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Methods@#The FT and FA of dried C1 and C2 vertebrae (identified bones; n=107, males=53 and females=54) were observed and measured using a Digital Vernier Caliper (Mitutoyo, Kawasaki, Japan). Anteroposterior (AP) and transverse diameters of the left and right FTs (n=214) were measured and compared between sexes. Variations and types of FT and FA found on the upper vertebrae were recorded and classified. @*Results@#The FT shape of the Thai C1 was AP elliptical, while of that of C2 was transverse elliptical. Compared to females, both diameters of the upper spine were significantly greater in males except for the AP diameter of C2 on the right side. All diameters were significantly different in both sexes and sides except for the AP diameter of C1 and C2. A common type of FT classified in C1 was type 2 (male [69.81%], female [79.63%]) whereas for C2 it was type 1 (male [63.21%], female [59.26%]). Moreover, an incomplete osseous bridge was a major FA subtype observed in the Thai spine. @*Conclusions@#FT morphometry has an elliptical shape and diameters are greater in males. The FT and FA variations identified in this study will be useful for surgeons treating vertebral neurovascular injuries of the posterior upper cervical spine in the Thai population.
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STUDY DESIGN: Agreement study. PURPOSE: To validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model. OVERVIEW OF LITERATURE: Epidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been developed to investigate the prevention of epidural fibrosis. One of the common outcome measurements is the epidural fibrous adherence grading, but the classification has not yet been validated. METHODS: Five identical sets of histopathological digital files of L5-L6 laminectomized adult Sprague-Dawley rats, representing various degrees of postoperative epidural fibrous adherence were randomized and evaluated by five independent assessors masked to the study processes. Epidural fibrosis was rated as grade 0 (no fibrosis), grade 1 (thin fibrous band), grade 2 (continuous fibrous adherence for less than two-thirds of the laminectomy area), or grade 3 (large fibrotic tissue for more than two-thirds of the laminectomy area). A statistical analysis was performed. RESULTS: Four hundred slides were independently evaluated by each assessor. The percent agreement and intraclass correlation coefficient (ICC) between each pair of assessors varied from 73.5% to 81.3% and from 0.81 to 0.86, respectively. The overall ICC was 0.83 (95% confidence interval, 0.81-0.86). CONCLUSIONS: The postoperative epidural fibrosis classification showed almost perfect agreement among the assessors. This classification can be used in research involving the histopathology of postoperative epidural fibrosis; for example, for the development of preventions of postoperative epidural fibrosis or treatment in an animal model.
Subject(s)
Adult , Humans , Animal Experimentation , Classification , Failed Back Surgery Syndrome , Fibrosis , Laminectomy , Masks , Models, Animal , Pathology , Postoperative Period , Rats, Sprague-DawleyABSTRACT
Screw is the internal fixator that used to fasten plates or hold together the fragments of bone. Orthopaedic surgeon must familiar the principles of the screw for safe application for the patients. In this review articles, orthopaedic screws are classified into 4 main types as cancellous screw, cortical screw, malleolar screw and shaft screw. The new trend of the screws such as cannulated screw, interference screw or PC-fix screw are developed to improve the tensile strength, easier utilization and no associated bony or soft tissue complications.
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Background : Low back pain is the common orthopaedic complaint. The Oswestry questionnaire has become one of the principal low back pain outcome measurement that commonly used worldwide such as America and Europe.We developed the Thai version of Oswestry questionnaire to use in Thai culture that differ from the others. Reliability of the Thai version of Oswestry questionnaire has never been reported. So we test an internal consistency using Cronbach’s alpha and item-scale correlation as the reliability of the questionnaire for the usefulness in clinical studies or the future researches.Objective : To evaluate the reliability of the Thai version of Oswestry questionnaire for assessing the Thai low back pain patients.Design : Prospective descriptive studySetting : Srinagarind hospital, Khon Kaen UniversitySubjects : The 63 low back pain volunteers were classified to 2 groups. The first 30 patients had only low back pain and the second 33 patients had low back pain associated with leg pain. These patients complete the Thai version of Oswestry questionnaire by themselves. For patients who cannot read, we read the questionnaire step by step for their answers.Results : The results demonstrated that Chronbach’s alpha of every aspect of the questionnaire exceeded 0.7 and all inter-item correlation exceeded 0.4. Conclusions : The Thai version of Oswestry disability questionnaire is a valuable tool in assessing clinical symptoms and clinical researches in Thai patients with low back pain.
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Objective: The purpose of this study was to prospectively evaluate the diagnostic sensitivity, specificity and accuracy of a new dynamic clinical examination, named knee compression-rotation test, for detection of meniscal tears.Study design: Prospective study for diagnostic testSetting : Srinagarind hospital, Faculty of Medicine, Khon Kaen UniversityPatients and Methods: The injured knee patients, age from 18-39 years old, were included in this study. These 58 patients underwent knee arthroscopy. During preoperative admission, the author examined the patients and recorded the demographic data, duration of symptoms and the clinical findings including knee compression-rotation test. All patients underwent arthroscopic examination by orthopaedic surgeon who did not involve in this study. Predictive results of preoperative knee compression-rotation test for detection of meniscal tear were compared with arthroscopic findings and calculated as sensitivity, specificity and diagnostic accuracy rates.Results: In 58 injured knee of 52 males and 6 females were 26.19 + 5.66 years old at the time of hospital admission. Eleven patients sustained injuries from traumatic events and 47 patients sustained sport injuries. Arthroscopic findings were a total of 28 medial meniscal tears, 8 lateral meniscal tears and 9 of both medial and lateral meniscal tears. While the positive knee compression-rotation test was found in 38 patients and 20 patients were negative tests. The sensitivity, specificity and accuracy of the knee compression-rotation test were 84.44, 100 and 87.93% respectively, comparing with the diagnostic arthroscopy.Conclusion: The sensitivity, specificity and diagnostic accuracy of the knee compression-rotation test are highly corresponded to the arthroscopic diagnosis of meniscal tears. So this test can diagnose the meniscal tear preoperatively and improve the patient surgical management finally.