ABSTRACT
Background: The obturator hernia is relatively rare.A preoperative diagnosis is unusual since the manifestration shown is highly variable and often concealed by pectineus muscle.High mortality rate of obturator hernia was due to the difficulty diagnosis and operation.The incidence of obturator hernia has not been reported in Thai cadavers.Objective: To study the incidence of obturator hernia in Thai cadaversResults: During pelvic dissection of 104 cadavers (56 males, 48 females),an obturator hernia (0.96 %) was found on the right side of a female of age 56.The hernial mass consisted of a hernial sac containing fat tissue surrounded by thin fibrous connective tissue,skeletal muscle and its fascia.The hernial mass plugged in the obturator foramen with obturator nerve and vessels.The distal end of the hernial mass pass through the obturator canal to the thigh and located above pectineus muscle.Surprisingly,the obturator membrane and obturator externus muscle was absent.Histological study of the distal end of the hernial mass revealed its contents identical to the greater omental tissue.Conclusions: During gross dissection,an obturator hernia (0.96%) was found on the right side of a female of age 56.The hernial contents showed histological characteristics identical to omental tissue and was surrounded by peritoneum,skeletal muscle and its fascia.The absence of obturator membrane and obturator externus muscle in this case might be the weakpoint and caused obturator hernia consequently.
ABSTRACT
Background: The sacrum generally is composed of five vertebrae fused to form a triangular bony mass. Numerous anatomical variations of the sacrum have been reported including many reports of sacralization of the fifth lumbar in different race. There has never been reported among Thais.Objective: To determine the incidence of sacralization of the fifth lumbar vertebra among ThaisDesign: Descriptive study based on numerical survey.Setting: Bone Collection Unit, Department of Anatomy, faculty of Medicine, Khon Kaen University, ThailandSubjects: Included were 206 sacra from Thai skeletons, 114 males and 92 females between 26 and 90 years of age at death. Methods: An anatomical study was done on the sacrum. The sacra consisting of six vertebrae, by incorporation of the fifth lumbar, were selected. To confirm the lack of a fifth lumbar vertebra, we re-counted the lumbar vertebrae belonging to the same skeleton of the selected sacrum. The specimens were then carefully examined and recorded.Results: We found 9 (4.4%) specimens with the 5th lumbar vertebra fused to the first segment of the sacrum, representing sacralization; the incidence of which was 7 (6.1%) in males and 2 (2.1 %) in females. The degree of sacralization varied: complete in four out of seven of the males and incomplete in the remaining three out of seven males and in the two females. Conclusions: The present study shows that the incidence of sacralization of the 5th lumbar vertebra among Thai is about 4.4 %. The knowledge of this anatomical variation could be useful for the preliminary consideration in patient with low back problems.Key words: Anatomic variation, Sacral foramina, Sacrum
ABSTRACT
Background: Vertebral osteophyte was the bony outgrowth occurred as a result of pathological destruction to the vertebral joints. The plausible causes were osteoarthritis, inflammatory and degenerative diseases of the spine. There was still no report of the prevalence of vertebral osteophyte formation in the northeast Thais.Objective: To study the prevalence and distribution of vertebral osteophyte formation in the northeast Thais. Materials and Methods: Two hundred Thai vertebral columns from 120 males and 80 females with an age range of 18-94 years were examined for the presence of osteophyte. Locations of osteophyte on the vertebral body, facet joint and vertebral foramen were recorded. The size of osteophyte on the vertebral body was also recorded.Design: Descriptive studySetting: Department of Anatomy, Faculty of Medicine, Khon Kaen UniversityResults: The prevalence of osteophyte formation was 85% on the vertebral body, 71% on the facet joint and 47% in the vertebral foramen. The most frequent sites on the vertebral body were at L4 (73%), L5 (70%) and L3 (69%). In the thoracic levels, the most frequent sites of osteophyte formation were found at T11 (50.5%) and T10 (49.5%). In the cervical levels, the most frequent sites were found at C5 (46%), C6 (44%) and C4 (38%). The average biggest size of osteophyte were found in the anterior part of the superior border of L4 (123.71 mm2), L5 (111.18 mm2) and L3 (109 mm2). The most frequent sites of osteophyte formation on the facet joint were found at L4 (62%), L5 (59%) and L3 (52%) respectively. The most frequent sites of osteophyte formation in vertebral foramen were found at C4 (32.5%), C5 (29%) and C3 (24%). The frequency-association among the osteophyte locations was highest between the vertebral body and facet joint. The frequency of osteophyte formation at all vertebral levels significantly increased with age. Between the sexes, osteophyte formation occurred more significantly in male than females.Conclusion: The prevalence of osteophyte formation on vertebral columns in Northeast Thais were 85% on vertebral body, 71% on facet joint, and 47% in vertebral foramen. The osteophyte formation significantly increased with age and occurred more frequently among males.Keywords: prevalence, osteophyte, vertebral column