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SUMMARY: Parietal emissary foramina (PEF) are small holes, which are localized between the middle and posterior thirds of the parietal bone posterior surface close to the sagittal suture. PEF are important structures that protect the parietal emissary vein, which passes through it. During neurosurgery procedures, parietal foramina (PF) knowledge is crucial. This work aimed to evaluate presence and location of the PF in the skull of an adult human. Moreover, measure the distance amidst PF and the sagittal suture's midline to ascertain its clinical repercussions. 74 adult human skulls, without gross pathology, were observed for the PF's existence. The PF's and sagittal suture's midline distance were measured. According to the PF patterns of presence, five groups were distributed. Finally, specimens were photographed and subjected to statistical analysis. The PF was absent in 7 skulls (9.5 %). There were 9 skulls (12.2 %) exhibited central parietal foramen where the parietal foramen lies on the sagittal suture. 17 skulls (23 %) showed right unilateral parietal foramen, whereas 15 skulls (20.3 %) demonstrated left unilateral parietal foramen. The final 26 skulls (35.1 %) exhibited bilateral parietal foramen. This descriptive study supplies valuable information of PF variations, which is crucial for neurosurgeons in modifying surgical techniques and procedures to alleviate injury to PF-emerging structures such as emissary veins.
Los forámenes emisarios parietales (FEP) son pequeños orificios que se localizan entre los tercios medio y posterior de la superficie posterior del hueso parietal, cerca de la sutura sagital. Los FEP son estructuras importantes que protegen la vena emisaria parietal, que lo atraviesa. Durante los procedimientos de neurocirugía, el conocimiento de los forámenes parietales (FP) es crucial. Este trabajo tuvo como objetivo evaluar la presencia y ubicación del FP en el cráneo de hombres adultos, además, medir la distancia entre el FP y la línea mediana de la sutura sagital para conocer su repercusión clínica. Se examinaron 74 cráneos humanos adultos, sin patología grave, para determinar la existencia del FP. Se midió la distancia de la línea mediana de la sutura sagital y del FP. De acuerdo con los patrones de presencia del FP, se distribuyeron en cinco grupos. Finalmente, los especímenes fueron fotografiados y sometidos a análisis estadístico. El PF estaba ausente en 7 cráneos (9,5 %). Hubo 9 cráneos (12,2 %) que presentaban un PF central localizándose en la sutura sagital. 17 cráneos (23 %) presentaban un FP unilateral derecho, mientras que 15 cráneos (20,3 %) se observó un FP unilateral izquierdo. Los 26 cráneos restantes (35,1 %) exhibieron FP bilaterales. Este estudio descriptivo proporciona información valiosa sobre las variaciones del FP, que es fundamental para los neurocirujanos en el momento de modificar las técnicas y los procedimientos quirúrgicos para aliviar las lesiones de las estructuras emergentes del FP, como las venas emisarias.
Subject(s)
Humans , Male , Adult , Parietal Bone/anatomy & histology , Cranial Sutures/anatomy & histology , Skull/anatomy & histologyABSTRACT
SUMMARY: Anatomical variation of the foramina transversaria (FT) is associated with vertebral neurovascular symptoms and can cause complications after lower spine surgery, especially cervical pedicle screw (CPS) insertion. FT variation has been documented and classified in various populations, as this information can help increase cervical stability in subaxial vertebral surgery. Although the morphometry of the upper cervical spine in Thai populations has been reported, there have yet been no studies examining the features of FT. The FT of dried cervical spines (C3-C7; left and right side; n = 107, male = 53 and female = 54) were examined for morphological variation, and their anteroposterior (AP) and transverse (T) diameters were measured using a digital vernier caliper. Morphometric data and variations were compared by sex and lateral side. It was that the C3-C6 FT in both sexes were round, and the C7 FT was elliptical with an oblique right side. FT diameters did not differ significantly by sex except for the AP diameters of C6-C7 and for T diameters of C4 and C7. The left AP diameters of C3-C6 were significantly longer than the right, as were the T diameters of C4 and C7 FT. Additionally, T diameter was significantly longer than that of the AP, except that of the left C6 in male spines, which did not differ from the AP. Most FT examined were round. These findings should be considered in the provisional diagnosis of vertebral neurovascular symptoms caused by FT variation as well as that of neurovascular damage after cervical pedicle screw placement.
La variación anatómica del foramen transverso (FT) se asocia con síntomas neurovasculares vertebrales y puede causar complicaciones después de la cirugía de columna cervical inferior, especialmente la inserción de tornillos pediculares cervicales (TPC). La variación del FT se ha documentado y clasificado en varias poblaciones, ya que esta información puede ayudar a aumentar la estabilidad cervical en la cirugía vertebral subaxial. Aunque se ha informado sobre la morfometría de la columna cervical superior en poblaciones tailandesas, aún no se han realizado estudios que examinen las características de FT. Se examinó la variación morfológica del FT de vértebras cervicales secas (C3-C7; lado izquierdo y derecho; n = 107, hombres = 53 y mujeres = 54), y se midieron sus diámetros anteroposterior (AP) y transverso (T) usando un pie de metro digital. Se compararon datos morfométricos y variaciones por sexo y lado. Los FT de C3-a C6 en ambos sexos eran redondos, y el FT C7 era elíptico con el lado derecho oblicuo. Los diámetros del FT no difirieron significativamente por sexo excepto para los diámetros AP de C6- C7 y para los diámetros transversos de C4 y C7. Los diámetros AP izquierdos de C3-C6 eran significativamente más largos que los del lado derecho, al igual que los diámetros transversos de C4 y C7. Además, el diámetro transverso fue significativamente mayor que el AP, excepto el C6 izquierdo en las vértebras de hombres, que no difirió del AP. La mayoría de los FT examinados eran redondos. Estos hallazgos deben ser considerados en el diagnóstico provisional de síntomas neurovasculares vertebrales causados por la variación del FT, así como en el de daño neurovascular tras la colocación de tornillos pediculares cervicales.
Subject(s)
Humans , Male , Female , Cervical Vertebrae/anatomy & histology , Anatomic Variation , Thailand , Sex CharacteristicsABSTRACT
The stability of internal fixation of femoral neck fractures can be obtained through surgical techniques, the configuration of screws and bone grafting, etc. However, the blood supply injury caused by fractures could not be completely reversed by the current medical management. Hence, the comprehensive evaluation of the residual blood supply of the femoral neck, to perioperatively avoid further iatrogenic injury, has become a hotspot. The anatomy of the extraosseous blood supply of the femoral neck has been widely reported, while its clinical application mostly involved the assessment of the medial circumflex femoral artery and retinacular arteries. However, further studies are needed to explore the prognosis of patients with these artery injuries, with different degrees, caused by femoral neck fractures. Direct observations of nutrient foramina in vivo are not possible with current clinical technologies, but it is possible to make reasonable preoperative planning to avoid subsequent femoral head necrosis based on the distribution features of nutrient foramina. The anatomy and clinical application studies of the intraosseous blood supply focused on the junction area of the femoral head and neck to probe the mechanism of femoral head necrosis. Thus, the intraosseous blood supply of other regions in the femoral neck remains to be further investigated. In addition, a blood supply evaluation system based on a three-level structure, extraosseous blood vessels, nutrient foramina, and intraosseous vascular network, could be explored to assist in the treatment of femoral neck fractures.
Subject(s)
Humans , Femur Head Necrosis , Femoral Neck Fractures/surgery , Femur Neck , Femur Head/surgery , Femoral Artery , Fracture Fixation, InternalABSTRACT
【Objective】 To analyze the effect of different range and location of foramen formation on the biomechanics of lumbar spine by three-dimensional finite element analysis （D-FEA）. 【Methods】 A complete model of the lumbar spine （L5）， M0， was developed using the finite element method， and the models M1， M2， M3， M4 and M5 were obtained by sequentially simulating the apical， medial 1/4， 2/4， 3/4 and 4/4 graded resections of the left superior articular process of L5 under a lateral posterior approach with full spinal endoscopy. The displacements were recorded in six conditions： forward flexion， back extension， left and right lateral bending， and left and right lateral rotation. The results were compared between the resected models and the unresected group M0. 【Results】 The three-dimensional finite model of the L4-L5 segment developed in this experiment was valid. Compared with the unresected group M0， the differences in ROM were statistically significant for M1 under forward flexion load （all P<0.05）， M2 under forward flexion and back extension load （all P<0.05）， M3 and M4 under forward flexion， back extension and left and right lateral bending load （all P<0.05）. The differences were statistically significant for M3 and M4 under anterior flexion， posterior extension， left and right lateral flexion， and right rotation loads （all P<0.05）； and for M5 under anterior flexion， posterior extension， left and right lateral flexion and right rotation loads （all P<0.05）. Compared with M0 in the unresected group， the differences were statistically significant for M1 under anterior flexion loads （all P<0.05）， M2 under anterior flexion and left and right rotation loads （all P<0.05）. The differences were statistically significant for M3， M4 and M5 in forward flexion and extension， left and right lateral flexion， and left and right rotational loading （all P<0.05）. 【Conclusion】 In the process of foramen formation， removal of the tip or the medial quarter of the unilateral single segment of the upper articular process of the lumbar spine will affect the stability of the lumbar spine， and increase the maximum value of the stress of the intervertebral disc during the activities of the lumbar spine. Removal of one half or more will significantly damage the biomechanics of the lumbar spine. In order to avoid damaging the normal biomechanics of the lumbar spine， the upper articular process should be protected as much as possible during the whole spinal endoscopic foraminal reconstruction.
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SUMMARY: Blood supply to the diaphysis of long bones is majorly through nutrient artery, which enters the bone via nutrient foramen. The present study aims to identify morphological and morphometric variations of nutrient foramina of the femur, which is the largest long bone of the body extending from the pelvis to knee. A sample of 81 Sri Lankan adult femur were analyzed. The mean length of the femur analyzed was 436.93 mm and mean foramen index was 43.52. The majority of the bones had a single nutrient foramen. The predominant location of the nutrient foramen was on the posterior aspect of the bone in the middle third of the shaft according to the study. Majority of foramina were directed distally. The indices on nutrient foramen are important for procedures such as bone grafts and tumor resections, in managing trauma, orthopedic procedures and radiological interpretations.
RESUMEN: El suministro de sangre a la diáfisis de los huesos largos se realiza principalmente a través de la arteria nutricia, que ingresa al hueso a través del foramen nutricio diafisario. El presente estudio tiene como objetivo identificar las variaciones morfológicas y morfométricas del foramen nutricio del fémur, el hueso largo más grande del cuerpo que se extiende desde la pelvis hasta la rodilla. Se analizó una muestra de 81 fémures adultos de individuos de Sri Lanka. La longitud media de los fémures analizados fue de 436,93 mm y el índice de foramen medio fue de 43,52. La mayoría de los huesos tenían un solo foramen nutricio. Según el estudio, la ubicación predominante del foramen nutricio estaba en la cara posterior del hueso en el tercio medio del eje. La mayoría de los forámenes estaban dirigidos distalmente. Los índices sobre el foramen nutricio son importantes para procedimientos tales como injertos óseos y resecciones tumorales, en el manejo de traumatismos, procedimientos ortopédicos e interpretaciones radiológicas.
Subject(s)
Humans , Femur/anatomy & histology , Anatomic Variation , Sri Lanka , Diaphyses , Femur/blood supplyABSTRACT
Background: To provide anatomical information on theposition and incidence of accessory foramina in mandible asthey are important for dental surgeons and anesthetists inachieving complete nerve blocks and for avoiding injury toneurovascular structures passing through them.Objective: To study the incidence of accessory foramina in drymandible in population of Bihar & compare it with incidenceamong various races of the world.Materials & Methods: Present study is a cross sectional studywhich has been carried out on 56 dried fully ossified adulthuman mandibles, which were examined in the Department ofAnatomy and Forensic Medicine of Indira Gandhi Institute ofMedical Sciences, Patna, Bihar. The age of the bones used inthe study was not predetermined. Only fully ossified dried,macerated and thoroughly cleaned mandibles which werecomplete in all respects, in order to give the correctobservations, were included in the study while the mandibleshaving any deformity or pathology were excluded. Theaccessory foramina and their positions were observed.Results: Accessory mandibular foramina were found in 55.36%, accessory mental in 23.22 %, and retromolar in 17.85% ofthe cases. The accessory foramen observed most commonly inright side (39.28%) followed by bilateral (37.5%) then left side(19.65%).Conclusion: The anatomical variability of incidence andposition of accessory foramina should be considered as theymay be used to give additional locoregional anesthesia in caseof failed mandibular blocks. Knowledge of the commonestpositions will be beneficial for oncologists and oromaxillofacialsurgeons in planning graft implants.
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OBJECTIVE@#To explore the clinical efficacy and safety of posterior intervertebral foraminal discectomy via Delta channel for cervical spondylotic radiculopathy in the early phase.@*METHODS@#From September 2017 to July 2018, 10 patients with cervical spondylotic radiculopathy underwent posterior intervertebral foraminal discectomy via Delta channel. There were 6 males and 4 females, aged from 30 to 62 years old with an average of (41.5±4.3) years old. All of them had unilateral symptoms caused by cervical nerve root compression, including 2 cases of C, 5 cases of C and 3 cases of C. CT and MRI examination of all the patients did not show ossification of posterior longitudinal ligament or calcification of ligamentum flavum, and no cervical spine instability was present in dynamic radiographs. The clinical outcome was poor after more than 6 weeks of systematic non-surgical treatment. The VAS score, JOA score, NDI score, the cervical spine physiological curvature, and the height and stability of the compressed cervical vertebrae were measured before operation and at the latest follow-up.@*RESULTS@#All patients successfully completed the surgeries without any spinal cord, nerve root or major blood vessel injury. The operation time was 70 to 120 min with an average of 90 min. Intraoperative blood loss ranged from 30 to 90 ml with an average of 40 ml. All the 10 patients were followed up for 6 to 14 months with an average of 9 months. Postoperative nerve root pain got relievd and nerve function was improved in all patients. VAS score decreased from 7.15±2.01 before surgery to 1.59±0.83 at the latest follow-up;JOA score increased from 12.57±1.24 before surgery to 16.42±0.58 at the latest follow-up;NDI score increased from 41.82±4.71 before surgery to 9.59±3.52 at the latest follow-up. All the results above presented significant difference between latest follow-up and preoperative (0.05). At the latest follow-up, no cervical instability was observed on dynamic radiographs.@*CONCLUSION@#Treatment of cervical spondylotic radiculopathy by posterior intervertebral foraminal discectomy via Delta channel can obtain a satisfactory clinical outcome without affecting the stability of cervical vertebra. The surgery is safe, reliable and worthy of clinical application.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cervical Vertebrae , Diskectomy , Radiculopathy , Retrospective Studies , Spinal Cord Diseases , Spinal Fusion , Spondylosis , Treatment OutcomeABSTRACT
Objective@# To explore the cause and preventive measures of floor-of-mouth hematoma after dental implant placement. @*Methods@#The prevention of hematoma of the floor of the mouth in a case of lower anterior teeth implant placement was analyzed, and the literature was reviewed.@*Results@# Four mandibular vascular canals were found on the lingual side of the anterior mandible before dental surgery in the reported case. Two of them were quite thick (1.4 mm and 1.0 mm, respectively) and were located adjacent to the crest of the alveolar bone and superior to the mental spine. These two thick endosseous branches from the sublingual artery were dissected and ligated , and there was no obvious hematoma in the patients immediately after the operation and at the postoperative 3 d review. The results of the literature review show that the incidence of endosseous branches from the lingual vascular canal of the mandible is 90%-100%. The distribution of the vessels on the lingual side of the mandible is highly variable and adjacent to the lingual cortical plate. Accidental injury of the lingual cortical plate during implant surgery would probably lead to bleeding or hematoma on the floor of the mouth. @*Conclusion @#Mastering the anatomy of blood vessels on the floor of the mouth, elaboratively examining preoperative three-dimensional radiographic imaging, and cautiously exploring the lower jaw bone morphology after flap elevation are preventive measures to avoid damage to the arterial supply on the lingual side of the anterior lower jaw and to prevent complications of hematoma in the floor of the mouth.
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Background: An understanding of the location, number, direction and size of nutrient foramina in long bones isvery important clinically, especially in orthopaedic surgical procedures such as fracture repair, bone grafting,vascularized bone microsurgery, intramedullary reaming and plating,as well as in medico legal cases. An accurateknowledge of the location of the nutrient foramina in long bones should help prevent intraoperative injuries inorthopaedic, as well as in plastic and reconstructive surgery.Aims & Objectives: The aim of our study is to observe the variations in number, location, direction and size of thenutrient foramina of Dried Human Femur.Materials and Methods: The study comprised 200 dry normal adult femur bones of unknown sex obtained fromthe Department of Anatomy of various medical colleges of Telangana, India.Results: The total number of nutrient foramina obtained in 200 femurs was 326. 82 bones had single nutrientforamen (41%), 111 bones had double nutrient foramina (55.5%), 6 bones had triple nutrient foramina (3%), andonly 1 bone 4 nutrient foramina (0.5%) and none of the bones showed zero foramen. The size of nutrient foraminawere also noted in 200 bones, 60 bones presented small sized foramina (18%), 130 bones presented with mediumsized foramina (40%), and rest of 136 bones presented with large sized foramina (42%). The nutrient foraminaobeyed the general rule that is, directed away from the growing end of the bone. Among 326 nutrient foramina149 were located on posterior surface (46%), about 126 foramina were located on medial surface (38.50%), 38were located on the lateral surface (12%), and the remaining 12 were located on the popliteal surface (6%), andnone on the anterior surface.Conclusion: Knowledge of the localization and number of the nutrient foramina is useful in certain surgicalprocedures such as bone grafting and microsurgical vascularized bone transplantation, to preserve the circulationintact and for open reduction surgeries.
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Background: The sternum is one of the bones of the skeleton with frequently detected variation, present studyfocused on morphometric study of the egyptian sternum by CT scan.Methods: 240 CT scan film from individual aged between 10 to more than 60 years divided into 6 groupsaccording to age each group included 40 cases (20 males and 20 females) for estimation of the sternal parameterswhich include the lengths of manubrium, sternal body , xiphoid process , the whole sternal length , detection ofthe variable maturation of the sternum and the presence of sternal foramina, sex variations of results aredetectedResults: The mean length of different parts of sternum was recorded as following: manubrium was 3.8 cm inmales, 3.6 cm in females. The body length was 8.6 cm in males, 7.9 cm in females, The xiphoid length was 2.5 cmin males, 1.9 cm in females. The total sterna length was 14.9 cm in males, 13.6 cm in females. The complete orpartial fusion of the manbriosternal junction is noticed in all the cases above fifty years. The complete or partialfusion of the xiphisternal junction is noticed in most of subjects by the age of forty five years. The pattern offusion of the sternal elements has no relation to sex .The sternal foramen detected only in 8.3 % of cases.Conclusions: Identification of sternal measurement and their anomalies such as sternal foramen has medicolegaland forensic importance
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Background: Nutrient foramen is an opening in the bone shaft which allows passage to the blood vessels of themedullary cavity of a bone for its nourishment and growth. Knowledge about precise location and direction ofthe nutrient artery of long bones is important during any surgical or orthopaedic procedures of limbs, such asbone grafts and microsurgical vascular bone transplantations. This study was carried to record the number,situation and position of nutrient foramina in humerus of adults in south Indian population.Materials and methods: The study was conducted on 85(Right-38, Left-47) humerii collected from AnatomyDepartment of Coimbatore Medical College, Coimbatore. Length of each humerus bone was measured with thehelp of osteometric board. With the help of hand lens bones were observed for the number, direction andlocation of nutrient foramen with respect to the surface and borders.Results: In the present study majority of humerus bones have single nutrient foramen(64.7%) and mainly locatedon the anteromedial surface(51.7%) followed by medial border (36.5%) especially in the middle one third (87.1%)of the humerus.Conclusion: This study may give precise knowledge about location and number of nutrient foramina which isimportant for orthopaedic surgeons during surgical procedures such as fracture repair, bone grafts andmicrosurgeries.
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Introduction: Any unnamed opening is termed as Accessory foramen. Mandible being the strongest bone of theskull is pervaded by many accessory foramina other than mandibular and mental foramen. In the present studyaccessory mandibular, mental, retromolar and lingual foramina are distinguished and clinical implications arediscussed. The presence of such foramina if not identified during clinical practice may cause complications.Hence our study is done to find out the incidence and distribution of various accessory foramina of mandibleamong South Indians.Materials and Methods: The study was done on 100 adult dry human mandibles of South Indian origin obtainedfrom first MBBS students. The location and distribution of various accessory foramina were carefully observed,noted and tabulated.Results: Accessory foramen was found in 93% of mandibles. Accessory lingual foramen was found in 93 mandibles,with supraspinous foramen in 84%, accessory mandibular foramen in 34%, accessory mental foramen in 12%and retromolar foramen in 6%.Conclusion: Presence of accessory foramina may cause failure of anaesthesia during inferior alveolar nerveblock and haemorrhage during mandibular reconstruction surgeries owing to the neurovascular structurespassing through these accessory foramina. The clinicians should be aware about the presence of such accessoryforamina during the procedures.
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Introduction: The foramina which leads into a canal on the shaft, through which the vessels enter to supply themedullary cavity is called nutrient foramina. The major source of blood supply during the bone growth anddevelopment is by nutrient artery.Materials and methods: The study was conducted on 218 adult humerii. The number, direction and location ofnutrient foramen were observed with the help of a hand lens. The Total length of humerus, distance of the nutrientforamen from its upper end, Location of the nutrient foramen with respect to the surfaces, zones and the foramenindex were noted.Results: It was observed that 81.19% of the humeri had a single nutrient foramen, 18.35% double foramen, 0.45%triple foramen, where as 3.67% humeri did not have any nutrient foramina. The majority (82.11%) of the nutrientforamina were present on the antero-medial surface, 14.22% on the medial border and 9.63% on the anterolateral surface,7.8%on the posterior border and 0.46% on anterior border of the shaft of humeri. The foramenindex was observed to be 56.35 ±7.36 on right side and 55.57±8.5 on left side, indicating the zonal distributionof foramina in the middle third of the bone.Conclusion: With the increasing number of fracture cases due to various causes, the knowledge of nutrientforamina is of much importance in bone reduction and grafting techniques. The present study adds to theexisting data on nutrient foramina especially in the population of Telangana region.
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Background: Nutrient artery is the major source of blood supply to long bones. This artery enters the shaft of thelong bone through nutrient foramen. Vascular insults to the Ulna during fracture dislocation or during surgicalcorrection of fracture may result in delayed healing or non-union of fracture.Materials and Methods: The present study was undertaken on 100 dry adult ulna bones of unknown sex (50 eachof right and left sides) from Department of Anatomy, Gadag Institute of Medical Sciences, Gadag, Karnataka. Theulna bones were numbered using a marker pen. Using Hepburn’s osteometric board, length of the bone wasmeasured. The size and direction of the nutrient foramina was assessed using 19, 22 and 25 gauge hypodermicneedles.Results: Among the total 100 ulna studied, 86 had single nutrient foramina, 13 had two nutrient foramina and 1had three nutrient foramina. 59.13% of nutrient foramina were of medium sized and 20% were of large size.85.22% of nutrient foramina were located in upper third of shaft of ulna; 12.17% in middle third and 2.61% inlower third. 1% of NF were directed horizontally, 2% lower oblique and remaining upper oblique. No correlationcould be demonstrated between the length of ulna and number of nutrient foramina in the present study.Conclusion: The present study conducted on nutrient foramina of 100 dry adult ulna arrived at a conclusion thatmajority of nutrient foramina were located in the upper third of the shaft in anterior surface. The results of thepresent study are consistent with most similar studies. The knowledge of location, direction and number ofnutrient foramen on shaft of ulna is of utmost importance to the Orthopaedicians and Oncologists.
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Introduction: The Femur bone is a highly vascular structure with unique features in its blood supply via numerous foramina located over its different segments, being named as vascular foramina . Among vascular foramina, nutrient foramen is an important one which gives way to the nutrient artery. Aim: To evaluate the nutrient foramina of the dry adult human femur bone of north Indian population. Subjects and Methods: The present study was undertaken using 50 dry adult human Femur bones of North Indian population. The samples were collected from the Anatomy department of the institute. Results: In the present study, among foramina of 50 dry adult human Femora, 31 Femora had single nutrient foramen, 18 had two nutrient foramina and 1 had three nutrient foramina. The medial lip of lineaaspera of Femur depicted the presence of nutrient foramina in majority of bones suggesting the entry zone for nourishment of shaft by perforating arteries. Size of nutrient foramina were ranging from size ≥ 0.55 mm to size ≥ 1.27 mm. Direction of nutrient foramina of all the Femora were directed upwards. Conclusion: This study may help orthopaedic surgeons in planning the surgical treatment of fracture of Femur with a possible reduction in post-operative complications. Combined periosteal and medullary blood supply to the bone cortex helps to explain the success of intramedullary reaming of long bone fractures particularly in the weight bearing Femur.
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Spinal stenosis most commonly occurs on lumbar vertebrae because of degenerative changes. This research studied the characteristics of osteophyte development in lumbar vertebrae foramina and association of osteophyte development with lumbar spinal stenosis. The total number of all levels of lumbar spines of subjects was 179 from 31 to 90 years of age. The vertebral foramen was divided into six zones. The prevalence and measurements of the length of osteophytes in the vertebral foramina were obtained. The prevalence and length of osteophytes in the posterior body zone were higher than the laminal zone, and higher than the pedicular zone, respectively. In each zone, the highest prevalence of osteophytes was at L5, except for the inferior posterior body zone that the highest prevalence is at L4. The length of osteophyte was also in same direction as the prevalence. The prevalence of osteophytes among six zones of each level were compared, and found, in L1 to L4, the inferior posterior body zone generally had the highest prevalence, except in L5, the superior posterior body zone had the highest prevalence. Moreover, prevalence, as well as length, of osteophytes in lumbar vertebral foramina, of all levels, was positively associated with age. Vertebral osteophytes can develop beginning at 31 years of age. In conclusion, posterior body of L4 and L5 had the highest prevalence of osteophyte formation, thus, these area had the highest probability to cause spinal stenosis.
Subject(s)
Lumbar Vertebrae , Osteophyte , Prevalence , Spinal Stenosis , SpineABSTRACT
Introduction: Posterior Condylar foramina present just behind the occipital condyles, which transmits emissaryvein connecting sub occipital venous plexus with intracranial sinuses.Materials and Methods: Study conducted on 60 dry human skulls. Each skull is observed for incidence, lateralityand patency of posterior condylar foramina. Here patency of foramina is observed by probe.Result: We observed that 77% skulls have presence of condylar foramina and 23% have absence of foramina.50%skulls have bilateral foramina,20% skulls have left sided and 7% have right sided foramina.70% skulls havepatent foramina and 30% skulls have absent patency.Conclusion: There is variation in incidence, laterality and patency of condylar foramina so knowledge of variationin condylar foramina is important for neurosurgeon and ENT surgeon in skull base surgery and also for radiologist.
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Background: Bone formation, growth and its vitality necessitates blood supply. Nutrient artery is the key sourceof blood supply to the long bone apart from the other important sources like periosteal, metaphyseal andepiphyseal arteries. Nutrient foramina allows nutrient artery. Typically, the direction of the nutrient foramina istowards the elbow joint in radius, away from its growing end. Knowledge of foramen index, number, directionand size of the nutrient foramina assists the surgeon to take an exact section of bone in case of bone resectionand transplantation techniques.Aim: The aim of the present study is to determine the number, position, size, direction of the nutrient foraminaand the Foramen Index of the human dry radius bonesMaterials and Methods: In the present study, 91 right sided and 88 left sided radius bones of unknown age andsex were taken into consideration from the department of anatomy, Mamata Medical College, Khammam,Telanagana.Results: Average length of the radius on the right side was observed to be 23.72 ± 1.93 cm and on left side 23.35± 1.75 cm. The foramen index on right side was 34.92 ± 4.97 cm where as on the left side 34.79 ± 4.43 cm. Thenutrient foramen was directed towards the proximal end of radius in all the bones studied. Most of the foramenwere observed on the anterior surface of the bone. Nutrient foramina was found to be absent in 4 right sided and3 left sided bones.Conclusion: This study may add to the present statistical data available on foramen index, number of foramenand their location in the population of Telangana region, during recent orthopaedic techniques like bone resectionand transplantation
ABSTRACT
SUMMARY: Lingual foramina and canals are located in the midline of the jaw, which are important due to their neurovascular content. The location of the lingual foramina and canals can be classified according to their relationship to the mental spines; upper, middle or lower. The objective of the study was to determine the prevalence, size and anatomic location of the lingual foramina and canals and in patients older than 18 years of age that were patients at the Universidad de Los Andes, Dentistry Clinic, San Bernardo, Santiago, Chile. Furthermore, to establish sex differences regarding the presence, location and diameter of lingual foramina. From the sample total, 296 foramina were found, from which 133 (45 %) were upper foramina, 43 (15 %) middle foramina and 120 (40 %) lower foramina. In both sexes the prevalence of upper foramina was higher. Regarding the vertical diameter of the foramina, the median of the upper foramina was 0.76 mm, the median of the middle foramina was 0.52 mm and the median of the lower foramina was 0.55 mm. As for the length of the lingual canals, the middle canal was the largest (7.48 mm), followed by the upper (7.53 mm) and the lower (6.83 mm). There was no statistically significant difference between sexes regarding the amount and size of the lingual foramina, neither regarding the size and age of the patients, but there was a difference between the lengths of the canals, being the male patients the ones that presented longer canals in the 3 different kinds. Because of the high prevalence of foramina and canals in the sample, it is recommended to consider them in the planning of surgical procedures on the mandible midline.
RESUMEN: Las foraminas y canales linguales están localizados en la línea media mandibular, los cuales son relevantes dado a su componente neurovascular. Las foraminas linguales pueden ser clasificadas según su localización respecto a las espinas mentonianas pudiendo ser supraespinosas, interespinosas e infraespinosas. El objetivo del trabajo fue determinar la prevalencia, tamaño y relación anatómica de foraminas y canales linguales en pacientes mayores de 18 años de edad que hayan sido tratados en el centro odontológico de la Universidad de Los Andes, San Bernardo, Chile. Además establecer diferencias de sexo en cuanto a la presencia de foraminas linguales, ubicación y diámetro. Del total de la muestra, 296 foraminas fueron encontradas de las cuales 133 (45 %) eran supraespinosas, 43 (15 %) intraespinosas y 120 (40 %) infraespinosas. En ambos sexos la prevalencia de las supraespinosas fue mayor. Respecto al diámetro vertical de las foraminas, la mediana de diámetro para la supraespinosa fue de 0,76 mm, de la intraespinosa fue de 0,52 mm y de la infraespinosa fue de 0,55 mm. Respecto a la longitud de los canales linguales, el canal intraespinoso fue el más largo (7,48 mm), seguido por el supraespinoso (7,53 mm) y finalmente el infraespinoso (6,83 mm). No había una diferencia estadísticamente significativa entre sexos respecto a la cantidad y tamaño de las foraminas linguales. Tampoco lo hubo respecto al diámetro de los canales y la edad de los pacientes. Sin embargo, si lo hubo respecto a la longitud de los canales, siendo los pacientes masculinos lo que presentaban los canales más largos. Debido a la alta prevalencia de las foraminas y canales linguales en la muestra es recomendado considerarles en los planes de tratamiento de procedimientos quirúrgicos en la línea media mandibular.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Cone-Beam Computed Tomography , Mandible/anatomy & histology , Mandible/diagnostic imaging , ChileABSTRACT
Se han descrito forámenes ubicados en la cara interna del sector mandibular anterior, ya sea en hueso seco, radiografía convencional y en estudios mediante cone beam CT (CBCT). El objetivo de este estudio fue comparar la presencia, posición y las características anatómicas de los forámenes y canales linguales encontrados en CBCT de mandíbulas Chilenas secas, con los resultados de la misma muestra estudiada con visión directa en hueso seco. Se utilizaron 68 mandíbulas secas de la unidad de morfología de la Universidad de los Andes. Se evaluó número de dientes remanentes, número de forámenes relacionados con las espinas mentonianas, posición, área y longitud de cada canal en hueso seco y en CBCT de la misma muestra. Se encontró presencia del foramen lingual en 100 % de CBCT y 97 % de observación directa en hueso. Se observaron 150 forámenes en hueso seco y 170 forámenes en CBCT. La mayor cantidad se encontró por superior (hueso: 55; CBCT:61) e inferior (hueso:66 ; CBCT:92) a las espinas mentonianas. La confiablidad no fue la esperada, con un kappa para el número de forámenes superiores de 0,43, una correlación intraclase (rho) para el número de forámenes inferiores de 0,31. El área de forámenes superiores tuvo un rho de 0,059 e inferiores un rho de 0,144, mientras que, la longitud de los canales superiores, un rho de 0,5 e inferiores un rho de 0,246. Se observó una tendencia a mayores diámetros y longitudes de canales en las mediciones realizadas en CBCT comparadas con las mediciones en hueso seco. Teniendo en cuenta la alta prevalencia de estos forámenes, es recomendable previo a cualquier cirugía en el sector mandibular anterior, el estudio mediante CBCT. Además de mantener un margen de seguridad respecto a los forámenes linguales debido a una mínima distorsión esperable de estas estructuras.
On several studies, there has been described foramina located in the inner face of the anterior mandible, whether on dry bone, conventional radiography and cone beam CT (CBCT). The aim of this study was compare the presence, position and anatomical characteristics of foramina and lingual canals found in CBCT of Chilean mandibles, with the results of the same sample studied with direct vision in dry bone. We studied 68 mandibles from the morphology unit of Universidad de los Andes. The number of teeth, foramina related to mental spines, position, area and length of each canal were evaluated, in dry bone and CBCT from the same sample. Presence of lingual foramen was found in 100 % of CBCT and 97 % of direct observation in bone. There were 150 foramina in dry bone and 170 foramina in CBCT. The greatest amount was found superior (bone: 55; CBCT: 61) and inferior (bone: 66; CBCT: 92) to the mental spines. . The reliability was not as expected, with a kappa for the number of upper foramina of 0.43, an intraclass correlation for the number of lower foramen of 0.31. The upper foramen area had an intraclass correlation of 0,059 and an inferior correlation of 0.144 while, the length of the superior canals, had a 0.5 and inferior 0.246 of intraclass correlation. A trend was observed for higher diameters and canal lengths in the measurements performed with CBCT compared to the measurements in dry bone. Taking into account the high prevalence of these foramina, it is advisable prior to any surgery in the anterior mandible, the prior study using CBCT. In addition to maintaining a margin of safety with respect to lingual foramina.