tools should measure changes in both geometry and material properties. We have developed an automated, user-friendly, Spine Cancer Assessment (SCA) image-based analysis method that builds on a platform designed for clinical practice providing failure characteristics of vertebrae. The objectives of this study were to (1) validate SCA predictions with experimental failure load outcomes; (2) evaluate the planning capabilities for prophylactic vertebroplasty procedures; and (3) investigate the effect of computed tomography (CT) protocols on predicted failure loads. Twenty-one vertebrae were randomly divided into two groups: (1) simulated defect without treatment (negative control) [n = 9] and (2) with treatment [n = 12]. Defects were created and a polymeric biomaterial was injected into the vertebrae in the treated-defect group. Spines were scanned, reconstructed with two algorithms, and analyzed for fracture loads. To virtually plan for prophylactic intervention, vertebrae with empty lesions were simulated to be augmented with either poly(methyl methacrylate) (PMMA) or a novel bone replacement copolymer, poly(propylene fumarate-co-caprolactone) [P(PF-co-CL)]. Axial rigidities were calculated from the CT images. Failure loads, determined from the cross section with the lowest axial rigidity, were compared with experimental values. Predicted loads correlated well with experimental outcomes (R(2) = 0.73, p < 0.0001). Predictions from negative control specimens highly correlated with measured values (R(2) = 0.90, p < 0.0001). Although a similar correlation was obtained using both algorithms, the smooth reconstruction (B30) tended to underestimate predicted failure loads by ∼50% compared with the ∼10% underestimate

  11. Cervical vertebral strain measurements under axial and eccentric loading.

    PubMed

    Pintar, F A; Yoganandan, N; Pesigan, M; Reinartz, J; Sances, A; Cusick, J F

    1995-11-01

    The mid to lower cervical spine is a common site for compression related injury. In the present study, we determined the patterns of localized strain distribution in the anterior aspect of the vertebral body and in the lateral masses of lower cervical three-segment units. Miniature strain gages were mounted to human cadaveric vertebrae. Each preparation was line-loaded using a knife-edge oriented in the coronal plane that was moved incrementally from anterior to posterior to induce compression-flexion or compression-extension loading. Uniform compressive loading and failure runs were also conducted. Failure tests indicated strain shifting to "restabilize" the preparation after failure of a component. Under these various compressive loading vectors, the location which resulted in the least amount of deformation for a given force application (i.e., stiffest axis) was quantified to be in the region between 0.5- 1.0 cm anterior to the posterior longitudinal ligament. The location in which line-loading produced no rotation (i.e., balance point) was in this region; it was also close to where the vertebral body strains change from compressive to tensile. Strain values from line loading in this region produced similar strains as recorded under uniform compressive loading, and this was also the region of minimum strain. The region of minimum strain was also more pronounced under higher magnitudes of loading, suggesting that as the maximum load carrying capacity is reached the stiffest axis becomes more well defined. PMID:8748531

  12. Accuracy of positioning the cervical spine for radiation therapy and the relationship to GTV, CTV and PTV.

    PubMed

    Kippenes, Hege; Gavin, Patrick R; Sande, Ronald D; Rogers, Dennis; Sweet, Vaughn

    2003-01-01

    The purpose of the study was to evaluate the accuracy and precision of a rigid positioning device for repositioning the cervical spine accurately and precisely during conformal radiation therapy of dogs. Fifteen purpose bred research dogs in a radiation therapy study were included. The dogs were positioned using a head holder and a deflatable pillow attached to the treatment table. Port films were reviewed retrospectively, and repositioning precision was recorded by measurements in three orthogonal planes of the head, 2nd cervical vertebra and 1st thoracic spinous process. Mean treatment position was compared to the planning position for a measurement of systematic set-up error. Mean interfraction position variation of the 2nd cervical vertebra was 0.2, 0.1 and 0.2 cm for the ventrodorsal, caudocranial and laterolateral directions respectively, and the average systematic set up error was 0.2, 0.1 and 0.2 cm for the ventrodorsal, caudocranial and laterolateral directions respectively. Knowledge of the magnitude of reposition errors should be included when determining the margins around the tumor. PMID:14703256

  13. Cisplatin and Radiation Therapy With or Without Tirapazamine in Treating Patients With Cervical Cancer

    ClinicalTrials.gov

    2014-06-18

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  14. Chemoradiation Therapy and Ipilimumab in Treating Patients With Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2016-08-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  15. Changes in Bone Mineral Density in Uterine Cervical Cancer Patients After Radiation Therapy

    SciTech Connect

    Okonogi, Noriyuki; Saitoh, Jun-ichi; Suzuki, Yoshiyuki Noda, Shin-ei; Ohno, Tatsuya; Oike, Takahiro; Ohkubo, Yu; Ando, Ken; Sato, Hiro; Nakano, Takashi

    2013-12-01

    Purpose: To prospectively investigate the changes in bone mineral density (BMD) after pelvic radiation therapy in patients with uterine cervical cancer. Methods and Materials: Of 52 cervical cancer patients who received pelvic RT in our university hospital between 2009 and 2011, 46 patients without recurrence and who were followed up for more than 12 months were included in the study. The BMD of the irradiated region and nonirradiated regions, serum estradiol, tartrate-resistant acid phosphatase-5b, and N-terminal cross-linking telopeptide of collagen 1 were measured before, at 3 months after, and at 12 months after RT. The patient cohort was divided into 2 groups according to estradiol level before RT, and the groups were defined as postmenopausal (<40 pg/mL) and premenopausal (≥40 pg/mL). Results: The mean BMDs within the irradiation field (lumbar vertebra 5) in the postmenopausal and the premenopausal groups were 0.825 and 0.910 g/cm{sup 2} before RT and 0.746 and 0.841 g/cm{sup 2} 12 months after RT, respectively. Significant decreases were observed in both groups (P<.05 and P<.01, respectively). In addition, in the premenopausal group the mean BMDs of the nonirradiated regions at thoracic vertebrae 9-12 and lumbar vertebrae 2-4 were 0.753 and 0.958 g/cm{sup 2} before RT and were significantly decreased to 0.706 and 0.921 g/cm{sup 2} 12 months after RT (P<.01 and P<.05, respectively). Estradiol significantly decreased 3 months after RT, whereas tartrate-resistant acid phosphatase-5b and N-terminal cross-linking telopeptide of collagen 1 continued to increase over time in the premenopausal group. Conclusions: A decrease in BMD in the irradiated region after RT was observed within 1 year, regardless of menopausal status. Furthermore, in premenopausal patients, pelvic RT caused a decrease in systemic BMD.

  16. Cervical Neoplasia Probe Control

    Energy Science and Technology Software Center (ESTSC)

    1997-01-24

    This software, which consists of a main executive and several subroutines, performs control of the optics, image acquisition, and Digital Signal Processing (DSP) of this image, of an optical based medical instrument that performs fluoresence detection of precancerous lesions (neoplasia) of the human cervix. The hardware portion of this medical instrument is known by the same name Cervical Neoplasia Probe (CNP)

  17. Cervical silicone lymphadenopathy.

    PubMed

    Gilbert, Latoni Kaysha; Thiruchelvam, Janavikulam

    2016-07-01

    A patient presented to the department of oral and maxillofacial surgery with a rare case of cervical silicone lymphadenopathy. She had a painless ovoid mass in the left side of her neck and had had cosmetic breast augmentation 10 years before. Radiological imaging and core biopsy examination were consistent with silicone lymphadenopathy. PMID:26830068

  18. Congenital Midline Cervical Cleft

    PubMed Central

    Villanueva-Meyer, Javier; Glastonbury, Christine; Marcovici, Peter

    2015-01-01

    Congenital midline cervical cleft is a rare anomaly that typically presents in the neonatal period as a thin suprasternal vertical band of erythematous skin with a nipple-like projection superiorly, which may exude fluid. We present the clinical and pathophysiologic features and the imaging findings of this uncommon, and rarely described entity in a newborn girl. PMID:25926928

  19. Diabetes and cervical myelopathy.

    PubMed

    Houten, John K; Lenart, Christopher

    2016-05-01

    Diabetes may affect the typical physical findings associated with cervical spondylotic myelopathy, as coexisting diabetic neuropathy may dampen expected hyperreflexia and also produce non-dermatomal extremity numbness. Most large studies of surgically treated diabetic patients with cervical spondylotic myelopathy have focused upon infection rates rather than exploring any differences in the presenting physical signs. We conducted a retrospective study of the pattern of presenting neurological signs and symptoms and of the clinical outcomes in 438 patients surgically treated for cervical spondylotic myelopathy, 79 of whom had diabetes. Compared with non-diabetic patients, those with diabetes were slightly older and had lower preoperative modified Japanese Orthopaedic Association (mJOA) scores. Those with diabetes also had a significantly higher incidence of hyporeflexia and a higher incidence of a positive Babinski sign, but there was no difference in the appearance of the Hoffman sign. The magnitude of mJOA improvement after surgery was comparable. We conclude that diabetes may alter the typical signs and symptoms of cervical spondylotic myelopathy and suggest that knowledge of the differences may aid in securing a prompt and accurate diagnosis. PMID:26747704

  20. An Incidental Finding of a Radiopaque Pill following Cervical Spinal Surgery in a Parkinson's Disease Patient.

    PubMed

    Gu, Bon Sub; Choi, Soo-Jung; Yoo, Byoungwoo; Han, Koon Hee; Park, Jong Kyu; Lee, Young-Seok; Park, Jin Hoon

    2015-09-01

    There are previous reports of the identification of radiopaque medications on abdominal X-rays or computed tomography (CT). We describe an interesting case of the incidental identification of a radiopaque medication on cervical spinal CT following cervical spinal surgery. A sixty seven-year-old male patient with Parkinson's disease (PD) visited our emergency center with a C5-6 dislocation and fracture. Surgery was performed with open reduction and pedicle screw fixation through the posterior approach. No abnormal events occurred during the perioperative period. However, a radiopaque incidental foreign body in front of the C6 vertebrae was found on a cervical spinal CT and X-rays that were performed as routine examinations on postoperative day 3. After 6 hours, we performed gastrofibroscopy (GFS) but were unable to find anything. Therefore, we checked all of his medications related to the neck and check X-ray again. One enteric-coated pill he had taken exhibited strong radiodensity. Although our patient underwent an unnecessary GFS, every spinal surgeon should keep in mind that radiopaque pills can appear similar to spinal instruments on X-ray and CT. In addition, we should also know the associated dysphagia is a possible cause of the delayed passage of medicine in PD with or without cervical osteophytes. PMID:26512272

  1. Cervical ectopic pregnancy.

    PubMed

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

    Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Early diagnosis and medical management with systemic or local administration of methotrexate is the treatment of choice. If the pregnancy is disturbed, it may lead to massive hemorrhage, which may require hysterectomy to save the patient. We report three cases of cervical pregnancy managed successfully with different approaches of management. Our first case, 28 years old G3P2L2 with previous two lower segment cesarean sections, presented with bleeding per vaginum following 6 weeks of amenorrhea. Clinical examination followed by transvaginal ultrasound confirmed the diagnosis of cervical pregnancy. Total abdominal hysterectomy was done in view of intractable bleeding to save the patient. The second case, a 26-year-old second gravida with previous normal vaginal delivery presented with pain abdomen and single episode of spotting per vaginum following 7 weeks of amenorrhea. Transvaginal ultrasound revealed empty endometrial cavity, closed internal os with gestational sac containing live fetus of 7 weeks gestational age in cervical canal and she was treated with intra-amniotic potassium chloride followed by systemic methotrexate. Follow up with serum beta human chorionic gonadotropin level revealed successful outcome. Our third case, a 27-year-old primigravida with history of infertility treatment admitted with complaints of bleeding per vaginum for 1 day following 8 weeks amenorrhea. She was diagnosed as cervical pregnancy by clinical examination, confirmed by transvaginal ultrasonography and subsequently managed by dilation and curettage with intracervical Foleys' ballon tamponade. PMID:25810679

  2. Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli

    PubMed Central

    Yin, Zhaoyang; Yin, Jian; Cai, Jun; Sui, Tao; Cao, Xiaojian

    2015-01-01

    Abstract Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk (CST) ganglia in Chinese cadaver specimens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining specimens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilateral CST and the midline of the vertebra was 11.2°±1.8° on the left side and 10.3°±1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°±1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries. PMID:26668584

  3. Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli.

    PubMed

    Yin, Zhaoyang; Yin, Jian; Cai, Jun; Sui, Tao; Cao, Xiaojian

    2015-11-01

    Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk (CST) ganglia in Chinese cadaver specimens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining specimens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilateral CST and the midline of the vertebra was 11.2°±1.8° on the left side and 10.3°±1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°±1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries. PMID:26668584

  4. Late prevertebral abscess with sinus following anterior cervical corpectomy and fusion.

    PubMed

    Bhise, Swapnil D; Mathesul, Ambarish A; Deokate, Pravin; Chandanwale, Ajay S; Bartakke, Girish D

    2015-01-01

    Anterior cervical discectomy/corpectomy and fusion is performed in degenerative, traumatic and neoplastic etiologies of the cervical spine. This procedure is highly successful and associated with fewer complications. The rates of early and late postoperative infection have been reported to be between 0.1% and 1.6%, the late infections are being very rare. We report a rare case of a 30-year-old HIV negative, non-diabetic male who developed a late prevertebral cervical abscess with discharging sinus over posterior triangle of neck 3 years after an anterior cervical C6 corpectomy with fibular grafting and buttress screw fixation performed elsewhere for traumatic fracture C6 vertebra. The abscess was drained using radical neck dissection approach with complete excision of sinus track and removal of the infected implant. On culture, the organism was found to be beta-hemolytic streptococci, for which appropriate antibiotics were administered postoperatively. The sinus tract completely healed in 3 months time. Late infection as a complication of anterior cervical spine surgeries is rare and is associated with esophageal perforation, implant migration, seeding of the deep prevertebral space with oropharyngeal flora, or from surgical site/bacteremia or with Zenker's diverticulum. Few cases have been reported till date, but none have presented with a sinus tract. We present a case of delayed prevertebral abscess after cervical spine instrumentation that followed abnormal path causing sinus track to be developed in the site (the posterior triangle of the neck) other than previous incision site. Exploring both triangles of the neck using radical neck dissection approach was essential for complete excision of sinus track, removal of screw and debridement. PMID:26396628

  5. Surgical correction of severe cervical kyphosis in patients with neurofibromatosis Type 1.

    PubMed

    Kawabata, Soya; Watanabe, Kota; Hosogane, Naobumi; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

    2013-03-01

    Severe cervical kyphosis requiring surgical treatment is rare in patients with neurofibromatosis Type 1 (NF1). When it occurs, however, dystrophic changes in the vertebrae make surgical correction and fusion of the deformity extremely difficult. The authors report on 3 cases of severe cervical kyphosis associated with NF1 that were successfully treated with combined anterior and posterior correction and fusion. All patients underwent halo-gravity traction for approximately 1 month prior to surgery to correct the deformity gradually. Posterior correction and fusion were performed with segmental spinal instrumentation consisting of lateral mass screws, lamina screws, pedicle screws, and polyethylene tape for sublaminar wiring. Anterior spinal fusion was performed using a fibula strut to induce solid bone fusion. All patients used a halo vest for postoperative external fixation. Preoperative CT scans showed dystrophic cervical spine changes, and MR images demonstrated extensive neurofibromas outside the cervical spine in all 3 patients. The preoperative kyphotic angles were as follows: Case 1, 140°; Case 2, 81°; and Case 3, 72°; after halo-gravity traction, the kyphosis angles improved to 50°, 55°, and 51°, respectively; and after surgery, they were 50°, 15°, and 27°, respectively. Solid bone union was observed in all patients at the latest follow-up. All three patients experienced postoperative complications consisting of superficial infection, severe pneumonia, and partial dislocation of the distal fibula graft after removing the halo vest, in one patient each. Although dystrophic cervical vertebral changes in these patients with NF1 complicated the correction of severe cervical kyphosis, the use of preoperative halo-gravity traction, a combination of spinal instrumentations, an anterior strut bone graft, and postoperative halo-vest fixation made it possible to correct the kyphosis, maintain the correction, and achieve solid bone fusion. PMID:23289507

  6. Late prevertebral abscess with sinus following anterior cervical corpectomy and fusion

    PubMed Central

    Bhise, Swapnil D.; Mathesul, Ambarish A.; Deokate, Pravin; Chandanwale, Ajay S.; Bartakke, Girish D.

    2015-01-01

    Anterior cervical discectomy/corpectomy and fusion is performed in degenerative, traumatic and neoplastic etiologies of the cervical spine. This procedure is highly successful and associated with fewer complications. The rates of early and late postoperative infection have been reported to be between 0.1% and 1.6%, the late infections are being very rare. We report a rare case of a 30-year-old HIV negative, non-diabetic male who developed a late prevertebral cervical abscess with discharging sinus over posterior triangle of neck 3 years after an anterior cervical C6 corpectomy with fibular grafting and buttress screw fixation performed elsewhere for traumatic fracture C6 vertebra. The abscess was drained using radical neck dissection approach with complete excision of sinus track and removal of the infected implant. On culture, the organism was found to be beta-hemolytic streptococci, for which appropriate antibiotics were administered postoperatively. The sinus tract completely healed in 3 months time. Late infection as a complication of anterior cervical spine surgeries is rare and is associated with esophageal perforation, implant migration, seeding of the deep prevertebral space with oropharyngeal flora, or from surgical site/bacteremia or with Zenker's diverticulum. Few cases have been reported till date, but none have presented with a sinus tract. We present a case of delayed prevertebral abscess after cervical spine instrumentation that followed abnormal path causing sinus track to be developed in the site (the posterior triangle of the neck) other than previous incision site. Exploring both triangles of the neck using radical neck dissection approach was essential for complete excision of sinus track, removal of screw and debridement. PMID:26396628

  7. A systematic review of the use of expandable cages in the cervical spine.

    PubMed

    Elder, Benjamin D; Lo, Sheng-Fu; Kosztowski, Thomas A; Goodwin, C Rory; Lina, Ioan A; Locke, John E; Witham, Timothy F

    2016-01-01

    Expandable vertebral body replacement cages (VBRs) have been widely used for reconstruction of the thoracolumbar spine following corpectomy. However, their use in the cervical spine is less common, and currently, no expandable cages on the market are cleared or approved by the US Food and Drug Administration for use in the cervical spine. The objective of this study was to perform a systematic review on the use of expandable cages in the treatment of cervical spine pathology with a focus on fusion rates, deformity correction, complications, and indications. A comprehensive Medline search was performed, and 24 applicable articles were identified and included in this review. The advantages of expandable cages include greater ease of implantation with less risk of damage to the end plate, less intraoperative manipulation of the device, and potentially greater control over lordosis. They may be particularly advantageous in cases with poor bone quality, such as patients with osteoporosis or metastatic tumors that have been radiated. However, there is a potential risk of overdistraction, which is increased in the cervical spine, their minimum height limits their use in cases with collapsed vertebra, and the amount of hardware in the expansion mechanism may limit the surface area available for fusion. The use of expandable VBRs are a valuable tool in the armamentarium for reconstruction of the anterior column of the cervical spine with an acceptable safety profile. Although expandable cervical cages are clearly beneficial in certain clinical situations, widespread use following all corpectomies is not justified due to their significantly greater cost compared to structural bone grafts or non-expandable VBRs, which can be utilized to achieve similar clinical outcomes. PMID:26212700

  8. Group-wise registration of ultrasound to CT images of human vertebrae

    NASA Astrophysics Data System (ADS)

    Gill, Sean; Mousavi, Parvin; Fichtinger, Gabor; Pichora, David; Abolmaesumi, Purang

    2009-02-01

    Automatic registration of ultrasound (US) to computed tomography (CT) datasets is a challenge of considerable interest, particularly in orthopaedic and percutaneous interventions. We propose an algorithm for group-wise volume-to-volume registration of US to CT images of the lumbar spine. Each vertebra in CT is treated as a sub-volume and transformed individually. The sub-volumes are then reconstructed into a single volume. The algorithm dynamically combines simulated US reflections from the vertebrae surfaces and surrounding soft tissue in the reconstructed CT, with scaled CT data to simulate US images of the spine anatomy. The simulated US data is used to register preoperative CT data to intra-operative US images. Covariance Matrix Adaption - Evolution Strategy (CMA-ES) is utilized as the optimization strategy. The registration is tested using a phantom of the lumbar spine (L3-L5). Initial misalignments of up to 8 mm were registered with a mean target registration error of 1.87+/-0.73 mm for L3, 2.79+/-0.93 mm for L4, 1.72+/-0.70 mm for L5, and 2.08+/-0.55 mm across the entire volume. To select an appropriate optimization strategy, we performed a volume-to- volume registration of US to CT of the lumbar spine, allowing no relative motion between vertebrae. We compare the results of this registration using three optimization strategies: simplex, gradient descent and CMA-ES. CMA-ES was found to converge slower than gradient descent and simplex, but was more robust for rigid volume-to-volume registration for initial misalignments up to 20 mm.

  9. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage IB-IVA Cervical Cancer

    ClinicalTrials.gov

    2016-03-16

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  10. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    ClinicalTrials.gov

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  11. Induction of osteosarcomas in mouse lumbar vertebrae by repeated external beta-irradiation

    SciTech Connect

    Ootsuyama, A.; Tanooka, H.

    1989-03-15

    Besides skin tumors, osteosarcomas were induced at high frequency in the lumbar vertebrae of ICR mice by repeated local external irradiation of the back with /sup 90/Sr-/sup 90/Y beta-rays when irradiation was repeated three times a week until tumors appeared. The optimum dose range for osteosarcoma induction was 250-350 cGy per exposure at the surface of the back, or 125-175 cGy at the depth of the center of the bone. With the same irradiation schedule, the optimal dose of radiation for induction of osteosarcomas was much lower than that for induction of skin tumors.

  12. Retroaortic Variant of Reverse Horseshoe Kidney With Butterfly Vertebrae Presenting as Neurogenic Bladder.

    PubMed

    Esen, Baris; Telli, Onur; Ucan, Berna; Fitoz, Suat; Unlu, Agahan; Burgu, Berk; Soygur, Tarkan

    2016-09-01

    Horseshoe kidney is a relatively common congenital anomaly. In 95% of the cases, lower poles are connected to each other. In a small subset, an isthmus connects both upper poles (reverse horseshoe kidney). Almost always, the fusion of kidney poles occurs anterior to the aorta and vena cava. The fusion of renal poles posterior to both aorta and vena cava is extremely rare. Herein, we present a case with multiple rare congenital anomalies-retroaortic variant of reverse horseshoe kidney, retroaortic left renal vein, and butterfly vertebrae. PMID:27282812

  13. [Research advances of three-dimension printing technology in vertebrae and intervertebral disc tissue engineering].

    PubMed

    Yang, Zechuan; Li, Chunde; Sun, Haolin

    2016-03-01

    Three-dimensional (3D) printing technology is characterized by "inside-out" stack manufacturing. Compared with conventional technologies, 3D printing has the advantage of personalization and precision. Therefore, the shape and internal structure of the scaffolds made by 3D printing technology are highly biomimetic. Besides, 3D bioprinting can precisely deposit the biomaterials, seeding cells and cytokines at the same time, which is a breakthrough in printing technique and material science. With the development of 3D printing, it will make great contributions to the reconstruction of vertebrae and intervertebral disc in the future. PMID:27273987

  14. Current insights and controversies in the pathogenesis and diagnosis of disc-associated cervical spondylomyelopathy in dogs.

    PubMed

    De Decker, S; da Costa, R C; Volk, H A; Van Ham, L M L

    2012-11-24

    Disc-associated cervical spondylomyelopathy (DA-CSM) is the most common cause of cervical spondylomyelopathy in dogs. In this condition, progressive caudal cervical spinal cord compression is typically caused by protrusion of one or more intervertebral discs. This disc-associated compression is sometimes seen in combination with mild vertebral abnormalities and dorsal compression resulting from ligamentum flavum hypertrophy. The intervertebral disc space between the sixth (C6) and seventh (C7) cervical vertebrae is most commonly affected. Although several large breed dogs can be affected, the adult to older dobermann is overrepresented. Clinical signs vary from cervical hyperaesthesia to tetraplegia. Dogs can present with a chronic progressive or an acute onset of clinical signs. Many aspects of this multifactorial neurological syndrome are not completely understood and are the subject of controversy and debate. Although several factors have been proposed, the underlying pathology and aetiology remain unknown. Recently, new insights have been gained in the pathogenesis, diagnosis and treatment of this challenging neurological syndrome. This review outlines current controversies and new developments concerning the pathogenesis and diagnosis of DA-CSM. PMID:23180710

  15. Accessory articulation of elongated anterior transverse process: a rare anatomical variant of the cervical spine depicted with CT and post-processing techniques.

    PubMed

    Bilreiro, C; Saraiva, J; Duarte Silva, L; Brito, J; Grande, P

    2016-03-01

    There are several described anatomical variants of the cervical spine, ranging from common to extremely rare, which may have different clinical implications. We present the case of an extremely rare anatomical variant of the cervical spine, in a symptomatic patient, consisting of a unilateral accessory articulation between the 5th and 6th cervical vertebrae, due to elongated anterior transverse processes. Our search found only three cases in the English literature describing similar findings to the case here reported. Our case is, to our knowledge, the first report of this anatomical variant imaged with computed tomography including post-processing images (volume rendering technology and multiplanar reformations), which contribute greatly to a better understanding and depiction of the anatomical variant. PMID:26251024

  16. Adenocarcinoma of the cervical stump

    SciTech Connect

    Goodman, H.M.; Niloff, J.M.; Buttlar, C.A.; Welch, W.R.; Marck, A.; Feuer, E.J.; Lahman, E.A.; Jenison, E.; Knapp, R.C. )

    1989-11-01

    Sixteen women with adenocarcinoma of the cervical stump were treated over a 15-year period. The median survivals of 40 months for stage IB and 17 months for stages II and III were significantly worse compared with those for patients treated for cervical adenocarcinoma of the intact uterus or squamous carcinoma of the cervical stump. The poor results were due to both local and distant failure. Implications regarding tumor radiosensitivity and adjuvant therapy in these high-risk patients are discussed.

  17. The cervical spine: radiologist's perspective.

    PubMed

    Mink, Jerrold H; Gordon, Rachael E; Deutsch, Andrew L

    2003-08-01

    This article provides an essential curriculum in cervical spine radiology. It discusses the uses of plain radiographs, MR imaging, computed tomography (CT), and CT myelography, in addition to the methodologies of discography, epidural injections under visualization, and facet and nerve root injections. It explains how radiographic images of the cervical spine can differentiate tumors, inflammation, recent or prior trauma, and the range of discal, arthritic, neural, and vascular cervical pathologies and, just as importantly, when they cannot. PMID:12948340

  18. Degenerative cervical myelopathy.

    PubMed

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  19. [Cervical disc herniation].

    PubMed

    Schnake, K J; Hoffmann, C-H; Kandziora, F

    2012-12-01

    The cervical disc herniation is characterized by prolapsed nucleus pulposus material through the annulus into the spinal canal. The local mechanical or chemical irritation of neural structures typically leads to symptoms of radiculopathy, cervicocephalgia or myelopathy. Pronounced sensorimotor deficits or intractable pain constitute surgical treatment. In all other cases conservative treatment is indicated, including pain medication, active and passive physiotherapy, and local injections, respectively. Anterior cervical discectomy and interbody fusion (ACDF) is still the surgical treatment of choice. Predominantly, cages with or without plates are in use to obtain solid fusion. The implantation of a total disc replacement is a viable alternative, if no contraindications exist. Other surgical techniques may be performed in proper selected cases. The overall clinical and radiological results of both surgical and conservative treatment are good. PMID:23296562

  20. [Primary cervical cancer screening].

    PubMed

    Vargas-Hernández, Víctor Manuel; Vargas-Aguilar, Víctor Manuel; Tovar-Rodríguez, José María

    2015-01-01

    Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis. PMID:26162490

  1. Preinduction cervical ripening.

    PubMed

    Thiery, M

    1983-01-01

    This work reviews the evolution of cervical ripening procedures and discusses the most effective current techniques. Current knowledge of the process of spontaneous ripening of the cervix is briefly assessed, but the review concentrates on methodological aspects and the clinical results of preinduction cervical ripening. The historical development of mechanical and pharmacologic ripening procedures is examined, including enzymes, oxytocin, relaxin, corticosteriods, estrogens administered parenterally or locally, and prostaglandins (PGs) administered intravenously, orally, locally, and intravaginally. 3 effective procedures for preinduction cervical ripening are identified and described in greater detail: the catheter technique and local and vaginal administration of PGs. The extraamniotic catheter technique is simple, effective, and safe and is recommended for patients with not totally unripe cervixes and for whom PGs are unavailable or contraindicated. Single-dose extraamniotic instillation of PGE2 in Tylose gel was found to be highly effective for priming the unfavorable cervix before conventional labor induction. In some patients the procedure induces labor. The technique is easy to use, well accepted by the woman, and safe when applied appropriately to carefully selected patients. PGF2alpha gel has been less thoroughly studied. Electronic monitoring at the ripening stage is recommended for patients at risk, and even in low-risk cases much larger series will require study before conclusions can be reached about safety. Injection of PG gel into the cervical canal is less invasive than extraamniotic instillation, but no definite conclusions about its safety are possible due to small series and dissimilar clinical protocols. Pericervical administration of PGE2 and PGF2 alpha and intracervical and intraamniotic tablets of PGE2 are briefly assessed. Adoption of the intravaginal route has been a major step in the development of ripening techniques. 3 types of media

  2. Congenital midline cervical cleft.

    PubMed

    Agag, Richard; Sacks, Justin; Silver, Lester

    2007-01-01

    Congenital midline cervical cleft (CMCC) is a rare disorder of the ventral neck that is clinically evident at birth and must be differentiated from the more common thyroglossal duct cyst. The case of CMCC presented here was associated with chromosomes 13/14 de novo Robertsonian translocations as well as midline deformities including a sacral tuft and a minor tongue-tie. The case is presented as well as discussion of histopathology, embryology, and surgical treatment. PMID:17214531

  3. Cervical spondylosis. An update.

    PubMed Central

    McCormack, B M; Weinstein, P R

    1996-01-01

    Cervical spondylosis is caused by degenerative disc disease and usually produces intermittent neck pain in middle-aged and elderly patients. This pain usually responds to activity modification, neck immobilization, isometric exercises, and medication. Neurologic symptoms occur infrequently, usually in patients with congenital spinal stenosis. For these patients, magnetic resonance imaging is the preferred initial diagnostic study. Because involvement of neurologic structures on imaging studies may be asymptomatic, consultation with a neurologist is advised to rule out other neurologic diseases. In most cases of spondylotic radiculopathy, the results of conservative treatment are so favorable that surgical intervention is not considered unless pain persists or unless there is progressive neurologic deficit. If indicated, a surgical procedure may be done through the anterior or posterior cervical spine; results are gratifying, with long-term improvement in 70% to 80% of patients. Cervical spondylotic myelopathy is the most serious and disabling condition of this disease. Because many patients have nonprogressive minor impairment, neck immobilization is a reasonable treatment in patients presenting with minor neurologic findings or in whom an operation is contraindicated. This simple remedy will result in improvement in 30% to 50% of patients. Surgical intervention is indicated for patients presenting with severe or progressive neurologic deficits. Anterior cervical approaches are generally preferred, although there are still indications for laminectomy. Surgical results are modest, with good initial results expected in about 70% of patients. Functional outcome noticeably declines with long-term follow-up, which raises the question of whether, and how much, surgical treatment affects the natural course of the disease. Prospective randomized studies are needed to answer these questions. Images Figure 1. Figure 2. Figure 3. PMID:8855684

  4. Osteotomies in the Cervical Spine

    PubMed Central

    Nemani, Venu M.; Derman, Peter B.

    2016-01-01

    Rigid cervical deformities are difficult problems to treat. The goals of surgical treatment include deformity correction, achieving a rigid fusion, and performing a thorough neural decompression. In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance. In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment. We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications. PMID:26949476

  5. Automatic construction of patient-specific finite-element mesh of the spine from IVDs and vertebra segmentations

    NASA Astrophysics Data System (ADS)

    Castro-Mateos, Isaac; Pozo, Jose M.; Lazary, Aron; Frangi, Alejandro F.

    2016-03-01

    Computational medicine aims at developing patient-specific models to help physicians in the diagnosis and treatment selection for patients. The spine, and other skeletal structures, is an articulated object, composed of rigid bones (vertebrae) and non-rigid parts (intervertebral discs (IVD), ligaments and muscles). These components are usually extracted from different image modalities, involving patient repositioning. In the case of the spine, these models require the segmentation of IVDs from MR and vertebrae from CT. In the literature, there exists a vast selection of segmentations methods, but there is a lack of approaches to align the vertebrae and IVDs. This paper presents a method to create patient-specific finite element meshes for biomechanical simulations, integrating rigid and non-rigid parts of articulated objects. First, the different parts are aligned in a complete surface model. Vertebrae extracted from CT are rigidly repositioned in between the IVDs, initially using the IVDs location and then refining the alignment using the MR image with a rigid active shape model algorithm. Finally, a mesh morphing algorithm, based on B-splines, is employed to map a template finite-element (volumetric) mesh to the patient-specific surface mesh. This morphing reduces possible misalignments and guarantees the convexity of the model elements. Results show that the accuracy of the method to align vertebrae into MR, together with IVDs, is similar to that of the human observers. Thus, this method is a step forward towards the automation of patient-specific finite element models for biomechanical simulations.

  6. Cervical Footprint Anthropometry in Indian Population: Implications on Design of Artificial Disc Replacement Devices

    PubMed Central

    Patil, Vishwanath Mahabaleshwar; Bangalore, Shashidhar Kantharajanna; Saraf, Abhishek

    2016-01-01

    Study Design Cross-sectional study. Purpose To accurately measure the dimensions of cervical endplates based on computed tomography (CT) scans in Indian population and assess accuracy of match with currently available cervical disc prostheses. Overview of Literature The dimensions of currently available cervical disc replacement implants are based on early published geometrical measurements of vertebrae endplates for Caucasian population. To author's knowledge, similar study has not been published for patients from Indian subcontinent. Methods CT scans of cervical spine of patients from Indian subcontinent were collected and reviewed. Seventy patients (54 men and 16 women; aged 18–56 years with average of 37 years) who underwent CT scans of cervical spine were included in study. 3D CT scans of sub axial cervical spine (C3 to C7) were analyzed. The anterior-posterior (AP) and central mediolateral (CML) dimensions of superior and inferior endplates from C3 to C7 were measured using digital measuring system. Results A total of 560 endplates of 70 patients were included in the study. The AP diameter of cervical endplates ranged from 0.87 to 2.47 cm. The CML diameters ranged from 0.84 to 2.98 cm. For levels C3/C4 and C4/C5 for AP dimension Prestige-LP (90.5%) and Prodisc-C (89%) discs showed higher percentage of matching than Discover discs (58.5%). For CML diameter, Prestige-LP (69.5%), Prodisc-C (70%) and Discover (39.5%) discs showed almost similar matching with measured endplates. For levels C5/C6 and C6/C7 for AP dimension, Prestige-LP (67.25%), Prodisc-C (49.35%) and Discover (51.5%) discs showed similar matching. For CML diameter Prestige-LP (32%), Prodisc-C (27.5%) and Discover (42.2%) discs showed poor matching with measured endplates. Conclusions This study indicates need for redesign of cervical disc prostheses to match Indian patients. The collected anthropometric dimensions from this study may be used to design and develop indigenous artificial total disc

  7. High Prevalence of Cervical Deformity and Instability Requires Surveillance in Loeys-Dietz Syndrome

    PubMed Central

    Fuhrhop, Sara K.; McElroy, Mark J.; Dietz, Harry C.; MacCarrick, Gretchen L.; Sponseller, Paul D.

    2015-01-01

    Background: Loeys-Dietz syndrome is a connective tissue disorder characterized by vascular, craniofacial, and musculoskeletal malformation. Our goal was to report the manifestations, surgical treatment, and complications in the cervical spine in patients with Loeys-Dietz syndrome. Methods: We reviewed the clinical and cervical spine imaging data of eighty patients with Loeys-Dietz syndrome who were seen at our institution from January 2005 through January 2014. Their mean age at presentation was 17.3 years (range, three months to seventy-five years). We tested associations with use of the Fisher exact test (type of TGF-βR [transforming growth factor-beta receptor] mutation and cervical abnormalities) and the Student t test (age at presentation and type of TGF-βR mutation) (significance, p = 0.05). Results: Vertebral anomalies and cervical instability were common; we found no significant association of TGF-βR-type with cervical abnormalities or age at presentation. Twenty-eight patients had atlas defects (anterior and/or posterior arch defects or hypoplasia), fifty-three had axis malformations (elongation, apex-anterior dens angulation, or spondylolysis), and twelve had focal kyphosis. Ten patients had hypoplastic subaxial vertebrae, leading to focal kyphosis (eight) and subaxial instability (nine). Eight patients had atlantoaxial instability. Of the thirteen patients with cervical instability, nine were treated surgically: fusion (eight patients) and halo application (one) (mean age, four years; range, three months to twelve years). Postoperative complications (seven patients) were pseudarthrosis, failure of fixation, junctional kyphosis or instability, and development of occipital-cervical instability. Conclusions: Cervical midline defects (most often C1-C3) are common in Loeys-Dietz syndrome. Patients have a high prevalence of cervical instability, particularly a pattern of instability at C2-C3 associated with C3 vertebral body hypoplasia and C2-C3 focal

  8. Application of bioabsorbable screw fixation for anterior cervical decompression and bone grafting

    PubMed Central

    Zhao, Bo; Qiu, Xiaowen; Wang, Dong; Li, Haopeng; He, Xijing

    2016-01-01

    OBJECTIVES: To examine the application of bioabsorbable screws for anterior cervical decompression and bone grafting fixation and to study their clinical effects in the treatment of cervical spondylosis. METHODS: From March 2007 to September 2012, 56 patients, 36 males and 20 females (38-79 years old, average 58.3±9.47 years), underwent a novel operation. Grafts were fixed by bioabsorbable screws (PLLA, 2.7 mm in diameter) after anterior decompression. The bioabsorbable screws were inserted from the midline of the graft bone to the bone surface of the upper and lower vertebrae at 45 degree angles. Patients were evaluated post-operatively to observe the improvement of symptoms and evaluate the fusion of the bone. The Japanese Orthopaedic Association (JOA) score was used to evaluate the recovery of neurological functions. RESULTS: All screws were successfully inserted, with no broken screws. The rate of symptom improvement was 87.5%. All of the grafts fused well with no extrusion. The average time for graft fusion was 3.8±0.55 months (range 3-5 months). Three-dimensional reconstruction of CT scans demonstrated that the grafts fused with adjacent vertebrae well and that the screws were absorbed as predicted. The MRI findings showed that the cerebrospinal fluid was unobstructed. No obvious complications appeared in any of the follow-up evaluations. CONCLUSIONS: Cervical spondylosis with one- or two-level involvement can be effectively treated by anterior decompression and bone grafting with bioabsorbable screw fixation. This operative method is safe and can avoid the complications induced by metal implants. PMID:27438565

  9. Biomechanics of Cervical ‘Skip’ Corpectomy versus Standard Multilevel Corpectomy

    PubMed Central

    Yilmaz, Murat; Yüksel, K. Zafer; Baek, Seungwon; Sawa, Anna G.U.; Dalbayrak, Sedat; Sonntag, Volker K.H.; Crawford, Neil R.

    2012-01-01

    Study Design In vitro biomechanical study of flexibility with finite element simulation to estimate screw stresses. Objective To compare cervical spinal stability after a standard plated three-level corpectomy with stability after a plated three-level “skip” corpectomy where the middle vertebra is left intact (i.e., two one-level corpectomies), and to quantify pullout forces acting on the screws during various loading modes. Summary of Background Data Clinically, three-level cervical plated corpectomy has a high rate of failure, partially because only four contact points affix the plate to the upper and lower intact vertebrae. Leaving the intermediate vertebral body intact for additional fixation points may overcome this problem while still allowing dural sac decompression. Methods Quasistatic nonconstraining torque (maximum 1 Nm) induced flexion, extension, lateral bending, and axial rotation while angular motion was recorded stereophotogrammetrically. Specimens were tested intact and after corpectomy with standard plated and strut-grafted three-level corpectomy (7 specimens) or ‘skip’ corpectomy (7 specimens). Screw stresses were quantified using a validated finite element model of C3–C7 mimicking experimentally tested groups. Skip corpectomy with C5 screws omitted was also simulated. Results Plated skip corpectomy tended to be more stable than plated standard corpectomy, but the difference was not significant. Compared to standard plated corpectomy, plated skip corpectomy reduced peak screw pull-out force during axial rotation (mode of loading of highest peak force) by 15% (4-screw attachment) and 19% (6-screw attachment). Conclusions Skip corpectomy is a good alternative to standard three-level corpectomy to improve stability, especially during lateral bending. Under pure moment loading, the screws of a cervical multilevel plate experience the highest pullout forces during axial rotation. Thus, limiting this movement in patients undergoing plated

  10. Fitting the cervical cap.

    PubMed

    Brokaw, A K; Baker, N N; Haney, S L

    1988-07-01

    The cervical cap is now available for general use by American women. Several steps are necessary to select women who are good candidates for cap usage and to successfully fit the cap. Many women are not good candidates for the cap. The cap is generally not suitable for women who have recently become sexually active or who are first-time contraceptors. Many users are women who cannot use more widely available contraceptives. Successful cap use requires a highly motivated, persistent woman who will correctly insert and remove her cap. The size, shape, length, position and location of the cervix must be assessed by the clinician prior to fitting the cap. The cervix should be visually inspected for lesions or cervicitis and a Pap smear should be taken. After an initial cap is selected, the stability of the cap, gaps between the cap and cervix, areas of uncovered cervix and the adequacy of the suction seal should be assessed. The woman should be taught how to insert and remove the cap. Additionally, she should be instructed to use a backup method of contraception until she is sure that the cap will remain in place during sexual intercourse. Successful cap fitting requires a careful, methodical approach by the clinician and a carefully selected, highly motivated client. This article presents the steps of cervical cap fitting. PMID:3405494

  11. Optimization of spinal implant screw for lower vertebra through finite element studies.

    PubMed

    Biswas, Jayanta; Karmakar, Santanu; Majumder, Santanu; Banerjee, Partha Sarathi; Saha, Subrata; Roychowdhury, Amit

    2014-01-01

    The increasing older population is suffering from an increase in age-related spinal degeneration that causes tremendous pain. Spine injury is mostly indicated at the lumbar spine (L3-L5) and corresponding intervertebral disks. Finite element analysis (FEA) is now one of the most efficient and accepted tools used to simulate these pathological conditions in computer-assisted design (CAD) models. In this study, L3-L5 spines were modeled, and FEA was performed to formulate optimal remedial measures. Three different loads (420, 490.5, and 588.6 N) based on three body weights (70, 90, and 120 kg) were applied at the top surface of the L3 vertebra, while the lower surface of the L5 vertebra remained fixed. Models of implants using stainless steel and titanium alloy (Ti6Al4V) pedicle screws and rods with three different diameters (4, 5, and 6 mm) were inserted into the spine models. The relative strengths of bone (very weak, weak, standard, strong, and very strong) were considered to determine the patient-specific effect. A total of 90 models were simulated, and von Mises stress and strain, shear stress, and strain intensity contour at the bone-implant interface were analyzed. Results of these analyses indicate that the 6-mm pedicle screw diameter is optimal for most cases. Experimental and clinical validation are needed to confirm these theoretical results. PMID:25272208

  12. Jack-of-all-trades master of all? Snake vertebrae have a generalist inner organization

    NASA Astrophysics Data System (ADS)

    Houssaye, Alexandra; Boistel, Renaud; Böhme, Wolfgang; Herrel, Anthony

    2013-11-01

    Snakes are a very speciose group of squamates that adapted to various habitats and ecological niches. Their ecological diversity is of particular interest and functional demands associated with their various styles of locomotion are expected to result in anatomical specializations. In order to explore the potential adaptation of snakes to their environment we here analyze variation in vertebral structure at the microanatomical level in species with different locomotor adaptations. Vertebrae, being a major element of the snake body, are expected to display adaptations to the physical constraints associated with the different locomotor modes and environments. Our results revealed a rather homogenous vertebral microanatomy in contrast to what has been observed for other squamates and amniotes more generally. We here suggest that the near-absence of microanatomical specializations in snake vertebrae might be correlated to their rather homogeneous overall morphology and reduced range of morphological diversity, as compared to lizards. Thus, snakes appear to retain a generalist inner morphology that allows them to move efficiently in different environments. Only a few ecologically highly specialized taxa appear to display some microanatomical specializations that remain to be studied in greater detail.

  13. Surgical outcome of posterior fixation, including fractured vertebra, for thoracolumbar fractures

    PubMed Central

    Zhao, Quan M.; Gu, Xiao F.; Yang, Hui L.; Liu, Zhong T.

    2015-01-01

    Objective: To evaluate the role of posterior fixation including the fractured vertebra (PFFV) for the treatment of thoracolumbar vertebral fractures. Methods: Sixty-seven patients that sustained a single-level thoracolumbar fracture were included in this retrospective study carried out in the Wuxi People’s Hospital, Wuxi, China between August 2010 and June 2013. Thirty-two cases were treated with PFFV, and 35 cases were treated with traditional short-segment fixation (TSSF). All patients were periodically followed-up with clinical and radiologic evaluation. Cobb’s angle and vertebral body height were analyzed and compared, and the operational time, intra-operational blood loss, and the Denis pain scale scores were also compared. Results: Compared with preoperative angles, the Cobb’s angles were reduced and the vertebral body height of the fractured vertebra was increased after operation at a statistically significant level. Twelve months post-operative, the loss of Cobb’s angle and vertebral body height in the PFFV group was significantly less than that in the TSSF group. There was no statistical significance in the Denis pain scale score 12 months post-operatively between the 2 groups. Conclusion: Selective adoption of PFFV is helpful not only for stabilization of fractures and restoration of anatomy, but also maintaining the effectiveness of the restoration with good functional outcome. PMID:26492116

  14. Comparisons of Anterior Plate Screw Pullout Strength Between Polyurethane Foams and Thoracolumbar Cadaveric Vertebrae.

    PubMed

    Nagaraja, Srinidhi; Palepu, Vivek

    2016-10-01

    Synthetic polyurethane foams are frequently used in biomechanical testing of spinal medical devices. However, it is unclear what types of foam are most representative of human vertebral trabecular bone behavior, particularly for testing the bone-implant interface. Therefore, a study was conducted to compare polyurethane foam microstructure and screw pullout properties to human vertebrae. Cadaveric thoracolumbar vertebrae underwent microcomputed tomography to assess trabecular bone microstructure. Spine plate screws were implanted into the vertebral body and pullout testing was performed. The same procedure was followed for eight different densities (grades 5-30) of commercially available closed cell (CCF) and open cell foams (OCF). The results indicated that foam microstructural parameters such as volume fraction, strut thickness, strut spacing, and material density rarely matched that of trabecular bone. However, certain foams provided mechanical properties that were comparable to the cadavers tested. Pullout force and work to pullout for screws implanted into CCF grade 5 were similar to osteoporotic female cadavers. In addition, screw pullout forces and work to pullout in CCF grade 8, grade 10, and OCF grade 30 were similar to osteopenic male cadavers. All other OCF and CCF foams possessed pullout properties that were either significantly lower or higher than the cadavers tested. This study elucidated the types and densities of polyurethane foams that can represent screw pullout strength in human vertebral bone. Synthetic bone surrogates used for biomechanical testing should be selected based on bone quantity and quality of patients who may undergo device implantation. PMID:27536905

  15. Radiation Therapy and Cisplatin With or Without Epoetin Alfa in Treating Patients With Cervical Cancer and Anemia

    ClinicalTrials.gov

    2014-12-29

    Anemia; Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Drug Toxicity; Radiation Toxicity; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  16. Modified distraction-stabilization technique using an interbody polymethyl methacrylate plug in dogs with caudal cervical spondylomyelopathy.

    PubMed

    Dixon, B C; Tomlinson, J L; Kraus, K H

    1996-01-01

    A modified technique for distraction-stabilization that used an interbody polymethyl methacrylate plug was performed in 22 dogs with confirmed caudal cervical spondylomyelopathy. Myelographically, all compressive lesions were dynamic and predominantly located ventral to the spinal cord. Nineteen of 21 (90%) dogs for which success/failure could be determined had a successful outcome, and 11 of 22 (50%) dogs attained normal neurologic status. The 2 cases that were considered failures involved dogs that were nonambulatory tetraparetic prior to surgery and failed to improve to a functional status. Complications were self-limiting and included ventral displacement of the cement without loss of distraction in 1 dog and diskosponsylitis at an adjacent disk space in another dog. Evidence of fusion of the affected vertebrae, in the distracted position, was radiographically evident in all dogs. Use of the interbody polymethyl methacrylate plug appears to be a viable surgical treatment of caudal cervical spondylomyelopathy in dogs. PMID:8682707

  17. Bone Density in Patients with Cervical Cancer or Endometrial Cancer in comparison with Healthy Control; According to the stages

    PubMed Central

    Lee, Yubin; Kim, Ari; Kim, Heung Yeol; Eo, Wan Kyu; Lee, Eun Sil; Chun, Sungwook

    2015-01-01

    Objective: To evaluate the bone mineral density (BMD) in the lumbar spine and femur in postmenopausal women with cervical cancer and endometrial cancer without bone metastasis in comparison with that in healthy control postmenopausal women, and to assess the loss of BMD according to the cancer stage. Materials and methods: We analyzed the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry (DXA) in 218 patients with cervical cancer, 85 patients with endometrial cancer, and 259 healthy controls. The serum levels of calcium (Ca), phosphorus (P), osteocalcin (OSC), and total alkaline phosphatase (ALP), and urine deoxypyridinoline(DPL) were measured in all participants. Results: Age, body mass index, parity, and time since menopause were not significantly different between the three groups. Serum Ca level was higher in the cervical cancer group (p = 0.000), however, urine DPL was lower in endometrial cancer group (p = 0.000). The T-scores of basal BMD at the second and fourth lumbar vertebra (L2, L4) were significantly lower in patients with cervical cancer (p = 0.038, 0.000, respectively) compared to those in the healthy control groups. Additionally, the incidence of osteoporosis and osteopenia basal status of bone mass was significantly higher in patients with cervical cancer compared to that in controls (p = 0.016). No differences in basal BMD of the lumbar spine and femur were observed between patients with cervical cancer according to their stages. Conclusion: Our results suggest that postmenopausal women with cervical cancer have a lower BMD and are at increased risk of osteoporosis in the lumbar spine before receiving anticancer treatment compared with postmenopausal women with endometrial cancer. PMID:26185529

  18. Automatic localization of target vertebrae in spine surgery using fast CT-to-fluoroscopy (3D-2D) image registration

    NASA Astrophysics Data System (ADS)

    Otake, Y.; Schafer, S.; Stayman, J. W.; Zbijewski, W.; Kleinszig, G.; Graumann, R.; Khanna, A. J.; Siewerdsen, J. H.

    2012-02-01

    Localization of target vertebrae is an essential step in minimally invasive spine surgery, with conventional methods relying on "level counting" - i.e., manual counting of vertebrae under fluoroscopy starting from readily identifiable anatomy (e.g., the sacrum). The approach requires an undesirable level of radiation, time, and is prone to counting errors due to the similar appearance of vertebrae in projection images; wrong-level surgery occurs in 1 of every ~3000 cases. This paper proposes a method to automatically localize target vertebrae in x-ray projections using 3D-2D registration between preoperative CT (in which vertebrae are preoperatively labeled) and intraoperative fluoroscopy. The registration uses an intensity-based approach with a gradient-based similarity metric and the CMA-ES algorithm for optimization. Digitally reconstructed radiographs (DRRs) and a robust similarity metric are computed on GPU to accelerate the process. Evaluation in clinical CT data included 5,000 PA and LAT projections randomly perturbed to simulate human variability in setup of mobile intraoperative C-arm. The method demonstrated 100% success for PA view (projection error: 0.42mm) and 99.8% success for LAT view (projection error: 0.37mm). Initial implementation on GPU provided automatic target localization within about 3 sec, with further improvement underway via multi-GPU. The ability to automatically label vertebrae in fluoroscopy promises to streamline surgical workflow, improve patient safety, and reduce wrong-site surgeries, especially in large patients for whom manual methods are time consuming and error prone.

  19. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years. PMID:27606653

  20. Cervical spondylomyelopathy in Great Danes: a magnetic resonance imaging morphometric study.

    PubMed

    Martin-Vaquero, P; da Costa, R C; Lima, C G D

    2014-07-01

    Morphometric investigations comparing normal and affected animals increase our understanding of spinal diseases in dogs. The aim of this study was to generate morphometric data for osseous-associated cervical spondylomyelopathy (CSM) in Great Danes (GDs). Magnetic resonance imaging (MRI) morphometric features of the cervical vertebral column of GDs with and without clinical signs of CSM were characterized and compared. Thirty client-owned GDs were prospectively enrolled, including 15 clinically normal and 15 CSM-affected GDs. All dogs underwent MRI of the cervical to thoracic vertebral column (C2-C3 through T1-T2). Areas of the cranial and caudal articular processes, and the height, width and areas of the vertebral canal and spinal cord were determined. Middle foraminal heights were measured. Intervertebral disc width was measured before and after traction. Intraobserver and interobserver agreement were calculated. CSM-affected GDs had larger areas of the caudal articular processes from C2-C3 through T1-T2. In CSM-affected GDs, the vertebral canal and spinal cord areas were significantly smaller at C5-C6 and C6-C7, the vertebral canal width was significantly narrower at C6-C7 and C7-T1, and the spinal cord width was significantly narrower at C5-C6 and C6-C7. Middle foraminal height was smaller in CSM-affected GDs from C3-C4 through C7-T1. Neutral intervertebral disc widths were smaller in CSM-affected GDs. It was concluded that the cervical vertebral canal dimensions are significantly different between normal and CSM-affected GDs. Absolute vertebral canal stenosis and severe foraminal stenosis involving the cervical vertebrae distinguish CSM-affected from clinically normal GDs. These findings are relevant to the pathogenesis of osseous-associated CSM and should be taken into consideration when performing imaging studies and planning surgery. PMID:24888675

  1. Fractures of the cervical spine

    PubMed Central

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  2. Radiotherapy of Cervical Cancer.

    PubMed

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  3. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    PubMed

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  4. Nordic walking--is it suitable for patients with fractured vertebra?

    PubMed

    Wendlova, J

    2008-01-01

    This article brings the biomechanical analysis of sport--Nordic walking--for patients with osteoporotic fractured vertebrae and shows that it is suitable for them. Based on the biomechanical model of skeletal load we have developed a method of walking movement for patients, different from the method of walking movement for healthy people. And so came into being the "first sport" for patients with osteoporotic fractures. They can go for regular walks in easy terrains outdoors with friends and family, and so be liberated from social isolation. It requires only one-off financial costs of buying the poles and special footwear (Tab. 7, Fig. 3, Ref. 14). Full Text (Free, PDF) www.bmj.sk. PMID:18814434

  5. Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits

    PubMed Central

    Onu, David O; Hunn, Andrew W; Bohmer, Robert D

    2014-01-01

    The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors’ knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review. PMID:24403388

  6. Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits.

    PubMed

    Onu, David O; Hunn, Andrew W; Bohmer, Robert D

    2014-01-01

    The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review. PMID:24403388

  7. Morphological models of trabecular bone suitable for high-porosity regions and vertebrae.

    PubMed

    Rammohan, Abhishek Vishwanath; Tan, Vincent Beng Chye

    2016-10-01

    The complex microarchitecture of trabecular bone makes it difficult to perform computational analyses on the real structure. Researchers have often resorted to using morphological idealizations employing simplified geometries. One such idealized structure, based on the gyroid, was found to mimic trabecular bone well. However, structures generated using the basic gyroid equation manifested discontinuities at high porosities. Another disadvantage of the gyroid is that it cannot model vertebral trabecular bone, which generally resembles cubic cells. To address these two shortcomings, we describe: (i) a modified structure based on the skeletal gyroid, which remains connected even at extremely high porosities, (ii) a cubic grid-like structure, based on the primitive minimal surface, for studying vertebrae. PMID:26892403

  8. Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads.

    PubMed

    Kumaresan, S; Yoganandan, N; Pintar, F A; Maiman, D J

    1999-12-01

    An anatomically accurate, three-dimensional, nonlinear finite element model of the human cervical spine was developed using computed tomography images and cryomicrotome sections. The detailed model included the cortical bone, cancellous core, endplate, lamina, pedicle, transverse processes and spinous processes of the vertebrae; the annulus fibrosus and nucleus pulposus of the intervertebral discs; the uncovertebral joints; the articular cartilage, the synovial fluid and synovial membrane of the facet joints; and the anterior and posterior longitudinal ligaments, interspinous ligaments, capsular ligaments and ligamentum flavum. The finite element model was validated with experimental results: force-displacement and localized strain responses of the vertebral body and lateral masses under pure compression, and varying eccentric anterior-compression and posterior-compression loading modes. This experimentally validated finite element model was used to study the biomechanics of the cervical spine intervertebral disc by quantifying the internal axial and shear forces resisted by the ventral, middle, and dorsal regions of the disc under the above axial and eccentric loading modes. Results indicated that higher axial forces (compared to shear forces) were transmitted through different regions of the disc under all loading modes. While the ventral region of the disc resisted higher variations in axial force, the dorsal region transmitted higher shear forces under all loading modes. These findings may offer an insight to better understand the biomechanical role of the human cervical spine intervertebral disc. PMID:10717549

  9. Pathological burst fracture in the cervical spine with negative red flags: a case report

    PubMed Central

    Cox, Jocelyn; DeGraauw, Chris; Klein, Erik

    2016-01-01

    Objective: To report on a case of a pathological burst fracture in the cervical spine where typical core red flag tests failed to identify a significant lesion, and to remind chiropractors to be vigilant in the recognition of subtle signs and symptoms of disease processes. Clinical Features: A 61-year-old man presented to a chiropractic clinic with neck pain that began earlier that morning. After a physical exam that was relatively unremarkable, imaging identified a burst fracture in the cervical spine. Intervention & Outcomes: The patient was sent by ambulance to the hospital where he was diagnosed with multiple myeloma. No medical intervention was performed on the fracture. Summary: The patient’s initial physical examination was largely unremarkable, with an absence of clinical red flags. The screening tools were non-diagnostic. Pain with traction and the sudden onset of symptoms prompted further investigation with plain film imaging of the cervical spine. This identified a pathological burst fracture in the C4 vertebrae. PMID:27069270

  10. C2-fractures: part I. Quantitative morphology of the C2 vertebra is a prerequisite for the radiographic assessment of posttraumatic C2-alignment and the investigation of clinical outcomes

    PubMed Central

    Acosta, Frank; Tauber, Mark; Komarek, Elisabeth; Fox, Michael; Moursy, Mido; Hitzl, Wolfgang; Resch, Herbert

    2009-01-01

    Pertinent literature exists concerning indications, techniques, complications of treatment, and risk factors for nonunion in axis and odontoid fractures; however, there are scarce data regarding the incidence and definition of malunion in these fractures. As a prerequisite for the study of anatomical alignment following surgical and nonsurgical treatment of C2-fractures, an understanding of normal C2 anatomy is essential. Therefore, the authors intended to evaluate morphometrical dimensions of the C2 vertebra. The purpose was to provide normalized quantitative data to enable assessment of malalignment following the treatment of C2-fractures within a classification system. Using digitized cervical spine lateral and transoral odontoid radiographs of 100 consecutive patients without any evidence of traumatic or neoplastic disorders, the authors performed measurements on distinct anatomical structures and investigated morphometrical dimensions of the normal axis vertebra. The incidence of atlantoaxial arthritis was also evaluated. In addition, with the assessment of twenty arbitrarily chosen sets of radiographs by three different observers we calculated the interobserver reliability in terms of intraclass correlation coefficients for each parameter. With calculation of SD and 95% confidence limits, pathological cut-offs were reconstructed from measurements performed resembling non-physiological and pathological limits. Distinct parameters were selected to form a new classification system for radiographical follow-up that focuses on the quantitative C1–2 vertebral alignment. The measurement process resulted in 2,400 data points. Distinct morphometrical parameters, such as a quantitative characterization of the sagittal atlantoaxial congruency, the lateral mass inclination and the type of degenerative changes at the atlantoaxial joint could be demonstrated to be valuable and reliably used within a proposed classification for C2-malunions following C2-fractures. The

  11. Morphometric and radiological assessments of dimensions of Axis in dry vertebrae: A study in Indian population

    PubMed Central

    Sharma, Raman Mohan; Pruthi, Nupur; Pandey, Paritosh; Dawn, Rose; Ravindranath, Yogitha; Ravindranath, Roopa

    2015-01-01

    Background: The technique of intralaminar screw placement for achieving axis (C2) fixation has been recently described. The purpose of the study was to provide the morphometric and radiological measurements in Indian population and to determine the feasibility of safe translaminar screw placement in this population. To the best of our knowledge there is no study (cadaveric or radiological) done in Indian population to detect suitability of axis bone for laminar screw fixation. Material and Methods: 38 dry axis vertebrae from adult South Indian population were subjected to morphometric measurement and CT scan analysis. Height of posterior arch, midlaminar width(bilateral) in upper 1/3rd, middle 1/3rd and lower 1/3rd were measured using high precision Vernier Calipers. Each vertebra was subjected to a spiral CT scan (Philips brilliance 16 slice) thin 0.5 mm slices were taken and reconstruction was done in coronal and sagittal plane. Analysis was done on a CT work station. Using axial slices, sagittal cuts were reconstructed in plane perpendicular to the lamina at the mid laminar point and upper-middle and lower 1/3rd width of the lamina measured. Height of the posterior arch was measured in the sagittal plane. Intralaminar angle was measured bilaterally. Results: Middle 1/3rd lamina was the thickest portion (mean 5.17 mm +/- 1.42 mm). A total of 32 (84.2%) specimen were having midlaminar width in both lamina greater than 4 mm, however only 27 (71%) out of them had spinous process more than 9 mm. CT scan measurement in middle and lower 1/3rd lamina was found to be strongly correlated with the direct measurement. Conclusion: There is high variability in the thickness of the C2 lamina. As compared to western population, the axis bones used in the present study had smaller profiles. Hence the safety margin for translaminar screw insertion is low. PMID:26806963

  12. Costal process of the first sacral vertebra: sexual dimorphism and obstetrical adaptation.

    PubMed

    Tague, Robert G

    2007-03-01

    The human sacrum is sexually dimorphic, with males being larger than females in most dimensions. Previous studies, though, suggest that females may have a longer costal process of the first sacral vertebra (S1) than males. However, these studies neither quantified nor tested statistically the costal process of S1. This study compares S1 with the five lumbar vertebrae (L1 to L5) for a number of metric dimensions, including costal process length. Four issues are addressed, the: 1) hypothesis that females have a longer costal process of S1 than males; 2)hypothesis that homologous structures (i.e., costal processes of L1 to S1) differ in their direction of sexual dimorphism; 3) importance of the costal process of S1 to the obstetrical capacity of the pelvis; and 4) evolution of sexual dimorphism in costal process length of S1. One hundred ninety-seven individuals, including males and females of American blacks and whites, from the Hamann-Todd and Terry Collections were studied. Results show that males are significantly larger than females for most vertebral measurements, except that females have a significantly longer costal process of S1 than males. Costal process length of S1 is positively correlated with the transverse diameter and circumference of the pelvic inlet. The magnitude of sexual dimorphism in costal process length of S1 ranks this measure among the most highly dimorphic of the pelvis. Compared with the humans in this study, australopithecines have a relatively long costal process of S1, but their broad sacrum was not associated with obstetrical imperatives. PMID:17266155

  13. Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report

    PubMed Central

    Dimar, John R.; Endriga, David T.; Carreon, Leah Y.

    2016-01-01

    Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression. This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction. A 61-year-old man who underwent prior posterior cervical implantation with an SCS followed by multiple revisions presented with progressive paresthesias, numbness, and weakness of his upper extremities 10 years later. The SCS was removed followed by decompression, and instrumented fusion of the cervical spine. Histopathologic analysis reveals foreign-body reaction to the SCS and its silicone debris. Tissue cultures were negative for bacterial, fungal, or mycobacterial infection. No malignancy was seen. The current case illustrates the inherent possibility of foreign-body granulomatous reactions with SCS and its silicone particulate matter, made unique in this instance by the associated bony destruction of the adjacent vertebrae. PMID:27247910

  14. Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report.

    PubMed

    Dimar, John R; Endriga, David T; Carreon, Leah Y

    2016-06-01

    Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression. This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction. A 61-year-old man who underwent prior posterior cervical implantation with an SCS followed by multiple revisions presented with progressive paresthesias, numbness, and weakness of his upper extremities 10 years later. The SCS was removed followed by decompression, and instrumented fusion of the cervical spine. Histopathologic analysis reveals foreign-body reaction to the SCS and its silicone debris. Tissue cultures were negative for bacterial, fungal, or mycobacterial infection. No malignancy was seen. The current case illustrates the inherent possibility of foreign-body granulomatous reactions with SCS and its silicone particulate matter, made unique in this instance by the associated bony destruction of the adjacent vertebrae. PMID:27247910

  15. [Cervical Spondylotic Amyotrophy].

    PubMed

    Sonoo, Masahiro

    2016-05-01

    Keegan (1965) reported a patient who presented with "dissociated motor loss," an acute paralysis of the upper extremity with minimal sensory signs and no long tract signs, and documented an anterior root lesion following autopsy. Sobue et al. (1975) reported similar cases using the term "cervical spondylotic amyotrophy (CSA)," but postulated pathology of the anterior horn. Although Keegan's "dissociated motor loss" surely referred to isolated motor paresis with no or minimal sensory signs, contrary to existing criticism, a more general term, CSA, should be preferred. CSA is divided into proximal and distal types. Distal CSA often presents with a drop finger, and thus may be misdiagnosed as posterior interosseous nerve palsy. Documentation of the involvement of ulnar muscles by clinical signs and EMG would lead to the diagnosis of distal CSA. Proximal CSA may be confused with neuralgic amyotrophy (NA), although the sparing of the serratus anterior and the stereotypic involvement of deltoid, infraspinatus, biceps brachii, and brachioradialis suggest CSA. Cervical MRI is not diagnostic in around half of CSA cases, and denervation in paraspinal EMG is a more sensitive test that can exclude NA. Amyotrophic lateral sclerosis is another important differential diagnosis for CSA. PMID:27156504

  16. Cervical extravasation of bevacizumab.

    PubMed

    Dréanic, Johann; Coriat, Romain; Mir, Olivier; Perkins, Géraldine; Boudou-Rouquette, Pascaline; Brezault, Catherine; Dhooge, Marion; Goldwasser, François; Chaussade, Stanislas

    2013-04-01

    Monoclonal antibodies such as bevacizumab are widely used in medical oncology, either alone or in combination with chemotherapy. No specific recommendations on the management of monoclonal antibodies extravasation exist. Incidence rates vary considerably. Estimates of 0.5-6% have been reported in the literature. Also, patient-associated and procedure-associated risk factors of extravasation are multiple, such as bolus injections or poorly implanted central venous access. We report on an 86-year-old woman with colon cancer with liver metastasis who was treated with 5-fluorouracil, folinic acid, and bevacizumab. Extravasation occurred during chemotherapy infusion because of a catheter migration of the port outside of the superior vena cava, causing cervical pain without skin modifications. Diagnosis was confirmed with the appearance of clinical right cervical tumefaction and cervicothoracic computed tomography scan indicated a perijugular hypodense collection, corresponding to the extravasation. Conservative management was proposed. The patient recovered within 3 weeks from all symptoms. Physicians should be aware that in cases of bevacizumab extravasation, a nonsurgical approach might be effective. PMID:23262983

  17. Age and Growth of Endangered Smalltooth Sawfish (Pristis pectinata) Verified with LA-ICP-MS Analysis of Vertebrae

    PubMed Central

    Scharer, Rachel M.; Patterson III, William F.; Carlson, John K.; Poulakis, Gregg R.

    2012-01-01

    Endangered smalltooth sawfish (Pristis pectinata) were opportunistically sampled in south Florida and aged by counting opaque bands in sectioned vertebrae (n = 15). Small sample size precluded traditional age verification, but fish collected in spring and summer had translucent vertebrae margins, while fish collected in winter had opaque margins. Trends in Sr:Ca measured across vertebrae with laser ablation-inductively coupled plasma-mass spectrometry corresponded well to annual salinity trends observed in sawfish estuarine nursery habitats in south Florida, thus serve as a chemical marker verifying annual formation of opaque bands. Based on that finding and assumptions about mean birth date and timing of opaque band formation, estimated age ranged from 0.4 y for a 0.60 m total length (TL) male to 14.0 y for a 4.35 m TL female. Von Bertalanffy growth parameters computed from size at age data were 4.48 m for L∞, 0.219 y−1for k, and −0.81 y for t0. Results of this study have important implications for sawfish conservation as well as for inferring habitat residency of euryhaline elasmobranchs via chemical analysis of vertebrae. PMID:23082225

  18. Effects of Vibration in Forced Posture on Biochemical Bone Metabolism Indices, and Morphometric and Mechanical Properties of the Lumbar Vertebra

    PubMed Central

    Zhang, Li; Ju, Xiaowei; Zhu, Lvgang; Huang, Changlin; Huang, Tao; Zuo, Xincheng; Gao, Chunfang

    2013-01-01

    Epidemiological studies have shown a relatively strong association between occupational lower back pain (LBP) and long-term exposure to vibration. However, there is limited knowledge of the impact of vibration and sedentariness on bone metabolism of the lumbar vertebra and the mechanism of bone-derived LBP. The aim of this study was to investigate the effects of vibration in forced posture (a seated posture) on biochemical bone metabolism indices, and morphometric and mechanical properties of the lumbar vertebra, and provide a scientific theoretical basis for the mechanism of bone-derived LBP, serum levels of Ca2+, (HPO4)2−, tartrate-resistant acid phosphatase (TRAP), bone-specific alkaline phosphatase (BALP), and bone gla protein (BGP),the pathological changes and biomechanics of lumbar vertebra of New Zealand white rabbits were studied. The results demonstrate that both forced posture and vibration can cause pathological changes to the lumbar vertebra, which can result in bone-derived LBP, and vibration combined with a seated posture could cause further damage to bone metabolism. Serological changes can be used as early markers for clinical diagnosis of bone-derived LBP. PMID:24265702

  19. Body Mass Index May Positively Correlate with Bone Mineral Density of Lumbar Vertebra and Femoral Neck in Postmenopausal Females

    PubMed Central

    Wu, Shi-Feng; Du, Xin-Jie

    2016-01-01

    Background Our study aimed to explore the relationship between body mass index (BMI) and bone mineral density (BMD) of lumbar vertebra and femoral neck in postmenopausal females. Material/Methods From September 2012 to September 2014, 236 healthy postmenopausal females who underwent physical examinations at the Women & Children’s Health Care Hospital of Linyi were enrolled into our study. These subjects were divided into 3 groups: underweight group, normal weight group, and overweight group. In addition, there were 2 age stratifications: <60 years old and ≥60 years old. DPX-L type dual-energy X-ray bone densitometry (American Lunar Company) was used to measure the BMD of lumbar vertebra and femoral neck in the recruited subjects. Pearson test was used for correlation analysis. Results BMDs and T-scores of lumbar vertebra (L1–L4), femoral neck, proximal femur, and Ward’s triangle region among the groups were ranked as follows: underweight group < normal weight group < overweight group. There were significant differences in body weight and BMI among the underweight, normal weight, and overweight groups (P<0.05). The T-scores of all examined anatomic locations showed significant differences between the underweight group and normal weight group, as well as between the underweight group and overweight group (both P<0.05). Only the T-scores of lumbar vertebra L2–L4 had significant differences between the normal weight group and overweight group (P<0.05). The BMDs of all anatomic components under study showed statistical differences in both age stratifications between the overweight group and underweight group, as well as between the overweight group and normal weight group (both P<0.05). When stratified above 60 years old, the BMDs of lumbar vertebra (L1, L2 and L4) showed statistical differences between the normal weight group and underweight group (P<0.05). Various factors could be ranked according to the absolute values of correlation coefficients as below

  20. Cervical facet joint kinematics during bilateral facet dislocation

    PubMed Central

    Panjabi, Manohar M.; Simpson, Andrew K.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet surface along the lower), separation and compression (displacement of upper facet away from and towards the lower), and lateral shear were determined at the anterior and posterior edges of the right and left facets and statistically compared (P < 0.05). First, peak facet separation occurred, and was significantly greater at the left posterior facet edge, as compared to the anterior edges. Next, peak flexion rotation and anterior facet sliding occurred, followed by peak facet compression. The highest average facet translation peaks were 22.0 mm for anterior sliding, 7.9 mm for separation, 9.9 mm for compression and 3.6 mm for lateral shear. The highest average rotation of 63° occurred in flexion, significantly greater than all other directions. These events occurred, on average, within 0.29 s following impact. During BFD, the main sagittal motions included facet separation, flexion rotation, anterior sliding, followed by compression, however, non-sagittal motions also existed. These motions indicated that unilateral dislocation may precede bilateral dislocation. PMID:17566792

  1. Cervical Tissue Engineering Using Silk Scaffolds and Human Cervical Cells

    PubMed Central

    Sanchez, Cristina C.; Rice, William L.; Socrate, Simona; Kaplan, David L.

    2010-01-01

    Spontaneous preterm birth is a frequent complication of pregnancy and a common cause of morbidity in childhood. Obstetricians suspect abnormalities of the cervix are implicated in a significant number of preterm births. The cervix is composed of fibrous connective tissue and undergoes significant remodeling in preparation for birth. We hypothesized that a tissue engineering strategy could be used to develop three-dimensional cervical-like tissue constructs that would be suitable for investigating cervical remodeling. Cervical cells were isolated from two premenopausal women undergoing hysterectomy for a benign gynecological condition, and the cells were seeded on porous silk scaffolds in the presence or absence of dynamic culture and with 10% or 20% serum. Morphological, biochemical, and mechanical properties were measured during the 8-week culture period. Cervical cells proliferated in three-dimensions and synthesized an extracellular matrix with biochemical constituents and morphology similar to native tissue. Compared to static culture, dynamic culture was associated with significantly increased collagen deposition (p < 0.05), sulfated glycosaminoglycan synthesis (p < 0.05), and mechanical stiffness (p < 0.05). Serum concentration did not affect measured variables. Relevant human tissue-engineered cervical-like constructs constitute a novel model system for a range of fundamental and applied studies related to cervical remodeling. PMID:20121593

  2. Cervical tissue engineering using silk scaffolds and human cervical cells.

    PubMed

    House, Michael; Sanchez, Cristina C; Rice, William L; Socrate, Simona; Kaplan, David L

    2010-06-01

    Spontaneous preterm birth is a frequent complication of pregnancy and a common cause of morbidity in childhood. Obstetricians suspect abnormalities of the cervix are implicated in a significant number of preterm births. The cervix is composed of fibrous connective tissue and undergoes significant remodeling in preparation for birth. We hypothesized that a tissue engineering strategy could be used to develop three-dimensional cervical-like tissue constructs that would be suitable for investigating cervical remodeling. Cervical cells were isolated from two premenopausal women undergoing hysterectomy for a benign gynecological condition, and the cells were seeded on porous silk scaffolds in the presence or absence of dynamic culture and with 10% or 20% serum. Morphological, biochemical, and mechanical properties were measured during the 8-week culture period. Cervical cells proliferated in three-dimensions and synthesized an extracellular matrix with biochemical constituents and morphology similar to native tissue. Compared to static culture, dynamic culture was associated with significantly increased collagen deposition (p < 0.05), sulfated glycosaminoglycan synthesis (p < 0.05), and mechanical stiffness (p < 0.05). Serum concentration did not affect measured variables. Relevant human tissue-engineered cervical-like constructs constitute a novel model system for a range of fundamental and applied studies related to cervical remodeling. PMID:20121593

  3. Recurrence of cervical spine instability in rheumatoid arthritis following previous fusion: can disease progression be prevented by early surgery?

    PubMed

    Agarwal, A K; Peppelman, W C; Kraus, D R; Pollock, B H; Stolzer, B L; Eisenbeis, C H; Donaldson, W F

    1992-09-01

    In a retrospective study, 110 patients with rheumatoid arthritis who had cervical spine fusion were evaluated for recurrence of cervical spine instability and resultant need for further surgery. Recurrence of cervical instability was correlated with initial radiographic abnormality, primary surgical procedure and interval between the 2 surgeries. There were 55 patients who had atlantoaxial subluxation (AAS) and required C1-C2 fusion as primary surgery. Three of these patients (5.5%) developed subaxial subluxation (SAS) and had a second procedure after a mean interval of 9 years. Twenty-two patients had AAS with superior migration of the odontoid (AAS-SMO) and had initial surgery of occiput-C3 fusion. Eight of these patients (36%) developed SAS and had a second surgery after a mean interval of 2.6 years. Of the 19 patients with primary radiographic deformity of SAS, one required further surgery for subluxation of an adjacent superior vertebra after a period of 6 years. Fourteen patients had combined deformity of AAS-SMO-SAS, and one required further surgery for SAS after an interval of 22 months. Recurrence of cervical instability following a previous fusion occurred in 15% of these 110 patients. It was seen in 5.5% of patients with initial deformity of AAS vs 36% of patients with AAS-SMO. No patients with C1-C2 fusion for AAS progressed to develop superior migration of the odontoid. We conclude that early C1-C2 fusion for AAS before development of SMO decreases the risk of further progression of cervical spine instability. The pattern of progression of cervical spine involvement, as discussed in the literature, is reviewed. PMID:1433002

  4. Resection of cervical ependymoma.

    PubMed

    Lanzino, Giuseppe; Morales-Valero, Saul F; Krauss, William E; Campero, Mario; Marsh, W Richard

    2014-09-01

    Intramedullary ependymomas are surgically curable tumors. However, their surgical resection poses several challenges. In this intraoperative video we illustrate the main steps for the surgical resection of a cervical intramedullary ependymoma. These critical steps include: adequate exposure of the entire length of the tumor; use of the intraoperative ultrasound; identification of the posterior median sulcus and separation of the posterior columns; Identification of the plane between the spinal cord and the tumor; mobilization and debulking of the tumor and disconnection of the vascular supply (usually from small anterior spinal artery branches). Following these basic steps a complete resection can be safely achieved in many cases. The video can be found here: http://youtu.be/QMYXC_F4O4U. PMID:25175575

  5. Cervical Spine Stenosis Measures in Normal Subjects.

    PubMed

    Tierney, Ryan T; Maldjian, Catherine; Mattacola, Carl G; Straub, Stephen J; Sitler, Michael R

    2002-06-01

    OBJECTIVE: To compare 2 methods of determining cervical spinal stenosis (Torg ratio, space available for the cord [SAC]); determine which of the components of the Torg ratio and the SAC account for more of the variability in the measures; and present standardized SAC values for normal subjects using magnetic resonance imaging (MRI). DESIGN AND SETTING: The research design consisted of a posttest-only, comparison-group design. The independent variable was method of measurement (Torg ratio and SAC). The dependent variables were Torg ratio and SAC scores. SUBJECTS: Fourteen men (age = 24.4 +/- 2.5 years, height = 181.0 +/- 5.8 cm, weight = 90 +/- 13.5 kg) participated in this study. The C3 to C7 vertebrae were examined in each subject (n = 70). MEASUREMENTS: The Torg ratio was determined by dividing the sagittal spinal-canal diameter by the corresponding sagittal vertebral-body diameter. The SAC was determined by subtracting the sagittal spinal-cord diameter from the corresponding sagittal spinal-canal diameter. The Torg ratio and SAC were measured in millimeters. RESULTS: The SAC ranged from 2.5 to 10.4 mm and was greatest at C7 in 71% (10 of 14) of the subjects. The SAC was least at C3 or C5 in 71% (10 of 14) of the subjects. A Pearson product moment correlation revealed a significant relationship between the Torg ratio and SAC (r =.53, P <.01). Regression analyses revealed the vertebral body (r (2) =.58) accounted for more variability in the Torg ratio than the spinal canal (r (2) =.48). Also, the spinal canal (r (2) =.66) accounted for more variability in the SAC than the spinal cord (r (2) =.23). CONCLUSIONS: The SAC measure relies more on the spinal canal compared with the Torg ratio and, therefore, may be a more effective indicator of spinal stenosis. This is relevant clinically because neurologic injury related to stenosis is a function of the spinal canal and the spinal cord (not the vertebral body). Further research must be done, however, to validate the SAC

  6. Get Tested for Cervical Cancer

    MedlinePlus

    ... help understanding your Pap test result . What about cost? Testing for cervical cancer is covered under the ... may be able to get tested at no cost to you. If you have private insurance, check ...

  7. Spinal surgery -- cervical - series (image)

    MedlinePlus

    ... on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine problems include: pain that interferes with daily ...

  8. [Combined surgical and physical treatment in traumatic painful syndromes of the cervical spine].

    PubMed

    Stachowski, B; Kaczmarek, J; Nosek, A; Kocur, L

    1976-01-01

    Clinical observations suggest the need for changing therapeutic management to a more active one in cases of cervical spine injury with damage to the spinal cord and nerve roots or brachial plexus. In 248 patients with these injuries treated initially conservatively the incidence of cervicobrachial pain was analysed. Neuralgic pains were present in 31.5% of cases, causalgic pains in 2.4% and sympathalgic pains in 2%. Conservative treatment conducted in these patients (89 cases) during many months after trauma had no effect on return of mobility. Long-term application of physioterapy prevented only temporarily the development of trophic changes and only partially relieved pains. Only surgical decompression of the spinal cord or spinal nerves with stabilization of damaged vertebrae caused disappearance of painful syndromes and improvement in the motor activity of the extremities. These observations show that early surgical intervention for decompression of the spinal cord, roots or brachial plexus should be advocated in these cases. PMID:980212

  9. A huge ependymoma of the cervical spinal cord with subtle atypical manifestations and hyperhidrosis: Case report

    PubMed Central

    Haddadi, Kaveh

    2015-01-01

    Introduction Ependymomas are the most common neuroepithelial tumors of the spinal cord, accounting for 50–60% of spinal cord gliomas. The nonspecific clinical presentation of a spinal cord tumor frequently results in delay of diagnosis with opposing outcomes. Presentation of case We report a 34-year-old man presented with abnormally enhanced sweating on the left side of his neck, upper extremity, and chest that had been occurring for 1 year. In the sagittal MRI there were a centrally localized mass lesion extending from medulla and C1 to T2 vertebra level and expanding the cord. Surgical elimination of the tumor was performed with posterior midline approach and near total resection of tumor was achieved. Conclusion Cervical intramedullary ependymal is a rare, slow growing spinal cord tumor. Attention to uncommon characteristics like hyperhidrosis might be an important key to early diagnosis of this rare spinal tumor. Surgical resection is the choice of treatment with infrequent recurrence. PMID:26741275

  10. Airway management for cervical spine surgery.

    PubMed

    Farag, Ehab

    2016-03-01

    Cervical spine surgery is one of the most commonly performed spine surgeries in the United States, and 90% of the cases are related to degenerative cervical spine disease (the rest to cervical spine trauma and/or instability). The airway management for cervical spine surgery represents a crucial step in the anesthetic management to avoid injury to the cervical cord. The crux for upper airway management for cervical spine surgery is maintaining the neck in a neutral position with minimal neck movement during endotracheal intubation. Therefore, the conventional direct laryngoscopy (DL) can be unsuitable for securing the upper airway in cervical spine surgery, especially in cases of cervical spine instability and myelopathy. This review discusses the most recent evidence-based facts of the main advantages and limitations of different techniques available for upper airway management for cervical spine surgery. PMID:27036600

  11. What Should You Ask Your Doctor about Cervical Cancer?

    MedlinePlus

    ... for cervical cancer? What should you ask your doctor about cervical cancer? It is important for you ... and Staging Treating Cervical Cancer Talking With Your Doctor After Treatment What`s New in Cervical Cancer Research? ...

  12. How Are Cervical Cancers and Pre-Cancers Diagnosed?

    MedlinePlus

    ... How is cervical cancer staged? How is cervical cancer diagnosed? The first step in finding cervical cancer ... systems. Tests for women with symptoms of cervical cancer or abnormal Pap results Medical history and physical ...

  13. Cervical cord injury after massage.

    PubMed

    Lee, Tzu-Han; Chiu, Jan-Wei; Chan, Rai-Chi

    2011-10-01

    We present the case of a 47-yr-old gentleman with cervical cord injury after he received massage in the neck area. Magnetic resonance imaging of the cervical spine showed a herniation of the nucleus pulposus and compressive myelopathy. The patient required surgical intervention and rehabilitation. Despite 6 mos of rehabilitation, residual hand dysfunction and minor ambulation problems persisted. Although massage has many benefits, this case reminds us that there is potential danger in performing neck massage. PMID:21862908

  14. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    ClinicalTrials.gov

    2016-02-19

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  15. CT evaluation of the pattern of odontoid fractures in the elderly--relationship to upper cervical spine osteoarthritis.

    PubMed

    Lakshmanan, Palaniappan; Jones, Alwyn; Howes, John; Lyons, Kathleen

    2005-02-01

    Odontoid fractures are common in the elderly following minor falls. Almost all of them have osteoarthritis of the cervical spine below the axis vertebra. As a result, there is increased stress on the spared upper cervical spine, resulting in a higher incidence of injuries. As movement in the upper cervical spine involves participation of five joints, degeneration in any one particular joint may affect the biomechanics of loading of the upper cervical spine. We aimed to analyse the relationship of odontoid fractures to the pattern of upper cervical spine osteoarthritis in the elderly. We studied the CT-scan images of the cervical spine in 23 patients who were over the age of 70 years and had odontoid fractures. In each patient, the type of odontoid fracture and the characteristics of the degenerative changes in each joint were analysed. Twenty-one of 23 patients had Type-II odontoid fractures. The incidence of significant atlanto-odontoid degeneration in these individuals was very high (90.48%), with relative sparing of the lateral atlantoaxial joints. Osteoporosis was found in 13 of 23 patients at the dens-body junction and in seven of 23 patients at the odontoid process and body of the axis. With ageing, progressively more severe degenerative changes develop in the atlanto-odontoid joint. These eventually obliterate the joint space and fix the odontoid to the anterior arch of the atlas. In contrast, the lateral atlantoaxial joints are hardly affected by osteoarthritis. Thus, ultimately, atlantoaxial movements including atlantoaxial rotation are markedly limited by osteoarthritis of the atlanto-odontoid joint. However, there is still potential for movement in the lateral atlantoaxial joints, as they remain relatively free of degenerative change. The vulnerability of the atlantoaxial segment is further increased by markedly limited rotation below the axis vertebra due to severe facet-joint degeneration. As a consequence, a relatively low-energy trauma to the lateral

  16. Vertebroplasty and kyphoplasty for cervical spine metastases: a systematic review and meta-analysis

    PubMed Central

    De la Garza-Ramos, Rafael; Benvenutti-Regato, Mario

    2016-01-01

    Background Vertebroplasty (VP) and kyphoplasty (KP) are two minimally invasive techniques used to relieve pain and restore stability in metastatic spinal disease. However, most of these procedures are performed in the thoracolumbar spine, and there is limited data on outcomes after VP/KP for cervical metastases. The purpose of this article is to evaluate the safety and efficacy of VP and KP for treating pain in patients with cervical spine metastases. Methods A systematic review of the literature was conducted using the PubMed and Medline databases. Only studies that reported five or more patients treated with VP/KP in the cervical spine were included. Levels of evidence and grades of recommendation were established based on the Oxford Centre for Evidence-Based Medicine guidelines. Data was pooled to perform a meta-analysis for pain relief and complication rates. Results Six studies (all level 4 studies) met the inclusion criteria, representing 120 patients undergoing VP/KP at 135 vertebrae; the most common addressed level was C2 in 83 cases. The average volume of injected cement was 2.5 ± 0.5 milliliters at each vertebra. There were 22 asymptomatic cement leaks (16%; 95% CI, 9.8% - 22.2%) most commonly occurring in the paraspinal soft tissue. There were 5 complications (4%; 95% CI, 0.5% - 7.5%): 3 cases of mild odynophagia, 1 case of occipital neuralgia secondary to leak, and 1 case of stroke secondary to cement embolism. Pain relief was achieved in 89% of cases (range: 80 - 100%). The calculated average pain score decreased significantly from 7.6 ± 0.9 before surgery to 1.9 ± 0.8 at last evaluation (p=0.006). Conclusion Although the calculated complication rate after VP/KP in the cervical spine is low (4%) and the reported pain relief rate is approximately 89%, there is lack of high-quality evidence supporting this. Future randomized controlled trials are needed. PMID:26913227

  17. Cervical Cord Decompression Using Extended Anterior Cervical Foraminotomy Technique

    PubMed Central

    Kim, Sung-Duk; Lee, Cheol-Young; Kim, Hyun-Woo; Jung, Chul-Ku; Kim, Jong Hyun

    2014-01-01

    Objective At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. Methods Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. Results In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. Conclusions Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed. PMID:25328648

  18. Age, Gender and Normalization Covariates for Spinal Cord Gray Matter and Total Cross-Sectional Areas at Cervical and Thoracic Levels: A 2D Phase Sensitive Inversion Recovery Imaging Study

    PubMed Central

    Papinutto, Nico; Schlaeger, Regina; Panara, Valentina; Zhu, Alyssa H.; Caverzasi, Eduardo; Stern, William A.; Hauser, Stephen L.; Henry, Roland G.

    2015-01-01

    The source of inter-subject variability and the influence of age and gender on morphometric characteristics of the spinal cord, such as the total cross-sectional area (TCA), the gray matter (GM) and white matter (WM) areas, currently remain under investigation. Understanding the effect of covariates such as age, gender, brain volumes, and skull- and vertebra-derived metrics on cervical and thoracic spinal cord TCA and GM areas in healthy subjects would be fundamental for exploring compartment specific changes in neurological diseases affecting the spinal cord. Using Magnetic Resonance Imaging at 3T we investigated 32 healthy subjects using a 2D phase sensitive inversion recovery sequence and we measured TCA, GM and WM areas at 4 cervical and thoracic levels of the spinal cord. We assessed age and gender relationships of cord measures and explored associations between cord measures and a) brain volumes and b) skull- and vertebra-derived metrics. Age and gender had a significant effect on TCA, WM and GM areas (with women and elderly having smaller values than men and younger people respectively), but not on the GM area/TCA ratio. The total intracranial volume and C3 vertebra dimensions showed the highest correlations with cord measures. When used in multi-regression models, they reduced cord areas group variability by approximately a third. Age and gender influences on cord measures and normalization strategies here presented might be of use in the study of compartment specific changes in various neurological diseases affecting the spinal cord. PMID:25781178

  19. QUANTITATIVE PLUTONIUM MICRODISTRIBUTION IN BONE TISSUE OF VERTEBRA FROM A MAYAK WORKER

    PubMed Central

    Lyovkina, Yekaterina V.; Miller, Scott C.; Romanov, Sergey A.; Krahenbuhl, Melinda P.; Belosokhov, Maxim V.

    2010-01-01

    The purpose was to obtain quantitative data on plutonium microdistribution in different structural elements of human bone tissue for local dose assessment and dosimetric models validation. A sample of the thoracic vertebra was obtained from a former Mayak worker with a rather high plutonium burden. Additional information was obtained on occupational and exposure history, medical history, and measured plutonium content in organs. Plutonium was detected in bone sections from its fission tracks in polycarbonate film using neutron-induced autoradiography. Quantitative analysis of randomly selected microscopic fields on one of the autoradiographs was performed. Data included fission fragment tracks in different bone tissue and surface areas. Quantitative information on plutonium microdistribution in human bone tissue was obtained for the first time. From these data, quantitative relationship of plutonium decays in bone volume to decays on bone surface in cortical and trabecular fractions were defined as 2.0 and 0.4, correspondingly. The measured quantitative relationship of decays in bone volume to decays on bone surface does not coincide with recommended models for the cortical bone fraction by the International Commission on Radiological Protection. Biokinetic model parameters of extrapulmonary compartments might need to be adjusted after expansion of the data set on quantitative plutonium microdistribution in other bone types in human as well as other cases with different exposure patterns and types of plutonium. PMID:20838087

  20. Burst fracture of the lumbar vertebra due to a landmine injury: a case report

    PubMed Central

    Bilgic, Serkan; Kurklu, Mustafa; Yurttas, Yuksel; Ozkan, Huseyin; Sehirlioglu, Ali

    2009-01-01

    Introduction The reason we report this case is that spine injuries may well occur due to landmines similar to other injuries like traumatic limb amputations and more over they may be overlooked. Case presentation The patient was 29-years-old Turkish male and was a member of the military. He detonated the landmine that caused his injuries while in a conflict zone. He had a right below knee and left above knee traumatic amputations. He had also mild intermittent pain in his lower back. There were no focal neurological findings such as weakness, altered sensibility, or alteration in the function of the bowel or bladder. Radiographs of the lumbar spine revealed an L2 burst fracture. Computed tomography scans and magnetic resonance imaging of the lumbar spine demonstrated a burst fracture of the L2 vertebrae and moderate compression in the anterior portion of the thecal sac due to the fracture fragment. Because of the stabile nature of the L2 burst fracture and lack of neurological disturbance, operative decompression, instrumentation and fusion was not performed. After healing of the stumps, the patient was mobilized with immediate prostheses and a thoracolumbosacral brace. Conclusion Spine injuries should not be overlooked when evaluating patients after landmine explosions. After the patient has been stabilized, the secondary screening and radiographic evaluations should also comprise the thoracic, thoracolumbar and lumbar spine when treating patients after landmine injuries. PMID:19829776

  1. Mechanics of bone/PMMA composite structures: an in vitro study of human vertebrae.

    PubMed

    Race, Amos; Mann, Kenneth A; Edidin, Avram A

    2007-01-01

    The goal of this study was to provide material property data for the cement/bone composite resulting from the introduction of PMMA bone cement into human vertebral bodies. A series of quasistatic tensile and compressive mechanical tests were conducted using cement/bone composite structures machined from cement-infiltrated vertebral bodies. Experiments were performed both at room temperature and at body temperature. We found that the modulus of the composite structures was lower than bulk cement (p<0.0001). For compression at 37( composite function)C: composite =2.3+/-0.5GPa, cement =3.1+/-0.2GPa; at 23( composite function)C: composite =3.0+/-0.3GPa, cement =3.4+/-0.2GPa. Specimens tested at room temperature were stiffer than those tested at body temperature (p=0.0004). Yield and ultimate strength factors for the composite were all diminished (55-87%) when compared to cement properties. In general, computational models have assumed that cement/bone composite had the same modulus as cement. The results of this study suggest that computational models of cement infiltrated vertebrae and cemented arthroplasties could be improved by specifying different material properties for cement and cement/bone composite. PMID:16797554

  2. [Quantitative plutonium microdistribution in bone tissue of vertebra from occupationally exposed worker].

    PubMed

    Levkina, E V; Romanov, S A; Miller, S C; Krahenbuhl, M P; Belosokhov, M V

    2008-01-01

    The purpose of this work is the receiving of quantitative data on Pu microdistribution in different structural elements of human bone tissue for local dose assessment and dosimetric models validation. Thoracic vertebra sample was taken for the study from former Mayak worker with rather high Pu burden, including information on occupational and exposure history, medical information and data on Pu content in organs. Lexan film autodiagrams were obtained using method of neutron-induced autoradiography from bone tissue sections. Quantitative analysis of randomly selected vision fields on one of autoradiograms was performed: fission fragment tracks Pu in different bone tissue areas were calculated, surface of bone tissue areas were defined. Quantitative information on Pu microdistribution in human bone tissue was obtained for the first time. On the basis of obtained data quantitative relation of Pu decays in bone volume to decays on bone surface in cortical and trabecular fractions were defined as 2.0 and 0.4, correspondingly. Actual quantitative relation of decays in bone volume to decays on bone surface is significantly different from recommended by ICRP for cortical fraction. Biokinetic model parameters of extrapulmonary ICRP compartment might need to be adjusted after expansion of data set on quantitative Pu microdistribution in other bone types in human that will involve new cases with different exposure pattern of radionuclide. PMID:18689262

  3. Quantitative plutonium microdistribution in bone tissue of vertebra from a Mayak worker.

    PubMed

    Lyovkina, Yekaterina V; Miller, Scott C; Romanov, Sergey A; Krahenbuhl, Melinda P; Belosokhov, Maxim V

    2010-10-01

    The purpose of this study was to obtain quantitative data on plutonium microdistribution in different structural elements of human bone tissue for local dose assessment and dosimetric models validation. A sample of the thoracic vertebra was obtained from a former Mayak worker with a rather high plutonium burden. Additional information was obtained on occupational and exposure history, medical history, and measured plutonium content in organs. Plutonium was detected in bone sections from its fission tracks in polycarbonate film using neutron-induced autoradiography. Quantitative analysis of randomly selected microscopic fields on one of the autoradiographs was performed. Data included fission fragment tracks in different bone tissue and surface areas. Quantitative information on plutonium microdistribution in human bone tissue was obtained for the first time. From these data, the quantitative relationships of plutonium decays in bone volume to decays on bone surface in cortical and trabecular fractions were defined as 2.0 and 0.4, correspondingly. The measured quantitative relationship of decays in bone volume to decays on bone surface does not coincide with recommended models for the cortical bone fraction by the International Commission on Radiological Protection. Biokinetic model parameters of extrapulmonary compartments might need to be adjusted after expansion of the data set on quantitative plutonium microdistribution in other bone types in humans as well as other cases with different exposure patterns and types of plutonium. PMID:20838087

  4. Analysis of digitized cervical images to detect cervical neoplasia

    NASA Astrophysics Data System (ADS)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  5. Direct visualization of regions with lowered bone mineral density in dual-energy CT images of vertebrae

    NASA Astrophysics Data System (ADS)

    Wesarg, Stefan; Erdt, Marius; Kafchitsas, Konstantinos; Khan, M. Fawad

    2011-03-01

    Dual-energy CT allows for a better material differentiation than conventional CT. For the purpose of osteoporosis diagnosis, a detection of regions with lowered bone mineral density (BMD) is of high clinical interest. Based on an existing biophysical model of the trabecular bone in vertebrae a new method for directly highlighting those low density regions in the image data has been developed. For this, we combine image data acquired at 80 kV and 140 kV with information about the BMD range in different vertebrae and derive a method for computing a color enhanced image which clearly indicates low density regions. An evaluation of our method which compares it with a quantitative method for BMD assessment shows a very good correspondence between both methods. The strength of our method lies in its simplicity and speed.

  6. Preventing Cervical Cancer with HPV Vaccines

    Cancer.gov

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  7. NIH Research Leads to Cervical Cancer Vaccine

    MedlinePlus

    ... Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents ... in women, the cause of the majority of cervical cancers. Photo courtesy of Judy Folkenberg, NLM Writer By ...

  8. Nucleus pulposus cells derived IGF-1 and MCP-1 enhance osteoclastogenesis and vertebrae disruption in lumbar disc herniation

    PubMed Central

    Zhu, Zhongjiao; Huang, Peng; Chong, Yanxue; George, Suraj K; Wen, Bingtao; Han, Na; Liu, Zhiqiang; Kang, Lixin; Lin, Nie

    2014-01-01

    Study design: Chronic strained lumbar disc herniation (LDH) cases were classified into bulging LDH, herniated LDH and prolapse LDH types according to imaging examination, and vertebrae disruptions were evaluated. Cytokines derived from the nucleus pulposus cells were detected, and their effects on osteoclastogenesis, as well as the mechanisms involved, were studied via an in vitro osteoclast differentiation system. Objective: To clarify the mechanisms of lumbar vertebrae resorption induced by lumbar herniation. Summary and background data: Chronic strained lumbar disc herniation induced vertebrae erosion exacerbates quality of patients’ life and clinical outcome. Although nucleus pulposus cells derived cytokines were reported to play an important role in this pathogenesis, the fundamental mechanisms underlying this process are still unclear. Methods: Chronic strained lumbar disc herniation patients were diagnosed with CT scan and T2-weighted magnetic resonance imaging. RNA was extracted from 192 surgical specimens of the herniated lumbar disc and 29 surgical excisions of the lumbar disc from spinal injury patients. The expressions of osteoclastogenesis related cytokines and chemokines were examined using real time PCR. Monocytes were induced into osteoclast with M-CSF and RANKL in vitro, while the IGF-1 and MCP-1 were added into the differentiation procedure in order to evaluate the effects and explore the molecular mechanisms. Results: Vertebrae erosion had a positive relationship with lumbar disc herniation severity types. In all of the osteoclastogenesis related cytokines, the IGF-1 and MCP-1 were the most highly expressed in the nucleus pulposus cells. IGF-1 enhances activation of NF-kB signaling directly, but MCP-1 upregulated the expression of RANK, so that enhanced cellular sensitivity to RANKL resulted in increasing osteoclastogenesis and activity. Conclusion: Lumbar herniation induced overexpression of IGF-1 and MCP-1 in nucleus pulposus cells aggravated

  9. Determination of 3D location and rotation of lumbar vertebrae in CT images by symmetry-based auto-registration

    NASA Astrophysics Data System (ADS)

    Vrtovec, Tomaž; Likar, Boštjan; Pernuš, Franjo

    2007-03-01

    Quantitative measurement of vertebral rotation is important in surgical planning, analysis of surgical results, and monitoring of the progression of spinal deformities. However, many established and newly developed techniques for measuring axial vertebral rotation do not exploit three-dimensional (3D) information, which may result in virtual axial rotation because of the sagittal and coronal rotation of vertebrae. We propose a novel automatic approach to the measurement of the location and rotation of vertebrae in 3D without prior volume reformation, identification of appropriate cross-sections or aid by statistical models. The vertebra under investigation is encompassed by a mask in the form of an elliptical cylinder in 3D, defined by its center of rotation and the rotation angles. We exploit the natural symmetry of the vertebral body, vertebral column and vertebral canal by dividing the vertebral mask by its mid-axial, mid-sagittal and mid-coronal plane, so that the obtained volume pairs contain symmetrical parts of the observed anatomy. Mirror volume pairs are then simultaneously registered to each other by robust rigid auto-registration, using the weighted sum of absolute differences between the intensities of the corresponding volume pairs as the similarity measure. The method was evaluated on 50 lumbar vertebrae from normal and scoliotic computed tomography (CT) spinal scans, showing relatively large capture ranges and distinctive maxima at the correct locations and rotation angles. The proposed method may aid the measurement of the dimensions of vertebral pedicles, foraminae and canal, and may be a valuable tool for clinical evaluation of the spinal deformities in 3D.

  10. Cervical cancer screening.

    PubMed Central

    Katz, A.

    1998-01-01

    OBJECTIVE: To review the role of family physicians in screening for cancer of the cervix, to review the evidence for screening, in particular, frequency and technique for screening, and to review the reasons cervical cancer has not been prevented and the role of family physicians in addressing these failures. QUALITY OF EVIDENCE: The value of screening has been established with level II evidence. Many of the unresolved issues are not supported either way by good evidence; level II and III evidence predominates. MAIN FINDINGS: In Canada, 1350 women were predicted to be diagnosed with cancer of the cervix in 1996. Most of these women had not been screened. Minority, rural, low-income, and older women face important barriers to screening. Family physicians have a role in reaching out to these women to provide effective health care, including cancer screening. When cancer screening is performed, it should conform to recommended techniques with appropriate follow up of abnormal test results. CONCLUSIONS: Family physicians have an important role in preventing cancer of the cervix. Efforts should be concentrated on encouraging a greater proportion of eligible women to be screened. Criteria are suggested for effective screening. PMID:9721422

  11. Cervical interfacet spacers and maintenance of cervical lordosis.

    PubMed

    Tan, Lee A; Straus, David C; Traynelis, Vincent C

    2015-05-01

    OBJECT The cervical interfacet spacer (CIS) is a relatively new technology that can increase foraminal height and area by facet distraction. These offer the potential to provide indirect neuroforaminal decompression while simultaneously enhancing fusion potential due to the relatively large osteoconductive surface area and compressive forces exerted on the grafts. These potential benefits, along with the relative ease of implantation during posterior cervical fusion procedures, make the CIS an attractive adjuvant in the management of cervical pathology. One concern with the use of interfacet spacers is the theoretical risk of inducing iatrogenic kyphosis. This work tests the hypothesis that interfacet spacers are associated with loss of cervical lordosis. METHODS Records from patients undergoing posterior cervical fusion at Rush University Medical Center between March 2011 and December 2012 were reviewed. The FacetLift CISs were used in all patients. Preoperative and postoperative radiographic data were reviewed and the Ishihara indices and cervical lordotic angles were measured and recorded. Statistical analyses were performed using STATA software. RESULTS A total of 64 patients were identified in whom 154 cervical levels were implanted with machined allograft interfacet spacers. Of these, 15 patients underwent anterior-posterior fusions, 4 underwent anterior-posterior-anterior fusions, and the remaining 45 patients underwent posterior-only fusions. In the 45 patients with posterior-only fusions, a total of 110 levels were treated with spacers. There were 14 patients (31%) with a single level treated, 16 patients (36%) with two levels treated, 5 patients (11%) with three levels treated, 5 patients (11%) with four levels treated, 1 patient (2%) with five levels treated, and 4 patients (9%) with six levels treated. Complete radiographic data were available in 38 of 45 patients (84%). On average, radiographic follow-up was obtained at 256.9 days (range 48-524 days

  12. Validation of 3D surface reconstruction of vertebrae and spinal column using 3D ultrasound data--a pilot study.

    PubMed

    Nguyen, Duc V; Vo, Quang N; Le, Lawrence H; Lou, Edmond H M

    2015-02-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of spine associated with vertebra rotation. The Cobb angle and axial vertebral rotation are important parameters to assess the severity of scoliosis. However, the vertebral rotation is seldom measured from radiographs due to time consuming. Different techniques have been developed to extract 3D spinal information. Among many techniques, ultrasound imaging is a promising method. This pilot study reported an image processing method to reconstruct the posterior surface of vertebrae from 3D ultrasound data. Three cadaver vertebrae, a Sawbones spine phantom, and a spine from a child with AIS were used to validate the development. The in-vitro result showed the surface of the reconstructed image was visually similar to the original objects. The dimension measurement error was <5 mm and the Pearson correlation was >0.99. The results also showed a high accuracy in vertebral rotation with errors of 0.8 ± 0.3°, 2.8 ± 0.3° and 3.6 ± 0.5° for the rotation values of 0°, 15° and 30°, respectively. Meanwhile, the difference in the Cobb angle between the phantom and the image was 4° and the vertebral rotation at the apex was 2°. The Cobb angle measured from the in-vivo ultrasound image was 4° different from the radiograph. PMID:25550193

  13. Human Papillomavirus and Cervical Cancer

    PubMed Central

    Burd, Eileen M.

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Identification of precancerous lesions has been primarily by cytologic screening of cervical cells. Cellular abnormalities, however, may be missed or may not be sufficiently distinct, and a portion of patients with borderline or mildly dyskaryotic cytomorphology will have higher-grade disease identified by subsequent colposcopy and biopsy. Sensitive and specific molecular techniques that detect HPV DNA and distinguish high-risk HPV types from low-risk HPV types have been introduced as an adjunct to cytology. Earlier detection of high-risk HPV types may improve triage, treatment, and follow-up in infected patients. Currently, the clearest role for HPV DNA testing is to improve diagnostic accuracy and limit unnecessary colposcopy in patients with borderline or mildly abnormal cytologic test results. PMID:12525422

  14. Surgical conditions of the cervical spine.

    PubMed

    Tomlinson, J

    1996-11-01

    This article reviews the four most common surgical conditions of the cervical spinal cord other than vertebral fractures including atlantoaxial instability, cervical disc disease, caudal cervical spondylomyelopathy, and spinal cord tumors. Each disease is reviewed by signalment, history, neurological examination, differential diagnosis, pertinent diagnostic testing, treatment, postoperative care, and prognosis. PMID:9020576

  15. 21 CFR 884.3200 - Cervical drain.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cervical drain. 884.3200 Section 884.3200 Food and... OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3200 Cervical drain. (a) Identification. A cervical drain is a device designed to provide an exit channel for...

  16. Is the use of the cervical vertebrae maturation method justified to determine skeletal age? A comparison of radiation dose of two strategies for skeletal age estimation.

    PubMed

    Patcas, Raphael; Signorelli, Luca; Peltomäki, Timo; Schätzle, Marc

    2013-10-01

    The aim of this study was to assess effective doses of a lateral cephalogram radiograph with and without thyroid shield and compare the differences with the radiation dose of a hand-wrist radiograph. Thermoluminescent dosimeters were placed at 19 different sites in the head and neck of a tissue-equivalent human skull (RANDO phantom). Analogue lateral cephalograms with and without thyroid shield (67 kV, 250 mA, 10 mAs) and hand-wrist radiographs (40 kV, 250 mA, 10 mAs) were obtained. The effective doses were calculated using the 2007 International Commission on Radiological Protection recommendations. The effective dose for conventional lateral cephalogram without a thyroid shield was 5.03 microsieverts (µSv). By applying a thyroid shield to the RANDO phantom, a remarkable dose reduction of 1.73 µSv could be achieved. The effective dose of a conventional hand-wrist radiograph was calculated to be 0.16 µSv. Adding the effective dose of the hand-wrist radiograph to the effective dose of the lateral cephalogram with thyroid shield resulted in a cumulative effective dose of 3.46 µSv. Without thyroid shield, the effective dose of a lateral cephalogram was approximately 1.5-fold increased than the cumulative effective dose of a hand-wrist radiograph and a lateral cephalogram with thyroid shield. Thyroid is an organ that is very sensitive to radiation exposure. Its shielding will significantly reduce the effective dose. An additional hand-wrist radiograph, involving no vulnerable tissues, however, causes very little radiation risk. In accordance with the ALARA (As Low As Reasonably Achievable) principle, if an evaluation of skeletal age is indicated, an additional hand-wrist radiograph seems much more justifiable than removing the thyroid shield. PMID:22828078

  17. Automatic Localization of Target Vertebrae in Spine Surgery: Clinical Evaluation of the LevelCheck Registration Algorithm

    PubMed Central

    Lo, Sheng-fu L.; Otake, Yoshito; Puvanesarajah, Varun; Wang, Adam S.; Uneri, Ali; De Silva, Tharindu; Vogt, Sebastian; Kleinszig, Gerhard; Elder, Benjamin D; Goodwin, C. Rory; Kosztowski, Thomas A.; Liauw, Jason A.; Groves, Mari; Bydon, Ali; Sciubba, Daniel M.; Witham, Timothy F.; Wolinsky, Jean-Paul; Aygun, Nafi; Gokaslan, Ziya L.; Siewerdsen, Jeffrey H.

    2015-01-01

    Study Design A 3D-2D image registration algorithm, “LevelCheck,” was used to automatically label vertebrae in intraoperative mobile radiographs obtained during spine surgery. Accuracy, computation time, and potential failure modes were evaluated in a retrospective study of 20 patients. Objective To measurethe performance of the LevelCheck algorithm using clinical images acquired during spine surgery. Summary of Background Data In spine surgery, the potential for wrong level surgery is significant due to the difficulty of localizing target vertebrae based solely on visual impression, palpation, and fluoroscopy. To remedy this difficulty and reduce the risk of wrong-level surgery, our team introduced a program (dubbed LevelCheck) to automatically localize target vertebrae in mobile radiographs using robust 3D-2D image registration to preoperative CT. Methods Twenty consecutive patients undergoing thoracolumbar spine surgery, for whom both a preoperative CT scan and an intraoperative mobile radiograph were available, were retrospectively analyzed. A board-certified neuroradiologist determined the “true” vertebra levels in each radiograph. Registration of the preoperative CT to the intraoperative radiographwere calculated via LevelCheck, and projection distance errors were analyzed. Five hundred random initializations were performed for eachpatient, andalgorithm settings (viz., the number of robust multi-starts, ranging 50 to 200) were varied to evaluate the tradeoff between registration error and computation time. Failure mode analysis was performed by individually analyzing unsuccessful registrations (>5 mm distance error) observed with 50 multi-starts. Results At 200 robust multi-starts (computation time of ∼26 seconds), the registration accuracy was 100% across all 10,000 trials. As the number of multi-starts (and computation time) decreased, the registration remained fairly robust, down to 99.3% registration accuracy at 50 multi-starts (computation time

  18. Early Trabecular Development in Human Vertebrae: Overproduction, Constructive Regression, and Refinement

    PubMed Central

    Acquaah, Frank; Robson Brown, Katharine A.; Ahmed, Farah; Jeffery, Nathan; Abel, Richard L.

    2015-01-01

    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

  19. Spinal Deformity in Aged Zebrafish Is Accompanied by Degenerative Changes to Their Vertebrae that Resemble Osteoarthritis

    PubMed Central

    Hayes, Anthony J.; Reynolds, Scott; Nowell, Mari A.; Meakin, Lee B.; Habicher, Judith; Ledin, Johan; Bashford, Andrew; Caterson, Bruce; Hammond, Chrissy L.

    2013-01-01

    Age-related degenerative changes within the vertebral column are a significant cause of morbidity with considerable socio-economic impact worldwide. An improved understanding of these changes through the development of experimental models may lead to improvements in existing clinical treatment options. The zebrafish is a well-established model for the study of skeletogenesis with significant potential in gerontological research. With advancing age, zebrafish frequently develop gross deformities of their vertebral column, previously ascribed to reduced trunk muscle tone. In this study, we assess degenerative changes specifically within the bone and cartilage of the vertebral column of zebrafish at 1, 2 and 3-years of age. We show increased frequency and severity of spinal deformities/curvatures with age. Underlying the most severe phenotypes are partial or complete vertebral dislocations and focal thickening of the vertebral bone at the joint margins. MicroCT examination demonstrates small defects, fractures and morphological evidence suggestive of bone erosion and remodeling (i.e. osteophytes) within the vertebrae during aging, but no significant change in bone density. Light and electron microscopic examination reveal striking age-related changes in cell morphology, suggestive of chondroptosis, and tissue remodelling of the vertebral cartilage, particularly within the pericellular micro-environment. Glycosaminoglycan analysis of the vertebral column by HPLC demonstrates a consistent, age-related increase in the yield of total chondroitin sulfate disaccharide, but no change in sulfation pattern, supported by immunohistochemical analysis. Immunohistochemistry strongly identifies all three chondroitin/dermatan sulphate isoforms (C-0-S, C-4-S/DS and C-6-S) within the vertebral cartilage, particularly within the pericellular micro-environment. In contrast, keratan sulfate immunolocalises specifically with the notochordal tissue of the intervertebral disc, and its

  20. Role of trabecular microfractures in failure of human vertebrae estimated by the finite element method

    NASA Astrophysics Data System (ADS)

    Sidorenko, Irina N.; Bauer, Jan; Monetti, Roberto; Müller, Dirk; Rummeny, Ernst J.; Eckstein, Felix; Matsuura, Maiko; Lochmüller, Eva-Maria; Zysset, Philippe K.; Räth, Christoph W.

    2009-02-01

    Spine fractures are the most frequent complication of osteoporosis, a disease characterized by low bone mass and structural deterioration of bone tissue. In case of the spine, the trabecular network plays the main role in load carrying and distribution. A correct description of mechanical properties of this bone structure helps to differentiate between strong and weak bones and can be useful for fracture prediction and treatment monitoring. By means of the finite element method (FEM), applied to μCT images, we modelled biomechanical processes in probes during loading and correlated the estimated failure load with the maximum compressive strength (MCS), obtained in real biomechanical tests. We studied a sample of 151 specimens taken from the trabecular part of human vertebrae in vitro, visualised using μCT imaging at an isotropic resolution of 26μm and tested by uniaxial compression. Besides the standard way of estimating failure load, which takes into account only strong micro-fractures, we also included small micro-fractures, what improved the correlation with MCS (Pearson's correlation coefficient r=0.78 vs. r=0.58). This correlation coefficient was larger than that for both the standard morphometric parameters (r=0.73 for bone volume fraction) and for texture measures defined by the local (an-) isotropic scaling indices method (r=0.55) and Minkowski Functionals (r=0.61). However, the performance of the FEM was different for subsamples selected according to the MCS value. The correlation increased for strong specimens (r=0.88), slightly decreased for weak specimens (r=0.68) and markedly dropped for specimens with medium MCS, e.g. between 60

  1. Early Trabecular Development in Human Vertebrae: Overproduction, Constructive Regression, and Refinement.

    PubMed

    Acquaah, Frank; Robson Brown, Katharine A; Ahmed, Farah; Jeffery, Nathan; Abel, Richard L

    2015-01-01

    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

  2. On the relationship between stature and anthropometric measurements of lumbar vertebrae.

    PubMed

    Klein, Anke; Nagel, Katrin; Gührs, Julian; Poodendaen, Chanasorn; Püschel, Klaus; Morlock, Michael M; Huber, Gerd

    2015-12-01

    Stature estimation is important for identifying human remains. Analysis of body parts has become an important forensic tool during global operations in the context of cases in which human remains have been dismembered, mutilated or decomposed. However, unless almost the full skeleton or at least a long bone of the lower limb is available, accuracy is still limited to approximate body height. Especially with respect to single vertebral measurements, only a rough prediction is possible. Due to their complex geometry, vertebral measurements are possible at various locations. Nine locations have been considered in this study. Regression equations for stature estimation using lumbar vertebral geometry from computed tomography scans have been evaluated to identify the measurement which gives the most reliable body height estimation. The study group comprised a representative sample of a German metropolitan male population (42 autopsied individuals). Comparing the influence of various vertebral geometry measurements with body height resulted in a coefficient of correlation (R) of 0.19-0.53 and a 95% confidence interval (CI) of ± 11.6 up to ± 13.1cm. The largest correlation with a single vertebral measurement was achieved with the central height of the vertebral body of L2 as predictor; the standard error (SE) of the estimate was 5.9 cm. Using models from CT scans appeared superior to current invasive procedures that use direct measurements of the vertebral body, in terms of reproducibility and time efficiency. For fragmented non-skeletonized human bodies, height prediction based on an all-virtual model of the vertebrae is possible. However, the regression coefficient may be similar to classic caliper measurements that prove easier if skeletonized bones are available. PMID:26654071

  3. Stress-induced cervical lesions.

    PubMed

    Braem, M; Lambrechts, P; Vanherle, G

    1992-05-01

    The increasing occurrence of dental lesions at the cervical surfaces requires more knowledge of the causes of the process. Acidic and abrasive mechanisms have clearly been documented as causes but the stress theory by Lee and Eakle is still controversial. This report describes several incidences of possible stress-induced lesions according to the characteristics described by Lee and Eakle. The occurrences of subgingival lesions lend credence to the stress-induction theory by exclusion of other superimposing etiologic factors. With the current concepts, a perceptive approach to the treatment of cervical lesions can be executed. PMID:1527763

  4. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  5. Human papillomavirus testing in cervical cancer screening.

    PubMed

    Castle, Philip E; Cremer, Miriam

    2013-06-01

    Human papillomavirus (HPV) testing is more reliable and sensitive but less specific than Papanicolaou (Pap) testing/cervical cytology for the detection of cervical precancer and cancer. HPV-negative women are at lower risk of cervical cancer than Pap-negative women. In high-resource settings, HPV testing can be used to make cervical cancer prevention programs more efficient by focusing clinical attention on women who have HPV. In lower-resource settings, where Pap testing has not been sustained or widespread, new, lower-cost HPV tests may make cervical cancer screening feasible. PMID:23732037

  6. Cervical Whiplash: Considerations in the Rehabilitation of Cervical Myofascial Injury

    PubMed Central

    Ameis, Arthur

    1986-01-01

    Cervical whiplash, usually the result of impact injuries at high speed, is a typically 20th-century problem. This article describes the biomechanical stresses that result in whiplash and outlines the treatment programs that can be expected to help the patient through the four stages of recovery to achieve functional rehabilitation. PMID:21267293

  7. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation

    PubMed Central

    Li, Jian; Zhang, Zai-Heng

    2008-01-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors’ clinic and treated by PCN. The patients’ gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 ± 10.2 years). The levels of involvement were 21 cases at C3–4, 30 cases at C4–5, 40 cases at C5–6, and 35 cases at C6–7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) ≥11° or horizontal displacement (HD) ≥3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no

  8. BIOMECHANICAL EVALUATION OF THE INFLUENCE OF CERVICAL SCREWS TAPPING AND DESIGN

    PubMed Central

    Silva, Patricia; Rosa, Rodrigo César; Shimano, Antonio Carlos; Albuquerque de Paula, Francisco José; Volpon, José Batista; Aparecido Defino, Helton Luiz

    2015-01-01

    Objective: To assess if the screw design (self-drilling/self-tapping) and the pilot hole tapping could affect the insertion torque and screw pullout strength of the screw used in anterior fixation of the cervical spine. Methods: Forty self-tapping screws and 20 self-drilling screws were inserted into 10 models of artificial bone and 10 cervical vertebrae of sheep. The studied parameters were the insertion torque and pullout strength. The following groups were created: Group I-self-tapping screw insertion after pilot hole drilling and tapping; Group II-self-tapping screw insertion after pilot hole drilling without tapping; Group III-self-drilling screw insertion without drilling and tapping. In Groups I and II, the pilot hole had 14.0 mm in depth and was made with a 3mmn drill, while tapping was made with a 4mm tap. The insertion torque was measured and the pullout test was performed. The comparison between groups was made considering the mean insertion torque and the maximum mean pullout strength with the variance analysis (ANOVA; p≤ 0.05). Results: Previous drilling and tapping of pilot hole significantly decreased the insertion torque and the pullout strength. Conclusion: The insertion torque and pullout strength of self-drilling screws were significantly higher when compared to self-tapping screws inserted after pilot hole tapping. PMID:27004189

  9. Segmentation and feature extraction of cervical spine x-ray images

    NASA Astrophysics Data System (ADS)

    Long, L. Rodney; Thoma, George R.

    1999-05-01

    As part of an R&D project in mixed text/image database design, the National Library of Medicine has archived a collection of 17,000 digitized x-ray images of the cervical and lumbar spine which were collected as part of the second National Health and Nutrition Examination Survey (NHANES II). To make this image data available and usable to a wide audience, we are investigating techniques for indexing the image content by automated or semi-automated means. Indexing of the images by features of interest to researchers in spine disease and structure requires effective segmentation of the vertebral anatomy. This paper describes work in progress toward this segmentation of the cervical spine images into anatomical components of interest, including anatomical landmarks for vertebral location, and segmentation and identification of individual vertebrae. Our work includes developing a reliable method for automatically fixing an anatomy-based coordinate system in the images, and work to adaptively threshold the images, using methods previously applied by researchers in cardioangiography. We describe the motivation for our work and present our current results in both areas.

  10. Drugs Approved for Cervical Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  11. CNP. Cervical Neoplasia Probe Control

    SciTech Connect

    Vargo, T.

    1995-05-17

    This software, which consists of a main executive and several subroutines, performs control of the optics, image acquisition, and Digital Signal Processing (DSP) of this image, of an optical based medical instrument that performs fluoresence detection of precancerous lesions (neoplasia) of the human cervix. The hardware portion of this medical instrument is known by the same name Cervical Neoplasia Probe (CNP)

  12. Nonoperative Management of Cervical Radiculopathy.

    PubMed

    Childress, Marc A; Becker, Blair A

    2016-05-01

    Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 to 54 years of age. Cervical radiculopathy most often stems from degenerative disease in the cervical spine. The most common examination findings are painful neck movements and muscle spasm. Diminished deep tendon reflexes, particularly of the triceps, are the most common neurologic finding. The Spurling test, shoulder abduction test, and upper limb tension test can be used to confirm the diagnosis. Imaging is not required unless there is a history of trauma, persistent symptoms, or red flags for malignancy, myelopathy, or abscess. Electrodiagnostic testing is not needed if the diagnosis is clear, but has clinical utility when peripheral neuropathy of the upper extremity is a likely alternate diagnosis. Patients should be reassured that most cases will resolve regardless of the type of treatment. Nonoperative treatment includes physical therapy involving strengthening, stretching, and potentially traction, as well as nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. Epidural steroid injections may be helpful but have higher risks of serious complications. In patients with red flag symptoms or persistent symptoms after four to six weeks of treatment, magnetic resonance imaging can identify pathology amenable to epidural steroid injections or surgery. PMID:27175952

  13. Primary adenocarcinoma of cervical esophagus.

    PubMed

    Alrawi, S J; Winston, J; Tan, D; Gibbs, J; Loree, T R; Hicks, W; Rigual, N; Lorè, J M

    2005-06-01

    Most upper esophageal malignancies are squamous cell carcinomas, rarely adenocarcinomas arising from Barrett's esophagus and very rarely adenocarcinomas from heterotopic gastric mucosa without evidence of Barrett's especially in the cervical part of the esophagus. We report a case of adenocarcinoma of the polypoid type in the upper esophagus (cervical esophagus) arising from ectopic gastric mucosa, in a 60 year-old man who presented with progressive dysphagia. Accurate diagnosis by esophagogram revealed a large mass in the cervical esophagus; CAT scan showed intraluminal mass at the level of thoracic inlet, esophagogastroscopy showed a fleshy polyp (3.2cm x 3.0cm) at 20 cm from the incisors with a biopsy confirming moderately differentiated adenocarcinoma with no evidence of Barrett's esophagus. Through a left cervical approach and resection of medial third of clavicle, the tumor was removed by partial esophagectomy followed by lymph node dissection, and proved to be T1NOMO, stage I (AJCC staging 6th ed.). Post operatively, the patient received chemoradiation with no evidence of recurrence or metastasis in six years of follow up. It seems this tumor has a much better prognosis than adenocarcinomas arising from Barrett's. To our knowledge only 19 cases have been reported in literature so far. PMID:16110768

  14. Cervical Cancer Risk Prediction Models

    Cancer.gov

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  15. Semi-automatic delineation of the spino-laminar junction curve on lateral x-ray radiographs of the cervical spine

    NASA Astrophysics Data System (ADS)

    Narang, Benjamin; Phillips, Michael; Knapp, Karen; Appelboam, Andy; Reuben, Adam; Slabaugh, Greg

    2015-03-01

    Assessment of the cervical spine using x-ray radiography is an important task when providing emergency room care to trauma patients suspected of a cervical spine injury. In routine clinical practice, a physician will inspect the alignment of the cervical spine vertebrae by mentally tracing three alignment curves along the anterior and posterior sides of the cervical vertebral bodies, as well as one along the spinolaminar junction. In this paper, we propose an algorithm to semi-automatically delineate the spinolaminar junction curve, given a single reference point and the corners of each vertebral body. From the reference point, our method extracts a region of interest, and performs template matching using normalized cross-correlation to find matching regions along the spinolaminar junction. Matching points are then fit to a third order spline, producing an interpolating curve. Experimental results demonstrate promising results, on average producing a modified Hausdorff distance of 1.8 mm, validated on a dataset consisting of 29 patients including those with degenerative change, retrolisthesis, and fracture.

  16. Nanomechanical clues from morphologically normal cervical squamous cells could improve cervical cancer screening

    NASA Astrophysics Data System (ADS)

    Geng, Li; Feng, Jiantao; Sun, Quanmei; Liu, Jing; Hua, Wenda; Li, Jing; Ao, Zhuo; You, Ke; Guo, Yanli; Liao, Fulong; Zhang, Youyi; Guo, Hongyan; Han, Jinsong; Xiong, Guangwu; Zhang, Lufang; Han, Dong

    2015-09-01

    Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis.Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03662c

  17. Effect of trabecular orientation on mechanical resistance and ultrasound propagation in specimens of equine vertebrae.

    PubMed

    Cavani, Francesco; Fini, Milena; de Terlizzi, Francesca; Cadossi, Matteo; Ciminelli, Luca; Ortolani, Sergio; Cherubini, Roberto; De Aloysio, Domenico; Giavaresi, Gianluca; Cadossi, Ruggero; Canè, Valerio

    2003-12-01

    Osteoporosis involves alterations, not only in density, but also in the architectural organisation of the bone; in particular, trabecular orientation, following the skeletal load directions, lends a high degree of stiffness to the whole bone. We investigated the relationship between trabecular orientation, density, stiffness and ultrasound (US) propagation in two orthogonal directions (par. = parallel to, and ort. = orthogonal to the main orientation of the trabeculae) in cylindrical equine bone specimens (thoracic vertebrae) where a preferential orientation is present. A total of 15 cylinders were progressively decalcified with 0.2 mol/L ethylenediaminetetraacetic acid (EDTA). At different levels of decalcification, we measured the apparent density (g/cm(3)), bone mineral density or BMD (g/cm(2)), stiffness coefficient (MPa) and various US parameters. Before decalcification, stiffness values were the same in all directions. As the decalcification proceeded, the stiffness declined and, at low BMD values, it was significantly different in the two directions, being the highest in the par. one. Different behaviours of US parameters were observed in the two directions: SoS (speed of sound) was closely related to apparent density, BMD and stiffness in the par. direction (r = 0.88, 0.92 and 0.88, respectively, p < 0.0001). In the ort. direction, no significant association has been found between SoS and apparent density, BMD or stiffness. In the same experimental setup, US fast wave amplitude (FWA) was related to apparent density and BMD in the par. direction (r = 0.72 and 0.67, respectively, p < 0.0001) and in the ort. direction (r = 0.83 and r = 0.84 respectively, p < 0.0001). FWA was also correlated to stiffness in both directions (r = 0.61 par.; 0.81 ort., p < 0.0001). These results show that trabecular orientation strongly influences both mechanical properties of bone and US propagation. Furthermore, we found that US parameters can be predictors of mechanical

  18. Aberrant methylation during cervical carcinogenesis.

    PubMed

    Virmani, A K; Muller, C; Rathi, A; Zoechbauer-Mueller, S; Mathis, M; Gazdar, A F

    2001-03-01

    We studied the pattern of aberrant methylation during the multistage pathogenesis of cervical cancers. We analyzed a total of 73 patient samples and 10 cervical cancer cell lines. In addition, tissue samples [peripheral blood lymphocytes (n = 10) and buccal epithelial cells (n = 12)] were obtained from 22 healthy volunteers. On the basis of the results of preliminary analysis, the cervical samples were grouped into three categories: (a) nondysplasia/low-grade cervical intraepithelial neoplasia (CIN; n = 37); (b) high-grade CIN (n = 17); and (c) invasive cancer (n = 19). The methylation status of six genes was determined (p16, RARbeta, FHIT, GSTP1, MGMT, and hMLH1). Our main findings are as follows: (a) methylation was completely absent in control tissues; (b) the frequencies of methylation for all of the genes except hMLH1 were >20% in cervical cancers; (c) aberrant methylation commenced early during multistage pathogenesis and methylation of at least one gene was noted in 30% of the nondysplasia/low-grade CIN group; (d) an increasing trend for methylation was seen with increasing pathological change; (e) methylation of RARbeta and GSTP1 were early events, p16 and MGMT methylation were intermediate events, and FHIT methylation was a late, tumor-associated event; and (f) methylation occurred independently of other risk factors including papillomavirus infection, smoking history, or hormone use. Although our findings need to be extended to a larger series, they suggest that the pattern of aberrant methylation in women with or without dysplasia may help identify subgroups at increased risk for histological progression or cancer development. PMID:11297252

  19. Cryptococcosis of lumbar vertebra in a patient with rheumatoid arthritis and scleroderma: case report and literature review

    PubMed Central

    2013-01-01

    Background Although cryptococcosis mainly occurs in the central nervous system and lungs in immunocompromised hosts, it can involve any body site or structure. Here we report the first case of primary cryptococcosis of a lumbar vertebra without involvement of the central nervous system or lungs in a relatively immunocompromised individual with rheumatoid arthritis and scleroderma. Case presentation A 40-year-old Chinese woman with rheumatoid arthritis diagnosed 1 year beforehand and with a subsequent diagnosis of scleroderma was found to have an isolated cryptococcal infection of the fourth lumbar vertebra. Her main complaints were severe low back and left leg pain. Cryptococcosis was diagnosed by CT-guided needle biopsy and microbiological confirmation; however, serum cryptococcal antigen titer was negative. After 3 months of antifungal therapy with fluconazole the patient developed symptoms and signs of scleroderma, which was confirmed on laboratory tests. After taking fluconazole for 6 months, the progressive destruction of the lumbar vertebral body had halted and the size of an adjacent paravertebral mass had decreased substantially. On discharge symptoms had resolved and at an annual follow-up there was no evidence of recurrence on the basis of symptoms, signs or imaging investigations. Conclusion Although cryptococcosis of the lumbar vertebra is extremely rare, it should be considered in the differential diagnosis for patients with lumbar vertebral masses to avoid missed diagnosis, misdiagnosis and diagnostic delay. Early treatment with antifungals proved to be a satisfactory alternative to surgery in this relatively immunocompromised patient. Any residual spinal instability can be treated later, once the infection has resolved. PMID:23496879

  20. Cervical cancer: screening, diagnosis and staging.

    PubMed

    Tsikouras, Panagiotis; Zervoudis, Stefanos; Manav, Bachar; Tomara, Eirini; Iatrakis, George; Romanidis, Constantinos; Bothou, Anastasia; Galazios, George

    2016-01-01

    Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging. PMID:27273940

  1. THE EFFECT OF ANGLE SLICE ACQUISITION ON COMPUTED TOMOGRAPHIC CERVICAL VERTEBRAL COLUMN MORPHOMETRY IN GREAT DANES.

    PubMed

    Jurkoshek, Amanda M; da Costa, Ronaldo C; Martin-Vaquero, Paula

    2015-01-01

    Computed tomography (CT) scans can be acquired with the transverse images aligned either parallel to the endplates or perpendicular to the vertebral canal. The purpose of this prospective cross-sectional study was to determine the effect of angle acquisition on CT morphometric evaluation of the cervical vertebral column of Great Danes with and without cervical spondylomyelopathy. Twenty-eight Great Danes (13 normal, 15 affected) were sampled. For each dog, a set of CT images was acquired with the transverse slices aligned parallel to the endplates and another one with the transverse images aligned perpendicular to the vertebral canal. For each different set, transverse slices from the cranial, middle, and caudal aspects of the individual vertebral bodies C2-C7 were measured. Height, width, transverse area, right dorsal to left ventral height (RDLV), and left dorsal to right ventral height (LDRV) were recorded by a single observer at each location. For both affected and control dogs, significant differences between the measurements obtained from the two sets of transverse images were found only at the cranial aspect of the vertebrae (P = 0.005, P < 0.001, P < 0.001, P = 0.005, and P = 0.010 for height, width, area, RDLV, and LDRV, respectively). Measurements for the middle and caudal aspects did not differ. The funnel-shape morphology of the cervical vertebral foramina in Great Danes with stenosis of their cranial aspect may be responsible for the significant differences found. Considering that the morphometric parameters were significantly affected by CT slice angle in the current study, authors recommend that a standardized scanning protocol be followed when morphometric evaluations using CT are planned. PMID:25872964

  2. Cervical spondylomyelopathy in Great Danes: A magnetic resonance imaging morphometric study

    PubMed Central

    Martin-Vaquero, P.; da Costa, R.C.; Lima, C.G.D.

    2014-01-01

    Morphometric investigations comparing normal and affected animals increase our understanding of spinal diseases in dogs. The aim of this study was to generate morphometric data for osseous-associated cervical spondylomyelopathy (CSM) in Great Danes (GDs). Magnetic resonance imaging (MRI) morphometric features of the cervical vertebral column of GDs with and without clinical signs of CSM were characterized and compared. Thirty client-owned GDs were prospectively enrolled, including 15 clinically normal and 15 CSM-affected GDs. All dogs underwent MRI of the cervical to thoracic vertebral column (C2–C3 through T1–T2). Areas of the cranial and caudal articular processes, and the height, width and areas of the vertebral canal and spinal cord were determined. Middle foraminal heights were measured. Intervertebral disc width was measured before and after traction. Intraobserver and interobserver agreement were calculated. CSM-affected GDs had larger areas of the caudal articular processes from C2–C3 through T1–T2. In CSM-affected GDs, the vertebral canal and spinal cord areas were significantly smaller at C5–C6 and C6–C7, the vertebral canal width was significantly narrower at C6–C7 and C7–T1, and the spinal cord width was significantly narrower at C5–C6 and C6–C7. Middle foraminal height was smaller in CSM-affected GDs from C3–C4 through C7-T1. Neutral intervertebral disc widths were smaller in CSM-affected GDs. It was concluded that the cervical vertebral canal dimensions are significantly different between normal and CSM-affected GDs. Absolute vertebral canal stenosis and severe foraminal stenosis involving the cervical vertebrae distinguish CSM-affected from clinically normal GDs. These findings are relevant to the pathogenesis of osseous-associated CSM and should be taken into consideration when performing imaging studies and planning surgery. PMID:24888675

  3. Cervical compensatory alignment changes following correction of adult thoracic deformity: a multicenter experience in 57 patients with a 2-year follow-up.

    PubMed

    Oh, Taemin; Scheer, Justin K; Eastlack, Robert; Smith, Justin S; Lafage, Virginie; Protopsaltis, Themistocles S; Klineberg, Eric; Passias, Peter G; Deviren, Vedat; Hostin, Richard; Gupta, Munish; Bess, Shay; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P

    2015-06-01

    OBJECT Alignment changes in the cervical spine that occur following surgical correction for thoracic deformity remain poorly understood. The purpose of this study was to evaluate such changes in a cohort of adults with thoracic deformity treated surgically. METHODS The authors conducted a multicenter retrospective analysis of consecutive patients with thoracic deformity. Inclusion criteria for this study were as follows: corrective osteotomy for thoracic deformity, upper-most instrumented vertebra (UIV) between T-1 and T-4, lower-most instrumented vertebra (LIV) at or above L-5 (LIV ≥ L-5) or at the ilium (LIV-ilium), and a minimum radiographic follow-up of 2 years. Sagittal radiographic parameters were assessed preoperatively as well as at 3 months and 2 years postoperatively, including the C-7 sagittal vertical axis (SVA), C2-7 cervical lordosis (CL), C2-7 SVA, T-1 slope (T1S), T1S minus CL (T1S-CL), T2-12 thoracic kyphosis (TK), apical TK, lumbar lordosis (LL), pelvic incidence (PI), PI-LL, pelvic tilt (PT), and sacral slope (SS). RESULTS Fifty-seven patients with a mean age of 49.1 ± 14.6 years met the study inclusion criteria. The preoperative prevalence of increased CL (CL > 15°) was 48.9%. Both 3-month and 2-year apical TK improved from baseline (p < 0.05, statistically significant). At the 2-year follow-up, only the C2-7 SVA increased significantly from baseline (p = 0.01), whereas LL decreased from baseline (p < 0.01). The prevalence of increased CL was 35.3% at 3 months and 47.8% at 2 years, which did not represent a significant change. Postoperative cervical alignment changes were not significantly different from preoperative values regardless of the LIV (LIV ≥ L-5 or LIV-ilium, p > 0.05 for both). In a subset of patients with a maximum TK ≥ 60° (35 patients) and 3-column osteotomy (38 patients), no significant postoperative cervical changes were seen. CONCLUSION Increased CL is common in adult spinal deformity patients with thoracic deformities

  4. [Injury of upper cervical spine].

    PubMed

    Ryba, Luděk; Cienciala, Jan; Chaloupka, Richard; Repko, Martin; Vyskočil, Robert

    2016-01-01

    Injuries of the upper cervical spine represent 1/3 of all cervical spine injuries and approximately 40 % result by the death. Every level of the cervical spine can be injured - fractures of condyles of the occipital bone (CO), atlantooccipital dislocation (AOD), fractures of the Atlas (C1), atlantoaxial dislocation (AAD) and fractures of the axis (C2). Most of cases in younger patients are caused by high-energy trauma, while by elderly people, because of the osteoporosis, is needed much less energy and even simple falls can cause the injury of the cervical spine. That´s why the etiology of injuries can be different. In younger patients are caused mainly by car accidents, motorcycle and bicycle accidents and pedestrian crashes by car and in elderly populations are the main reason falls. The mechanism of the injury is axial force, hyperflexion, hyperextension, latero-flexion, rotation and combination of all. The basic diagnostic examination is X ray in AP, lateral and transoral projection. But in the most of cases is CT examination necessary and in the suspicion of the ligamentous injury and neurological deterioration must be MRI examination added. Every injury of the upper cervical spine has its own classification. Clinical symptoms can vary from the neck pain, restricted range of motion, antalgic position of the head, injury of the cranial nerves and different neurologic symptoms from the irritation of nerves to quadriplegia. A large percentage of deaths is at the time of the injury. Therapy is divided to conservative treatment, which is indicated in bone injuries with minimal dislocation. In more severe cases, with the dislocation and ligamentous injury, when is high chance of the instability, is indicated the surgical treatment. We can use anterior or posterior approach, make the osteosynthesis, stabilisation and fusion of the spine. Complex fractures and combination of different types of injuries are often present in this part of the spine. Correct and early

  5. What's New in Cervical Cancer Research and Treatment?

    MedlinePlus

    ... resources for cervical cancer What`s new in cervical cancer research and treatment? New ways to prevent and treat ... Your Doctor After Treatment What`s New in Cervical Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

  6. Cervical spondylosis and hypertension: a clinical study of 2 cases.

    PubMed

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-03-01

    Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  7. Cervical disc arthroplasty: Pros and cons

    PubMed Central

    Moatz, Bradley; Tortolani, P. Justin

    2012-01-01

    Background: Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. Methods: This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Results: Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Conclusion: Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing. PMID:22905327

  8. Cervical Cancer, Version 2.2015.

    PubMed

    Koh, Wui-Jin; Greer, Benjamin E; Abu-Rustum, Nadeem R; Apte, Sachin M; Campos, Susana M; Cho, Kathleen R; Chu, Christina; Cohn, David; Crispens, Marta Ann; Dorigo, Oliver; Eifel, Patricia J; Fisher, Christine M; Frederick, Peter; Gaffney, David K; Han, Ernest; Huh, Warner K; Lurain, John R; Mutch, David; Fader, Amanda Nickles; Remmenga, Steven W; Reynolds, R Kevin; Teng, Nelson; Tillmanns, Todd; Valea, Fidel A; Yashar, Catheryn M; McMillian, Nicole R; Scavone, Jillian L

    2015-04-01

    The NCCN Guidelines for Cervical Cancer provide interdisciplinary recommendations for treating cervical cancer. These NCCN Guidelines Insights summarize the NCCN Cervical Cancer Panel's discussion and major guideline updates from 2014 and 2015. The recommended systemic therapy options for recurrent and metastatic cervical cancer were amended upon panel review of new survival data and the FDA's approval of bevacizumab for treating late-stage cervical cancer. This article outlines relevant data and provides insight into panel decisions regarding various combination regimens. Additionally, a new section was added to provide additional guidance on key principles of evaluation and surgical staging in cervical cancer. This article highlights 2 areas of active investigation and debate from this new section: sentinel lymph node mapping and fertility-sparing treatment approaches. PMID:25870376

  9. Recovery Effects of a 180 mT Static Magnetic Field on Bone Mineral Density of Osteoporotic Lumbar Vertebrae in Ovariectomized Rats

    PubMed Central

    Xu, Shenzhi; Okano, Hideyuki; Tomita, Naohide; Ikada, Yoshito

    2011-01-01

    The effects of a moderate-intensity static magnetic field (SMF) on osteoporosis of the lumbar vertebrae were studied in ovariectomized rats. A small disc magnet (maximum magnetic flux density 180 mT) was implanted to the right side of spinous process of the third lumbar vertebra. Female rats in the growth stage (10 weeks old) were randomly divided into 4 groups: (i) ovariectomized and implanted with a disc magnet (SMF); (ii) ovariectomized and implanted with a nonmagnetized disc (sham); (iii) ovariectomized alone (OVX) and (vi) intact, nonoperated cage control (CTL). The blood serum 17-β-estradiol (E2) concentrations were measured by radioimmunoassay, and the bone mineral density (BMD) values of the femurs and the lumbar vertebrae were assessed by dual energy X-ray absorptiometry. The E2 concentrations were statistically significantly lower for all three operated groups than those of the CTL group at the 6th week. Although there was no statistical significant difference in the E2 concentrations between the SMF-exposed and sham-exposed groups, the BMD values of the lumbar vertebrae proximal to the SMF-exposed area statistically significantly increased in the SMF-exposed group than in the sham-exposed group. These results suggest that the SMF increased the BMD values of osteoporotic lumbar vertebrae in the ovariectomized rats. PMID:20953437

  10. OXYTOCIN-INDUCED CERVICAL DILATION AND CERVICAL MANIPULATION IN SHEEP: EFFECTS ON LAPAROSCOPIC ARTIFICIAL INSEMINATION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Difficulty of cervical penetration during transcervical artificial insemination (TAI), limits its use in sheep. Trauma of cervical manipulation (CM) may explain low fertility after TAI. We investigated effects of cervical dilation using exogenous oxytocin (OT) to facilitate TAI and its effect on rep...

  11. Cervical vertebral fusion with anterior meningocele

    PubMed Central

    Chavredakis, Emmanuel; Carter, David; Bhojak, Manesh; Jenkinson, Michael D; Clark, Simon R

    2015-01-01

    We present the first described case of cervical vertebral fusion associated with anterior meningocele and syringomyelia. A 45-year-old woman presented with minor trauma, and plain cervical spine radiographs highlighted a congenital deformity of the cervical vertebral bodies. She had a normal neurological examination; however, further imaging revealed a meningocele and syringomyelia. This case highlights the importance of thorough imaging investigation when presented with a congenital deformity in order to detect and prevent development of degenerative spinal cord pathologies. PMID:25923673

  12. Cervical Spine Instrumentation in Children.

    PubMed

    Hedequist, Daniel J; Emans, John B

    2016-06-01

    Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic and clinical studies have been conducted in children, confirming the feasibility of anterior or posterior instrumentation of the cervical spine with modern implants. Knowledge of the relevant spine anatomy and preoperative imaging studies can aid the clinician in understanding the pitfalls of instrumentation for each patient. Preoperative planning, intraoperative positioning, and adherence to strict surgical techniques are required given the small size of children. Instrumentation options include anterior plating, occipital plating, and a variety of posterior screw techniques. Complications related to screw malposition include injury to the vertebral artery, neurologic injury, and instrumentation failure. PMID:27097300

  13. Molecular imaging in cervical cancer.

    PubMed

    Khan, Sairah R; Rockall, Andrea G; Barwick, Tara D

    2016-06-01

    Despite the development of screening and of a vaccine, cervix cancer is a major cause of cancer death in young women worldwide. A third of women treated for the disease will recur, almost inevitably leading to death. Functional imaging has the potential to stratify patients at higher risk of poor response or relapse by improved delineation of disease extent and tumor characteristics. A number of molecular imaging biomarkers have been shown to predict outcome at baseline and/or early during therapy in cervical cancer. In future this could help tailor the treatment plan which could include selection of patients for close follow up, adjuvant therapy or trial entry for novel agents or adaptive clinical trials. The use of molecular imaging techniques, FDG PET/CT and functional MRI, in staging and response assessment of cervical cancer is reviewed. PMID:26859085

  14. Human cervical mucus: research update.

    PubMed

    Katz, D F

    1991-12-01

    Evaluation of cervical mucus is a standard for determining the fertile period in natural family planning. Cervical mucus accepts, filters, prepares, and releases sperm for successful transport to the egg and fertilization. Recent scientific advances provide answers to how the mucus regulates fertility as its physical properties change during the menstrual cycle. Transmission electron microscopy reveals small interstices between mucus macromolecules relative to a sperm head. Thus advancing sperm must push aside or cut through the microstructure. The interstices are largest in the periovulatory phase of the cycle. Small magnetic spheres, comparable with the size of a sperm head, are now being used to study the physical properties of the mucus on the scale of individual sperm. PMID:1755453

  15. Anterior cervical discectomy and fusion for noncontiguous cervical spondylotic myelopathy

    PubMed Central

    Qizhi, Sun; Peijia, Li; Lei, Sun; Junsheng, Chen; Jianmin, Li

    2016-01-01

    Background: Noncontiguous cervical spondylotic myelopathy (CSM) is a special degenerative disease because of the intermediate normal level or levels between supra and infraabnormal levels. Some controversy exists over the optimal procedure for two noncontiguous levels of CSM. The study was to evaluate the outcomes of the anterior cervical discectomy and fusion (ACDF) with zero-profile devices for two noncontiguous levels of CSM. Materials and Methods: 17 consecutive patients with two noncontiguous levels of CSM operated between December 2009 and August 2012 were included in the study. There were 12 men and 5 women with a mean age of 60.7 years (range 45–75 years). Involved disc levels were C3/4 and C5/6 in 11 patients and C4/5 and C6/7 in six patients. Preoperative plain radiographs, computed tomography (CT) with 3-D reconstruction and magnetic resonance imaging (MRI) of the cervical spine were taken in all patients. All radiographs were independently evaluated by 2 spine surgeons and 1 radiologist. The outcomes were assessed by the average operative time, blood loss, Japanese Orthopedic Association (JOA) score, improvement rate, neck dysfunction index (NDI), swallowing quality of life (SWAL-QOL) score, the cervical lordosis and complications. Results: The mean followup was 48.59 months (range 24-56 months). The average operative time and blood loss was 105.29 min and 136.47 ml, respectively. The preoperative JOA score was 8.35, which significantly increased to 13.7 at the final followup (P < 0.01). The NDI score was significantly decreased from preoperative 13.06 to postoperative 3.35 (P < 0.01). The operation also provided a significant increase in the cervical lordosis (P < 0.01) from preoperative 10.17° to postoperative 17.06°. The fusion rate was 94.1% at 6 months postoperatively, and 100% at 12 months after surgery. The mean SWAL-QOL score decreased from preoperative 68.06 to immediate postoperatively 65.65 and then increased to 67.65 at final followup

  16. Surgery for cervical intraepithelial neoplasia

    PubMed Central

    Martin-Hirsch, Pierre PL; Paraskevaidis, Evangelos; Bryant, Andrew; Dickinson, Heather O; Keep, Sarah L

    2014-01-01

    Background Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2 or 3). Cervical intraepithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the grade and extent of the disease. Objectives To assess the effectiveness and safety of alternative surgical treatments for CIN. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (up to April 2009). We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) of alternative surgical treatments in women with cervical intraepithelial neoplasia. Data collection and analysis Two review authors independently abstracted data and assessed risks of bias. Risk ratios that compared residual disease after the follow-up examination and adverse events in women who received one of either laser ablation, laser conisation, large loop excision of the transformation zone (LLETZ), knife conisation or cryotherapy were pooled in random-effects model meta-analyses. Main results Twenty-nine trials were included. Seven surgical techniques were tested in various comparisons. No significant differences in treatment failures were demonstrated in terms of persistent disease after treatment. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although the trials did not provide data for every outcome measure. There were not enough data to assess the effect on morbidity when compared with laser ablation. Authors’ conclusions The evidence

  17. Cervical arterial dissection: current concepts .

    PubMed

    Menon, Ranjith K; Norris, John W

    2008-10-01

    The increasing use and safety of noninvasive imaging in recent years has revealed the surprising frequency of dissection of the carotid and vertebral arteries (cervical arterial dissection [CAD]) as a cause of ischemic and hemorrhagic stroke. This review is an overview of current concepts and practice of patients with CAD, but our ideas are constantly evolving with new discoveries from neurovascular imaging and medical and surgical management in this area. PMID:18990128

  18. Lynch syndrome and cervical cancer.

    PubMed

    Antill, Yoland C; Dowty, James G; Win, Aung Ko; Thompson, Tina; Walsh, Michael D; Cummings, Margaret C; Gallinger, Steven; Lindor, Noralane M; Le Marchand, Loïc; Hopper, John L; Newcomb, Polly A; Haile, Robert W; Church, James; Tucker, Katherine M; Buchanan, Daniel D; Young, Joanne P; Winship, Ingrid M; Jenkins, Mark A

    2015-12-01

    Carriers of germline mutations in DNA mismatch repair (MMR) genes are at increased risk of several cancers including colorectal and gynecologic cancers (Lynch syndrome). There is no substantial evidence that these mutations are associated with an increased risk of cervical cancer. A total of 369 families with at least one carrier of a mutation in a MMR gene (133 MLH1, 174 MSH2, 35 MSH6 and 27 PMS2) were ascertained via population cancer registries or via family cancer clinics in Australia, New Zealand, Canada, and USA. Personal and family histories of cancer were obtained from participant interviews. Modified segregation analysis was used to estimate the hazard ratio (incidence rates for carriers relative to those for the general population), and age-specific cumulative risks of cervical cancer for carriers. A total of 65 cases of cervical cancer were reported (including 10 verified by pathology reports). The estimated incidence was 5.6 fold (95% CI: 2.3-13.8; p = 0.001) higher for carriers than for the general population with a corresponding cumulative risk to 80 years of 4.5% (95% CI: 1.9-10.7%) compared with 0.8% for the general population. The mean age at diagnosis was 43.1 years (95% CI: 40.0-46.2), 3.9 years younger than the reported USA population mean of 47.0 years (p = 0.02). Women with MMR gene mutations were found to have an increased risk of cervical cancer. Due to limited pathology verification we cannot be certain that a proportion of these cases were not lower uterine segment endometrial cancers involving the endocervix, a recognized cancer of Lynch syndrome. PMID:26077226

  19. Clinical technique for invasive cervical root resorption

    PubMed Central

    Silveira, Luiz Fernando Machado; Silveira, Carina Folgearini; Martos, Josué; Piovesan, Edno Moacir; César Neto, João Batista

    2011-01-01

    This clinical case report describes the diagnosis and treatment of an external invasive cervical resorption. A 17-year-old female patient had a confirmed diagnosis of invasive cervical resorption class 4 by cone beam computerized tomography. Although, there was no communication with the root canal, the invasive resorption process was extending into the cervical and middle third of the root. The treatment of the cervical resorption of the lateral incisor interrupted the resorptive process and restored the damaged root surface and the dental functions without any esthetic sequelae. Both the radiographic examination and computed tomography are imperative to reveal the extent of the defect in the differential diagnosis. PMID:22144822

  20. Laparoscopic fertility sparing management of cervical cancer.

    PubMed

    Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

    2014-04-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

  1. Nanotechnology in the management of cervical cancer.

    PubMed

    Chen, Jiezhong; Gu, Wenyi; Yang, Lei; Chen, Chen; Shao, Renfu; Xu, Kewei; Xu, Zhi Ping

    2015-03-01

    Cervical cancer is a major disease with high mortality. All cervical cancers are caused by infection with human papillomaviruses (HPV). Although preventive vaccines for cervical cancer are successful, treatment of cervical cancer is far less satisfactory because of multidrug resistance and side effects. In this review, we summarize the recent application of nanotechnology to the diagnosis and treatment of cervical cancer as well as the development of HPV vaccines. Early detection of cervical cancer enables tumours to be efficiently removed by surgical procedures, leading to increased survival rate. The current method of detecting cervical cancer by Pap smear can only achieve 50% sensitivity, whereas nanotechnology has been used to detect HPVs with greatly improved sensitivity. In cervical cancer treatment, nanotechnology has been used for the delivery of anticancer drugs to increase treatment efficacy and decrease side effects. Nanodelivery of HPV preventive and therapeutic vaccines has also been investigated to increase vaccine efficacy. Overall, these developments suggest that nanoparticle-based vaccine may become the most effective way to prevent and treat cervical cancer, assisted or combined with some other nanotechnology-based therapy. PMID:25752817

  2. Laparoscopic Fertility Sparing Management of Cervical Cancer

    PubMed Central

    Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

  3. Quality of systematic reviews: an example of studies comparing artificial disc replacement with fusion in the cervical spine

    PubMed Central

    Tashani, Osama A.; El-Tumi, Hanan; Aneiba, Khaled

    2015-01-01

    Cervical artificial disc replacement (C-ADR) is now an alternative to anterior cervical discectomy and fusion (ACDF). Many studies have evaluated the efficacy of C-ADR compared with ACDF. This led to a series of systematic reviews and meta-analyses to evaluate the evidence of the superiority of one intervention against the other. The aim of the study presented here was to evaluate the quality of these reviews and meta-analyses. Medline via Ovid, Embase, and Cochrane Library were searched using the keywords: (total disk replacement, prosthesis, implantation, discectomy, and arthroplasty) AND (cervical vertebrae, cervical spine, and spine) AND (systematic reviews, reviews, and meta-analysis). Screening and data extraction were conducted by two reviewers independently. Two reviewers then assessed the quality of the selected reviews and meta-analysis using 11-item AMSTAR score which is a validated measurement tool to assess the methodological quality of systematic reviews. Screening of full reports of 46 relevant abstracts resulted in the selection of 15 systematic reviews and/or meta-analyses as eligible for this study. The two reviewers’ inter-rater agreement level was high as indicated by kappa of >0.72. The AMSTAR score of the reviews ranged from 3 to 11. Only one study (a Cochrane review) scored 100% (AMSTAR 11). Five studies scored below (AMSTAR 5) indicating low-quality reviews. The most significant drawbacks of reviews of a score below 5 were not using an extensive search strategy, failure to use the scientific quality of the included studies appropriately in formulating a conclusion, not assessing publication bias, and not reporting the excluded studies. With a significant exception of a Cochrane review, the methodological quality of systematic reviews evaluating the evidence of C-ADR versus ACDF has to be improved. PMID:26205640

  4. Cervical Sagittal Alignment Parameters of Patients Admitted to Neurosurgery and Emergency Clinics in a State Hospital at Eastern Part of Turkey

    PubMed Central

    Kaplan, Sümeyye Çoruh

    2015-01-01

    Objective Cervical spine encompasses a bridge role between the head and the lower parts of the spine and therefore has unique properties. Our aim in this study was to evaluate the cervical sagittal alignment parameters in pediatric and adult non-surgical patients and to find any differences in respect of age, sex and admission type. Methods All patients who were admitted to emergency and neurosurgery clinics of Diyarbakir Bismil State Hospital due to cervical spine problems (trauma, radiculopathy, paraspinal pain) in 2014 were enrolled retrospectively into the study. Cervical anterior-posterior and lateral X-rays were obtained. Our exclusion criteria were cervical coronal deformity, multitrauma, Glasgow Coma Scale <15, traumatic disruption of the cervical spine, history of malignancy, spinal infection, metabolic or rheumatologic diseases. Results There were 44 female and 55 male patients (n=99) in the study. Thirty-five (35.35%) of the patients were younger than 18 years of age. Mean cervical spinal alignment parameters were as follows: -42.81±11.23° (OC2), -17.15±11.48° (C2-C7), -29.82±7.60° (T1 slope), -3.62±3.05° (C3), -3.14±3.05 (C4), -3.80±2.74° (C5), -3.12±2.36° (C6), -3.43±2.53° (C7). Positive correlations were observed between age-C2C7 angle, C2C7 angle-T1 slope, C3 angle-C4 angle, C4 angle-OC2 angle, C4 angle-T1 slope, C4 angle-C5 angle. The one only negative correlation was between OC2 angle-C2C7 angle. Conclusion In this regional study, it has been observed that global cervical lordosis increases as age increases. C4 vertebra is in the middle of this evaluation as it has many correlations with other cervical segments, which should be kept in mind when making surgical plans for this delicate spine region. PMID:26217386

  5. Metric and morphological study of the upper cervical spine from the Sima de los Huesos site (Sierra de Atapuerca, Burgos, Spain).

    PubMed

    Gómez-Olivencia, Asier; Carretero, José Miguel; Arsuaga, Juan Luis; Rodríguez-García, Laura; García-González, Rebeca; Martínez, Ignacio

    2007-07-01

    In this article, the upper cervical spine remains recovered from the Sima de los Huesos (SH) middle Pleistocene site in the Sierra de Atapuerca (Burgos, Spain) are described and analyzed. To date, this site has yielded more than 5000 human fossils belonging to a minimum of 28 individuals of the species Homo heidelbergensis. At least eleven individuals are represented by the upper cervical (C1 and C2) specimens: six adults and five subadults, one of which could represent an adolescent individual. The most complete adult vertebrae (three atlases and three axes) are described, measured, and compared with other fossil hominins and modern humans. These six specimens are associated with one another and represent three individuals. In addition, one of these sets of cervical vertebrae is associated with Cranium 5 (Individual XXI) from the site. The metric analysis demonstrates that the Sima de los Huesos atlases and axes are metrically more similar to Neandertals than to our modern human comparative sample. The SH atlases share with Neandertals a sagittally elongated canal. The most remarkable feature of the SH (and Neandertal) axes is that they are craniocaudally low and mediolaterally wide compared to our modern male sample. Morphologically, the SH sample shares with Neandertals a higher frequency of caudally projected anterior atlas arch, which could reflect greater development of the longus colli muscle. In other features, such as the frequency of weakly developed tubercles for the attachment of the transverse ligament of the atlas, the Sima de los Huesos fossils show intermediate frequencies between our modern comparative samples and the Neandertals, which could represent the primitive condition. Our results are consistent with the previous phylogenetic interpretation of H. heidelbergensis as an exclusively European species, ancestral only to H. neanderthalensis. PMID:17467038

  6. Neuroendocrine differentiation in cervical carcinoma.

    PubMed Central

    Savargaonkar, P R; Hale, R J; Mutton, A; Manning, V; Buckley, C H

    1996-01-01

    AIMS: To examine neuroendocrine differentiation, as shown by chromogranin A (CGA) expression, in cervical carcinomas. METHODS: Sixty seven cervical carcinomas were studied and were classified as adenocarcinomas, adenosquamous carcinomas or squamous cell carcinomas based on the assessment of haematoxylin and eosin staining and stains for mucin. Where features of glandular differentiation were identified, sections were also stained for evidence of intestinal type mucin. CGA immunostaining was done and the results were graded on a three point scale: 0, + (1-5% of cells positive) and ++ (> 5% of cells positive). These findings were then analysed with respect to lymph node status, tumour differentiation and clinical outcome. RESULTS: There were 32 adenocarcinomas, 18 adenosquamous carcinomas and 17 squamous cell carcinomas. Positive staining was seen in 14 (20.9%) cases, of which four were strongly positive. All but one case were either adenocarcinomas or adenosquamous carcinomas. There was a trend for CGA positivity to be related to intestinal differentiation but this failed to reach statistical significance. No correlation could be demonstrated between CGA staining and lymph node status, tumour differentiation and clinical outcome. CONCLUSIONS: Neuroendocrine differentiation is common in cervical carcinomas where there is evidence of glandular differentiation. Whilst the numbers in this study are relatively small, the presence of neuroendocrine cells in otherwise typical carcinomas does not seem to have any association with clinical behaviour. Images PMID:8655680

  7. Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

    ClinicalTrials.gov

    2016-02-09

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer; Stage IA2 Cervical Cancer; Stage IB1 Cervical Cancer

  8. MR and CT image fusion of the cervical spine: a noninvasive alternative to CT-myelography

    NASA Astrophysics Data System (ADS)

    Hu, Yangqiu; Mirza, Sohail K.; Jarvik, Jeffrey G.; Heagerty, Patrick J.; Haynor, David R.

    2005-04-01

    CT-Myelography (CTM) is routinely used for planning surgery for degenerative disease of the spine, but its invasive nature, significant potential morbidity, and high costs make a noninvasive substitute desirable. We report our work on evaluating CT and MR image fusion as an alternative to CTM. Because the spine is only piecewise rigid, a multi-rigid approach to the registration of spinal CT and MR images was developed (SPIE 2004), in which the spine on CT images is first segmented into separate vertebrae, each of which is then rigidly registered with the corresponding vertebra on MR images. The results are then blended to obtain fusion images. Since they contain information from both modalities, we hypothesized that fusion images would be equivalent to CTM. To test this we selected 34 patients who had undergone MRI and CTM for degenerative disease of the cervical spine, and used the multi-rigid approach to produce fused images. A clinical vignette for each patient was created and presented along with either CT/MR fusion images or CTM images. A group of spine surgeons are asked to formulate detailed surgical plans based on each set of images, and the surgical plans are compared. A similar study assessing diagnostic agreement is being performed with neuroradiologists, who also assess the accuracy of registration. Our work to date has demonstrated the feasibility of segmentation and multi-rigid fusion in clinical cases and the acceptability of the questionnaire to physicians. Preliminary analysis of one surgeon's and one neuroradiologist"s evaluation has been performed.

  9. Opposing effects of Sca-1(+) cell-based systemic FGF2 gene transfer strategy on lumbar versus caudal vertebrae in the mouse.

    PubMed

    Lau, K-H W; Chen, S-T; Wang, X; Mohan, S; Wergedal, J E; Kesavan, C; Srivastava, A K; Gridley, D S; Hall, S L

    2016-06-01

    Our previous work showed that a Sca-1(+) cell-based FGF2 therapy was capable of promoting robust increases in trabecular bone formation and connectivity on the endosteum of long bones. Past work reported that administration of FGF2 protein promoted bone formation in red marrow but not in yellow marrow. The issue as to whether the Sca-1(+) cell-based FGF2 therapy is effective in yellow marrow is highly relevant to its clinical potential for osteoporosis, as most red marrows in a person of an advanced age are converted to yellow marrows. Accordingly, this study sought to compare the osteogenic effects of this stem cell-based FGF2 therapy on red marrow-filled lumbar vertebrae with those on yellow marrow-filled caudal vertebrae of young adult W(41)/W(41) mice. The Sca-1(+) cell-based FGF2 therapy drastically increased trabecular bone formation in lumbar vertebrae, but the therapy not only did not promote bone formation but instead caused substantial loss of trabecular bone in caudal vertebrae. The lack of an osteogenic response was not due to insufficient engraftment of FGF2-expressing Sca-1(+) cells or inadequate FGF2 expression in caudal vertebrae. Previous studies have demonstrated that recipient mice of this stem cell-based FGF2 therapy developed secondary hyperparathyroidism and increased bone resorption. Thus, the loss of bone mass in caudal vertebrae might in part be due to an increase in resorption without a corresponding increase in bone formation. In conclusion, the Sca-1(+) cell-based FGF2 therapy is osteogenic in red marrow but not in yellow marrow. PMID:26934099

  10. Does Balloon Kyphoplasty Deliver More Cement Safely into Osteoporotic Vertebrae with Compression Fractures Compared with Vertebroplasty? A Study in Vertebral Analogues

    PubMed Central

    Abduljabbar, Fahad H.; Al-jurayyan, Abdulaziz; Alqahtani, Saad; Sardar, Zeeshan M.; Saluja, Rajeet Singh; Ouellet, Jean; Weber, Michael; Steffen, Thomas; Beckman, Lorne; Jarzem, Peter

    2015-01-01

    Study Design A biomechanical and radiographic study using vertebral analogues. Objectives Kyphoplasty and vertebroplasty are widely used techniques to alleviate pain in fractures secondary to osteoporosis. However, cement leakage toward vital structures like the spinal cord can be a major source of morbidity and even mortality. We define safe cement injection as the volume of the cement injected into a vertebra before the cement leakage occurs. Our objective is to compare the amount of cement that can be safely injected into an osteoporotic vertebra with simulated compression fracture using either vertebroplasty or balloon kyphoplasty techniques. Methods Forty artificial vertebral analogues made of polyurethane with osteoporotic cancellous matrix representing the L3 vertebrae were used for this study and were divided into four groups of 10 vertebrae each. The four groups tested were: low-viscosity cement injected using vertebroplasty, high-viscosity cement injected using vertebroplasty, low-viscosity cement injected using balloon kyphoplasty, and high-viscosity cement injected using balloon kyphoplasty. The procedures were performed under fluoroscopic guidance. The injection was stopped when the cement started protruding from the created vascular channel in the osteoporotic vertebral fracture model. The main outcome measured was the volume of the cement injected safely into a vertebra before leakage through the posterior vascular channel. Results The highest volume of the cement injected was in the vertebroplasty group using high-viscosity cement, which was almost twice the injected volume in the other three groups. One-way analysis of variance comparing the four groups showed a statistically significant difference (p < 0.005). Conclusions High-viscosity cement injected using vertebroplasty delivers more cement volume before cement leakage and fills the vertebral body more uniformly when compared with balloon kyphoplasty in osteoporotic vertebrae with

  11. Cervical Spine Injuries in the Athlete.

    PubMed

    Schroeder, Gregory D; Vaccaro, Alexander R

    2016-09-01

    Cervical spine injuries are extremely common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as American football and rugby, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma. Therefore, physicians who cover athletic events must have a thorough knowledge of cervical spine injures and the most appropriate ways in which they should be managed. Although cervical spine injuries can be career-ending injuries, athletes often are able to return to play after appropriate treatment if the potential for substantial re-injury is minimized. PMID:27479833

  12. Cervical spondylomyelopathy (wobbler syndrome) in dogs.

    PubMed

    da Costa, Ronaldo C

    2010-09-01

    Cervical spondylomyelopathy (CSM) is a common and controversial disease of the cervical spine of large and giant breed dogs. Not many diseases in veterinary medicine have been referred to by 14 different names and have had 21 surgical techniques proposed to treat it. This article reviews the current knowledge of CSM with regard to its etiology, pathophysiology, diagnosis, treatment, and outcome. PMID:20732597

  13. 21 CFR 884.3200 - Cervical drain.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cervical drain. 884.3200 Section 884.3200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... drain. (a) Identification. A cervical drain is a device designed to provide an exit channel for...

  14. Cervical screening in Luxembourg: 1990-1999.

    PubMed

    Scheiden, R; Wagener, C; Knolle, U; Wehenkel, A; Dippel, W; Capesius, C

    2003-10-01

    For quality assurance purposes, the results of the 1990's obtained by the National Cervical Cancer Screening Programme (NCCSP) launched in 1962 were reviewed. The positive cytodiagnosis, the histologically verified in situ and invasive cervical cancers and the mortality rates were reported. PMID:14510886

  15. Management of delayed posttraumatic cervical kyphosis.

    PubMed

    Lopez, Alejandro J; Scheer, Justin K; Abode-Iyamah, Kingsley; Smith, Zachary A; Hitchon, Patrick W; Dahdaleh, Nader S

    2016-01-01

    We describe three patients with misdiagnosed unstable fractures of the cervical spine, who were treated conservatively and developed kyphotic deformity, myelopathy, and radiculopathy. All three patients were then managed with closed reductions by crown halo traction, followed by instrumented fusions. Their neurologic function was regained without permanent disability in any patient. Unstable fractures of the cervical spine will progress to catastrophic neurologic injuries without surgical fixation. Posttraumatic kyphosis and the delayed reduction of partially healed fracture dislocations by preoperative traction are not well characterized in the subaxial cervical spine. The complete evaluation of any subaxial cervical spine fracture requires CT scanning to assess for bony fractures, and MRI to assess for ligamentous injury. This allows for assessment of the degree of instability and appropriate management. In patients with delayed posttraumatic cervical kyphosis, preoperative closed reduction provided adequate realignment, facilitating subsequent operative stabilization. PMID:26321304

  16. Mechanical and cellular processes driving cervical myelopathy

    PubMed Central

    Dolan, Roisin T; Butler, Joseph S; O’Byrne, John M; Poynton, Ashley R

    2016-01-01

    Cervical myelopathy is a well-described clinical syndrome that may evolve from a combination of etiological mechanisms. It is traditionally classified by cervical spinal cord and/or nerve root compression which varies in severity and number of levels involved. The vast array of clinical manifestations of cervical myelopathy cannot fully be explained by the simple concept that a narrowed spinal canal causes compression of the cord, local tissue ischemia, injury and neurological impairment. Despite advances in surgical technology and treatment innovations, there are limited neuro-protective treatments for cervical myelopathy, which reflects an incomplete understanding of the pathophysiological processes involved in this disease. The aim of this review is to provide a comprehensive overview of the key pathophysiological processes at play in the development of cervical myelopathy. PMID:26807352

  17. In vivo three-dimensional intervertebral kinematics of the subaxial cervical spine during seated axial rotation and lateral bending via a fluoroscopy-to-CT registration approach.

    PubMed

    Lin, Cheng-Chung; Lu, Tung-Wu; Wang, Ting-Ming; Hsu, Chao-Yu; Hsu, Shih-Jung; Shih, Ting-Fang

    2014-10-17

    Accurate measurement of the coupled intervertebral motions is helpful for understanding the etiology and diagnosis of relevant diseases, and for assessing the subsequent treatment. No study has reported the in vivo, dynamic and three-dimensional (3D) intervertebral motion of the cervical spine during active axial rotation (AR) and lateral bending (LB) in the sitting position. The current study fills the gap by measuring the coupled intervertebral motions of the subaxial cervical spine in ten asymptomatic young adults in an upright sitting position during active head LB and AR using a volumetric model-based 2D-to-3D registration method via biplane fluoroscopy. Subject-specific models of the individual vertebrae were derived from each subject's CT data and were registered to the fluoroscopic images for determining the 3D poses of the subaxial vertebrae that were used to obtain the intervertebral kinematics. The averaged ranges of motion to one side (ROM) during AR at C3/C4, C4/C5, C5/C6, and C6/C7 were 4.2°, 4.6°, 3.0° and 1.3°, respectively. The corresponding values were 6.4°, 5.2°, 6.1° and 6.1° during LB. Intervertebral LB (ILB) played an important role in both AR and LB tasks of the cervical spine, experiencing greater ROM than intervertebral AR (IAR) (ratio of coupled motion (IAR/ILB): 0.23-0.75 in LB, 0.34-0.95 in AR). Compared to the AR task, the ranges of ILB during the LB task were significantly greater at C5/6 (p=0.008) and C6/7 (p=0.001) but the range of IAR was significantly smaller at C4/5 (p=0.02), leading to significantly smaller ratios of coupled motions at C4/5 (p=0.0013), C5/6 (p<0.001) and C6/7 (p=0.0037). The observed coupling characteristics of the intervertebral kinematics were different from those in previous studies under discrete static conditions in a supine position without weight-bearing, suggesting that the testing conditions likely affect the kinematics of the subaxial cervical spine. While C1 and C2 were not included owing to

  18. Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer

    ClinicalTrials.gov

    2014-04-21

    Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

  19. Reoperations Following Cervical Disc Replacement

    PubMed Central

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential complications associated with CDR. The published rates of reoperation (mean, 1.0%; range, 0%-3.1%), revision (mean, 0.2%; range, 0%-0.5%), and removal (mean, 1.2%; range, 0%-1.9%) following CDR are low and comparable to the published rates of reoperation (mean, 1.7%; range; 0%-3.4%), revision (mean, 1.5%; range, 0%-4.7%), and removal (mean, 2.0%; range, 0%-3.4%) following cervical arthrodesis. The surgical interventions following CDR range from the repositioning to explantation followed by fusion or the reimplantation to posterior foraminotomy or fusion. Strict patient selection, careful preoperative radiographic review and surgical planning, as well as surgical technique may reduce adverse events and the need for future intervention. Minimal literature and no guidelines exist for the approaches and techniques in revision and for the removal of implants following CDR. Adherence to strict indications and precise surgical technique may reduce the number of reoperations, revisions, and removals following CDR. Long-term follow-up studies are needed, assessing the implant survivorship and its effect on the revision and removal rates. PMID:26097667

  20. [Laminoplasty for cervical spondylotic myelopathy].

    PubMed

    Fransen, P

    2014-10-01

    Cervical spondylotic myelopathy (CSM) is a common condition. Uninstrumented laminectomy may be complicated by postoperative instability, whereas anterior or posterior decompression with fusion may be associated with stiffness and adjacent segment disease. Cervical laminoplasty, initially oriented towards pediatric patients and ossification of the posterior longitudinal ligament, becomes an interesting surgical alternative to decompress and reconstruct cervical anatomy without fusion. Eighteen patients (12 men, 6 women), mean age 64.2 who presented with CSM were treated surgically using multilevel laminoplasty, and reviewed after 1 month, 6 months, 1 year and 2 years. Clinical evaluation was performed based on the Benzel-JOA and Nurick scores. The preoperative mean Benzel-JOA score was 13.55; Preoperative mean Nurick score was 1.88. Preoperative MRI was carried-out in 16/18 patients. Intramedullary hyperintensity in T2 was observed in 6 patients. The operation was performed on 2 levels (4 patients) 3 levels (11 patients) and 4 levels (3 patients). We used the open-door hinged laminoplasty technique, using metallic implants, without bone graft. At one month FU, mean JOA score was 15.44, and Nurick dropped to 1.05. At 6 months, mean JOA was 16.28 and Nurick was 0.71. At one year, the mean JOA score was 16.16, and Nurick was 0.83. At 2 years, mean JOA was 17.5, and Nurick was 0.25. One infection, one dural tear and one transient episode of C5 paresthesia were observed. We conclude that spinal cord decompression by open-door laminoplasty for CSM allows significant clinical improvement observed progressively in the two years following surgery. PMID:25239380

  1. Cervical myelopathy in rheumatoid arthritis.

    PubMed

    Meijers, K A; Cats, A; Kremer, H P; Luyendijk, W; Onvlee, G J; Thomeer, R T

    1984-01-01

    Results obtained in 43 Rheumatoid arthritis (RA) patients with cervical myelopathy are described; all patients showed several alarm signs together with neurological disturbances. Thirty-four cases were operable; nine patients were not operated upon for various reasons (refusal, and general condition). In the surgically treated patients, the changes were localized in the C1-C2 area (n = 20), in the area below C2 (n = 5), or in both (n = 9). The patients were put on skull traction pre- and post-operatively and nursed on a circo-electric bed. Pre-operatively, the duration of traction varied from a few days to weeks (mean 3 weeks). Post-operatively, the patients were given continuous skull traction for 2 1/2-3 months. This procedure yielded neurological improvement and a stable graft in all but two patients. On follow-up, recurrence of neurological complaints was seen in nine patients, in four due to a new slip at a lower level. Three of these cases were reoperated with good results. Twenty-three patients have died: four 'early' (one pre-operatively and three within 6 weeks post-operatively) and 19 'late'. The mean duration of follow-up was 4.5 years. In those who died 'late', the cause of death was due to the effects of an unstable graft in two cases and in the others the causes were not related to changes in the cervical spine. In the 10 patients who are still alive the mean duration of follow-up is 5 years. The nine patients who were not operated upon all died within a year, 4 of them due to consequences of cord compression. If cervical spondylodesis is feasible in an RA patient with myelopathy, the procedure is advocated. PMID:6529877

  2. Cervical cancer screening in Luxembourg.

    PubMed

    Scheiden, R; Knolle, U; Wagener, C; Wehenkel, A M; Capesius, C

    2000-11-01

    In 1962, a programme for early detection of cervical cancer was established at the national level. The programme is based on the collaboration of different groups of doctors and not on a system of sending out invitations to every woman. This programme was re-adapted twice according to the needs for assuring quality in a system of mainly liberal medicine. At present the programme is 'institutionalised' and is carried out according to the criteria defined in 1990. This includes a centralisation of the smear readings and handing out the material needed to take the smears. The contribution of the doctors is regulated by a system of bonuses given by the government and a reimbursement by the Health Fund. The annual cervical smear is free of charge for every woman. The participation of the women targeted by the programme (>15 years old) has increased by approximately 50% every decade from the early 1970s increasing from 10950 in 1972 to 70441 in 1999. Between 1980 and 1999, the number of women at risk taking part in the programme increased from 10.80 to 38.92%. The number of all the doctors taking smear samples increased from 68 to 105 and the number of gynaecologists increased from 19 (ratio Gyn/GP (gynaecologists/General Practitioners) of 28%) to 52 (ratio Gyn/GP of 50%). The mortality rate has decreased continuously from 6. 1/100000 in 1990 to 0.9/100000 in 1997. In conclusion, to be successful, a cervical cancer screening programme should be flexible enough to allow short-term adaptations to unexpected local situations and needs a highly motivated team of the different participants involved in the regional and national health policy. PMID:11072212

  3. Cervical disc hernia operations through posterior laminoforaminotomy

    PubMed Central

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis. PMID:27217655

  4. Histological aspects of cervical ripening.

    PubMed

    Ichijo, M; Shimizu, T; Sasai, Y

    1976-02-01

    There is a close relationship between the rate of the uterine cervix opening during parturition and the presence or absence of a completely ripened cervix. In order to learn the basic pattern of the ripening of cervix, histological and histochemical studies were performed on the human uterine cervix during pregnancy. It was noted that the collagen bundles disintegrated into fine fibers and also underwent quantitative changes during the ripening process of the cervix. During pregnancy, the number of connective tissue cells was increased, but that of mast cells was decreased. Acid mucopolysaccharides in the cervical ground substance were found to increase in late pregnancy. PMID:136067

  5. Panoramic-Based Mandibular Indices and Bone Mineral Density of Femoral Neck and Lumbar Vertebrae in Women

    PubMed Central

    Marandi, S.; Bagherpour, A.; Imanimoghaddam, M.; Hatef, MR.; Haghighi, AR.

    2010-01-01

    Objective: The aim of this cross-sectional analytic study was to evaluate the diagnostic efficacy of panoramic-based indices of the mandible (Mental Index-MI, Mandibular Cortical Index-MCI and Panoramic Mandibular Index-PMI) and to determine their correlation with bone mineral density (BMD) of the femoral neck and lumbar vertebrae (L2-L4) in order to assess the possibility of using these parameters as indicators of osteoporosis. Materials and Methods: The mandibular indices of 67 women over 35 years old were measured from panoramic radiographs, and bone densitometry was performed in the femoral neck and lumbar vertebrae (L2-L4), using DXA (Dual Energy X-ray Absorptiometry) technique. The patients were divided into three categories of normal, osteopenic and osteoporotic in each skeletal region. One-way ANOVA and ROC curve analyses were applied. The results were considered statistically significant when the P-value was less than 0.05. Results: Comparing the mean BMD in the femoral neck in women between C1 and C3 subgroups of MCI, a significant difference was detected (P=0.04). The mean PMI in the three skeletal subgroups was not different according to the skeletal region (P>0.05). We found a significant difference in mean MI between normal and osteopenic subgroups in the femoral neck (P=0.042). Conclusion: Using radiomorphometric indices of the mandible (MCI-MI) may be useful in determining the skeletal status of the patients, but is not sufficient for precise evaluation. PMID:21998782

  6. Overview of Cervical Insufficiency: Diagnosis, Etiologies, and Risk Factors.

    PubMed

    Roman, Amanda; Suhag, Anju; Berghella, Vincenzo

    2016-06-01

    The diagnosis of cervical insufficiency can be made in women with or without prior pregnancy losses. Cervical insufficiency has been defined by transvaginal ultrasound cervical length <25 mm before 24 weeks in women with prior pregnancy losses or preterm births at 14 to 36 weeks, or by cervical changes detected on physical examination before 24 weeks of gestation. PMID:27015229

  7. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    PubMed Central

    Gulsen, Salih

    2015-01-01

    BACKGROUND: Loss of cervical lordosis is a significant factor in the development of degeneration of the spine with aging. This degenerative changings of the cervical spine would cause pressure effect on the cervical root and/or medulla spinalis. AIM: Our goal is to understand the effect of the PEEK cage on cervical lordosis in the early postoperative period. Also, to interpret the effects of one- level, two- level, three-level and four- level disc pathologies on cervical lordosis. MATERIAL AND METHODS: We retrospectively investigated our archive, and we selected thirty-four patients undergoing anterior cervical discectomy and fusion with PEEK cage filled with demineralized bone matrix (ACDFP). RESULTS: We determined that ACDFP provides improvement in the cervical lordosis angle in both groups. Also, we found statistically significant difference between group 1 and 2 regarding causes of radiculomyelopathy statistically. CONCLUSION: We achieved better cervical lordotic angles at the postoperative period by implanting one-level, two-level, three-level or four-level PEEK cage filled with demineralized bone matrix. Also, the causes of cervical root and or medulla spinalis impingement were different in group1 and 2. While extruded cervical disc impingement was the first pathology in group 1, osteophyte formation was the first pathology in group 2.

  8. Anterior Cervical Spine Surgery for Degenerative Disease: A Review

    PubMed Central

    SUGAWARA, Taku

    Anterior cervical spine surgery is an established surgical intervention for cervical degenerative disease and high success rate with excellent long-term outcomes have been reported. However, indications of surgical procedures for certain conditions are still controversial and severe complications to cause neurological dysfunction or deaths may occur. This review is focused mainly on five widely performed procedures by anterior approach for cervical degenerative disease; anterior cervical discectomy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical foraminotomy, and arthroplasty. Indications, procedures, outcomes, and complications of these surgeries are discussed. PMID:26119899

  9. A comparative study on dynamic stiffness in typical finite element model and multi-body model of C6-C7 cervical spine segment.

    PubMed

    Wang, Yawei; Wang, Lizhen; Du, Chengfei; Mo, Zhongjun; Fan, Yubo

    2016-06-01

    In contrast to numerous researches on static or quasi-static stiffness of cervical spine segments, very few investigations on their dynamic stiffness were published. Currently, scale factors and estimated coefficients were usually used in multi-body models for including viscoelastic properties and damping effects, meanwhile viscoelastic properties of some tissues were unavailable for establishing finite element models. Because dynamic stiffness of cervical spine segments in these models were difficult to validate because of lacking in experimental data, we tried to gain some insights on current modeling methods through studying dynamic stiffness differences between these models. A finite element model and a multi-body model of C6-C7 segment were developed through using available material data and typical modeling technologies. These two models were validated with quasi-static response data of the C6-C7 cervical spine segment. Dynamic stiffness differences were investigated through controlling motions of C6 vertebrae at different rates and then comparing their reaction forces or moments. Validation results showed that both the finite element model and the multi-body model could generate reasonable responses under quasi-static loads, but the finite element segment model exhibited more nonlinear characters. Dynamic response investigations indicated that dynamic stiffness of this finite element model might be underestimated because of the absence of dynamic stiffen effect and damping effects of annulus fibrous, while representation of these effects also need to be improved in current multi-body model. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26466546

  10. New patterns of the growing L3 vertebra and its 3 ossification centers in human fetuses – a CT, digital, and statistical study

    PubMed Central

    Szpinda, Michał; Baumgart, Mariusz; Szpinda, Anna; WoŸniak, Alina; Mila-Kierzenkowska, Celestyna

    2013-01-01

    Background This study describes reference data for L3 vertebra and its 3 ossification centers at varying gestational ages. Material/Methods Using CT, digital-image analysis and statistics, the growth of L3 vertebra and its 3 ossification centers in 55 spontaneously aborted human fetuses aged 17–30 weeks was examined. Results Neither sex nor right-left significant differences were found. The height and transverse and sagittal diameters of the L3 vertebral body increased logarithmically. Its cross-sectional area followed linearly, whereas its volume increased parabolically. The transverse and sagittal diameters of the ossification center of the L3 vertebral body varied logarithmically, but its cross-sectional area and volume grew linearly. The ossification center-to-vertebral body volume ratio gradually declined with age. The neural ossification centers increased logarithmically in length and width, and proportionately in cross-sectional area and volume. Conclusions With no sex differences, the growth dynamics of the L3 vertebral body follow logarithmically in height, sagittal and transverse diameters, linearly (in cross-sectional area), and parabolically (in volume). The growth dynamics of the 3 ossification centers of the L3 vertebra follow logarithmically in transverse and sagittal diameters, and linearly (in cross-sectional area and volume). The age-specific reference intervals of the L3 vertebra and its 3 ossification centers present the normative values of clinical importance in the diagnosis of congenital spinal defects. PMID:23778313

  11. Effect of joint mobilization using KEOMT and PNF on a patient with CLBP and a lumbar transitional vertebra: a case study

    PubMed Central

    Park, Si-Eun; Wang, Joong-San

    2015-01-01

    [Purpose] The purpose of this case study was to identify the effects of joint mobilization using Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) and proprioceptive neuromuscular facilitation (PNF) techniques on a patient with chronic low back pain (CLBP) and a lumbar transitional vertebra. [Methods] The intervention methods were joint mobilization using KEOMT and PNF techniques. The program consisted of 40-min sessions 3 days a week for 4 weeks. The spinal motion (thoracic and lumbar vertebrae), pain, and thickness of the multifidus were measured. [Results] The angle of spinal curvature increased, and the range of motions (ROMs) flexion and extension increased in the thoracic and lumbar vertebrae. The pain score as measured on a visual analogue scale (VAS) and the Oswestry disability index (ODI) score decreased. The thickness of the multifidus (L4) increased on the left and right sides. [Conclusion] These results suggest that joint mobilization using KEOMT and PNF techniques had a positive effect on the spinal motion, pain, and thickness of the multifidus of a patient with chronic low back pain and a lumbar transitional vertebra. PMID:26157278

  12. Cervical cytology biobanking in Europe.

    PubMed

    Arbyn, Marc; Van Veen, Evert-Ben; Andersson, Kristin; Bogers, Johannes; Boulet, Gaëlle; Bergeron, Christine; von Knebel-Doeberitz, Magnus; Dillner, Joakim

    2010-01-01

    A cervical cytology biobank (CCB) is an extension of current cytopathology laboratory practice consisting in the systematic storage of Pap smears or liquid-based cytology samples from women participating in cervical cancer screening with the explicit purpose to facilitate future scientific research and quality audit of preventive services. A CCB should use an internationally agreed uniform cytology terminology, be integrated in a national or regional screening registry, and be linked to other registries (histology, cancer, vaccination). Legal and ethical principles concerning personal integrity and data safety must be respected strictly. Biobank-based studies require approval of ethical review boards. A CCB is an almost inexhaustible resource for fundamental and applied biological research. In particular, it can contribute to answering questions on the natural history of HPV infection and HPV-induced lesions and cancers, screening effectiveness, exploration of new biomarkers, and surveillance of the short- and long-term effects of the introduction of HPV vaccination. To understand the limitations of CCB, more studies are needed on the quality of samples in relation to sample type, storage procedures, and duration of storage. PMID:20872354

  13. Invasive Cervical Resorption: A Review

    PubMed Central

    Kandalgaonkar, Shilpa D; Gharat, Leena A; Tupsakhare, Suyog D; Gabhane, Mahesh H

    2013-01-01

    Invasive cervical resorption is a relatively uncommon form of external root resorption exhibiting no external signs. The resorptive condition is often detected by routine radiographic examination. The clinical features vary from a small defect at the gingival margin to a pink coronal discoloration of the tooth crown resulting in ultimate cavitation of the overlying enamel which is painless unless pulpal or periodontal infection supervenes. Radiographic features of lesions vary from well-delineated to irregularly bordered mottled radiolucencies, and these can be confused with dental caries. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal, because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing clastic cells adjacent to the dentin surface. More advanced lesions display fibro-osseous characteristics with deposition of ectopic bonelike calcifications both within the resorbing tissue and directly on the dentin surface. How to cite this article: Kandalgaonkar SD, Gharat LA, Tupsakhare SD, Gabhane MH. Invasive Cervical Resorption: A Review. J Int Oral Health 2013;5(6):124-30 . PMID:24453457

  14. Network Topologies Decoding Cervical Cancer

    PubMed Central

    Jalan, Sarika; Kanhaiya, Krishna; Rai, Aparna; Bandapalli, Obul Reddy; Yadav, Alok

    2015-01-01

    According to the GLOBOCAN statistics, cervical cancer is one of the leading causes of death among women worldwide. It is found to be gradually increasing in the younger population, specifically in the developing countries. We analyzed the protein-protein interaction networks of the uterine cervix cells for the normal and disease states. It was found that the disease network was less random than the normal one, providing an insight into the change in complexity of the underlying network in disease state. The study also portrayed that, the disease state has faster signal processing as the diameter of the underlying network was very close to its corresponding random control. This may be a reason for the normal cells to change into malignant state. Further, the analysis revealed VEGFA and IL-6 proteins as the distinctly high degree nodes in the disease network, which are known to manifest a major contribution in promoting cervical cancer. Our analysis, being time proficient and cost effective, provides a direction for developing novel drugs, therapeutic targets and biomarkers by identifying specific interaction patterns, that have structural importance. PMID:26308848

  15. Network Topologies Decoding Cervical Cancer.

    PubMed

    Jalan, Sarika; Kanhaiya, Krishna; Rai, Aparna; Bandapalli, Obul Reddy; Yadav, Alok

    2015-01-01

    According to the GLOBOCAN statistics, cervical cancer is one of the leading causes of death among women worldwide. It is found to be gradually increasing in the younger population, specifically in the developing countries. We analyzed the protein-protein interaction networks of the uterine cervix cells for the normal and disease states. It was found that the disease network was less random than the normal one, providing an insight into the change in complexity of the underlying network in disease state. The study also portrayed that, the disease state has faster signal processing as the diameter of the underlying network was very close to its corresponding random control. This may be a reason for the normal cells to change into malignant state. Further, the analysis revealed VEGFA and IL-6 proteins as the distinctly high degree nodes in the disease network, which are known to manifest a major contribution in promoting cervical cancer. Our analysis, being time proficient and cost effective, provides a direction for developing novel drugs, therapeutic targets and biomarkers by identifying specific interaction patterns, that have structural importance. PMID:26308848

  16. Life history reconstruction of modern and fossil sockeye salmon ( Oncorhynchus nerka) by oxygen isotopic analysis of otoliths, vertebrae, and teeth: Implication for paleoenvironmental reconstructions

    NASA Astrophysics Data System (ADS)

    Zazzo, A.; Smith, G. R.; Patterson, W. P.; Dufour, E.

    2006-09-01

    We evaluate the use of oxygen isotope values of biogenic apatite for tracking freshwater to marine migration in modern and fossil Pacific sockeye salmon. Oxygen isotope analyses of otoliths, vertebrae, and teeth of three anadromous modern sockeye salmon from Alaska establish a basis for the interpretation of fossil vertebrae and tooth apatite from Pleistocene sockeye salmon of the Skokomish River Valley, Washington. High resolution δ18O profiles in salmon otoliths provide, at a monthly resolution, a detailed record of individual history including continental rearing, migration to sea, seasonal variation in sea surface temperatures during marine life, and spawning migration before capture. Pacific salmon teeth are constantly renewed with the last set of teeth forming under the influence of freshwater. Therefore, they do not allow inference concerning sea-run versus landlocked life history in fossil salmon. Salmon vertebrae are also ambiguous indicators of life history regarding fresh versus marine water because centra are minimally ossified in the freshwater stages of life and the outermost layer of vertebral bone might be resorbed to provide nutrients during the non-feeding phase of the spawning migration. Therefore, δ18O values of accretionary growth rings in sea-run salmon vertebrae are dominated by the marine signal only if they are not diagenetically altered in freshwater deposits. In Pleistocene sockeye reported here, neither the teeth nor vertebral apatite present clear marine δ18O values due to the combined effects of tooth replacement and diagenetic alteration of bone and dentine. δ18O(PO 4) values of fossil vertebrae are intermediate between δ18O(PO 4) values of enamel and basal tooth dentin. Assuming a similar rate of isotope exchange of vertebrae and dentine with freshwater during diagenesis, these results are interpreted to reflect formation of the teeth under the influence of freshwater, and formation of the vertebrae under the influence of

  17. Epidemiology and Early Detection of Cervical Cancer.

    PubMed

    Hillemanns, Peter; Soergel, Phillip; Hertel, Hermann; Jentschke, Matthias

    2016-01-01

    The new German S3 guideline 'Prevention of Cervical Cancer' published in 2016 is based on the latest available evidence about cervical cancer screening and treatment of cervical precancer. Large randomized controlled trials indicate that human papillomavirus (HPV)-based screening may provide better protection against cervical cancer than cytology alone through improved detection of premalignant disease in the first screening round prior to progression. Therefore, women aged 30 years and older should preferably be screened with HPV testing every 3-5 years (cytology alone every 2 years is an acceptable alternative). Co-testing is not recommended. Screening should start at 25 years using cytology alone every 2 years. The preferred triage test after a positive HPV screening test is cytology. Women positive for HPV 16 and HPV 18 should receive immediate colposcopy. Another alternative triage method is p16/Ki-67 dual stain cytology. The mean yearly participation rate in Germany is between 45 and 50%. Offering devices for HPV self-sampling has the potential to increase participation rates in those women who are at higher risk of developing cervical cancer. Regarding primary prevention, the 9-valent vaccine may provide protection against up to 85% of cervical intraepithelial neoplasia (CIN) 3 and 90% of cervical cancer, and is available in Europe as a 2-dose schedule from May 2016. PMID:27614953

  18. HOXB homeobox gene expression in cervical carcinoma.

    PubMed

    López, R; Garrido, E; Piña, P; Hidalgo, A; Lazos, M; Ochoa, R; Salcedo, M

    2006-01-01

    The homeobox (HOX) genes are a family of transcription factors that bind to specific DNA sequences in target genes regulating gene expression. Thirty-nine HOX genes have been mapped in four conserved clusters: A, B, C, and D; they act as master genes regulating the identity of body segments along the anteroposterior axis of the embryo. The role played by HOX genes in adult cell differentiation is unclear to date, but growing evidence suggests that they may play an important role in the development of cancer. To study the role played by HOX genes in cervical cancer, in the present work, we analyzed the expression of HOXB genes and the localization of their transcripts in human cervical tissues. Reverse transcription-polymerase chain reaction analysis and nonradioactive RNA in situ hybridization were used to detect HOXB expression in 11 normal cervical tissues and 17 cervical carcinomas. It was determined that HOXB1, B3, B5, B6, B7, B8, and B9 genes are expressed in normal adult cervical epithelium and squamous cervical carcinomas. Interestingly, HOXB2, HOXB4, and HOXB13 gene expression was found only in tumor tissues. Our findings suggest that the new expression of HOXB2, HOXB4, and B13 genes is involved in cervical cancer. PMID:16445654

  19. The Korean guideline for cervical cancer screening.

    PubMed

    Min, Kyung Jin; Lee, Yoon Jae; Suh, Mina; Yoo, Chong Woo; Lim, Myong Cheol; Choi, Jaekyung; Ki, Moran; Kim, Yong Man; Kim, Jae Weon; Kim, Jea Hoon; Park, Eal Whan; Lee, Hoo Yeon; Lim, Sung Chul; Cho, Chi Heum; Hong, Sung Ran; Dang, Ji Yeon; Kim, Soo Young; Kim, Yeol; Lee, Won Chul; Lee, Jae Kwan

    2015-07-01

    The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D). PMID:26197860

  20. Quantification of Pediatric Cervical Growth: Anatomical Changes in the Sub-Axial Spine

    PubMed Central

    Lee, Jung Jae; Hong, Jae Taek; Kim, Jong Tae

    2015-01-01

    Objective In order to provide normal values of the pediatric sub-axial cervical spinal canal and vertebral body growth pattern using computed tomographic scans, a total of 318 patients less than 10 years old were included. Methods The growth of the vertebral body and canal space was investigated using four different age groups. The Torg ratio (TR) was calculated and all patients were classified into a low TR group and a high TR group according to a cutoff value of 1.0. To account for spinal curvature, the C3-7 angle was measured. Results Very little axial expansion and growth in height were observed (2.9 mm and 3.4 mm, respectively), and the spinal canal increments (1.8 mm) were much smaller than the dimensions of the vertebral body. The mean TR values were 1.03±0.14 at the C3 vertebral level, 1.02±0.13 at C4, 1.05±0.13 at C5, 1.04±0.13 at C6, and 1.02±0.12 at C7 in all patients. The mean sub-axial angle (C3-7) was 7.9±10.6° (range: -17-47°). Conclusion The upper sub-axial spinal canal continuously increased in size compared to the lower sub-axial spine after 8 years of age. Considerable decrements in the TR was found after late childhood compared to younger ages. Generally, there were no significant differences between boys and girls in vertical length of the cervical vertebrae. However, the axial dimension of the vertebral body and the spinal canal space varied according to gender. PMID:25810858

  1. Cortical Margining Capabilities of Fins Associated with Ventral Cervical Spine Instrumentation

    PubMed Central

    Kwon, Heum-Dai; Cho, Yong-Eun

    2005-01-01

    Fins incorporated into the design of a dynamic cervical spine implant have been employed to enhance axial load-bearing ability, yet their true biomechanical advantages, if any, have not been defined. Therefore, the goal of this study was to assess the biomechanical and axial load-bearing contributions of the fin components of the DOC ventral cervical stabilization system. Eighteen fresh cadaveric thoracic vertebrae (T1-T3) were obtained. Three test conditions were devised and studied: Condition A (DOC implants with fins were placed against the superior endplate and bone screws were not inserted); Condition B (DOC implant without fins was placed and bone screws were inserted); and Condition C (DOC implant with fins were placed against the superior endplate and bone screws were inserted). Specimens were tested by applying a pure axial compressive load to the superior platform of the DOC construct, and load-displacement data were collected. Condition C specimens had the greatest stiffness (459 ± 80 N/mm) and yield load (526±168 N). Condition A specimens were the least stiff (266±53 N/mm), and had the smallest yield loads (180±54 N). The yield load of condition A plus condition B was approximately equal to that of condition C, with condition A contributing about one-third and condition B contributing two-thirds of the overall load-bearing capacity. Although the screws alone contributed to a substantial portion of axial load-bearing ability, the addition of the fins further increased load-bearing capabilities. PMID:15988809

  2. [Cervical actinomycosis due to Actinomyces naeslundii].

    PubMed

    Kimura, Hiroshi

    2011-07-01

    Actinomyces naeslundii, an oral biofilm bacterium of, can be cured using intravenous piperacillin, clindamycin, and surgery. We report a case of cervical actinomycosis due to Actinomyces naeslundii. A 56-year-old man seen for right cervical swelling had undergone dental work. Computed tomography indicated an abscess, from which we aspirated pus using a needle. Although no sulfur granules were found, pus yielded Actinomyces naeslundii. This case is, to our knowledge, the first reported in Japan of cervical actinomycosis due to A. naeslundii. PMID:21838058

  3. [Induction chemotherapy for locally advanced cervical cancer].

    PubMed

    Morkhov, K Yu; Nechushkina, V M; Kuznetsov, V V

    2015-01-01

    The main methods of treatment for cervical cancer are surgery, radiotherapy or their combination. During past two decades chemotherapy are increasingly being used not only in patients with disseminated forms of this disease but also in patients undergoing chemoradiotherapy or as induction therapy. Possibilities of adjuvant chemotherapy for cervical cancer are being studied. According to A.D.Kaprin and V.V. Starinskiy in 2013 in Russia, 32% of patients with newly diagnosed cervical cancer underwent only radiation therapy, 32%--combined or complex treatment, 27.3%--only surgery, and just 8.7%--chemoradiotherapy. PMID:26087600

  4. Cervical squamous cell carcinoma metastatic to placenta.

    PubMed

    Can, Nhu Thuy T; Robertson, Patricia; Zaloudek, Charles J; Gill, Ryan M

    2013-09-01

    A pregnant 29-year-old gravida 4, para 3 woman with Stage IIB cervical cancer was admitted at 33 weeks and 4 days of gestation and delivered a healthy neonate. Her placenta was small but otherwise grossly unremarkable. Microscopic examination revealed metastatic squamous cell carcinoma. An immunohistochemical stain for p16 was positive in the carcinoma cells, supporting metastasis from the cervical tumor. Cervical squamous cell carcinoma metastatic to placenta is very rare. We report a case and discuss metastatic cancer during pregnancy with recommendations for infant follow-up. PMID:23896714

  5. How will HPV vaccines affect cervical cancer?

    PubMed Central

    Roden, Richard; Wu, T.-C.

    2011-01-01

    Cancer of the uterine cervix is the second largest cause of cancer deaths in women, and its toll is greatest in populations that lack screening programmes to detect precursor lesions. Persistent infection with ‘high risk’ genotypes of human papillomavirus (HPV) is necessary, although not sufficient, to cause cervical carcinoma. Therefore, HPV vaccination provides an opportunity to profoundly affect cervical cancer incidence worldwide. A recently licensed HPV subunit vaccine protects women from a high proportion of precursor lesions of cervical carcinoma and most genital warts. Here we examine the ramifications and remaining questions that surround preventive HPV vaccines. PMID:16990853

  6. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs.

    PubMed

    Ellison, G W; Seim, H B; Clemmons, R M

    1988-08-15

    Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space. PMID:3049487

  7. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  8. MRI morphometric characterisation of the paediatric cervical spine and spinal cord in children with MPS IVA (Morquio-Brailsford syndrome).

    PubMed

    Solanki, Guirish A; Lo, William B; Hendriksz, Christian J

    2013-03-01

    Nearly all children with MPS IVA develop skeletal deformities affecting the spine. At the atlanto-axial spine, odontoid hypoplasia occurs. GAG deposition around the dens, leads to peri-odontoid infiltration. Transverse/alar ligament incompetence causes instability. Atlanto-axial instability is associated with cord compression and myelopathy, leading to major morbidity and mortality. Intervention is often required. Does the presence of widened bullet shaped vertebra in platyspondily encroach on the spinal canal and cause spinal stenosis in MPS IVA? So far, there have been no standardised morphometric measurements of the paediatric MPS IVA cervical spine to evaluate whether there is pre-existing spinal stenosis predisposing to compressive myelopathy or whether this is purely an acquired process secondary to instability and compression. This study provides the first radiological quantitative analysis of the cervical spine and spinal cord in a series of affected children. MRI morphometry indicates that the MPS IVA spine is narrower at C1-2 level giving an inverted funnel shape. There is no evidence of a reduction in the Torg ratio (canal-body ratio) in the cervical spine. The spinal canal does not exceed 11 mm at any level, significantly smaller than normal historical cohorts (14 mm). The sagittal diameter and axial surface area of both spinal canal and cord are reduced. C1-2 level cord compression was evident in the canal-cord ratio but the Torg ratio was not predictive of cord compression. In MPS IVA the reduction in the space available for the cord (SAC) is multifactorial rather than due to congenital spinal stenosis. PMID:23404316

  9. Subject-specific multi-validation of a finite element model of ovine cervical functional spinal units.

    PubMed

    Mengoni, Marlène; Vasiljeva, Ksenija; Jones, Alison C; Tarsuslugil, Sami M; Wilcox, Ruth K

    2016-01-25

    The complex motion and geometry of the spine in the cervical region makes it difficult to determine how loads are distributed through adjacent vertebrae or between the zygapophysial (facet) joints and the intervertebral disc. Validated finite element modes can give insight on this distribution. The aim of this contribution was to produce direct validation of subject-specific finite element models of Functional Spinal Units (FSU׳s) of the cervical spine and to evaluate the importance of including fibre directionality in the mechanical description of the annulus fibrosus. Eight specimens of cervical FSU׳s were prepared from five ovine spines and mechanically tested in axial compression monitoring overall load and displacements as well as local facet joints pressure and displacement. Subject-specific finite element models were produced from microCT image data reproducing the experimental setup and measuring global axial force and displacement as well as local facet joints displacement and contact forces. Material models and parameters were taken from the literature, testing isotropic and anisotropic materials for the annulus fibrosus. The validated models showed that adding the direction of the fibres to their non-linear behaviour in the description of the annulus fibrosus improves the predictions at large strain values but not at low strain values. The load transferred through the facet joints was always accurate, irrespective of the annulus material model, while the predicted facet displacement was larger than the measured one but not significantly. This is, to the authors׳ knowledge, the first subject-specific direct validation study on a group of specimens, accounting for inter-subject variability. PMID:26708919

  10. Cisplatin and Radiation Therapy With or Without Carboplatin and Paclitaxel in Patients With Locally Advanced Cervical Cancer

    ClinicalTrials.gov

    2016-03-17

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Chemotherapeutic Agent Toxicity; Cognitive Side Effects of Cancer Therapy; Psychological Impact of Cancer; Radiation Toxicity; Sexual Dysfunction and Infertility; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  11. Cervicitis

    MedlinePlus

    ... during their adult life. Risks include: High-risk sexual behavior History of STIs Many sexual partners Sex (intercourse) ... Sexual partners who have engaged in high-risk sexual behavior or have had an STI Bacteria (such as ...

  12. Differential cytology of cervical neoplasias

    NASA Astrophysics Data System (ADS)

    Koenig, Rainer; Bergander, S.

    1990-11-01

    In the context of the early recognition of cervical cancer the cytology has to detect tumor positive cases among a bulk of un suspicious specimens. Unfortunately there is a group of cases with a vague diaxosis, the so called PAP-ill-group. There are many reasons for the recent impossibility of a safe conclusion from the PAP-Ill-smears to their histological diagnoses (Pig. 1). Today for an exact statement a cone biopsy and a microscopical investigation of its histological sections for such caseS are necessary. That results in a high medical and economical expense and, last not least, that means a higher risk of complications and of future family planning problems for the women affected.

  13. NIH Research Leads to Cervical Cancer Vaccine

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past ... gov . What's New Community-wide treatment of ... of Allergy and Infectious Diseases (NIAID). The study was conducted in a rural ...

  14. Airway management in cervical spine injury

    PubMed Central

    Austin, Naola; Krishnamoorthy, Vijay; Dagal, Arman

    2014-01-01

    To minimize risk of spinal cord injury, airway management providers must understand the anatomic and functional relationship between the airway, cervical column, and spinal cord. Patients with known or suspected cervical spine injury may require emergent intubation for airway protection and ventilatory support or elective intubation for surgery with or without rigid neck stabilization (i.e., halo). To provide safe and efficient care in these patients, practitioners must identify high-risk patients, be comfortable with available methods of airway adjuncts, and know how airway maneuvers, neck stabilization, and positioning affect the cervical spine. This review discusses the risks and benefits of various airway management strategies as well as specific concerns that affect patients with known or suspected cervical spine injury. PMID:24741498

  15. Congenital narrowing of the cervical spinal canal.

    PubMed Central

    Kessler, J T

    1975-01-01

    The clinical and laboratory findings in six patients with congenital narrowing of the cervical spinal canal and neurological symptoms are described. A variable age of onset and an entirely male occurrence were found. Signs and symptoms of spinal cord dysfunction predominated in all but one patient. Symptoms were produced in five patients by increased physical activity alone. Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes. The clinical features may be distinguishable from those found in cervical spondylosis without congenital narrowing. Intermittent claudication of the cervical spinal cord appears to be an important feature of this syndrome. Surgery improved four out of five people. PMID:1219087

  16. Cervical Cancer - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Cervical Cancer URL of this page: https://medlineplus.gov/languages/cervicalcancer.html Other topics A-Z A B ...

  17. Anterior Cervical Discectomy and Fusion with Plating

    MedlinePlus Videos and Cool Tools

    Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  18. Anterior corpectomy and fusion for severe ossification of posterior longitudinal ligament in the cervical spine.

    PubMed

    Chen, Yu; Chen, Deyu; Wang, Xinwei; Lu, Xuhai; Guo, Yongfei; He, Zhimin; Tian, Haijun

    2009-04-01

    Between May 2002 and October 2006, 19 patients (17 men and 2 women; average age 57.2; range 47-71 years) received anterior corpectomy and fusion for severe ossification of the posterior longitudinal ligament (OPLL) in our department. Preoperative radiological evaluation showed the narrowing by the OPLL exceeded 50% in all cases, and OPLL extended from one to three vertebrae. We followed-up all patients for 12-36 months (mean 18 months). The Japanese Orthopaedic Association (JOA) score before surgery was 9.3 +/- 1.8 (range 5-12) which significantly increased to 14.2 +/- 1.3 (range 11-16) points at the last follow-up (P < 0.01). The improvement rate (IR) of neurological function ranged from 22.2-87.5%, with a mean of 63.2% +/- 15.2%. The operation also provided a significant increase in the cervical lordosis and the cord flatting rate (P < 0.01). No severe neurological complication developed. We therefore concluded that anterior decompression and fusion was effective and safe in the treatment of the selected patients, although OPLL exceeded 50% diameter of the spinal canal. PMID:18408927

  19. A Biomechanical Comparison of Intralaminar C7 Screw Constructs with and without Offset Connector Used for C6-7 Cervical Spine Immobilization : A Finite Element Study

    PubMed Central

    Qasim, Muhammad; Natarajan, Raghu N.; An, Howard S.

    2013-01-01

    Objective The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex. PMID:24003366

  20. Activ C cervical disc replacement for myelopathy

    PubMed Central

    McGonagle, L.; Cadman, S.; Chitgopkar, S. D.; Canavan, L.; O’Malley, M.; Shackleford, I. M.

    2011-01-01

    Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO’M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS) for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI) and the Centre for Epidemiologic Studies Depression questionnaire (CES-D). Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64). Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision. PMID:23125494

  1. Grading of cervical dysplasias by frozen section.

    PubMed

    Fletcher, S; Smart, G E; Livingstone, J R

    1985-09-14

    Grading of cervical dysplasias at colposcopy by means of rapid frozen section avoids the delay inevitable with paraffin sections. The immediacy of the diagnosis benefits the patient, who can be treated at her first visit. A comparison of grading by frozen sections with paraffin sections has confirmed the safety of the frozen method. Additional advantages are opportunities for optimum orientation and "rescue" of specimens, improved colposcopic training, and the facilitation of special investigations on fresh cervical tissue. PMID:2863606

  2. Tophaceous gout in the cervical spine.

    PubMed

    Cabot, Jonathan; Mosel, Leigh; Kong, Andrew; Hayward, Mike

    2005-12-01

    Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. PMID:16028084

  3. Anterior cervical hypertrichosis: a sporadic case

    PubMed Central

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-01-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  4. Automated image analysis of uterine cervical images

    NASA Astrophysics Data System (ADS)

    Li, Wenjing; Gu, Jia; Ferris, Daron; Poirson, Allen

    2007-03-01

    Cervical Cancer is the second most common cancer among women worldwide and the leading cause of cancer mortality of women in developing countries. If detected early and treated adequately, cervical cancer can be virtually prevented. Cervical precursor lesions and invasive cancer exhibit certain morphologic features that can be identified during a visual inspection exam. Digital imaging technologies allow us to assist the physician with a Computer-Aided Diagnosis (CAD) system. In colposcopy, epithelium that turns white after application of acetic acid is called acetowhite epithelium. Acetowhite epithelium is one of the major diagnostic features observed in detecting cancer and pre-cancerous regions. Automatic extraction of acetowhite regions from cervical images has been a challenging task due to specular reflection, various illumination conditions, and most importantly, large intra-patient variation. This paper presents a multi-step acetowhite region detection system to analyze the acetowhite lesions in cervical images automatically. First, the system calibrates the color of the cervical images to be independent of screening devices. Second, the anatomy of the uterine cervix is analyzed in terms of cervix region, external os region, columnar region, and squamous region. Third, the squamous region is further analyzed and subregions based on three levels of acetowhite are identified. The extracted acetowhite regions are accompanied by color scores to indicate the different levels of acetowhite. The system has been evaluated by 40 human subjects' data and demonstrates high correlation with experts' annotations.

  5. Targeted treatments for cervical cancer: a review

    PubMed Central

    Peralta-Zaragoza, Oscar; Bermúdez-Morales, Víctor Hugo; Pérez-Plasencia, Carlos; Salazar-León, Jonathan; Gómez-Cerón, Claudia; Madrid-Marina, Vicente

    2012-01-01

    Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%–95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development. PMID:23144564

  6. Cervical cerclage: a review of the evidence.

    PubMed

    Fox, Nathan S; Chervenak, Frank A

    2008-01-01

    Cervical insufficiency is a difficult and confusing diagnosis. Its diagnostic criteria, etiology, and treatment are all debated. Cervical cerclage has been a common practice in obstetrics since it was first described by Shirodker and then McDonald in the 1950s. Cerclages have been placed because of a patient's obstetrical history, physical examination, ultrasound, or a combination of the above. However, the data supporting cerclage placement is limited. There has never been a prospective, randomized, controlled trial of cerclage versus no cerclage in patients with a classic history of cervical insufficiency (multiple painless second trimester losses occurring at progressively earlier gestational ages). This article attempts to review the relevant studies regarding cerclage placement for the treatment of cervical insufficiency. Based on the current literature, there is evidence supporting cervical cerclage in the following limited circumstances: a history of 3 or more spontaneous preterm births or second trimester losses; a high-risk patient with a singleton pregnancy who has a short cervix in the second trimester. Because the majority of patients with risk factors for preterm birth and second trimester loss (poor obstetric history, short cervix) will still deliver at term or near-term, studies on the effectiveness of cervical cerclage would need many patients to be powered appropriately. PMID:18081941

  7. Simple trachelectomy during pregnancy for cervical cancer

    PubMed Central

    Moreno-Luna, Estefania; Alonso, Patricia; Santiago, Javier De; Zapardiel, Ignacio

    2016-01-01

    Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70–80% of cases. We present here the case of a patient with initial diagnosis of cervical cancer made around 20th week of pregnancy. It was then treated by a simple trachelectomy and cerclage during week 24. The pregnant woman gave birth to a healthy baby at the end of her pregnancy. Definitive treatment was completed three months after giving birth with a total hysterectomy and laparoscopic bilateral salpingectomy while preserving both ovaries. After 17 months of monitoring the patient showed no signs of reoccurrence. In conclusion, during the early stage of cervical cancer conservative management may be a reasonable option to preserve the current pregnancy. PMID:27610199

  8. [Uterine cervical carcinoma and human papillomaviruses].

    PubMed

    Sugase, M

    1992-06-01

    For many years it has been thought that a significant proportion of cervical cancer could be attributed to sexually transmitted agents, such as sperm, smegma, Treponema pallidum, Gonococcus and herpes simplexvirus type 2. Recent advances of molecular biology, however, have revealed that human papillomavirus (HPV) might be the most causative virus of the disease. Since HPV type 16 DNA was found in a patient with cervical cancer in 1983, many HPV types have been cloned from cervical cancers, also from premalignant lesions (intraepithelial neoplasias). In Japan, we have found 6 new types of HPV (HPV 58, 59, 61, 62, 64, 67) in the female genital tract so far. Especially, HPV 58, which was cloned from a patient with cervical squamous cell carcinoma and was already fully sequenced, is thought to be an important agent for the development of cervical cancer as well as HPV 16. Now we are investigating extensively to clarify the real relationship between genital HPV infection and cervical cancer. PMID:1327090

  9. Targeted treatments for cervical cancer: a review.

    PubMed

    Peralta-Zaragoza, Oscar; Bermúdez-Morales, Víctor Hugo; Pérez-Plasencia, Carlos; Salazar-León, Jonathan; Gómez-Cerón, Claudia; Madrid-Marina, Vicente

    2012-01-01

    Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%-95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development. PMID:23144564

  10. Simple trachelectomy during pregnancy for cervical cancer.

    PubMed

    Moreno-Luna, Estefania; Alonso, Patricia; Santiago, Javier De; Zapardiel, Ignacio

    2016-01-01

    Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70-80% of cases. We present here the case of a patient with initial diagnosis of cervical cancer made around 20th week of pregnancy. It was then treated by a simple trachelectomy and cerclage during week 24. The pregnant woman gave birth to a healthy baby at the end of her pregnancy. Definitive treatment was completed three months after giving birth with a total hysterectomy and laparoscopic bilateral salpingectomy while preserving both ovaries. After 17 months of monitoring the patient showed no signs of reoccurrence. In conclusion, during the early stage of cervical cancer conservative management may be a reasonable option to preserve the current pregnancy. PMID:27610199

  11. Anterior cervical hypertrichosis: a sporadic case.

    PubMed

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  12. Intrapartum Cervical Laceration and Subsequent Pregnancy Outcomes

    PubMed Central

    Wong, Luchin F.; Wilkes, Jacob; Korgenski, Kent; Varner, Michael W.; Manuck, Tracy A.

    2016-01-01

    Objective  The objective of this study was to describe pregnancy outcomes, including cervical insufficiency and preterm birth, in the subsequent pregnancy following an intrapartum cervical laceration. Study Design  Retrospective cohort of women with their first two consecutive singleton pregnancies carried to ≥ 200/7 weeks' gestation within a tertiary health care system from 2002 to 2012. Cervical laceration cases were identified by ICD9 codes and included if suture repair was required. Results  In this study, 55 women were confirmed to have a cervical laceration in the first delivery; 43 lacerations after vaginal delivery (VD) and 12 after cesarean delivery (CD). The median gestational age of the first delivery was 400/7 weeks and the median birth weight 3,545 g; these did not differ between VD and CD. In the second pregnancy, 2 of 55 women (4.6%) had a prophylactic cerclage placed; 1 carried to term and the other delivered at 356/7 weeks. In total, four women (9.3%) delivered the second pregnancy < 37 weeks: three had a prior term VD and one had a prior 34 weeks VD. There was only one case of recurrent cervical laceration, occurring in the setting of vaginal deliveries. Conclusion  Obstetric cervical lacerations are uncommon. Complications in the following pregnancy were low, despite lack of additional prophylactic cerclage use. PMID:27621953

  13. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment.

    PubMed

    Woods, Barrett I; Hilibrand, Alan S

    2015-06-01

    Cervical radiculopathy is a relatively common neurological disorder resulting from nerve root dysfunction, which is often due to mechanical compression; however, inflammatory cytokines released from damaged intervertebral disks can also result in symptoms. Cervical radiculopathy can often be diagnosed with a thorough history and physical examination, but an magnetic resonance imaging or computed tomographic myelogram should be used to confirm the diagnosis. Because of the ubiquity of degenerative changes found on these imaging modalities, the patient's symptoms must correlate with pathology for a successful diagnosis. In the absence of myelopathy or significant muscle weakness all patients should be treated conservatively for at least 6 weeks. Conservative treatments consist of immobilization, anti-inflammatory medications, physical therapy, cervical traction, and epidural steroid injections. Cervical radiculopathy typically is self-limiting with 75%-90% of patients achieving symptomatic improvement with nonoperative care. For patients who are persistently symptomatic despite conservative treatment, or those who have a significant functional deficit surgical treatment is appropriate. Surgical options include anterior cervical decompression and fusion, cervical disk arthroplasty, and posterior foraminotomy. Patient selection is critical to optimize outcome. PMID:25985461

  14. A Biomechanical Comparison of Three Different Posterior Fixation Constructs Used for C6–C7 Cervical Spine Immobilization: A Finite Element Study

    PubMed Central

    HONG, Jae Taek; QASIM, Muhammad; ESPINOZA ORÍAS, Alejandro A.; NATARAJAN, Raghu N.; AN, Howard S.

    2014-01-01

    The intralaminar screw construct has been recently introduced in C6–C7 fixation. The aim of the study is to compare the stability afforded by three different C7 posterior fixation techniques using a three-dimensional finite element model of a C6–C7 cervical spine motion segment. Finite element models representing three different cervical anchor types (C7 intralaminar screw, C7 lateral mass screw, and C7 pedicle screw) were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the three screw techniques were compared under pure moments in flexion, extension, lateral bending, and axial rotation. ROM for pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in all the three screw constructs. Maximum von Mises stress in pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in all loading modes. This study demonstrated that the pedicle screw fixation is the strongest instrumentation method for C6–C7 fixation. Pedicle screw fixation resulted in least stresses around the C7 pedicle-vertebral body complex. However, if pedicle fixation is not favorable, the laminar screw can be a better option compared to the lateral mass screw because the stress around the pedicle-vertebral body complex and ROM predicted for laminar screw construct was smaller than those of lateral mass screw construct. PMID:24418790

  15. Triapine With Chemotherapy and Radiation Therapy in Treating Patients With IB2-IVA Cervical or Vulvar Cancer

    ClinicalTrials.gov

    2016-07-19

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Vulvar Cancer; Stage IB2 Cervical Cancer; Stage II Vulvar Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Cervical Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vulvar Cancer; Vulvar Adenocarcinoma; Vulvar Squamous Cell Carcinoma

  16. Experimental study using diode laser in discs: the healing process in discs and adjacent vertebrae after laser irradiation

    NASA Astrophysics Data System (ADS)

    Naga, Kumi; Nakai, Sadaaki; Maehara, Kazuyuki; Nishimoto, Seiji

    2004-09-01

    The direct and secondary changes following diode laser irradiation of intervertebral discs were studied in rabbits. A quartz fiber was inserted into the discs, and laser irradiation was applied. Subsequently, the lumbar vertebrae were extracted en bloc, and subjected to sagittal magnetic resonance (MR) imaging and histologic examination immediately after irradiation, and 3, 12, and 24 weeks after irradiation. MR images showed low signal intensity of the intervertebral discs on T2-weighted images 3 weeks after irradiation, which remained unchanged to 24 weeks. Although the signal intensity of the adjacent vertebral bodies remained unchanged on T1-weighted images, the intensity was high on T2-weighted images 3 weeks after irradiation, but had reverted to normal or was low 12 to 24 weeks after irradiation. On histologic examination, the inner layer of the annulus fibrosus was seen to protrude into the void created by vaporization of the nucleus pulposus 3 weeks after irradiation. Multinuclear chondrocytes were observed, as if the disc was being reconstructed. Fibrous tissue in the epiphysis and metaphysis was observed soon after irradiation but decreased over time and was replaced by normal bone marrow.

  17. In vivo dynamic compression has less detrimental effect than static compression on newly formed bone of a rat caudal vertebra.

    PubMed

    Benoit, A; Mustafy, T; Londono, I; Grimard, G; Aubin, C-E; Villemure, I

    2016-01-01

    Fusionless devices are currently designed to treat spinal deformities such as scoliosis by the application of a controlled mechanical loading. Growth modulation by dynamic compression was shown to preserve soft tissues. The objective of this in vivo study was to characterize the effect of static vs. dynamic loading on the bone formed during growth modulation. Controlled compression was applied during 15 days on the 7(th) caudal vertebra (Cd7) of rats during growth spurt. The load was sustained in the "static" group and sinusoidally oscillating in the "dynamic" group. The effect of surgery and of the device was investigated using control and sham (operated on but no load applied) groups. A high resolution CT-scan of Cd7 was acquired at days 2, 8 and 15 of compression. Growth rates, histomorphometric parameters and mineral density of the newly formed bone were quantified and compared. Static and dynamic loadings significantly reduced the growth rate by 20% compared to the sham group. Dynamic loading preserved newly formed bone histomorphometry and mineral density whereas static loading induced thicker (+31%) and more mineralized (+12%) trabeculae. A significant sham effect was observed. Growth modulation by dynamic compression constitutes a promising way to develop new treatment for skeletal deformities. PMID:27609036

  18. Quantitative ultrasound assessment of cervical microstructure.

    PubMed

    Feltovich, Helen; Nam, Kibo; Hall, Timothy J

    2010-07-01

    The objective of this preliminary study was to determine whether quantitative ultrasound (QUS) can provide insight into, and characterization of, uterine cervical microstructure. Throughout pregnancy, cervical collagen reorganizes (from aligned and anisotropic to disorganized and isotropic) as the cervix changes in preparation for delivery. Premature changes in collagen are associated with premature birth in mammals. Because QUS is able to detect structural anisotropy/isotropy, we hypothesized that it may provide a means of noninvasively assessing cervical microstructure. Thorough study of cervical microstructure has been limited by lack of technology to detect small changes in collagen organization, which has in turn limited our ability to detect abnormal and/or premature changes in collagen that may lead to preterm birth. In order to determine whether QUS may be useful for detection of cervical microstructure, radiofrequency (rf) echo data were acquired from the cervices of human hysterectomy specimens (n = 10). The angle between the acoustic beam and tissue was used to assess anisotropic acoustic propagation by control of transmit/receive angles from -20 degrees to +20 degrees. The power spectrum of the echo signals from within a region of interest was computed in order to investigate the microstructure of the tissue. An identical analysis was performed on a homogeneous phantom with spherical scatterers for system calibration. Power spectra of backscattered rf from the cervix were 6 dB higher for normal (0 degree) than steered (+/- 20 degrees) beams. The spectral power for steered beams decreased monotonically (0.4 dB at +5 degrees to 3.6 dB at +20 degrees). The excess difference (compared to similar analysis for the phantom) in normally-incident (0 degree) versus steered beams is consistent with scattering from an aligned component of the cervical microstructure. Therefore, QUS appears to reliably identify an aligned component of cervical microstructure

  19. Impact responses of the cervical spine: A computational study of the effects of muscle activity, torso constraint, and pre-flexion.

    PubMed

    Nightingale, Roger W; Sganga, Jake; Cutcliffe, Hattie; Bass, Cameron R 'Dale'

    2016-02-29

    Cervical spine injuries continue to be a costly societal problem. Future advancements in injury prevention depend on improved physical and computational models, which are predicated on a better understanding of the neck response during dynamic loading. Previous studies have shown that the tolerance of the neck is dependent on its initial position and its buckling behavior. This study uses a computational model to examine three important factors hypothesized to influence the loads experienced by vertebrae in the neck under compressive impact: muscle activation, torso constraints, and pre-flexion angle of the cervical spine. Since cadaver testing is not practical for large scale parametric analyses, these factors were studied using a previously validated computational model. On average, simulations with active muscles had 32% larger compressive forces and 25% larger shear forces-well in excess of what was expected from the muscle forces alone. In the short period of time required for neck injury, constraints on torso motion increased the average neck compression by less than 250N. The pre-flexion hypothesis was tested by examining pre-flexion angles from neutral (0°) to 64°. Increases in pre-flexion resulted in the largest increases in peak loads and the expression of higher-order buckling modes. Peak force and buckling modality were both very sensitive to pre-flexion angle. These results validate the relevance of prior cadaver models for neck injury and help explain the wide variety of cervical spine fractures that can result from ostensibly similar compressive loadings. They also give insight into the mechanistic differences between burst fractures and lower cervical spine dislocations. PMID:26874970

  20. Is atlantoaxial instability the cause of “high” cervical ossified posterior longitudinal ligament? Analysis on the basis of surgical treatment of seven patients

    PubMed Central

    Goel, Atul

    2016-01-01

    Background: Multilevel ossified posterior longitudinal ligaments (OPLLs), particularly those that extend into the high cervical region, are formidable and challenging surgical problems. The aim of the presentation is to analyze the results of surgical treatment of seven consecutive patients having high cervical OPLL with atlantoaxial and subaxial facetal fixations. Objectives: We analyze the role of atlantoaxial instability in the management of OPLL that extended into the high cervical region, above the lower border of C3 vertebra. Materials and Methods: All patients in the series were males. The age of the patients ranged 48-65 years. Clinical evaluation was done by a 5-point clinical grading scale described by us, Japanese Orthopedic Association (JOA) score, and visual analog scale (VAS). All patients were identified to have relatively “subtle” but definite atlantoaxial facetal instability on sagittal imaging and the instability was confirmed by direct handling of the facets during surgery. All patients were treated by multilevel facetal fixation that included fixation of atlantoaxial facets. The aim of surgery was stabilization and arthrodesis of the involved spinal segments, as instability was considered to be the prime pathogenetic factor of OPLL. Spinal canal decompression, either by anterior corpectomy or discoidectomy or by posterior laminectomy or laminoplasty was not done and no attempts were made to remove the OPLL. At an average follow-up of 8 months, all patients showed progressive symptomatic recovery. Conclusion: Atlantoaxial facetal instability can be a cause or an association of high cervical OPLL. Stabilization of the atlantoaxial joint forms a remarkably effective method of treatment. PMID:27041881

  1. How protective is cervical cancer screening against cervical cancer mortality in developing countries? The Colombian case

    PubMed Central

    2010-01-01

    Background Cervical cancer is one of the top causes of cancer morbidity and mortality in Colombia despite the existence of a national preventive program. Screening coverage with cervical cytology does not explain the lack of success of the program in reducing incidence and mortality rates by cervical cancer. To address this problem an ecological analysis, at department level, was carried out in Colombia to assess the relationship between cervical screening characteristics and cervical cancer mortality rates. Methods Mortality rates by cervical cancer were estimated at the department level for the period 2000-2005. Levels of mortality rates were compared to cervical screening coverage and other characteristics of the program. A Poisson regression was used to estimate the effect of different dimensions of program performance on mortality by cervical cancer. Results Screening coverage ranged from 28.7% to 65.6% by department but increases on this variable were not related to decreases in mortality rates. A significant reduction in mortality was found in departments where a higher proportion of women looked for medical advice when abnormal findings were reported in Pap smears. Geographic areas where a higher proportion of women lack health insurance had higher rates of mortality by cervical cancer. Conclusions These results suggest that coverage is not adequate to prevent mortality due to cervical cancer if women with abnormal results are not provided with adequate follow up and treatment. The role of different dimensions of health care such as insurance coverage, quality of care, and barriers for accessing health care needs to be evaluated and addressed in future studies. PMID:20846446

  2. μFE models can represent microdamaged regions of healthy and metastatically involved whole vertebrae identified through histology and contrast enhanced μCT imaging.

    PubMed

    Choudhari, Chetan; Chan, Katelyn; Akens, Margarete K; Whyne, Cari M

    2016-05-01

    Micro-damage formation within the skeleton is an important stimulant for bone remodeling, however abnormal build-up of micro-damage can lead to skeletal fragility. In this study, µCT imaging based micro finite element (μFE) models were used to evaluate tissue level damage criteria in whole healthy and metastatically-involved vertebrae. T13-L2 spinal segments were excised from osteolytic (n=3) and healthy (n=3) female athymic rnu/rnu rats. Osteolytic metastasis was generated by intercardiac injection of HeLa cancer cells. Micro-mechanical axial loading was applied to the spinal motion segments under μCT imaging. Vertebral samples underwent BaSO4 staining and sequential calcein/fuchsin staining to identify load induced micro-damage. μCT imaging was used generate specimen specific μFE models of the healthy and osteolytic whole rat vertebrae. Model boundary conditions were generated through deformable image registration of loaded and unloaded scans. Elevated stresses and strains were detected in regions of micro-damage identified through histological and BaSO4 staining within healthy and osteolytic vertebral models, as compared to undamaged regions. Additionally, damaged regions of metastatic vertebrae experienced significantly higher local stresses and strains than those in the damaged regions of healthy specimens. Areas identified by BaSO4 staining, however, yielded lower levels of stress and strain in damaged and undamaged regions of healthy and metastatic vertebrae as compared to fuschin staining. The multimodal (experimental, image-based and computational) techniques used in this study demonstrated the ability of local stresses and strains computed through µFE analysis to identify trabecular micro-damage, that can be applied to biomechanical analyses of healthy and diseased whole bones. PMID:26947031

  3. Letter: Contraceptive choice and cervical cytology.

    PubMed

    Leppaluoto, P

    1974-02-15

    In the evaluation of biological potentials of contraceptives in the genesis of cervical cancer, cytology seems to have been given due attention while information on the clinical condition and specific treatment of the target organ, the cervix, is repeatedly neglected. "Cancer does not develop in a healthy cervix" is an old dogma derived from impressions gained by clinical examination of the organ. This concept is supported by epidemiologic studies indicating that cancer is extremely rare in cervices restored to a normal condition by cauterization. It may be postulated that this type of treatment destroys the permissive target cells of the cervix, thus indirectly rendering possible coitus-associated and contraceptive-associated(?) mutagen(s) invalid. Also, in comparative studies, an evaluation should be made of the significance of a higher incidence of cervical ectopy reported in women receiving oral hormonal contraceptives. The importance of ectopy in the genesis of cervical malignancy has been derived from the presumption that permissive cervical cells are thus created and exposed to vaginal contents which may harbor the mutagens(s). Therefore, it would seem not only desirable but imperative to include the neglected parameters of clinical condition and of specific treatment (both past and present) of the uterine cervix in the structure of studies like the recent one in this Journal on "Contraceptive choice and cervical cytology", by Drs. Shulman and Merritt. Still another parameter which might prove to be of significance is the predominant type of vaginal flora, which can be assessed readily in the routine examination of Papanicolaou smears. It may be that vaginal contents, which would seem to be somewhat different in wearers of the intrauterine contraceptive device as compared to "pill" users, might play a part in the advent of cervical malignancy as a medium of or for coitus-associated mutagens(s). PMID:4855868

  4. What Are the Key Statistics about Cervical Cancer?

    MedlinePlus

    ... factors for cervical cancer? What are the key statistics about cervical cancer? The American Cancer Society's estimates ... this country. Visit the American Cancer Society’s Cancer Statistics Center for more key statistics. Last Medical Review: ...

  5. 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian

    MedlinePlus

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian Past Issues / Spring 2007 ... of this page please turn Javascript on. Gynecologic Cancers Cervical, Endometrial, and Ovarian NCI estimates that endometrial, ...

  6. Inactive Women May Face Higher Risk for Cervical Cancer

    MedlinePlus

    ... html Inactive Women May Face Higher Risk for Cervical Cancer But study found just 30 minutes of exercise ... who are sedentary appear more likely to develop cervical cancer, but just 30 minutes of exercise each week ...

  7. Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED)

    Cancer.gov

    A study to comprehensively assess biomarkers of risk for progressive cervical neoplasia, and thus develop a new set of biomarkers that can distinguish those at highest risk of cervical cancer from those with benign infection

  8. Understanding Cervical Changes: A Health Guide for Women

    Cancer.gov

    Explains HPV Infection; cervical cancer screening tests including Pap test, HPV test, and Pap/HPV cotesting; new cervical cancer screening guidelines; possible Pap test results and Pap/HPV cotest results; follow-up testing; treatment; and HPV vaccination.

  9. Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in Multilevel Cervical Disc Diseases

    PubMed Central

    Zhang, Jianfeng; Meng, Fanxin; Ding, Yan; Li, Jie; Han, Jian; Zhang, Xintao; Dong, Wei

    2016-01-01

    Abstract To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases. Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF. To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched. Studies were included when they compared HS with ACDF and reported at least one of the following outcomes: functionality, neck pain, arm pain, cervical range of motion (ROM), quality of life, and incidence of complications. No language restrictions were used. Two authors independently assessed the methodological quality of included studies and extracted the relevant data. Seven clinical controlled trials were included in this study. Two trials were prospective and the other 5 were retrospective. The results of the meta-analysis indicated that HS achieved better recovery of NDI score (P = 0.038) and similar recovery of VAS score (P = 0.058) compared with ACDF at 2 years follow-up. Moreover, the total cervical ROM (C2–C7) after HS was preserved significantly more than the cervical ROM after ACDF (P = 0.000) at 2 years follow-up. Notably, the compensatory increase of the ROM of superior and inferior adjacent segments was significant in ACDF groups at 2-year follow-up (P < 0.01), compared with HS. The results demonstrate that HS provides equivalent outcomes and functional recovery for cervical disc diseases, and significantly better preservation of cervical ROM compared with ACDF in 2-year follow-up. This suggests the HS is an effective alternative invention for the treatment of multilevel cervical

  10. [Cervical neuroblastoma in an infant].

    PubMed

    Arvai, Krisztina; Tóth, Judit; Németh, Tamás; Kiss, Csongor; Molnár, Péter; Oláh, Eva

    2004-01-01

    The case of a one-month-old patient admitted to the Department of Pediatrics (Medical and Health Science Center, Debrecen University) because of respiratory distress caused by a cervical mass compressing the upper respiratory pathways is presented. The mass could only be partially removed, the histological diagnosis proved to be neuroblastoma (SBCT: "small blue cell tumor"). Despite the fact that the DNA index of tumor cells (ploidy measurements) and the age of the patient suggested a favourable prognosis, the tumor continued to grow and metastases appeared. Because of symptoms of compression exerted on the respiratory system by the tumor, chemotherapy had to be applied. Since a standard OPEC/OJEC chemotherapeutic protocol proved to be not entirely effective and a residual tumor was still present, retinoic acid and interferon treatment was introduced. Presently, 4 years after the diagnosis, the patient is in complete remission and can be considered to be cured. The case presented here demonstrates that despite the favorable prognosis of the majority of infant neuroblastomas, in some cases the anatomic location of the tumor, leading to disturbance of vital functions, may serve as indication of chemotherapy. Our experience also proved the efficacy of retinoic acid and interferon treatment in relapsed neuroblastoma. PMID:15105902

  11. [Monitoring cervical dilatation by impedance].

    PubMed

    Salvat, J; Lassen, M; Sauze, C; Baud, S; Salvat, F

    1992-01-01

    Several different physics procedures have been tried to mechanize the recording of partograms. Can a measure of impedance of tissue Z using potential difference V, according to Ohm's law V = Z1, and 1 is a constant, be correlated with a measure of cervical dilatation using vaginal examination? This was our hypothesis. The tissue impedance meter was made to our design and applied according to a bipolar procedure. Our work was carried out on 28 patients. 10 patients were registered before labour started in order to test the apparatus and to record the impedance variations without labour taking place, and 18 patients were registered in labour to see whether there was any correlation. The level of impedance in the cervix without labour was 302.7 Ohms with a deviation of 8.2. Using student's t tests it was found that there was a significant correlation (p less than 0.001) in four measurements between the impedance measure and measures obtained by extrapolating the degrees of dilatation calculated from vaginal examination. This is a preliminary study in which we have defined the conditions that are necessary to confirm these first results and to further develop the method. PMID:1401774

  12. Raman spectroscopic characterization on cervical neoplasm in biopsy direction

    NASA Astrophysics Data System (ADS)

    Shin, Hsiao Hsin; Tsai, Yan Sheng; Wang, Tao Yuan; Chu, Shou Chia; Chiang, Huihua Kenny

    2007-02-01

    Raman spectroscopy was applied to distinguish the spectroscopic information between normal cervical tissues (14) and cervical neoplasia (17), including low grade squamous intraepithelial lesions (6) and high grade squamous intraepithelial lesions (11). Standard pathological sections of these cervical tissues were measured from superficial to stroma layers. We have normalized significant Raman peaks, 1250 and 1579-1656 cm -1 by taking a ratio over a stationary Raman at 1004 cm -1, and successfully discriminated between normal and neoplasm cervical tissues.

  13. Cervical cytology service in Nigeria: providers' perspective.

    PubMed

    Adesina, O A; Babarinsa, I A; Fawole, O A; Oladokun, A; Adeniji, A R; Adewole, I F

    2003-07-01

    It has been noted that efforts to organise an effective screening programme in developing countries will have to find adequate financial resources, develop the infrastructure, train the necessary manpower and elaborate surveillance mechanisms. In our study, we set out to determine (a) just how frequent is cervical cancer, to warrant the investment of funds in screening programmes; (b) what proportion of surveyed health facilities offer a cervical cytology screening programme; and (c) what basic facilities are currently available where such programmes exist? A pretested, self-completed questionnaire was sent to heads of department of obstetrics and gynaecology in public tertiary and secondary care hospitals in Nigeria as well as major mission hospitals. The response rate was 63%, monthly consultations included a mean of 114 (+/-11.7) new gynaecological patients and an average of 5 (4.7+/-0.8) cervical cancer cases. One-half of the institutions had a hospital-based cervical screening programme with an average of 27 patients being screened monthly. Finance was the main difficulty encountered in maintaining a screening service. Only four had a certified gynaecological oncologist. In conclusion, there is dismal utilisation of available services and a dearth of trained specialists should any cervical cancer screening programme be considered. PMID:12881085

  14. Curcumin Nanoformulation for Cervical Cancer Treatment

    PubMed Central

    Zaman, Mohd S.; Chauhan, Neeraj; Yallapu, Murali M.; Gara, Rishi K.; Maher, Diane M.; Kumari, Sonam; Sikander, Mohammed; Khan, Sheema; Zafar, Nadeem; Jaggi, Meena; Chauhan, Subhash C.

    2016-01-01

    Cervical cancer is one of the most common cancers among women worldwide. Current standards of care for cervical cancer includes surgery, radiation, and chemotherapy. Conventional chemotherapy fails to elicit therapeutic responses and causes severe systemic toxicity. Thus, developing a natural product based, safe treatment modality would be a highly viable option. Curcumin (CUR) is a well-known natural compound, which exhibits excellent anti-cancer potential by regulating many proliferative, oncogenic, and chemo-resistance associated genes/proteins. However, due to rapid degradation and poor bioavailability, its translational and clinical use has been limited. To improve these clinically relevant parameters, we report a poly(lactic-co-glycolic acid) based curcumin nanoparticle formulation (Nano-CUR). This study demonstrates that in comparison to free CUR, Nano-CUR effectively inhibits cell growth, induces apoptosis, and arrests the cell cycle in cervical cancer cell lines. Nano-CUR treatment modulated entities such as miRNAs, transcription factors, and proteins associated with carcinogenesis. Moreover, Nano-CUR effectively reduced the tumor burden in a pre-clinical orthotopic mouse model of cervical cancer by decreasing oncogenic miRNA-21, suppressing nuclear β-catenin, and abrogating expression of E6/E7 HPV oncoproteins including smoking compound benzo[a]pyrene (BaP) induced E6/E7 and IL-6 expression. These superior pre-clinical data suggest that Nano-CUR may be an effective therapeutic modality for cervical cancer. PMID:26837852

  15. Cervical Laminoplasty: The History and the Future

    PubMed Central

    KUROKAWA, Ryu; KIM, Phyo

    Cervical laminoplasty was developed as an alternative to cervical laminectomy for treatment of cervical myelopathy, in which hinges are created to lift the lamina. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi’s open-door laminoplasty and Kurokawa’s spinous process splitting (double-door) laminoplasty. Several in vitro studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. In clinical situation, randomized control studies are scarce and superiority of one procedure over another is not uniformly shown. Lack of hard evidence supporting the purported advantages of laminoplasty over laminectomy, that is, reduced rate of postoperative instability and kyphosis development, while preserving range of motion (ROM), has been a weak selling point. Currently, laminoplasty is performed by majority of spine surgeons in Japan, but is rarely performed in the United States and Europe. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck ROM exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM seems minimal. Well-designed clinical trials to show the effectiveness and long-term outcome of this surgical procedure are warranted. PMID:26119898

  16. Importance of cervical length in dysmenorrhoea aetiology.

    PubMed

    Zebitay, Ali G; Verit, Fatma F; Sakar, M Nafi; Keskin, Seda; Cetin, Orkun; Ulusoy, A Ibrahim

    2016-05-01

    The objective of this prospective case-control study was to determine whether uterine corpus and cervical length measurements have a role in dysmenorrhoea aetiology in virgins. Patients with severe primary dysmenorrhoea with visual analog scale scores of ≥7 composed the dysmenorrhoea group (n = 51), while the control group (n = 51) was of women with painless menstrual cycles or with mild pain. Longitudinal and transverse axes of the uterine cervix and uterine corpus were measured. Correlation between severity of dysmenorrhoea and uterine cervix and corpus axes was calculated. Longitudinal and transverse axes of uterine cervix as well as uterine cervix volume were significantly higher in the dysmenorrhoea group compared to the controls. There was a significant positive correlation between severity of dysmenorrhoea and the length of cervical longitudinal and transverse axes and uterine cervical volume. Our findings reveal longer cervical length and greater cervical volume in young virgin patients with dysmenorrhoea and severe pain compared to those with no or less pain. PMID:27012227

  17. Genital Cancers in Women: Cervical Cancer.

    PubMed

    Morris, Elise; Roett, Michelle A

    2015-11-01

    In 2015 in the United States, it is estimated there will be approximately 12,900 new patients with cervical cancer and 4,100 will die of the disease. If diagnosed at a localized stage, the 5-year survival rate exceeds 90%. Human papillomavirus (HPV) infection is the main risk factor for cervical cancer. Current recommendations for cervical cancer screening include Papanicolaou (Pap) testing every 3 years for women ages 21 to 29 years. For women ages 30 to 65 years, an alternative is screening with Pap and HPV testing every 5 years. If screening results are abnormal, further evaluation can be guided by an algorithm. For a diagnosis of carcinoma in situ or grade 3 cervical intraepithelial neoplasia (CIN), treatment typically involves ablation or excision. Women with CIN 1 or CIN 2 that persists typically are treated with the same methods. For women diagnosed with early-stage invasive cancer, standard treatment is radical hysterectomy. More advanced cancers also are treated with surgery, but chemotherapy and/or radiation also may be used depending on cancer stage. Because most cervical cancer is caused by HPV, it is potentially preventable with HPV vaccination, which is recommended for females and males, ideally beginning at age 11 or 12 years. PMID:26569047

  18. Landscape of genomic alterations in cervical carcinomas.

    PubMed

    Ojesina, Akinyemi I; Lichtenstein, Lee; Freeman, Samuel S; Pedamallu, Chandra Sekhar; Imaz-Rosshandler, Ivan; Pugh, Trevor J; Cherniack, Andrew D; Ambrogio, Lauren; Cibulskis, Kristian; Bertelsen, Bjørn; Romero-Cordoba, Sandra; Treviño, Victor; Vazquez-Santillan, Karla; Guadarrama, Alberto Salido; Wright, Alexi A; Rosenberg, Mara W; Duke, Fujiko; Kaplan, Bethany; Wang, Rui; Nickerson, Elizabeth; Walline, Heather M; Lawrence, Michael S; Stewart, Chip; Carter, Scott L; McKenna, Aaron; Rodriguez-Sanchez, Iram P; Espinosa-Castilla, Magali; Woie, Kathrine; Bjorge, Line; Wik, Elisabeth; Halle, Mari K; Hoivik, Erling A; Krakstad, Camilla; Gabiño, Nayeli Belem; Gómez-Macías, Gabriela Sofia; Valdez-Chapa, Lezmes D; Garza-Rodríguez, María Lourdes; Maytorena, German; Vazquez, Jorge; Rodea, Carlos; Cravioto, Adrian; Cortes, Maria L; Greulich, Heidi; Crum, Christopher P; Neuberg, Donna S; Hidalgo-Miranda, Alfredo; Escareno, Claudia Rangel; Akslen, Lars A; Carey, Thomas E; Vintermyr, Olav K; Gabriel, Stacey B; Barrera-Saldaña, Hugo A; Melendez-Zajgla, Jorge; Getz, Gad; Salvesen, Helga B; Meyerson, Matthew

    2014-02-20

    Cervical cancer is responsible for 10-15% of cancer-related deaths in women worldwide. The aetiological role of infection with high-risk human papilloma viruses (HPVs) in cervical carcinomas is well established. Previous studies have also implicated somatic mutations in PIK3CA, PTEN, TP53, STK11 and KRAS as well as several copy-number alterations in the pathogenesis of cervical carcinomas. Here we report whole-exome sequencing analysis of 115 cervical carcinoma-normal paired samples, transcriptome sequencing of 79 cases and whole-genome sequencing of 14 tumour-normal pairs. Previously unknown somatic mutations in 79 primary squamous cell carcinomas include recurrent E322K substitutions in the MAPK1 gene (8%), inactivating mutations in the HLA-B gene (9%), and mutations in EP300 (16%), FBXW7 (15%), NFE2L2 (4%), TP53 (5%) and ERBB2 (6%). We also observe somatic ELF3 (13%) and CBFB (8%) mutations in 24 adenocarcinomas. Squamous cell carcinomas have higher frequencies of somatic nucleotide substitutions occurring at cytosines preceded by thymines (Tp*C sites) than adenocarcinomas. Gene expression levels at HPV integration sites were statistically significantly higher in tumours with HPV integration compared with expression of the same genes in tumours without viral integration at the same site. These data demonstrate several recurrent genomic alterations in cervical carcinomas that suggest new strategies to combat this disease. PMID:24390348

  19. Comparison of Upper Cervical Flexion and Cervical Flexion Angle of Computer Workers with Upper Trapezius and Levator Scapular Pain

    PubMed Central

    Yoo, Won-gyu

    2014-01-01

    [Purpose] In this study, we compared upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain. [Subject] Eight male computer workers with upper trapezius muscle pain and eight others with levator scapular muscle pain participated. [Methods] Each subject was assessed in terms of upper cervical flexion angle and total cervical flexion angles using a cervical range of motion instrument after one hour of computer work. [Results] The upper cervical flexion angle of the group with levator scapular pain was significantly lower than that of the group with upper trapezius pain after computer work. The total cervical flexion angle of the group with upper trapezius pain was significantly lower than that of the group with levator scapular pain after computer work. [Conclusion] For selective and effective intervention for neck pain, therapists should evaluate upper and lower cervical motion individually. PMID:24648646

  20. Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomised study

    PubMed Central

    Nie, Lin; Zhang, Li; Hou, Yong

    2008-01-01

    In this prospective study, our aim was to compare the functional results and radiographic outcomes of fusion and Bryan Cervical Disc replacement in the treatment of two-level cervical disc disease. A total of 65 patients with two-level cervical disc disease were randomly assigned to two groups, those operated on with Bryan Cervical Disc replacement (31) and those operated on with anterior cervical fusion with an iliac crest autograft and plate (34). Clinical evaluation was carried out using the visual analogue scale (VAS), the Short Form 36 (SF-36) and the neck disability index (NDI) during a two year follow-up. Radiological evaluation sought evidence of range of motion, stability and subsidence of the prosthesis. Substantial reduction in NDI scores occurred in both groups, with greater percent improvement in the Bryan group (P = 0.023). The arm pain VAS score improvement was substantial in both groups. Bryan artificial cervical disc replacement seems reliable and safe in the treatment of patients with two-level cervical disc disease. PMID:18956190